bluuebunny/crossref_metadata_2025 huggingface dataset:
a Priori and Short-, Medium-, and Long-Term Social Acceptability of Innovative Robot-Assisted Gait Training by Users
Authors: bonan Isabelle veronique , Coignard Pauline , Guiet Jean luc Le , Bigot Ophelie , Denis Katell , Bidet Florient , Gautier Arnaud , Egault Jerome , Peuziat Marie Lise , Departe Jean paul , Cau Julien , Mottu Pauline , Morisset Nolwen , Pichot Nathalie
Published: April 2020

Background An innovative mobile and modular robot for gait rehabilitation was tested according to a psychosocial intervention framework, involving users, neuroscientists, engineers, and a social psychology laboratory. The study included a pre-design phase allowing the definition of the robot specifications. Our main objective was to study the social acceptability of the robot prototype among users and determine the relevance of the technological options chosen and the possible obstacles to the dissemination of the robot in light of the users' perceptions and experience with the robot. Methods The a priori acceptability of the robot by patients with a neurological impairment that altered their gait capacity and physical therapist (PT), both naïve to the robot, was evaluated just before its implementation in 2 rehabilitation departments and then that after 7 days (D7), and 28 days (D28), and 5 months (M5, only for the PT). The evaluation was conducted using questionnaires with Likert scale (maximum 7), according to the UTAUT (unified theory of acceptance and usage of technology) model, developed by the social psychology laboratory. Each patient participated in three 45-minute rehabilitation sessions with the robot per week for four weeks, for a total of 12 sessions, conducted by the 4 PT included. The change in the responses to the questionnaires as a function of time and the influence of the degree of gait recovery of the patients were analyzed, as well as the evolution of balance and gait parameters. Results 36 patients, mean age 58 years (SD10) and 4 PT were included. The robot was well accepted. It appeared to be useful, usable, and socially acceptable by both patients and PT and the intention to use was rated repeatedly ≥ 5. The rehabilitation activities met the functional expectations defined during the pre-design phase. In addition, a significant improvement in balance and gait was observed. Conclusion The acceptability of the robot was good for both patients and PT. Inclusion of a pre-design phase probably reduced the resistance to change often observed in healthcare organizations. The results concerning balance and gait are encouraging. They must be confirmed by a randomized controlled trial.
Provider Bias in Prescribing Opioid Analgesics: An Analysis of Emergency Department Electronic Medical Records
Authors: Aronson Brian , Keister Lisa A , Moody James
Published: April 2020

Background: Physicians do not prescribe opioid analgesics for pain treatment equally across groups, and such disparities may pose significant public health concerns. While research suggests that institutional constraints and cultural stereotypes influence doctors’ treatment of pain, prior quantitative evidence is mixed. The objective of this secondary analysis is therefore to clarify which institutional constraints and patient demographics truly bias provider prescribing of opioid analgesics.Methods: We used electronic medical record data from an emergency department of a large U.S hospital during years 2008-2014. We ran multi-level logistic regression models to estimate factors associated with providing an opioid prescription during a given visit while controlling for ICD-9 diagnosis and between-patient heterogeneity.Results: A total of 180,829 patient visits among 65,513 unique patients were recorded during the period of analysis. Overall, providers were significantly less likely to prescribe opioids to the same individual patient when the visit occurred during higher rates of emergency department crowding, earlier times of day, earlier times of the week, later years, and when the patient had received fewer previous opioid prescriptions. Across all patients, providers were significantly more likely to prescribe opioids to patients who were middle-aged, white, and married. We found no bias towards women and no interaction effects between race and crowding or between race and gender.Conclusions: Providers tend to undertreat pain during constrained diagnostic situations and undertreat pain for patients from high-risk and marginalized demographic groups. Harm from previous treatment mistakes are likely to accumulate through informing future treatment decisions.
Using a Hybrid Agent-Based and Equation Based Model to Test School Closure Policies
Authors: Hunter Elizabeth , Kelleher John
Published: April 2020

BackgroundIn order to be prepared for an infectious disease outbreak it is important to know what interventions will or will not have an impact on reducing the outbreak. While some interventions might have a greater effect in mitigating an outbreak, others might only have a minor effect but all interventions will have a cost in implementation. Estimating the effectiveness of an intervention can be done using computational modelling. In particular, comparing the results of model runs with an intervention in place to control runs where no interventions were used can help to determine what interventions will have the greatest effect on an outbreak. MethodsTo test the effects of a school closure policy on the spread of an infectious disease (in this case measles) we run simulations closing schools based on either the proximity of the town to the initial outbreak or the centrality of the town within the network of towns in the simulation. To do this we use a hybrid model that combines an agent-based model with an equation-based model. ResultsOur results show that closing down the schools in the town where an outbreak begins and the town with the highest in degree centrality provides the largest reduction in percent of runs leading to an outbreak as well as a reduction in the overall size of the outbreak compared to only closing down the town where the outbreak begins. Although closing down schools in the town with the closest proximity to the town where the outbreak begins also provides a reduction in the chance of an outbreak, we do not find the reduction to be as large as when the schools in the high in degree centrality town are closed. ConclusionsThus we believe that focusing on high in degree centrality towns during an outbreak is important in reducing the overall size of an outbreak.
A simple-to-use nomogram for the individualized prediction of multidrug-resistant tuberculosis among individuals with previous tuberculosis history
Authors: Cheng Qinglin , Zhao Gang , Wang Le , Lu Min , Li Qingchun , Wu Yifei , Huang Yinyan , Jia Qingjun , Xie Li
Published: April 2020

Background: So far, there are few studies that have investigated the risk of incident multidrug-resistant tuberculosis (MDR-TB) among individuals with previous tuberculosis history (PTBH), let alone developed a nomogram so as to comprehensively estimate an individualized risk of incident MDR-TB in this population. The present study was to construct a comprehensive nomogram for providing simple and precise personalized prediction of incident MDR-TB risk among individuals with PTBH.Methods: A matched case−control study (1: 2 ratios) was performed between 2005 and 2018 in Hangzhou City, China. A multivariable Cox proportional hazard regression was used to evaluate independent predictors of incident MDR-TB in individuals with PTBH. A comprehensive nomogram was developed based on the multivariable Cox model.Results: Overall, 1, 836 participants were included in this study. We developed a simple-to-use nomogram for predicting the individualized risk of incident MDR-TB by using the parameters of age < 60 years, a history of direct contact, passive mode of TB case finding, human immunodeficiency virus infection, re-treated TB history, unsuccessful treatment, 3HRZES/6HRE, duration of pulmonary cavities, and duration of positive sputum culture in individuals with PTBH. The concordance index of this nomogram was 0.833 [95% confidence interval (CI): 0.807-0.859] and 0.871 (95% CI 0.773-0.969) for the training and validation sets, respectively, which indicated adequate discriminatory power. The calibration curves for the risk of incident MDR-TB showed an optimal agreement between nomogram prediction and actual observation in the training and validation sets, respectively. The high sensitivity and specificity of nomogram was indicated by using a receiver operating characteristic curve analysis.Conclusions: We developed and validated a novel nomogram for predicting and preventing the risk of incident MDR-TB in individuals with PTBH. Through this clinic tool, TB control executives could more precisely monitor, estimate and intervene the risk of incident MDR-TB among individual PTB patients.
Knowledge, Attitude and Practice Associated with COVID-19 among University Students: a Cross-Sectional Survey in China
Authors: Peng Yaling , Pei Chenchen , Zheng Yan , Wang Juan , Zhang Kui , Zheng Zhaohui , Zhu Ping
Published: April 2020

BackgroundThe current COVID-19 pandemic is effectively constrained by intensified public health measures in China, among which ubiquitous education plays a vital part.ObjectiveThis survey aims to understand the status quo acquisition of the ongoing public health education campaign among university students. MethodsWe designed this cross-sectional survey to investigated the knowledge, attitude and practice (KAP) associated with COVID-19 among university students during their household isolation at the peak of this pandemic. 872 university undergraduates were recruited from 10 universities in Shaanxi Province, China, in a stratified cluster sampling method. A self-administered and close-ended questionnaire was answered by subjects online voluntarily and anonymously to collect their answers regarding their KAP associated with COVID-19.ResultsResults showed that appropriate knowledge was acquired by 82.34% subjects, but the level was significantly higher in students from public universities and medical programs than in their counterparts (P＜0.05). 73.81% subjects reported positive attitude, with level significantly higher in females (P＜0.01). Proactive practice was found in 87.94% subjects. Taken together, the score of KAP was 4.12±0.749, 8.54±1.201, and 8.91±1.431 respectively, suggesting a positive correlation between attitude and practice (r=0.319, P＜0.01). Total KAP score was 21.57±2.291, apparently correlated with gender (r=0.096, P=0.005) and major (r=-0.081, P=0.017).Conclusions﻿Most university students acquired necessary knowledge, positive attitude and proactive practice towards COVID-19, but their KAP score significantly varied by gender, major and school type.
Why do you wear a face mask? Taiwanese public epidemic awareness of COVID-19 from social media behavior
Authors: Chin Chih-Yu , Liu Chang-Pan , Wang Cheng-Lung
Published: April 2020

BackgroundFacing the COVID-19 epidemic, Taiwan has demonstrated resilience at the initial stage of epidemic prevention and effectively slowed down its spread. This study aims to capture public epidemic awareness toward the COVID-19 through collecting social media- and Internet-based data and elaborate on how the public epidemic awareness rose and played a role in the epidemic prevention in Taiwan during the initial course of COVID-19 spread.MethodsUsing the Google search query volume of COVID-19 and face mask as indicators of public epidemic awareness, we collected the volume of news reports and the mentions on social media about COVID-19 and face masks between December 31, 2019, and February 29, 2020, through big data analysis and sorted the daily total confirmed cases of COVID-19 worldwide and in Taiwan as well as critical mask-related measures implemented by the Taiwanese government to plot the trends in this information and conduct correlation analysis. Additionally, the content analysis was adopted to analyze the transmission of different types of fear information of COVID-19 between December 31, 2019, and March 29, 2020, and their effects on the public.ResultsThe Google search query volume of COVID-19 and face mask was significantly correlated with the number of confirmed cases in Taiwan, the number of news reports on COVID-19 (correlation coefficient: .74–.90). Since the first confirmed cases of COVID-19, public epidemic awareness has increased rapidly, prompting the government to formulate relevant emergency measures. Additionally, the findings from content analysis suggested that the fear of the loss of control best explains why panic behavior occurs in public.ConclusionsConfronting the highly infectious COVID-19, public epidemic awareness is vital. While fear is an inevitable product when an emerging infectious disease occurs, the government can convert resistance into assistance by understanding why fear arises and which fear factors cause excessive panic in public. Moreover, online social media promptly reflect public epidemic awareness, which can be used as a reference for epidemic prevention; this urges the government to deal with the crisis in the form of public opinion.
Influences of dietary Eucommia ulmoides extract on growth, flesh quality, antioxidant capacity and collagen-related genes expression in grass carp (Ctenopharyngodon idellus)
Authors: Yang Hang , Tan Sumei , Li Xiaoqin , Xu Zhen , Cheng Zhuo , Leng Xiang-jun
Published: April 2020

Background: The study investigated the effects of dietary Eucommia ulmoides extracts on growth, flesh quality and collagen-related genes expression of grass carp (Ctenopharyngodon idella). Eucommia ulmoides bark extract (EBE) and Eucommia ulmoides leaf extract (ELE) were individually supplemented into basal diet (control) at an inclusion of 4 g/kg, and then the three diets were fed to grass carp (59.7 ± 0.3g) for 60 days. Results: The results indicated that dietary ELE significantly increased weight gain (+4.22%), and decreased feed conversion ratio (-0.07) (P<0.05), while EBE did not significantly affect the growth performance of grass carp. Compared to the control, dietary ELE increased apparent digestibility coefficient of dry matter, crude protein and intestinal digestive enzyme activity (P<0.05), and the contents of calcium, total collagen, heat-insoluble collagen and free amino acids level (including delicious amino acids) in flesh were also increased (P<0.05). In both extracts groups, the flesh centrifugal loss, steaming loss, drip loss24h, protein carbonyl and malondialdehyde were significantly lower, and superoxide dismutase and glutathione peroxidase activities were higher than the control (P<0.05). No significant differences in the amount of saturated, monounsaturated and polyunsaturated fatty acids in flesh were found among the three groups, but DPA, DHA, n-3 polyunsaturated fatty acids and n-3/n-6 ratio in flesh were increased by dietary EBE and ELE (P<0.05). In collagen-related genes expression, the ELE supplementation significantly promoted the expression of collagen type Ⅰ (COL1A1, COL1A2), proline hydroxylase, lysine oxidasein in muscle, while the expression of matrix metalloproteinase-2 and matrix metalloproteinase-9 was decreased (P<0.05). Conclusion: In conclusion, dietary ELE improved the growth, muscle antioxidant capacity and flesh quality of grass carp.
Different surgical outcome and follow up status between dMMR and pMMR colorectal cancer patients who fulfilled with Amsterdam-II criteria
Authors: Sun Ciyuan , Chiang Jyming , Chen Tseching , Hung Hsinyun , You Jengfu
Published: April 2020

Background

Although hereditary non-polyposis colorectal cancer (HNPCC) could be subtyped into proficient or deficient mismatch repair gene expression (pMMR or dMMR), distinct clinical features between these two subgroups patients was rare reported.

Methods

We retrospectively analyzed 175 hereditary non-polyposis colorectal cancer (HNPCC) patients between January 1995 to December 2012. Cox proportional hazards model was used to compare the differences between two subgroups.

Results

Significant differences of disease free survival (DFS) and overall survival (OS) exist between dMMR and pMMR. In addition to other factors including younger mean age of diagnosis for dMMR patients (48.6 years v.s. 54.3 years), operation type (more extended colectomy for dMMR 35.8% v.s. 14.5%), tumor location (right colon predominance for dMMR 61.7% v.s. 27.3% and more rectum cases for pMMR 41.8% v.s. 11 .7%), tumor differentiation (more poor differentiation for dMMR 23.3% v.s. 9.0%), N staging (more N0 cases for dMMR 70.8% v.s. 50 .9%), more frequently presence of extra-colonic tumors for dMMR (16.7% v.s. 1.8%) and lower recurrence rates (9.1% v.s.35 .3%). Significantly different cumulative incidence of developing metachronous colorectal cancer were observed with 6.18 for pMMR patients and 20.57 person-years for dMMR patients ( p <0.001).

Conclusions

Distinct clinicopathological features significantly exist between dMMR and pMMR subtypes patient, MMR status should be consider to tailor operation types and follow up surveillance between these two subgroups patients who all fulfilled with Amsterdam-II criteria.
Determinants of Health-Related Quality of Life Decline in Interstitial Lung Disease
Authors: Maqhuzu Phillen Nozibuyiso , Szentes Boglárka Lilla , Kreuter Michael , Bahmer Thomas , Kahn Nicolas , Claussen Martin , Holle Rolf , Schwarzkopf Larissa
Published: April 2020

Background: Health-related quality of life (HRQL) in interstitial lung disease (ILD) patients is impaired. We aimed to identify baseline predictors for HRQL decline within a 12-month observation period. Methods: We analyzed 194 ILD patients from two German ILD-centers in the observational HILDA study. We employed the disease-specific King’s Brief Interstitial Lung Disease questionnaire (K-BILD) with the subdomains ‘psychological impact’, ‘chest symptoms’ and ‘breathlessness and activities’, and the generic EQ-5D Visual Analog Scale (VAS). We evaluated how many patients experienced a clinically meaningful decline in HRQL. Subsequently, we investigated medical and sociodemographic factors as potential predictors of HRQL deterioration. Results: Within the study population (34.0% male, Ø age 61.7) mean HRQL scores hardly changed between baseline and follow up (K-BILD: 52.8 vs. 52.5 | VAS: 60.0 vs. 57.3). On the intra-individual level, 30.4% (n = 59) experienced a clinically relevant deterioration in K-BILD total score and 35.4% (n = 68) in VAS. Lower baseline forced vital capacity % predicted determined HRQL decline in K-BILD total score (ß– coefficient -0.02, p = 0.007), VAS (ß–coefficient -0.03, p < 0.0001), and in the subdomain ‘psychological impact’ (ß– coefficient -0.02, p = 0.014). Lower baseline diffusing capacity of carbon monoxide % predicted determined deterioration in ‘breathlessness and activities’ (ß– coefficient -0.04, p = 0.003) and ‘chest symptoms’ (ß– coefficient -0.04, p = 0.002). Additionally, increasing age predicted decline in ‘psychological impact’ (ß–coefficient 0.06, p < 0.007). Conclusion: A third of ILD patients experience a clinically relevant HRQL deterioration within 12 months, which is mainly predicted by lung function baseline value.
Decisional conflict scale for elective thoracic surgery
Authors: Kaneda Hiroyuki , Nakano Takahito , Murakawa Tomohiro
Published: April 2020

Background The relationship between patients and physicians in medical decision-making has changed in recent times. Although patients understand essential medical information, the estimation of risk/benefit of planned treatments is a difficult decision-making process for them. The research of decisional conflict targeted decision at surgery has been rarely performed. We prospectively researched decisional conflict using a questionnaire survey for patients with elective thoracic surgery and retrospectively reviewed the quantified and subcategorized data to examine clinical factors related with the decisional conflict scale (DCS) and the quality of life (QOL).Methods For patients with thoracic surgery, self-administered questionnaire surveys regarding decisional conflict and QOL were conducted at three time points: the day before surgery, at discharge, and at 3 months after surgery. The questionnaire survey of DCS is composed of five categories (uncertainty, informed, values clarity, support, and effective decision making) that use a five-point Likert-type response. QOL was measured in the Japanese version of the M.D. Anderson Symptom Inventory.Results The questionnaire surveys were performed from April 2017 to March 2019. Eighty six patients were analyzed in this study. The total DCS scores did not differ among pre-surgery, post-surgery, and 3 months after surgery (21.8, 20.3, 19.2, respectively; P = 0.48). The effective decision subscores significantly decreased after surgery (19.2, 13.4, 13.7, p = 0.041). The pain scores at discharge were significantly higher in patients who underwent thoracotomy surgeries than VATS (6.5 vs. 4.0, p = 0.013). However, the DCS scores did not show any significant difference between the surgical approaches at discharge (thoracotomy: 12.5, VATS: 13.5, p = 0.86) and at 3 months after surgery (thoracotomy: 22.5, VATS: 12.5, p = 0.11). The effective decision subscores did not show significance to post-operative complications at post-surgery before discharge and at 3 months after surgery (p = 0.94 and p = 0.40). At 3 months after surgery, the most QOL scores were significantly related to the total scores of DCS.Conclusions Patient’s own experience of thoracic surgery and post-operative management may decrease patient dissatisfaction. The findings suggest that decisional support for patients to organize their concrete perioperative management would ameliorate their satisfaction.
Evaluation of Lens culinaris agglutinin-reactive α-fetoprotein for diagnosis of malignant tumors
Authors: Lu Qiong , Xia Jinxing , Zheng Meijuan , Jia Zhongwei
Published: April 2020

Background: To assess the potential of AFP-L3% for the utility to diagnose malignant tumors.Methods: The AFP-L3 was concentrated from clinically-collected serum samples via the Hotgen Biotech glycosyl capture spin columns and then measured through the protein microarrays. The levels of AFP and AFP-L3 were detected by electrochemiluminescence immunoassay. In this retrospective study, 266 patients with the level of serum AFP-L3 over 1ng/ml were recruited from December 2014 through April 2019,Among them, 155 patients were clinically diagnosed/confirmed with malignant tumors, including 101 hepatocellular carcinomas, 47 stomach malignant tumors, and 7 other malignant tumors; and the rest of 111 patients were nomalignant tumors.Results: Patients with serum AFP-L3 level of greater than 1ng/ml were mainly detected in hepatic diseases, including hepatocellular carcinoma, cirrhosis and chronic hepatitis. In patients with no tumors, the levels of serum AFP-L3 over 1ng/ml were only observed in liver disease. The levels of AFP-L3 in blood were substantially greater in patients with HCC. Among the malignant tumor patients with the level of serum AFP-L3 over 1ng/ml, HCC accounted for 60%, gastric cancer for nearly 40%. The AFP, AFP-L3 and AFP-L3% in blood were increased significantly in patients with liver malignancy, chronic liver disease and cirrhosis. However, the elevation of AFP-L3 and AFP-L3% in the malignant cohort was more evident than that in the nonmalignant counterpart.Conclusions: AFP-L3 is likely to contribute to differential diagnosis of HCC as well as other hepatic diseases, AFP-L3% is a reliable indicator for diagnosing benign and malignant tumors.
Effects of melatonin administration to cashmere goats on cashmere production and hair follicle characteristics in two consecutive cashmere growth cycles
Authors: Yang Chunhe , Duan Chunhui , Wu Ziyuan , Li Yan , Luan Yinyin , Fu Xiajie , Zhang Chunxiang , Zhang Wei
Published: April 2020

Background: Short-term melatonin treatment of cashmere goats has been shown to increase the quantity and quality of cashmere fibre. However, the long-term effects of melatonin treatment on cashmere production and hair follicle characteristics of these goats has not been reported. Therefore, we investigated changes in cashmere production and in hair follicle populations and their activity in melatonin-treated cashmere goats for two consecutive cashmere growth cycles.Methods: Twenty-four female Inner Mongolian Cashmere goats were randomly allocated to two groups (n = 12), one of which received melatonin implants, the other being an untreated control group. Melatonin implants were subcutaneously inserted behind the ear at a dose of 2 mg/kg live weight on two occasions – 30 April and 30 June 2016. Cashmere samples were collected at combing in April of 2017 and 2018. Blood and skin samples were collected monthly between April and September 2016, and during April and September in 2017. Results: Our results showed that melatonin treatment of cashmere goats in one cashmere growth cycle increased (P < 0.05) weight, length, density and decreased (P < 0.01) diameter of cashmere fibre, however it did not affect cashmere production in the following annual cycle. Melatonin treatment of cashmere goats had no effect on the population of secondary hair follicles for the two consecutive cycles. However, in the first growth cycle following treatment it advanced (P < 0.05) the onset of activity of secondary hair follicles by 2 months and it increased (P < 0.05) the population of these follicles that were active. Serum melatonin concentrations of the treated goats were elevated, relative to those of the control group (P < 0.05), but only during the first growth cycle.Conclusions: In summary, melatonin treatment of cashmere goats in one cashmere growth cycle improved cashmere production for that cycle only, with no residual effects on the following cycle. This makes the technique acceptable to the cashmere goat industry. The improvement in cashmere production following treatment of goats with melatonin appears to involve an acceleration of the annual regeneration of secondary hair follicles and an increased population of active secondary hair follicles in the skin of cashmere goats.
Effect of early enteral nutrition and aggressive intravenous fluid resuscitation on clinical outcomes in pediatric severe acute pancreatitis
Authors: Xia Jing , Li Jing , Wu Jie
Published: April 2020

Background : Early enteral nutrition (EN) and aggressive intravenous fluid (IVF) resuscitation are recommended in adult patients with severe acute pancreatitis (SAP). Whether these recommendations influence the outcomes of pediatric SAP is unclear and need to be figured out. Methods : We performed a retrospective review of pediatric patients with SAP admitted to Shengjing Hospital of China Medical University from January 1, 2012 to September 30, 2019. Data regarding demographic and baseline characteristics of SAP patients were collected. The outcomes studied were abdominal pain duration, time for recovery of food intake, length of stay (LOS), number of attacks, complication rate, and fatality rate. Results : This study included 40 pediatric SAP patients. We divided all patients into the EN+IVF group, nil per os (NPO)+IVF group, and NPO+ no IVF group. There was no significant difference in demographic and baseline characteristics in the different groups. However, children who received EN and IVF treatment had the shortest abdominal pain duration, time for recovery of food intake, and LOS. Conclusion : Our study found that early EN and aggressive IVF resuscitation improved the outcome of pediatric patients with SAP.
Rate, determinants, and causes of stillbirth in Jordan: Findings from the Jordan Stillbirth and Neonatal Surveillance (JSANDS) system
Authors: Shattnawi Khulood Kayed , Khader Yousef S. , Alyahya Mohammad , Al-Sheyab Nihaya , Batieha Anwar
Published: April 2020

Background: Annually, 2.6 million stillbirths occur around the world, with about 98% occur in low and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries.Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyse, and disseminate data on stillbirths, neonatal deaths, and their causes. Data on births, stillbirths and their causes, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analysed.Results: A total of 10328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths) with a rate of 9.9 per 1000 total births. The main fetal causes of antepartum stillbirths were antepartum death of unspecified cause (33.7%), acute antepartum event (33.7%), congenital malformations and chromosomal abnormalities (13.3%), and disorders related to the length of gestation and fetal growth (10.8%). The main maternal causes of antepartum stillbirths included complications of placental cord and membranes (48.7%), maternal complications of pregnancy (23.1%), and maternal medical and surgical conditions (23.1%). Fetal causes of intrapartum stillbirths included congenital malformations deformations and chromosomal abnormalities, other specified intrapartum disorder, intrapartum death of unspecified cause (33.3% each). Maternal causes of intrapartum stillbirths included complications of placental cord and membranes. In the multivariate analysis, the odds of stillbirth for very low birth weight (<1500 gm) babies and for low birthweight babies (1500-2499 gm) were 14.1 times 4.3 times that odds for babies born with normal birth weight, respectively. The stillbirth rate was significantly higher among preterm deliveries compared to full-term deliveries (OR = 5.6).Conclusions: Although the rate of stillbirth is lower than that in other countries in the region, there is an opportunity to prevent such deaths. While the majority of stillbirths occurred during the antepartum period, care should be taken for early identification of high-risk pregnancies and ensuring adequate antenatal obstetric interventions.
Root of Angelica gigas Nakai ameliorates ischemic stroke-induced brain injury in mice through the activation of the PI3K/AKT/mTOR and MAPK pathways
Authors: Lee Se-Eun , Lim Chiyeon , Cho Suin
Published: April 2020

Background: Ischemic stroke results in disability and increased risk of morbidity, resulting in a massive burden on patients and caregivers. Recombinant tissue plasminogen activator (r-tPA) has a limited window of opportunity for efficacy and causes side effects including hemorrhage; therefore, safer and more effective therapeutic strategies are required. In this study, the neuroprotective effects of a methanolic extract of AGR (AGmex) in ischemia/reperfusion-induced brain injury in mice were investigated. Methods: Ischemic brain injury was induced in the mice by transient occlusion of the middle cerebral artery (tMCAO) for 120 min, and the effect of AGmex on the amount of infarction was measured. Cresyl violet and hematoxylin and eosin stains were used to identify changes in the neurons, nuclei, and cytoplasm. Western blotting, immunohistochemistry, and terminal deoxynucleotidyl transferase dUTP nick end labeling staining were used to elucidate the neuroprotective mechanism of AGmex. Results: AGmex effectively reduced the infarction volume when the mice were pre-treated at 1,000 mg/kg bw/day for two consecutive days (AGmex 1000 group). Neurons, nuclei, and cytoplasmic staining were the lowest in the MCAO group, but recovered in the AGmex 1000 group. In addition, proteins related to cell growth, differentiation, and death were up-regulated in the AGmex 1000 group. Conclusion: The major recovery mechanisms appeared to be attenuation of the mitochondrial function of Bcl-2/Bax, and activation of the PI3K/AKT/mTOR and MAPK signaling pathways in ischemic neurons.
Preoperative serum sodium level as a prognostic and predictive biomarker for adjuvant therapy in esophageal cancer
Authors: Wang Qifeng , Peng Lin , Han Yongtao , Li Tao , Dai Wei , Wang Yi , Wu Lei , Wei Yang , Xie Tianpeng , Fang Qiang , Li Qiang , Lang Jinyi , Cao Bangrong
Published: April 2020

Background: Low serum sodium has been associated with unfavorable outcome in several cancers. The prognostic value of serum sodium in esophageal carcinoma (EC) remains unclear. This study aimed to investigate preoperative serum sodium in association with outcome and survival benefit of adjuvant therapy for patients with EC. Methods: Preoperative serum sodium and clinicopathological indexes were retrospectively collected from 2155 patients who underwent esophagectomy at Sichuan cancer hospital. Overall survival (OS) and disease-free survival (DFS) were analyzed by using Kaplan-Meier method and Cox regression. Benefit of adjuvant therapy was estimated by using Propensity Score Matching. Results: The incidence of hyponatremia and hypernatremia were 2% (43/2155) and 3.5% (76/2155) in treatment-naive patients. Both sodium disorders indicated unfavorable OS (hyponatremia, adjusted HR[95%CI] = 1.78[1.2-2.62]; hypernatremia, adjusted HR = 1.52[1.1-2.11]) and DFS (hyponatremia, adjusted HR[95%CI] = 1.52[1.03-2.23]; hypernatremia, adjusted HR = 1.45[1.06-1.99]). Decreased sodium concentrations within the normal range were associated with poor OS and DFS. Postoperative adjuvant therapy was associated with improved three-year OS (56.6% vs. 40%; adjusted HR = 0.55 [95%CI, 0.41-0.73]) and DFS (51.9% vs. 36.2%; adjusted HR = 0.63 [95%CI, 0.48-0.83]) versus surgery alone in patients with low serum sodium (Na < 139.6 mmol/L), but not in other sodium subgroups. Meanwhile, serum sodium was inversely correlated with cell counts of leukocytes, neutrophils, monocytes and C-reaction protein levels. Conclusions: These results suggested that low preoperative serum sodium is associated with poor outcome in EC patients, and may predict survival benefit of adjuvant therapy.
Coevolution of Coronavirus and Paramyxovirus with Their Bat Hosts in the Same Geographical Areas
Authors: Liang Jie , Zhu Chunchao , Zhang Libiao
Published: April 2020

Bat-borne viruses are relatively host specific. In this study, coevolution analyses were conducted on coronaviruses and paramyxoviruses and their bat hosts to investigate the potential mechanisms of such host specificity. The published nucleotide sequences of the RNA dependent RNA polymerase (RdRp) gene of 60 coronaviruses from 37 bat species and those of the RNA polymerase large (L) gene of 36 paramyxoviruses from 29 bat species were analyzed. Each of the coevolution signal detected was tested and verified by the ParaFit and PACo functions of the R program. Significant coevolution signals were detected in coronaviruses and paramyxoviruses and their bat hosts, and closely related bat hosts were found to carry viruses that are closely related. Results also suggest that similar geographical distribution and close phylogenetic relationship may have resulted in infection of different bat species by the same strain of virus. As the natural hosts of certain viruses were mostly found in their endemic and surrounding areas, we speculate that the ancestors of bat hosts of Middle East respiratory syndrome coronaviruses (MERS-CoVs) may belong to the family of Vespertilionidae and are evolutionarily close to Neoromicia capensis and Pipistrellus hesperidus bats that are present in Africa and west Asia. In addition, we speculate that bat coronaviruses that are closely related to the novel coronavirus 2019 (COVID-19) may be found in bats related to Rhinolophus affinis. Although the coevolution between viruses and bat host is not surprised, this is the first systematical summary elucidating the relationship between coronaviruses, paramyxoviruses, host and geographical areas. It provides a theoretical basis for the viruses trace.Significance Bat-borne coronaviruses and paramyxoviruses have caused a number of outbreaks worldwide, posing a great threat to the safety of human life and property. It is important to understand the bats-viruses evolutionary history and rules for the viruse tracing. In our long-term surveillance of bat viruses, we found that they are family, genus or species-specific. In this study, we are committed to show this phenomena through co-phylogenetic analysis. Host distribution were taken into account as an important analytical factor in this study. Our resualts suggest that similar hosts carry similar viruses, similar distribution area may facilitate inter-species transmission of bat viruses, and several endemic area were overlap with the natural host distribution. This study is of great significance for further study of bats-viruses evolutionary history and enhanced our awareness of virus prevention and control.# J. Liang and C. Zhu contributed equally to this study.
Molecular epidemiology of Aleutian mink disease virus from fecal swab of mink in northeast China
Authors: Tong Mingwei , Sun Na , Cao Zhigang , Cheng Yuening , Zhang Miao , Cheng Shipeng , Yi Li
Published: April 2020

Background: Aleutian mink disease parvovirus (AMDV) causes Aleutian mink disease (AMD), which is a serious infectious disease of mink. The aim of this study was to get a better understanding of the molecular epidemiology of AMDV in northeast China to control and prevent AMD from further spreading. This study for the first time isolated AMDV from fecal swab samples of mink in China. Results: A total of 157/291 (54.0%) of the fecal swab samples were positive for AMDV. Of these, 23 AMDV positive samples were randomly selected for sequence alignment and phylogenetic analysis based on the acquired partial fragments of VP2 gene with the hypervariable region. Comparative DNA sequence analysis of 23 AMDV isolates with a reference nonpathogenic (AMDV-G) strain revealed 8.3% difference in partial VP2 nucleotide sequences. Amino acid alignment indicated the presence of several genetic variants, as well as one single amino acid residue deletion . The most concentrated area of variation was located in the hypervariable region of VP2 protein. According to phylogenetic analysis, the Chinese AMDV strains and the other 14 reference AMDV strains from different countries clustered into three groups (clades A, B and C). Most of the newly sequenced strains were found to form a Chinese-specific group, which solely consisted of Chinese AMDV strains. Conclusion: These findings indicated that a high genetic diversity was found in Chinese AMDV strains and the virus distribution were not dependent on geographical origin. Both local and imported AMDV positive species were prevalent in the Chinese mink farming population. The genetic evidence of AMDV variety and epidemic isolates have importance in mink farming practice.
Predicted antiviral drugs Darunavir, Indinavir and Rimantadine can potentially bind to neutralize COVID-19 conserved proteins
Authors: Halder Umesh Chandra
Published: April 2020

Background: Novel Coronavirus disease 2019 or COVID-19 has become a threat to human society due to fast spreading and increasing mortality. It uses vertebrate hosts and presently deploying humans. Life cycle and pathogenicity of COVID-19 have already been deciphered and possible drug target tests are on the way.Results: The present study was aimed to analyze conserved Endoribonuclease, protease and replicase proteins of the virus as targets to all known drugs. A bioinformatics based web server Drug ReposeER predicted several drug binding motifs in these analyzed proteins. Results revealed that anti-viral Darunavir, Indinavir and Rimantadine were the most potent to have 3D-drug binding motifs on COVID-19 proteins.Conclusions: Repurposing of the antiviral drugs Darunavir, Indinavir and Rimantadine to treat COVID-19 infected persons could be useful that can potentially prevent thousands of human mortality.
General practitioners’ perspectives on barriers to depression care: development and validation of a questionnaire
Authors: Senchyna Arun , Abbiati Milena , Chambe Juliette , Haller Dagmar , Maisonneuve Hubert
Published: April 2020

Background General practitioners (GPs) regularly feel challenged by the care of depressed patients and may encounter several barriers in providing best management. GPs’ perspectives on barriers to depression care are a subject of growing interest but there is a lack of validated assessment tools. The aim of this study was to develop and validate a questionnaire assessing barriers to depression care (BDC-Q) encountered by GPs in France and the French-speaking part of Switzerland.Methods The BDC-Q was constructed in five steps: Item development, content validation, pretesting, testing phase and test-retest reliability. The questionnaire items were generated through a literature search. An expert panel of GPs (n=16) and psychiatrists (n=3) validated the content and 20 GPs pretested the questionnaire to provide response process validity evidence. We then tested the questionnaire among 116 GPs and used principal component analysis and internal consistency testing (Cronbach’s alpha) to structure it into consistent dimensions. Test-retest reliability using Pearson correlation coefficient was assessed with 30 GPs who completed the questionnaire twice after an interval of at least 2 weeks.Results The 25 items BDC-Q was structured in five dimensions: (i) provision of care by the general practitioner, (ii) patient and perspectives about depression, (iii) guidance for care, (iv) collaboration with mental health specialists and (v) access to mental health care.Conclusions The BDC-Q displays evidence of validity and reliability to meaningfully assess GPs’ perspectives on barriers to depression care. It can be used both at a practice level within a quality improvement strategy, and at a broader level, to inform health planners and tailor appropriate strategies to improve depression care in the community.
Managing diabetes mellitus with comorbidities in primary healthcare facilities: a qualitative study among physicians in Odisha, India
Authors: Pati Sandipana , Pati Sanghamitra , Akker Marjan van den , Schellevis F. (François) G. , Sahoo Krushna , Burgers Jako S.
Published: April 2020

Aim To explore the perceived barriers and facilitators in the management of the patients having diabetes with comorbidities by primary care physicians.Methods A qualitative In-Depth Interview study was conducted among the primary care physicians at seventeen urban primary health care centres at Bhubaneswar city of Odisha, India. The digitally recorded interviews were transcribed verbatim and translated into English. The data were analysed using content analysis.Results Barriers related to physicians, patients and health system were identified. Physicians felt lack of necessary knowledge and skills, communication skills and overburdening due to multiple responsibilities to be major barriers to quality care. Patients’ attitude and beliefs along with socio-economic status played an important role in treatment adherence and in the management of their disease conditions. Poor infrastructure, irregular medicine supply, and shortage of skilled allied health professionals were also found to be barriers to optimal care delivery, as was the lack of electronic medical records and personal treatment records.Conclusion Comprehensive guidelines with on the job training for capacity building of the physicians and creation of multidisciplinary teams at primary care level for a more holistic approach towards management of diabetes with comorbidities could be the way forward to optimal delivery of care.
Diarrhoea after treatment: an adverse drug reaction in patients with COVID-19
Authors: Li Xiang-Yu , Wang Ying , An Xu-Sheng , Yang Shu-Feng , Shen Peng , Yang Xiao-Zhong , Wang Hong-Gang
Published: April 2020

The coronavirus disease (COVID-19) is currently prevalent worldwide. We analysed the occurrence of diarrhoea of these patients after treatment. All patients were treated with nebulised α-interferon and oral administration of Lopinavir/Ritonavir tablets. Of the 62 patients, 38 (61.3%) developed diarrhoea after treatment. Of these 38 cases, 63.2% (24/38 cases) had their first diarrhoea within 24 hours after medication. Only 13.2% (5/38 cases) had more than 5 bowel movements per day with a maximum of 10 per day. Patients with diarrhoea had lower white blood cell counts. Leukopenia was a risk factor for the development of diarrhoea. We conclude that COVID-19 patients had a relatively high rate of diarrhoea after treatment. Lopinavir/Ritonavir was speculated to contribute to diarrhea, which is a common adverse drug reaction to Lopinavir/Ritonavir. Patients with reduced white blood cell counts at admission may be more likely to develop diarrhoea after admission.
Root-knot nematodes demonstrate temporal variation in host penetration
Authors: Mishra Shova , DiGennaro Peter
Published: April 2020

Root-knot nematodes (RKN; Meloidogyne spp.) are obligate plant parasites that require constant communication with their host to establish and maintain specialized feeding cells. The intimacy of this interaction likely requires constant monitoring of host biology and behavior. As plant processes follow tightly regulated circadian and diurnal patterns, RKN may use similar cues to regulate aspects of this symbiosis. We interrogated RKN biology within the context of host diurnal rhythms throughout nematode development. At 24-hr post-inoculation, RKN penetrated host roots significantly more when inoculated during the night compared to the day. We excluded the possibility that this phenomenon is due to nematode perception of light penetrating the soil, as an identical phenomenon is observed under inverted light conditions. Additionally, when plants were allowed to equilibrate and adjust their light-driven clock under constant light conditions, the temporal variation in nematode penetration was abolished. This phenomenon is not present during earlier nematode developmental stages as egg hatch and infective juvenile mobility did not follow rhythmic patterns and are not affected by light. Taken together, it appears nematode host seeking and penetration are at least partially influenced by daily changes in plant root signaling and light does not have a direct effect on RKN developmental stages. Understanding the role and origin of circadian and diurnal rhythms in the plant–nematode interaction underscores the importance of exploiting basal plant biology to develop novel control methods for these pathogens.
First molecular characterization of an Iranian population of Schistonchus caprifici (Gasparrini, 1864) Cobb, 1927 (Rhabditida; Aphelenchoidea)
Authors: Karimipour Fard Hadi , Zare Hamid
Published: April 2020

A population of Schistonchus caprifici was recovered in Iran during the present study. The molecular characters of this population were studied using partial sequences of large subunit ribosomal DNA (LSU rDNA D2-D3) for the first time, and its phylogenetic relationships with other isolates of the species were discussed. Compared to previous available data, no remarkable genetic distance was observed between the presently studied isolate and other isolates.