bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients’ knowledge of diabetes complications and self-management practices in Ghana
Authors: Bossman Irene , Dare Shadrach , Oduro Bright Anyimah , Baffour Prince Kyei , Nally Jane E.
Published: August 2020

BackgroundThe prevalence of diabetes is increasing and over two-thirds of these are not diagnosed, especially in low and middle-income countries (LMICs). As a consequence, diabetes complications usually exist at the time of diagnosis.PurposeTo assess the knowledge and experiences of adult patients with Diabetes on diabetes complications and self-management practices with emphasis on foot care.MethodologyTwenty patients attending Diabetes clinics were purposively sampled from two hospitals in Ghana. Face-to-face interviews were conducted to evaluate patient’s understanding of diabetes and self-management practices. The interviews were audio-taped, transcribed, and analysed to generate themes using the constant comparison method.ResultsThree-quarters of the participants in the study correctly defined diabetes as high blood glucose levels, but few knew the risk factors and complications of diabetes. Stroke and Hypertension were the most popular complications known, whiles diabetes foot complications were the least known. Almost all participants showed awareness of dietary self-management practices, but few had limited knowledge in foot care practices.ConclusionDiabetes education in LMICs should promote self-management practices, especially foot care and clear dietary guidelines. There is also opportunity to invest in specialist diabetes training for healthcare providers and increase community-based care for people living with diabetes in Ghana.
Microbiomes in Supragingival Biofilms and Saliva of Adolescent Patients with Induced and Naturally Occurring Gingivitis Relative to Gingival Health
Authors: Wirth Roland , Maróti Gergely , Lipták Lídia , Mester Mónika , Ayoubi Alaa Al , Pap Bernadett , Madléna Melinda , Minarovits Janos , Kovács Kornél L.
Published: August 2020

Background: Comparison of the microbiomes in supragingival biofilm and saliva samples collected from juvenile patients developing induced or spontaneous gingivitis with healthy controls.Results: 36 supragingival biofilm samples from 9 adolescent gingivitis patients wearing orthodontic appliances (induced gingivitis), 40 supragingival plaques from 10 patients having spontaneous gingivitis, and 36 control samples from 9 individuals without gingivitis in the same age group were analyzed by 16S rRNA gene amplicon sequencing. Salivary microbiomes of the same persons were characterized by shotgun metagenome sequencing to compare the sessile, i.e. biofilm immobilized communities with planktonic microbiota. The amplicon and whole genome data sets were scrutinized using bioinformatics workflows designed to minimize systemic biases. RDP and RefSeq reference databases were compared in the identification of microbiome members.The composition and diversity of bacterial communities did not differ extensively between the two groups of gingivitis patients and controls. In spite of the overall similarities, the relative abundance of the genera Fusobacterium, Accermansia, Treponema and Campylobacter was prominently higher in samples from gingivitis patients versus controls. In contrast, the genera Lautropia, Kingella, Neisseria, Actinomyces and Rothia were significantly more abundant in controls than in either of the two gingivitis groups. Conclusions: The higher relative abundance of certain gingivitis-associated taxa may either reflect their role in disease pathogenesis or may indicate that gingival inflammation favored the selective overgrowth of distinct bacterial clusters. At any rate, the abundance pattern of certain taxa rather than individual strains shows characteristic features of potential diagnostic value. Stringent bioinformatics treatment of the sequencing data is mandatory to avoid unintentional misinterpretations.
Harnessing Inter-disciplinary Collaboration to Improve Emergency Care in Low- and Middle-income Countries (LMICS): Results of Research Prioritisation Setting Exercise
Authors: Wallis Lee Alan , Lecky Fiona , Reynolds Teri , Otesile Olubukola , Hollis Sara , Turner Janette , Fuller Gordon , Sammy Ian , Williams-Johnson Jean , Geduld Heike , Tenner Andrea , French Simone , Govia Ishtar , Balen Julie , Goodacre Steve , Marahatta Sujan , DeVries Shaheem , Sawe Hendry , El-Shinawi Mohammed , Mfinanga Juma , Rubiano Andrés , Chebbi Henda , Shin Sang Do , Ferrer Jose Maria E , Haddadi Mashyaneh , Firew Tsion , Taubert Kathryn , Lee Andrew , Convocar Pauline , Jamaluddin Sabariah , Kotecha Shahzmah , Yaqeen Emad Abu , Wells Katie
Published: August 2020

BackgroundMore than half of deaths in low- and middle-income countries (LMICs) result from conditions that could be treated with emergency care - an integral component of universal health coverage (UHC) - through timely access to lifesaving interventions.MethodsThe World Health Organization (WHO) aims to extend UHC to a further 1 billion people by 2023, yet evidence supporting improved emergency care coverage is lacking. In this article, we explore four phases of a research prioritisation setting (RPS) exercise conducted by researchers and stakeholders from South Africa, Egypt, Nepal, Jamaica, Tanzania, Trinidad and Tobago, Tunisia, Colombia, Ethiopia, Iran, Jordan, Malaysia, South Korea and Phillipines, USA and UK as a key step in gathering evidence required by policy makers and practitioners for the strengthening of emergency care systems in limited-resource settings.ResultsThe RPS proposed seven priority research questions addressing: identification of context-relevant emergency care indicators, barriers to effective emergency care ; accuracy and impact of triage tools; potential quality improvement via registries; characteristics of people seeking emergency care; best practices for staff training and retention; and cost effectiveness of critical care – all within LMICs.Conclusions Convened by WHO and facilitated by the University of Sheffield, the Global Emergency Care Research Network project (GEM-CARN) brought together a coalition of 16 countries to identify research priorities for strengthening emergency care in LMICs. Our article further assesses the quality of the RPS exercise and reviews the current evidence supporting the identified priorities.
The relationship between the level of state anxiety, trait anxiety, satisfaction with life and the selected biochemical parameters among oncological nurses
Authors: Domagala Przemyslaw Mateusz , Gaworska-Krzeminska Aleksandra Edyta
Published: August 2020

Background. The working environment of nurses is associated with the presence of many stressors, for instance working the night shift and sleep deprivation, which may impair the secretion of various substances, such as prolactin, cortisol or cytokines. One of the groups particularly exposed to stress due to the specificity of work is oncological nurses.Aim. The aim of this work is to undertake an attempt at assessing the impact of work environment on psychological and biochemical parameters of occupational exposure to stress among nurses and to examine mutual correlations between the studied variables.Design and participants. Cross-sectional research design with the study group consisting of 90 registered nurses including 60 nurses working in oncology units and 30 primary health care nurses,Method. A diagnostic survey was used to collect psychological and socio-demographic data. The following research tools were used: State-Trait Anxiety Inventory (STAI), Satisfaction With Life Scale (SWLS) and the authors' questionnaire. Also, serum levels of cortisol, prolactin, C-reactive protein, tumour necrosis factor α, interleukin 6 and urine cortisol levels were assessed.Results. Psychological parameters significantly correlate with selected biochemical variables. A higher level of trait anxiety was associated with higher levels of proinflammatory cytokines in serum and a higher level of cortisol in urine.Conclusions. This study provides evidence that work-related stress is associated with selected proinflammatory cytokines and hormones. There are psychological strategies and relaxation techniques which nurses should use as they significantly reduce the level of perceived stress and positively influence the values of the biochemical markers of stress.
Clinical characteristics of acute pancreatitis in children: a single-center experience in Western China
Authors: Zhong Rui , Tan Shali , Peng Yan , Xu Huan , Jiang Xin , Yan Yongfeng , Tang Xiaowei
Published: August 2020

Background: The diagnosis of pediatric pancreatitis has been increasing over the last 20 years. We aimed to compare the clinical characteristics for pediatric acute pancreatitis (AP) with adult AP, and investigate the risk factor for acute recurrent pancreatitis (ARP) in children. Method: From June 2013 to June 2019, a total of 130 pediatric patients with AP at the inpatient database were enrolled. Univariate analysis and multivariate Cox regression analysis were performed to identify the risk factors for ARP in children. Result: Major etiologic factors in 130 patients were biliary (31.5%), idiopathic (28.5%), trauma (16.2%). There was a significant difference in the constituent ratio of etiology between pediatric patients and adult patients (p<0.001). Compared with the adult patients, the pediatric patients had significantly lower severity (p=0.012) and occurrence rate of pancreatic necrosis (p=0.02). During the follow-up time (34.2±20.8 months), 19 children (14.6%) developed into ARP. Multivariate Cox regression analysis showed that female (p=0.025; OR=3.632; 95%confidence interval(CI) 1.179-11.188), hyperlipidemia (p=0.022; OR=3.480; 95%CI 1.201-10.085), pancreatic necrosis (p=0.001; OR=8.815; 95%CI 2.446-31.774) were the independent risk factors of ARP. The risk of recurrence was significantly different in each etiology group. Hyperlipidemic AP had the highest risk of recurrence over time, while viral and drug-induced AP had the lowest risk of recurrence (p=0.035).Conclusion: Biliary and idiopathic disease were the major etiologies of AP in children. Compared to adults, children tend to have milder disease conditions and a better prognosis. Female, hyperlipidemia, and first AP attack with pancreatic necrosis were associated with the increased risk of ARP.
A Cross-sectional Survey of Prevalence and Related Factors for Frail Status Among Middle-aged and Elderly People in Chinese Communities
Authors: Sun Chao , Hu Yue , Yang Jie , Li Xing , Huo Cong , Jia Xin , Xu Rong , Hou Liming , Lei Yunzhen , Wang Xiaoming
Published: August 2020

Background With the aggravation of social competition and work burden pressure, the health condition of the middle-aged and above population in China has declined significantly. Frailty can be used as a criterion for evaluating a person's unhealthy state. However, there is limited data on the prevalence and related factors of frail status in Chinese middle-aged and older people.The objective of this study was to explore the correlation between frail status, chronic diseases, abnormal physical examination indicators among middle-aged and older populations. Methods Participants were 9,985 community-dwelling adults over the age of 40 years living in China. Data were from the 2015 China Health and Retirement Longitudinal Survey which was a nationally representative sample and frailty phenotype was based on Fried frailty criteria. We analyzed the demographics of participants and multivariate-adjusted related factors for frail and pre-frail population. Results The overall prevalence of frailty and pre-frailty was 3.1% (95% CI: 2.8, 3.5) and 53.66% (95% CI: 52.7, 54.6) among the general Chinese population aged 40 years or older. Hypertension (OR: 1.8, 95% CI: 1.3, 2.593), pain (OR: 1.8, 95% CI: 1.3, 2.5), and hip fracture (OR: 2.2, 95% CI: 1.1, 4.4) were associated with prevalent frailty. Relative factors for frailty also included increased cystatin C (OR: 4.5, 95% CI: 3.0, 6.7) and glycated hemoglobin (OR: 1.2, 95% CI: 1.1, 1.4), as well as decreased peak expiratory flow (OR: 0.993, 95% CI: 0.991, 0.994). Conclusions Fried-defined frailty and pre-frailty are highly prevalent in the Chinese population over 40 years older. Hypertension, pain, hip fracture, low education, and underweight are major related factors for frailty. The decrease in peak expiratory flow and the increase in cystatin C and glycated hemoglobin are good indicators for detecting frailty. Thus, frailty is an increasingly common condition and will become a major important health issue for people over middle age.
A generalized amino-modification strategy to boost CO2 electroreduction current density of single-atom catalysts to industrial application level
Authors: Chen Zhipeng , Zhang Xinxin , Liu Wei , Jiao Mingyang , Mou Kaiwen , Wang Zhiheng , Ma Xin , Cheng Feng , Zhang Xiangping , Liu Licheng
Published: August 2020

Although Faraday efficiency (FE) for CO production of single-atom catalysts immobilized on nitrogen-doped carbon supports (M-N/C) for CO2 electrocatalytic reduction reaction (CO2RR) is generally over 90%, M-N/C catalysts demonstrate a poor reaction current density, much worse than the current density of industrial level. Herein, we first report a generalized strategy of amino-functionalized carbon supports to regulate electronic structure of M-N/C catalysts (M=Ni, Fe, Zn) to significantly increase current density of CO production. The aminated Ni single-atom catalyst achieves a remarkable CO partial current density of 447.6 mA cm-2 (a total current density over 500 mA cm-2) with a nearly 90% CO FE at a moderate overpotential of 0.89 V, and especially CO FE can be maintained over 85% in a wide operating potential range from -0.5 V to -1.0 V. DFT calculations and experimental researches demonstrate that the superior activity is attributed to enhanced adsorption energies of CO2* and COOH* intermediates caused by the change of electronic structure of aminated catalysts. This work provides an ingenious method for significantly increasing current density at industrial-relevant level of single-atom catalysts for CO2RR.
Does Postgraduate Clinical Training Reduce Empathy Among Japanese Trainee Dentists? A Multi-perspective Assessment
Authors: Yoshida Toshiko , Watanabe Sho , Kono Takayuki , Taketa Hiroaki , Shiotsu Noriko , Shirai Hajime , Nakai Yukie , Torii Yasuhiro
Published: August 2020

Background: Even though enhancing empathy in healthcare education is a critical component of delivering better care to patients, the erosion of empathy has been frequently reported, especially when the curriculum transitions to clinical training. However, some studies have questioned the significance and frequency of this decline in empathy. Thus, this study determined whether postgraduate clinical training reduced dental trainees’ empathy.Methods: This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists completed the Japanese version of the Jefferson Scale of Empathy for health professionals immediately before conducting initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The SPs evaluated the trainees’ communication using an assessment questionnaire immediately after the interviews. The videotaped dialogue in interview was analyzed using the Roter Interaction Analysis System. Results: Sustained levels of trainees’ self-reported empathy, decreased communication behavior in emotional responsiveness for trainees, and unchanged SPs’ assessment of trainees’ communication were found when comparing results from the beginning and the end of the training.Conclusions: Overall, one-year postgraduate dental training neither reduced nor increased the empathy of the trainees. Providing regular educational support may help trainees to foster their empathy.
Serum anti-proteinase 3 anti-neutrophil cytoplasmic antibody in ulcerative colitis: a potential marker of disease activity that predicts steroid therapy failure
Authors: Aoyama Yuki , Inaba Tomoki , Takahashi Sakuma , Yasuhara Hisae , Hiraoka Sakiko , Izumikawa Koichi , Ishikawa Shigenao , Wato Masaki , Ando Midori , Nakamura Satoko , Mizobuchi Koichi , Okada Hiroyuki
Published: August 2020

Background Serum anti-proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA) is a disease-specific antibody against granulomatosis with polyangiitis. Some patients with ulcerative colitis (UC) have positive results for PR3-ANCA but the clinical significance of PR3-ANCA is not clear. Thus, we conducted a multicenter, retrospective, observational study to elucidate the clinical significance of PR3-ANCA in UC.Methods In total, 150 patients with UC underwent colonoscopy and serum PR3-ANCA measurements. Activity was evaluated using the Mayo Endoscopic Subscore (MES), and the relationship between activity and PR3-ANCA was analyzed.Results Twenty-six of the 150 patients who met the exclusion criteria were eliminated; 124 patients were included. A positive correlation was observed between MES and PR3-ANCA (r = 0.42; p < 0.001). Receiver-operating characteristic analysis showed that the cut-off value for calculations was 4.1 U/mL. Of 108 patients with active-phase UC, 58 (53.7%) were positive for PR3-ANCA. Furthermore, patients for whom steroid therapy was ineffective had a significantly higher rate of being PR3-ANCA positive (p = 0.045). Of 21 patients who reached clinical remission with PR3-ANCA-positive active-phase UC, 13 had an MES ≥ 1 and 8 patients had an MES 0. For MES 0 cases, the reduction of PR3-ANCA levels was significant (p = 0.012) when comparing the active-phase and clinical remission. All cases with MES 0 were negative for PR3-ANCA. Only 4 of 13 cases with MES ≥ 1 were negative for PR3-ANCA.Conclusions Approximately half of UC cases are PR3-ANCA-positive during the acute phase, indicating that PR3-ANCA is a potential marker of disease activity that predicts steroid therapy failure.Trial registration This study was registered in the UMIN Clinical Trials Registry System (000039174). Retrospectively registered on 16th Jan. 2020.
The Impact of the COVID-19 Pandemic on the Emergency Department Visits: A Retrospective Analysis in Shanghai, China
Authors: Long Wei , Hu Jiudong , Li Lijuan , Zuo Sheng , Yang Qian , Ren Zenghua
Published: August 2020

BackgroundThe novel coronavirus diseases (COVID-19) has led to a pandemic and affected people's lives greatly, including their health seeking behavior. We aimed to evaluate the impact of the current COVID-19 pandemic on characteristics and trends of emergency department (ED) visits in Shanghai, China.MethodsThis was a retrospective observational study using medical record databases from the Shanghai Sixth People's Hospital (East Campus) for years 2016 through 2020. All the patients referred to the ED between January 2016 and June 2020 were retrospectively reviewed. January 1, 2020, was chosen as the cutoff date for the statistical analysis and data of January and February in 2020 was compared with the same period of 2019.ResultsDuring the first two months of 2020, there was a 60.9% decline in ED visits when compared with the same period of 2019 (9,904 vs. 25,316, respectively), and the waiting time in ED has been greatly reduced correspondingly (12±4 vs. 66±19 min, p < 0.001); ED visits for acute ischemic stroke (AIS) and acute coronary syndrome(ACS) decreased by 53.9% and 41.2% respectively; proportion of intravenous thrombolysis for AIS has dropped(42.1% vs. 11.4%, p = 0.003), and percutaneous coronary intervention for ACS was similar (70.6% vs. 63.3%, p = 0.668); and onset-to-door time (ODT) of these patients increased significantly (AIS: 217(136-374) vs. 378(260-510)min, ACS: 135(85-195) vs. 226(155-368)min, all p < 0.001).ConclusionThe outbreak of COVID-19 pandemic was correlated with a significant decline in the number of ED visits including AIS and ACS patients when compared to the pre-COVID-19 period. ODT of AIS and ACS patients increased significantly. Raising public awareness is necessary to avoid serious healthcare and economic consequences of undiagnosed and untreated stroke and myocardial infarction attack.
The Hemodynamic Characteristics of Right Ventricle After Gradient Pulmonary Artery Banding in Rats
Authors: Jiyang Song , Nan Wan , Shutong Shen , Ying Wei , Yunshan Cao
Published: August 2020

Background: Right ventricular (RV) failure induced by sustained pressure overload is a major contributor to morbidity and mortality in several cardiopulmonary disorders. Reliable and reproducible animal models of RV failure are important in order to investigate disease mechanisms and effects of potential therapeutic strategies. To establish a rat model of RV failure perfectly, we observed the right ventricle and carotid artery hemodynamics characteristics in different degrees of pulmonary artery banding of rats of different body weights. Methods: Rats were subjected to 6 groups：control(0%, n=5)(pulmonary arterial banding 0%), PAB(1-30%, n=4)(pulmonary arterial banding1-30%), PAB(31-60%, n=6)(pulmonary arterial banding31-60%),PAB(61-70%, n=5)(pulmonary arterial bandin61-70%), PAB(71-80%,n=4)(pulmonary arterial banding71-80%), PAB(100%, n=3)(pulmonary arterial banding 100%). We measured the right ventricular pressure(RVP) by right heart catheterization when the pulmonary arterial was ligated. Results: The RVP gradually increased with increasing degree of banding, but when occlusion level exceeding 70%, high pressure state can be only maintained for a few minutes or seconds, and then the RVP drops rapidly until it falls below the normal pressure, which in Group F particularly evident.Conclusions: RVP have different reactions when the occlusion level is not the same, and the extent of more than 70% ligation is a successful model of acute right heart failure. These results may have important consequences for therapeutic strategies to prevent acute right heart failure.
Effects of floor- and net-reared systems on the intestinal growth and microbial diversity in the cecum of ducks
Authors: Chen Xuefei , Huang Liansi , Cheng Lumin , Hu Bo , Liu Hehe , Hu Jiwei , Hu Shenqiang , Han Chunchun , He Hua , Kang Bo , Xu Hengyong , Wang Jiwen , Li Liang
Published: August 2020

Background

Rearing systems can affect livestock production directly, but the effects of floor-reared systems (FRSs) and net-reared systems (NRSs) on the intestinal growth states and microbial diversity in the cecum of ducks are largely unclear.
Methods

The ducklings in this study were randomly divided into FRS and NRS groups, weighed at 4, 8 and 13 weeks, respectively, then the duodenum, jejunum, ileum and cecum were sampled and measured, and the content of cecum were analyzed by 16S RNA.
Results

The values of relative weight (RW), relative length (RL) and RW/ RL of four intestinal segments in FRS were significantly higher than that in the NRS during week 4, 8 and 13 (p < 0.05). A total of 157 genus were identified from ducks under the two systems,the dominant microorganisms in both groups were Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria at phyla level. The distribution of microorganisms in cecum of two groups showed significant separation in three time periods, and the value of Simpson index in FRS was significantly higher than NRS at 13 weeks (p < 0.05).Five differential microorganisms and 25 differential metabolic pathways were found in the cecum at week 4, 7 differential microorganisms and 25 differential metabolic pathways were found in the cecum at week 8, and 4 differential microorganisms and 2 differential metabolic pathways were found in the cecum at week 13.
Conclusions

There were differences in intestinal growth and microorganism between FRS and NRS ducks.
Construction of Lung Tumor Model for Drug Screening Based on 3D Bio-Printing Technology
Authors: Yang Yadong , Yang Geng , Liu Xingzhu , Xu Yimeng , Zhao Siyu , Zhang Wenyuang
Published: August 2020

Background: The sensitivity of two-dimensional (2D) cultured cells to the drugs cannot effectively mimic the effect of the drug in vivo, although 2D cell culture is the most widely used model for drug screening. With the development of tissue engineering, people are committed to developing 3D tissue models that can better reflect the biology in vivo, and tend to be mass and miniaturized. In this study, three-dimensional (3D) bio-printing was used to develop an appropriate 3D model for screening sensitive anti-lung cancer drugs in vitro. Methods: A549 lung cancer cells were mixed with sodium alginate/gelatin as bio-printing ink to fabricate a cell-laden hydrogel grid scaffold structure. The sensitivity of the printed 3D model to drugs was evaluated with eight anti-tumor traditional Chinese medicines (Oldenlandia，Atractylodes，Mylabris，S. Barbata，Zedoary，Nigrum，Cremastra and Prunella). The crude Chinese medicine was treated by water extraction and alcohol precipitation. A fluorescent live/dead staining was carried out at different time to assess the cell survival rate in the 3D scaffolds. MTT assay was used to determine the inhibitory rate of eight antitumor traditional Chinese medicines on A549 cell proliferation in 3D-printed lung tumor models and conventional 2D culture models. The data of each group were analyzed to clarify the difference between 2D and 3D cultures, and to evaluate the feasibility of 3D-printed lung tumor model as a drug screening model. Results: The growth states of A549 cells on the 3D scaffolds were different from 2D culture. The effect of various traditional Chinese medicines on the proliferation inhibition of tumor cells was positively correlated with the drug concentration, The inhibition rate of 2D cell culture was higher than that of 3D cell culture. However, microscopic observation showed that there were more dead cells in 3D culture than in 2D culture. But the fluorescence value detected by EGFP labeled cells was consistent with the results of MTT. Conclusions: We conclude that 3D printed lung tumor model can be used for drug screening. Before drug screening enters animal level, tissue level screening can be carried out by 3D printed tumor model.
Modern Health Service utilization and associated factors among adults in Southern, Ethiopia
Authors: BITEW SHIMELASH , Mekonen Nigussie , W/Michael Mulugeta , Molla Getahun , Abrha Solomon , Zema Zewde , Tadesse Takele
Published: August 2020

Background Ethiopian government is striving to improve the health status of its population through the expansion and strengthening of primary health care services in both rural and urban settings of the country. The study aimed to measure modern health service utilization and associated factors in Wolaita Sodo town, Ethiopia.Method: A cross-sectional study design was implemented from May to June 2019 in Wolaita Sodo town Ethiopia. All 786 study participants were selected by multistage systematic random sampling. Data were collected by face to face interviews using a pretested structured questionnaire. Data were collected by an open data kit. Stata window version 15.0 was also employed for statistical analysis. Multiple logistic regression was conducted, and a 95% confidence interval was considered for interpretation.Result Health service utilization were 77.2% with (95% CI of 74.1%,80.0%). In terms of health facility in which they visit first 50.6% were at the public health center and 25.5% of them were at Teaching and Referral Hospital. Respondents with marital status married and widowed have higher odds of utilizing health service compared to single marital status [AOR:2.96; 95% CI: 1.7–5.2 and 9.0; 95% CI: 1.69-48.0] respectively. Respondents with middle and highest wealth status have higher odds of health service utilization than poor wealth status with AOR (1.75 95%CI 1.03–2.97 and 1.58 95% CI; 1.01,2.77). Similarly, Respondents who had chronic disease and Perceived health status who had poor have higher odds of health service utilization.Conclusion Modern health services utilization was found to be unsatisfactory. Being married, wealth status being middle and high, having chronic health conditions, and having poor perceived health status were found to have a statistically significant association with health service utilization.
Regulation of DNA Methylation on Key Parasitism Genes of Cysticercus Cellulosae Revealed by Integrative Epigenomic-Transcriptomic Analyses
Authors: Wang Xinrui , Song Weiyi , Song Yining , Ji Guanyu , Luo Xuenong , Sun Shumin
Published: August 2020

Background: The life cycle of Taenia solium is characterized by different stages of development, requiring various kinds of hosts that can appropriately harbor the eggs (proglottids), the oncospheres, the larvae and the adults. Similar to other metazoan pathogens, T. solium undergoes transcriptional and developmental regulation via epigenetics during its complex lifecycle and host interactions.Result: In the present study, we integrated whole-genome bisulfite sequencing and RNA-seq technologies to characterize the genome-wide DNA methylation and its effect on transcription of Cysticercus cellulosae of T. solium. We confirm that the T. solium genome in the cysticercus stage is epigenetically modified by DNA methylation in a pattern similar to that of other invertebrate genomes, i.e., sparsely or moderately methylated. We also observed an enrichment of non-CpG methylation in defined genetic elements of the T. solium genome. Furthermore, an integrative analysis of both the transcriptome and the DNA methylome indicated a strong correlation between these two datasets, suggesting that gene expression might be tightly regulated by DNA methylation. Importantly, our data suggested that DNA methylation might play an important role in repressing key parasitism-related genes, including genes encoding excretion-secretion proteins, thereby raising the possibility of targeting DNA methylation processes as a useful strategy in therapeutics of cysticercosis.
A Potential Suite of Climate Markers of Long-Chain n-Alkanes and Alkenones Preserved in the top Sediments from the Pacific Sector of the Southern Ocean
Authors: Chen Xin , Liu Xiaodong , Lin Da-Cheng , Wang Jianjun , Chen Liqi , Yu Pai-Sen , Wang Linmiao , Xiong Zhifang , Chen Min-Te
Published: August 2020

Investigation of organic compounds in marine sediments can potentially unlock a wealth of new information in these overlooked climate archives. Here we present pilot study results of organic geochemical features of long-chain n-alkanes and alkenones and individual carbon isotope ratios of long-chain n-alkanes from a newly collected, approximately 8-meter long, Pleistocene age sediment core, located in the far reaches of the Pacific sector of the Southern Ocean. We initially analyzed a suite of organic compounds in the core, and the results show abundant long-chain n-alkanes (C29-C35) with predominant odd-over-even carbon preference, which suggests an origin of terrestrial higher plant waxes via long range transport of dust, possibly from Australia and New Zealand. The δ13C values of the C31 n-alkane range from -29.4 to -24.8‰, in which the higher δ13C values suggest more contributions from C4 plants waxes. In the analysis, we found that the mid-chain n-alkanes (C23-C25) have small odd-over-even carbon preference, suggesting that they were derived from marine non-diatom pelagic phytoplankton and microalgae, and terrestrial sources. Furthermore, the C26 and C28 with lower δ13C values (~ -34‰) indicate an origin from marine chemoautotrophic bacteria. We found that the abundances of tetra-unsaturated alkenones (C37:4) in this Southern Ocean sediment core ranges from 11-37%, perhaps a marker of low sea surface temperature (SST). The results of this study strongly indicate that the δ13C values of long-chain n-alkanes and index are potentially useful to reconstruct detailed history of C3/C4 plants and SST change in the higher latitudes of the Southern Ocean.
The Utility of the Rapid Emergency Medicine Score (REMS) compared with SIRS, qSOFA and NEWS for predicting in-Hospital Mortality Among Patients with Suspicion of Sepsis in an Emergency Department
Authors: Ruangsomboon Onlak , Boonmee Phetsinee , Limsuwat Chok , Chakorn Tipa , Monsomboon Apichaya
Published: August 2020

Background Many early warning scores (EWSs) have been validated to prognosticate adverse outcomes secondary to sepsis in the Emergency Department (ED). These EWSs include the Systemic Inflammatory Response Syndrome criteria (SIRS), the quick Sequential Organ Failure Assessment (qSOFA) and the National Early Warning Score (NEWS). However, the Rapid Emergency Medicine Score (REMS) has never been validated for this purpose. We aimed to assess and compare the prognostic utility of REMS with that of SIRS, qSOFA and NEWS for predicting mortality in patients with suspicion of sepsis in the ED.Methods We conducted a retrospective study at the ED of Siriraj Hospital Mahidol University, Thailand. Adult patients suspected of having sepsis in the ED between August 2018 and July 2019 were included. Their EWSs were calculated. The primary outcome was all-cause in-hospital mortality. The secondary outcome was 7-day mortality.Results A total of 1622 patients were included in the study; 574 (28.2%) died at hospital discharge. REMS yielded the highest discrimination capacity for in-hospital mortality (the area under the receiver operator characteristics curves (AUROC) 0.62 (95% confidence interval (CI) 0.59, 0.65)), which was significantly higher than qSOFA (AUROC 0.58 (95%CI 0.55, 0.60); p=0.005) and SIRS (AUROC 0.52 (95%CI 0.49, 0.55); p<0.001) but not significantly superior to NEWS (AUROC 0.61 (95%CI 0.58, 0.64); p=0.27). REMS was the best EWS in terms of calibration and association with the outcome. It could also provide the highest net benefit from the decision curve analysis. Comparison of EWSs plus baseline risk model showed similar results. REMS also performed better than other EWSs for 7-day mortality.ConclusionREMS was an early warning score with higher accuracy than sepsis-related scores (qSOFA and SIRS) and had the highest utility in terms of net benefit compared to SIRS, qSOFA and NEWS in predicting in-hospital mortality in patients presenting to the ED with suspected sepsis.
Biological Properties and Pathological Stages of Chondrocyte Colony-like Clusters in Osteoarthritic Cartilage Tissue
Authors: WANG XIAOJIAN , Wei Lei , Wei Xiaochun , Xue Yan , Sun Changqi , Zhang Zhiqiang , Zhang Yang , Chen Taoyu , Lu Xiao , Guo Songjia , Chang Feng , Su Yunxing , Li Rongshan
Published: August 2020

Objective:In these studies,we investigated the timing and location of chondrocyte colony-like clusters in cartilage tissue during the development of human knee osteoarthritis(OA),and explored the biological properties of chondrocytes in colony-like clusters and their significance for degenerative cartilage tissue.Methods:Osteoarthritis Research Society International (OARSI) grade 0～6 cartilage tissue was obtained from the human tibial plateau, and histologicalsections were made to observe whether there were chondrocyte colony-like clusters in the cartilage tissue and where they occurred. Immunohistochemistry, PCR and western blotting were used to detect the biological properties of chondrocytes in the colony-like clusters and to describe the histopathological stages of the colony-like clusters according to the properties of thechondrocytes in the cluster.Results: There were a large number of chondrocyte colony-like clusters in the middle zone of OARSI grade 3 and grade 4 cartilage tissue.The chondrocytes in the colony-like clusters rapidly proliferated from one to a certain number and then rapidly underwent hypertrophic changes,synthesizing and releasing the MMP-13 protein to degrade cartilage tissue and enlarge chondrocyte lacunae.Eventually, the chondrocytes in the colony-like cluster underwent apoptosis and disappeared, leaving large empty chondrocyte lacunae.According to this process, chondrocyte colony-like clusters could be divided into four stages.Conclusions: Chondrocyte colony-like clusters mainly formed during the development of OA of OARSI grades 3 and 4 could cause the cartilage tissue to become looser and more porous, with more severe cartilage degeneration.
Uterotonic Effects of Aqueous and Methanolic Extracts of Lannea Acida in Wistar Rats: An in Vitro Study.
Authors: ngadjui esther simo , Kouam Jibril Yves , Bonsou Georges Romeo Fozin , Momo Aimé Césaire Tetsatsi , Deeh Patrick Brice Defo , Wankeu-Nya Modeste , Nguelefack Telesphore Benoit , Watcho Pierre
Published: August 2020

Background: Lannea acida (Anacardiaceae), commonly called Kikié in the Noun division (West-Cameroon), is a tree whose bark is used locally to solve difficult childbirth. This study aimed to evaluate the in vitro uterotonic effects of aqueous and methanolic extracts of L. acida in female Wistar rats. Uterine strips isolated from female rats pretreated (48h) with oestradiol (5μg) were mounted in a single-organ bath containing a well aerated and thermostated De Jalon solution (37°C). The effects of L. acida extracts were recorded in a non-cumulative manner after application. The effect of the methanolic extract (the most active extract) was monitored in the presence of atosiban (a competitive antagonist of oxytocin receptors), atropine (a specific type 3 muscarinic receptor antagonist), nifedipine (an L-type calcium channel antagonist) and 2-Aminoethoxydiphenyl borate (2-ADB, a specific antagonist of inositol 1,4,5-triphosphate receptors type 1), and in calcium-free medium containing EGTA. Results: L. acidainduced uterine contraction in a concentration-dependent manner with the methanolic extract (1.506 ± 0.032 gf) being the most effective. Administration of atosiban (2 μmol/l), atropine (1 μmol/l), nifedipine (5 μmol), 2-APB (100 μmol), and calcium free medium containing EGTA (2 mmol) reduced the contractile effect of L. acida. Complete inhibition was observed with nifedipine, 2-APB, and calcium free medium containing EGTA.Conclusions: These results suggest that L. acida possesses an uterotonic effect mediated through oxytocin receptors with mobilization of extracellular calcium.
Positive Effect of Vitamin D and Magnesium Supplementation on Mental health Status of Attention-Deficit Hyperactive Children; A Randomized Double blind Controlled Clinical Trial
Authors: Hemamy Mostafa , Pahlavani Naseh , Askari Gholamreza , Malekahmadi Mahsa
Published: August 2020

Background: Attention-Deficit / Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, characterized by varying severity in attention deficit and hyperactivity. Studies have shown deficiencies in the serum level of magnesium and vitamin D in ADHD. The aim of this study is to determine the effect of Vitamin D and magnesium supplementation on mental health in children with ADHD.Method: This double‑blind, randomized controlled trial was performed on 66 ADHD children. participants were randomly allocated to receive both Vitamin D (50,000 IU/week) and magnesium (6 mg/kg/day) supplements (n = 33) or placebos (n = 33) for 8 weeks. Strengths and difficulties questionnaire were used to evaluate children’s mental health at baseline and at the end of the study.Results: After 8 weeks of intervention, the serum levels of 25‑hydroxy‑Vitamin D3 and magnesium increased significantly in the intervention group compared with the control group. Also a significant decrease in changes of emotional problems (p=0.001), conduct problems (p=0.002), peer problems (p=0.001), prosocial score (p=0.007), total difficulties (p=0.001), externalizing score (p=0.001), and internalizing score (p=0.001) was seen in intervention group at the end of study.Conclusion: Vitamin D (50,000 IU/week) and magnesium (6 mg/kg/day) co-supplementation during 8-week could improve the behavioral function and mental health in ADHD. Although further well-designed studies with a larger sample size are needed.the IRCT registration: IRCT2016030326886N1.
Review A meta-analysis of the efficacy and safety of additional anti-HER2-targeting drugs in HER2-positive advanced breast cancers
Authors: Du Nannan , Chen Bangsheng , Shen Zefeng , Zhou Bin , Fu Xiaojun , Mao Danyi , Mao Feiyan , Ng Derry Minyao , Khadaroo Parikshit Asutosh , Yang Lei
Published: August 2020

Background The purpose of this study was to analyze the efficacy and safety of additional anti-HER2 (human epidermal growth factor receptor 2)-targeting drugs in HER2-positive advanced breast cancers.Methods For this study, the following databases were searched for articles published from its inception until December 2019: PubMed, Web of Science, EBSCO, and Cochrane library, of which the main outcomes were the progression-free survival (PFS) and overall survival (OS).Results We conducted a meta-analysis and the results showed that additional anti-HER2-targeting drugs improved the HER2-positive advanced breast cancer patients’ PFS (HR: 0.66, p < 0.001), OS (HR: 0.77, p < 0.001), respectively. In terms of drug types, the efficacy of lapatinib was the most (HR: 0.53, 95% Cl: 0.39–0.67, p < 0.001), followed by pertuzumab (HR: 0.72, 95% Cl: 0.55–0.89, p = 0.001). Trastuzumab benefited the least, with no difference statistical significance (HR: 0.87, 95% Cl: 0.31–1.44, p = 0.594). In terms of treatment regimen, first-line treatment (HR: 0.67, 95% Cl: 0.52–0.82, p < 0.001) had a greater benefit than non-first-line treatment (HR: 0.82, 95% Cl: 0.71–0.94, p = 0.004). The main adverse events (AEs) observed were diarrhea and the main cardiotoxicity observed was decreased ejection fraction.Conclusions Additional anti-HER2-targting drugs may improve long-term prognosis in HER2-positive advanced breast cancers. Moreover, the AEs were safe and tolerable. Besides, lapatinib had the best benefit, and pertuzumab followed by, trastuzumab had the least benefit in terms of drug selection. From the aspect of treatment, it recommended significantly to use anti-HER2-targeting drugs in first-line therapy based on our research in HER2-positive advanced breast cancers.
Development of a Multi-gene-based Immune Prognostic Signature in Ovarian Cancer
Authors: cao tiefeng , shen huimin
Published: August 2020

Background：Chemotherapeutic resistance is responsible for treatment failure. Immunotherapy is important in ovarian cancer (OC). Systematic exploration of immunogenic landscape and reliable immune gene-based prognostic biomarkers or signature is necessary to be identified. This study aims to identify the immune gene-based prognostic biomarkers and regulatory factors, further to develop an individualized prediction signature.Methods: This study systematically explored the gene expression profiles from RNA-seq data set for The Cancer Genome Atlas (TCGA) ovarian cancer. Differentially expressed and survival-associated immune genes and transcription factors (TFs) were identified using immune genes from ImmPort dataset and TFs from Cistoma database. We developed the prognostic signature based on survival associated immune genes with LASSO (Least absolute shrinkage and selection operator) Cox regression analysis. Further, Network analysis was performed to uncover the potential molecular mechanisms of immune-related genes with the help of computational biology. Results: The prognostic signature, a weighted combination of the 21 immune-related genes, performed moderately in survival prediction with AUC was 0.746, 0.735, and 0.749 for 1, 3, and 5 year overall survival, respectively. Network analysis uncovered the regulatory role of TFs in immune genes. Intriguingly, the prognostic signature reflected infiltration of some immune cell subtypes.Conclusions: We first constructed a signature with 21 immune genes of clinical significance, which showed promising predictive value in the surveillance, prognosis, even immunotherapy response of OC patients.
Enhancement of L-amino Acid Oxidase Production by Bacillus Subtilis HLZ-68 With Oxygen-vector and Asymmetric Degradation of DL Arginine to D-arginine
Authors: xu peng , Pan Changpei , Cui Gongcheng , Wei ChunYan , Wang Lijuan , Li Yanting , Li Xiangping , Huang Shihai
Published: August 2020

The Bacillus subtilis HLZ-68 independently screened by our laboratory can produce L-amino acid oxidase (L-AAO), and DL-arginine can be degraded asymmetrically by suspending the wet bacteria in the degradation liquid. By adding oxygen-vectors to the fermentation medium, the collected amount of wet bacteria can be increased. Taking n-dodecane, n-hexadecane, oleic acid, paraffin, and n-hexane as oxygen-vectors, the optimal oxygen-vector oleic acid was 1.2% (v/v). The weight of wet cells increased by 66.83% compared with before, and the activity of L-AAO in fermentation broth increased by 38.88% compared with before. The standard sample DL-arginine was derivatized by phenyl isothiocyanate, and then subjected to high performance liquid chromatography(HPLC), and the obtained peak area and arginine content were used as standard curves to measure the DL-arginine. The content of D-arginine and L-arginine in the initial degradation solution was 50% each, and the bacterial cells are added to the initial degradation solution of DL-arginine. After 21 hours of reaction, L-arginine was completely Degraded, remaining 47% of D-arginine.D-alanine was easily extracted from the reaction solution using cation-exchange resin,after centrifugation, decolorization, concentration and vacuum drying, and the chemical and optical purity of the extracted d-alanine was 92.68 and 97.46%, respectively.
Memory-assisted Reinforcement Learning for Diverse Molecular De Novo Design
Authors: Blaschke Thomas , Engkvist Ola , Bajorath Jürgen , Chen Hongming
Published: August 2020

In de novo molecular design, recurrent neural networks (RNN) have been shown to be effective methods for sampling and generating novel chemical structures. Using a technique called reinforcement learning (RL), an RNN can be tuned to target a particular section of chemical space with optimized desirable properties using a scoring function. However, ligands generated by current RL methods so far tend to have relatively low diversity, and sometimes even result in duplicate structures when optimizing towards particular properties. Here, we propose a new method to address the low diversity issue in RL. Memory-assisted RL is an extension of the known RL, with the introduction of a so-called memory unit. As proof of concept, we applied our method to generate structures with an optimized logP. In a second case study, we applied our method to design ligands for the dopamine 2 receptor and the 5-hydroxytryptamine 1A receptor. For both receptors, a machine learning model was developed to predict whether generated molecules were active or not for the receptor. In both case studies, it was found that memory-assisted RL led to the generation of more active compounds and with higher chemical diversity, thus achieving better coverage of chemical space of known ligands compared to established RL method.