bluuebunny/crossref_metadata_2025 huggingface dataset:
SSCA-Net: Simultaneous Self- and Channel-attention Neural Network for Multi-scale Structure-Preserving Vessel Segmentation
Authors: Ni Jiajia , Wu Jianhuang , Tong Jing , Wei Mingqiang , Chen Zhengming
Published: December 2020

Background: Vessel segmentation is a fundamental, yet not well-solved problem in medical image analysis, due to complicated geometrical and topological structures of human vessels. Unlike existing rule- and conventional learning-based techniques, which hardly capture the location of tiny vessel structures and perceive their global spatial structures, Methods: we propose Simultaneous Self- and Channel-attention Neural Network (termed SSCA-Net) to solve the multi-scale structure-preserving vessel segmentation (MSVS) problem. SSCA-Net differs from the conventional neural networks in modeling image global contexts, showing more power to understand the global semantic information by both self- and channel-attention (SCA) mechanism, and offering high performance on segmenting vessels with multi-scale structures. Specifically, the SCA module is designed and embedded in the feature decoding stage to learn SCA features at different layers, which the self-attention is used to obtain the position information of the feature itself, and the channel attention is designed to guide the shallow features to obtain global feature information. Results: Three blood vessel data sets are train and validate the models. our SSCA-Net achieves 96.21% in Dic and 92.70% in Mean IoU on the intracranial vessel dataset and achieved 98.20 %, 83.52% and 96.14% in AUC, Sen and Acc respectively on retinal vessel dataset. The obtain model can segment the leg arteries and Dic score is 97.21% and the Mean IoU score is 94.42%. Conclusions: The results demonstrated that the proposed SSCA-Net clear improvements of our method over the state-of-the-arts in terms of preserving vessel details and global spatial structures.
Patient, Family, Caregiver, and Community Engagement in Research: A Sensibility Evaluation of a Novel Infographic and Planning Guide
Authors: Giannini Andrew Theodore , Leong Megan , Chan Kelvin , Ghaltaei Arman , Graham Eden , Robinson Craig Craig , Skorska Malvina Nina , Cross Andrea , Gabison Sharon
Published: December 2020

Background: Engaging patients, their families, caregivers and the community (PFCCs) throughout the research cycle provides many benefits of ensuring that research is meaningful for the population it is meant to benefit. Several engagement tools, guidelines, and recommendations have been developed to guide researchers in engaging PFCCs. However, many of these tools are lengthy, complex, and lack the recommended behaviours to facilitate engagement of PFCCs in research. An infographic and planning guide was developed as part of a family engagement in research course including families and researchers in order to facilitate engagement of PFCCs in research. The aim of this study was to evaluate the sensibility of this infographic and accompanying planning. Methods: Thirteen rehabilitation researchers reviewed the PFCC engagement tool, participated in a semi-structured interview, and completed a 10-item sensibility questionnaire. Interviews were transcribed, imported into NVivo Plus, and analyzed using direct content analysis. Median scores and proportions of responses for each of the 10 items in the questionnaire were calculated. Results: Median scores for all questionnaire items were ≥ 4 on a 7-point Likert Scale and none of the items’ median scores were ≤ 3. Participants reported the tool was easy to navigate, contained relevant items to promote PFCC engagement, and followed a logical sequence. Participants’ suggestions for modifications included reformatting the tool, redesigning the infographic redesign, and changing the title. Conclusions: The tool was deemed sensible for overt format, purpose and framework, face and content validity, and ease of usage. The tool is useful for researchers who require guidance to engage PFCCs across the research cycle. Further studies are recommended to assess the effectiveness of the tool to engage PFCCs in research.
Association of “Hypertriglyceridemic Waist” with Increased 5-Year Risk of Subclinical Atherosclerosis in a Multi-Ethnic Population: A Prospective Cohort Study
Authors: Namdarimoghaddam Peyman , Fowokan Adeleke O. , Humphries Karin H. , Mancini G.B. John , Lear Scott A.
Published: December 2020

Background: Hypertriglyceridemic waist (HTGW), which incorporates measures of waist circumference and levels of triglyceride in blood, could act as an early-stage predictor to identify the individuals at high-risk for subclinical atherosclerosis. Previous studies have explored the cross-sectional association between HTGW and atherosclerosis; however, understanding how this association might change over time is necessary. This study will assess the association between HTGW with five-year subclinical carotid atherosclerosis.Methods: 517 participants of Aboriginal, Chinese, European, and South Asian ethnicities were examined for baseline HTGW and five-year indices of subclinical atherosclerosis (intima media thickness (mm), total area (mm2), and plaque presence). Family history of cardiovascular disease, sociodemographic measures (age, sex, ethnicity, income level, maximum education), and traditional risk factors (systolic blood pressure, smoking status, total cholesterol, high-density lipoprotein cholesterol, body mass index) were incorporated into the models of association. These models used multiple linear regression and logistic regression.Results: Baseline HTGW phenotype is a statistically significant and clinically meaningful predictor of five-year intima media thickness (b = 0.08 [0.04, 0.11], p < 0.001), total area (b = 0.20 [0.07, 0.33], p = 0.002), and plaque presence (OR = 2.17 [1.13, 4.19], p = 0.02) compared to the non-HTGW group independent of sociodemographic factors and family history. However, this association is no longer significant after adjusting for the traditional risk factors of atherosclerosis (p = 0.27, p = 0.45, p = 0.66, respectively). Moreover, change in status of HTGW phenotype does not correlate with change in indices of atherosclerosis over five years.Conclusions: Our results suggest that when the traditional risk factors of atherosclerosis are known, HTGW may not offer additional value as a predictor of subclinical atherosclerosis over five years. Changes in HTGW may not be a reliable progress metric for prevention programs.
Vestibular Dose Correlates With Dizziness After Radiosurgery for the Treatment of Vestibular Schwannoma
Authors: Ermiş Ekin , Anschuetz Lukas , Leiser Dominic , Poel Robert , Raabe Andreas , Manser Peter , Aebersold Daniel M , Caversaccio Marco , Mantokoudis Georgios , Abu-Isa Janine , Wagner Franca , Herrmann Evelyn
Published: December 2020

BackgroundStereotactic radiosurgery (SRS) has been recognized as a first-line treatment option for small to moderate sized vestibular schwannoma (VS). Our aim is to evaluate the impact of SRS doses and other patient and disease characteristics on vestibular function in patients with VS.MethodsData on VS patients treated with single-fraction SRS to 12 Gy were retrospectively reviewed. No dose constraints were given to the vestibule during optimization in treatment planning. Patient and tumor characteristics, pre- and post-SRS vestibular examination results and patient-reported dizziness were assessed from patient records. ResultsFifty-three patients were analyzed. Median follow-up was 32 months (range, 6–79). The median minimum, mean and maximum vestibular doses were 2.6 ± 1.6 Gy, 6.7 ± 2.8 Gy, and 11 ± 3.6 Gy, respectively. On univariate analysis, Koos grade (p=0.04; OR: 3.45; 95% CI: 1.01–11.81), tumor volume (median 6.1 cm³; range, 0.8–38; p=0.01; OR: 4.85; 95% CI: 1.43–16.49), presence of pre-SRS dizziness (p=0.02; OR: 3.98; 95% CI; 1.19–13.24) and minimum vestibular dose (p=0.033; OR: 1.55; 95% CI: 1.03–2.32) showed a significant association with patient-reported dizziness. On multivariate analysis, minimum vestibular dose remained significant (p=0.02; OR: 1.75; 95% CI: 1.05–2.89). Patients with improved caloric function had received significantly lower mean (1.5 ± 0.7 Gy, p=0.01) and maximum doses (4 ± 1.5 Gy, p=0.01) to the vestibule.ConclusionsOur results reveal that 5 Gy and above minimum vestibular doses significantly worsened dizziness. Additionally, mean and maximum doses received by the vestibule were significantly lower in patients who had improved caloric function. Further investigations are needed to determine dose-volume parameters and their effects on vestibular toxicity.
Methodological Reflection on an Initiated Expert Stakeholder Engagement Process. A Case Study of a Dementia Prediction Discourse
Authors: Perry Julia
Published: December 2020

BackgroundEngagement and participation are vital for including experiences, opinions, or expertise regarding the need for action and specifying goals of relevant stakeholders. In recent years, engagement processes have significantly gained in prominence especially in the field of healthcare; and participation has been actively demanded by public health agencies as well as by health research funding organizations. Despite numerous international work and wide agreement on the benefits of stakeholder engagement, there is still limited published empirical evidence on methodological best practices for stakeholder approaches and even less on evaluation or outcomes in the process of developing policy.MethodsOn the basis of previous research on stakeholder discourses and with the German case study at hand, I inferred normative criteria for the evaluation of discourse processes. For the methodological examination, my manuscript presents a comprehensive framework of normative criteria relevant to stakeholder engagement planning, implementation, evaluation and reporting, and to illustrate different evaluation and reporting needs for research on stakeholder engagement, namely, depth of participation, legitimate selection of stakeholders, representativeness, process management, output, role definition, and transparency. ResultsThe developed normative evaluation criteria make the evaluation of an engagement process with a large amount of material possible. My analysis indicates the key facilitating elements and also barriers of this participatory approach, demonstrating the importance of especially deploying the following evaluation criteria: output, representativeness, process management, and transparency.ConclusionThe seven developed evaluation criteria have been effective for the evaluation of the stakeholder discourse on dementia prediction. These evaluation criteria may also be conducive to the evaluation of engagement processes on other health research topics with a large corpus of material. To date and to my knowledge, a comprehensive evaluation framework for engagement processes with experts in the field of assessing biomedical issues is missing in the literature and my work aims at bridging this gap.
Beneficial Effects of Dantrolene in the Treatment of Rhabdomyolysis as a Potential Late Complication Associated With COVID-19: A Case Report
Authors: Chiba Nobutaka , Matsuzaki Masakazu , Mawatari Takayuki , Mizuochi Minori , Sakurai Atsushi , Kinoshita Kosaku
Published: December 2020

Background: Patients with severe COVID-19 have disorders of the respiratory, cardiovascular, coagulation, skeletal muscle and central nervous systems. These system failures may be associated with cytokine release syndrome, characterized by hyperpyrexia, thrombocytopenia, hyperferritinemia, and the elevation of other inflammatory markers. Rhabdomyolysis with high fever is a complication that is rarely found in COVID-19. The exact relations of these clinical conditions in patients with COVID-19 are still unknown.Case presentation: We present the case of a 36-year-old man with severe COVID-19 complicated by rhabdomyolysis and high fever. After admission, his condition continued to deteriorate, with a high body temperature. After 9 days, in his laboratory examination, creatine kinase and myoglobin levels were noted to increase (to 26046 U/L, 3668 ng/mL). In addition to viral therapy, he was immediately treated with hydration. However, high fever and levels of rhabdomyolysis continued. The patient had been diagnosed with malignant hyperthermia associated with a late complication of COVID-19, although he had no hereditary predisposition to malignant hyperthermia or neuroleptic malignant syndrome. The administration of dantrolene with muscle relaxation and anti-inflammatory function showed potential efficacy for rhabdomyolysis, high fever and increased plasma inflammatory markers. Conclusions: Malignant hyperthermia is triggered by not only anesthetic agents but also viral infections. A possible mechanism of malignant hyperthermia is a hypersensitivity of calcium release from the sarcoplasmic reticulum. These include mutations in or the activation of the skeletal muscle ryanodine receptor calcium release channel. Dantrolene is a ryanodine receptor antagonist and is used as an anti-inflammatory agent. The administration of dantrolene showed potential efficacy for rhabdomyolysis, high body temperature due to inflammation, and increased inflammatory markers. The underlying mechanism of the association of rhabdomyolysis and high fever in COVID-19 might be a similar pathogenesis in malignant hyperthermia.
Establishment and Validation of a Clinically Predictive Nomogram Model for Thyroid Carcinoma Patients
Authors: Zhang Ruyi , Xu Mei , Liu Xiangxiang , Wang Miao , Jia Qiang , Wang Shen , Zheng Xiangqian , He Xianghui , Huang Chao , Fan Yaguang , Wu Heng , Xu Ke , Li Dihua , Meng Zhaowei
Published: December 2020

Objectives To develop a clinically predictive nomogram model which can maximize patients’ net benefit in terms of predicting the prognosis of patients with thyroid carcinoma based on the 8th edition of the AJCC Cancer Staging method. MethodsWe selected 134,962 thyroid carcinoma patients diagnosed between 2004 and 2015 from SEER database with details of the 8th edition of the AJCC Cancer Staging Manual and separated those patients into two datasets randomly. The first dataset, training set, was used to build the nomogram model accounting for 80% (94,474 cases) and the second dataset, validation set, was used for external validation accounting for 20% (40,488 cases). Then we evaluated its clinical availability by analyzing DCA (Decision Curve Analysis) performance and evaluated its accuracy by calculating AUC, C-index as well as calibration plot.ResultsDecision curve analysis showed the final prediction model could maximize patients’ net benefit. In training set and validation set, Harrell’s Concordance Indexes were 0.9450 and 0.9421 respectively. Both sensitivity and specificity of three predicted time points (12 Months,36 Months and 60 Months) of two datasets were all above 0.80 except sensitivity of 60-month time point of validation set was 0.7662. AUCs of three predicted timepoints were 0.9562, 0.9273 and 0.9009 respectively for training set. Similarly, those numbers were 0.9645, 0.9329, and 0.8894 respectively for validation set. Calibration plot also showed that the nomogram model had a good calibration.ConclusionThe final nomogram model provided with both excellent accuracy and clinical availability and should be able to predict patients’ survival probability visually and accurately.
Efficacy and Tolerability of High and Low-volume Bowel Preparation Compared: a Real-life Single-blinded Large-population Study
Authors: Occhipinti Vincenzo , Soriani Paola , Bagolini Francesco , Milani Valentina , Rondonotti Emanuele , Annunziata Maria Laura , Cavallaro Flaminia , Vavassori Sara , Vecchi Maurizio , Pastorelli Luca , Tontini Gian Eugenio
Published: December 2020

Background: Low-volume (LV) preparations for colonoscopy have shown similar efficacy compared to high-volume (HV) ones in trials. However, real-life clinical outcomes data are lacking. Our aim was to assess patients’ free choice among HV preparations (4L polyethylene glycol, PEG) and LV (2L PEG plus bisacodyl) and to compare efficacy and tolerability. Methods: Consecutive outpatients referred for colonoscopy could choose either LV or HV preparation with schedules (day-before or split-dose) depending on their appointment time. Adequate bowel preparation according to Boston Bowel Preparation Scale, clinical outcomes and self-reported tolerability of HV and LV were blindly assessed.Results: 2,040 patients were enrolled and 1,815 (age 60.6 years, 50.2% men) finally included. LV was chosen by 52% of patients (50.8% of men, 54.9% of women). Split-dose schedule was more common with HV (44.7% vs. 38.2%, p=0.0055). HV and LV preparations showed similar adequate bowel preparation rates (89.2% vs. 86.6%, p=0.0983) but HV ones resulted higher in detection rates for polyps (PDR; OR 1.30, 95% CI 1.03–1.64, p=0.0254), adenomas (ADR; OR 1.28, 95% CI 0.99–1.65, p=0.0519) and advanced adenomas (AADR; OR 1.54, 95% CI 0.96–2.46, p= 0.0723) after adjustment for sex, age, indications. Visual Analogue Scale tolerability scored equally (7 [5-9]) but a ≥75% dose intake was more frequent with LV.Conclusions: in a real-life setting, LV preparation confirms similar efficacy and tolerability compared to HV. However, with higher PDR and a trend toward higher ADR and AADR, HV should still be considered the reference standard for clinical trials.
Impact of travelling to high incidence countries on tuberculosis diagnostic delays among migrants: a retrospective study.
Authors: KASSEGNE Loïc , FRAISSE Philippe
Published: December 2020

Background

Most tuberculosis (TB) cases in high-income countries occur in foreign-born people, most of them coming from high incidence countries. However, migrants return more or less frequently to their birth countries. The aim of the study was to estimate the influence of travelling to high incidence countries on the diagnosis delay of tuberculosis in France.
Methods

a monocentric retrospective study of 224 consecutive cases followed at the Bas-Rhin Tuberculosis Prevention Centre.
Results

59.3% of cases were born abroad. Migrants who did not develop TB soon after arrival and, who travelled since then to high incidence countries, had a mean diagnosis delay, since their last trip, comparable to median diagnostic delay among immigrants who did not travel since their arrival (3.2 vs 4.4 years, p = 0.42). Diagnostic delays are shorter among those reporting an exposition to TB during their journey (1.5 years vs 3.7 years, p = 0.2).
Conclusion

These results suggest a targeted information on the risk of TB and LTBI among those persons and screening for tuberculosis and LTBI, in certain cases, including vulnerable patients (dialysis, under immunosuppressant drugs including anti-TNF, HIV).
The Association Between NCQA-PCMH Evaluation and Patients’ Experiences with Community Health Centres: Results from the Greater Bay Area Study, China
Authors: Liu RuQing , Meng YiFan , He Ning , Wu JingLan , Yan XinWen , Shi Leiyu , Hu RuWei
Published: December 2020

Background

To explore the association between the service quality of community health centres (CHCs) as the supplier evaluation and patients’ experiences of health services as the demand-side evaluation.
Methods

This study was conducted at six CHCs in the Greater Bay area of China. During August–October 2019, 1568 patients were recruited (55.8% women and 44.2% men). We evaluated the service quality of CHCs using the National Committee for Quality Assurance Patient-Centered Medical Home (NCQA-PCMH) recognition questionnaire. We assessed patients’ experiences with medical and health services using the Primary Care Assessment Tools (PCAT).
Results

The global PCAT score was higher at the CHCs with higher NCQA-PCMH levels, showing positive dose-effect trends. This was similar for the PCAT sub-dimensions. For example, the scores of each PCAT sub-dimension of NCQA-PCMH Level 3 were significantly higher than those of Levels 2 and 1. Except for D and F dimensions, the scores of other sub-dimensions of Level 2 were significantly higher than those of Level 1.
Conclusions

Our results indicated that better institutional service quality evaluation determined by the NCQA-PCMH led to better patients’ experiences as determined by the PCAT. Our findings added new evidence in support of better institutional primary healthcare service quality leading to better experiences among patients, and would help further improve the patient-centred primary healthcare service policy and management.
Interspecific competition in germination of bird-dispersed seeds in a habitat with sparse tree vegetation in South Africa
Authors: Mokotjomela Thabiso Michael , Vukeya Loyd , Malebo Ntsoaki , Oke Saheed
Published: December 2020

Avian frugivores provide directed seed dispersal services that contribute in shaping the native plant communities and facilitate population persistence. By transporting and scarifying the seeds during ingestion, avian frugivores reduce the competition with siblings, and may improve the germination which is critical for dispersal effectiveness. However, generally, there is limited knowledge on how deposited seeds interact/compete in the new microsite. Therefore, we investigated 1) whether bird-dispersed seeds benefit from improved germination after their passage through the bird’s gut; and 2) the potential impact of seed density on competition at the microsites by determining whether seed density and species diversity influence germination in the Free State Province, South Africa. Overall, the results partly supported the hypothesis. Germination trials with defecated seeds of five plant species compared with the manually depulped seeds showed that despite prolific seed germination observed in Ziziphus mucronata, only Searsia lancea seeds had significantly high seed germination after passage through the bird gut. Overall, there was a significant correlation between seed size and the germination of bird-ingested seeds except in Olea subsp. africana possibly due to possession of extremely hard protective seed cover. Seeds competition experiments pointed to Z. mucronata and O. subsp. africana having significant germination performance that was positively correlated to seed density and seed size while E. rigida did not germinate at all. Seed species diversity in the germination trays did not have significant impact since only two former plant species consistently displayed significantly higher germination across the competition levels. We conclude that not all bird-defecated seeds have their germination improved, and that further long-term tests for germination physiological responses of the seeds’ samples used in this study are required since poor germination observed in other tree/shrub species cannot be attributed to competition solely.
High prevalence of fragmented QRS on electrocardiography in Japanese subjects with diabetes irrespective of metabolic syndrome
Authors: Yagi Kunimasa , Nagata Yoshiki , Yamagami Takashi , Kamigishi Miki , Yokoyama Maki Nakagawa , Shikata Masataka , Enkaku Asako , Nishida Akiko Takikawa , Honoki Hisae , Fujisaka Shiho , Chujo Daisuke , Origasa Hideki , Tobe Kazuyuki
Published: December 2020

BackgroundFragmented QRS (fQRS) on electrocardiography is a marker of myocardial fibrosis and myocardial scar formation. fQRS has been reported as a reliable predictor of adverse cardiac events in several populations. We investigated the relationship of fQRS with diabetes mellitus (DM) and metabolic syndrome (MetS) in Japanese patients.Material and methodsOur study enrolled a total of 702 subjects (435 without DM and 267 with type 2 DM) who had a routine health checkup at the Hokuriku Health Service Association (Toyama, Japan) in October 2014. Based on MetS and DM status, participants were categorized into one of the following four groups: DM+ MetS + (157 subjects); DM+ MetS - (110 subjects); DM- MetS + (82 subjects); and DM- MetS- (353 subjects). fQRS was assessed using the results of electrocardiography.ResultsThe prevalence of fQRS was statistically higher in patients with DM+MetS+ (36%) and DM+MetS- (36%), than those with DM-MetS+ (18%) or DM-MetS- (9%) (p < 0.001). Significant differences were observed between the fQRS(+) and fQRS(-) groups for age, gender, waist circumference (WC), heart rate, hypertension, HbA1c, TC, MetS, and DM. The area under the receiver-operating curve for traditional risk factors and DM was 0.72 (p=0.0021, 95% confidence interval [CI]: 0.68-0.77), and for traditional risk factors and MetS it was 0.69 (p=0.1478, 95% CI: 0.64-0.73). Patients with DM had more than three-fold higher likelihood of showing fQRS (odds ratio, 3.41; 95% CI, 2.25-5.22; p<0.0001) compared to the reference group without DM, after adjusting for age, gender, dyslipidemia, hypertension, and WC.ConclusionfQRS was observed more frequently in DM than in MetS and control subjects. DM was the most significant determinant for fQRS among MetS and other traditional metabolic risk factors in the general Japanese population.
The Effect and Mechanism of Trimethylamine-N-oxide, a Metabolite of Intestinal Flora, on Coronary Heart Disease in Type 2 Diabetic Patients
Authors: li jie , Ha Xiaoqin , Cai Xiaoling , Yan Chenyuan , Jia Caixia , He Si
Published: December 2020

BackgroundTrimethylamine N-Oxide (TMAO) has been shown to be an independent risk factor for cardiovascular disease. Our aim is to study the effects of TMAO on type 2 diabetes mellitus-coronary heart disease and to explore its mechanism.MethodsA total of 50 healthy controls , 50 T2DM patients and 50 T2DM combined with CHD patients were enrolled. Serum samples were collected to detect glucose, myocardial enzyme spectrum and TMAO level. The 16S rRNA gene sequencing analyzed the diversity of intestinal flora. Taking the ZDF rat as the experimental object, the model of T2DM combined with CHD was established in rats. Blood samples were taken to detect glucose, myocardial enzyme spectrum and TMAO level. The inflammatory protein and mRNA expression of TLR4, NLRP3, Caspase-1 and IL-1β were detected by Western blot and RT-qPCR. In vitro culture of H9c2(2-1) for experiments. The CCK-8 method was used to detect the survival rate of cells after glucose and TMAO treatment. After the cells were treated with selected glucose and TMAO, the cells were treated with selected glucose, TMAO and BAY11-7082, Western blot detected the presence of pyroptosis and the pathway of TLR4/NF-κB/NLRP3. RT-qPCR was used to determine the mRNA level of inflammatory factor.DiscussionChanges in the composition of intestinal flora in patients with type 2 diabetes can lead to elevated serum TMAO levels. Animal and cell experiments have confirmed that elevated TMAO level may lead to inflammatory myocardial injury in rats and is related to the mechanism of TLR4/NF-κB/NLRP3.
High-performance electrical properties of La-based perovskite ceramics for the functional phase of thick film resistors
Authors: Lu Yongcheng , Li Yuanxun , Chen Daming , Peng Rui , Yang Qinghui , Zhang Shijun
Published: December 2020

In order to explore an economical functional phase alternative material for thick film resistors, the crystal structure, microstructure, and electrical properties of (1-x)LSCN + xLCNZ (x = 0.0–1.0) composite ceramics were studied through solid-state reaction experiments. The composite ceramics were characterized by x–ray diffraction, scanning electron microscopy, energy dispersive x–ray spectroscopy, and DC four–probe method. Results suggested that the main phases of LSCN and LCNZ were formed, along with a small part of impurity phases. The addition of LCNZ to LSCN decreased the electrical conductivity and changed the TCR from positive to negative. Zero TCR could be achieved around 0.6 < x < 0.8 and relatively low absolute TCR values could be obtained for the samples of 0.4 ≤ x ≤ 0.8. The ceramic of 0.6LSCN + 0.4LCNZ showed the optimal performances of conductivity = 1923 S/cm, TCR = 379.54 ppm/℃, and relative density = 95.05%.
High-temperature oxidation behavior of SiBN fibers in air
Authors: Long Xin , Wu Zhenyu , Shao Changwei , Wang Xiaozhou , Wang Yingde
Published: December 2020

SiBN fibers are one of the most admirable microwave-transparent reinforced materials for high Mach number aircrafts. Currently, the detailed high-temperature oxidation behavior of SiBN fibers have not been studied yet. In this work, we researched the high-temperature oxidation behavior of SiBN fibers with different boron contents at the temperature range of 1000 ~ 1400℃ in air. SiBN fibers started to be oxidized at 1100℃, with Si3N4 and BN phase oxidized to SiO2 and B2O3, respectively. Due to the gasification and the escape of molten B2O3 at high temperature, amorphous SiO2 could be remained at the fiber surface. As the fiber further oxidized, the molten B2O3 at the inside may infiltrate into the fiber interior to react with Si3N4, causing the precipitation of h-BN nanoparticles and the formation of SiO2/BN layer. Finally, complex oxidation layers with two distinct concentric sublayers accompanied with two transition sublayers could be formed after the oxidizing treatment.
Blue Widefield Images of Scanning Laser Ophthalmoscope Can Detect Retinal Ischemic Areas in Eyes With Diabetic Retinopathy
Authors: Horie Shintaro , Kukimoto Nobuyuki , Kamoi Koju , Igarashi-Yokoi Tae , Yoshida Takeshi , Ohno-Matsui Kyoko
Published: December 2020

Diabetic retinopathy (DR) is one of the leading causes of blindness worldwide. The retinal ischemic changes in DR need to be detected and treated appropriately to prevent further progression. At present, fluorescein angiography (FA) is the most commonly used method to detect the ischemic areas.　We present our results that showed a practical method of detecting retinal ischemic area covering mid-peripheral retina by multicolor widefield scanning laser ophthalmoscopy (SLO) without fluorescein. Ninety patients with and 50 patients without diabetes mellitus were studied retrospectively. All had undergone multicolor widefield SLO imaging. Hyporeflective areas in blue image of SLO were found in the incidence of 76.6% in eyes with proliferative DR eyes.　In a comparison of the hyporeflective areas of the blue SLO images to the non-perfused areas in the FA images, the appearance and the correspondence in the locations of these findings in the two types of images were found, and the incidence were highly concordant with Cohen kappa value of 0.785. The high concordance between the hyporeflective areas in the wide-field blue SLO images and the NPAs in the FA images indicates that this method can be clinically useful to identify ischemic retinal areas in DR.
Psychosocial Influences on Pregnancy and Childbirth Behaviors in Northwestern Nigeria: A Cross-Sectional Analysis
Authors: Johansson Emily White , Anaba Udochisom , Abegunde Dele , Okoh Mathew , Abdu-Aguye Shittu , Hewett Paul C , Hutchinson Paul L
Published: December 2020

BackgroundAntenatal care (ANC) and facility delivery are essential maternal health services, but uptake remains low in northwestern Nigeria. To increase service use, social and behavior change (SBC) programs target psychosocial influences across cognitive, emotional and social domains including knowledge, beliefs, self-efficacy, and social norms. Yet there remains limited research that measures and quantitatively examines the role of psychosocial influences on pregnancy and childbirth behaviors in Nigeria or elsewhere. MethodsA cross-sectional population-based survey of randomly sampled women with a child under two years was conducted in Kebbi, Sokoto and Zamfara states of northwestern Nigeria in September 2019. Women were asked about maternal health behaviors during their last pregnancy. New psychosocial metrics were developed using the Ideation Model of Strategic Communication and Behavior Change. Predicted probabilities for visiting ANC four or more times (ANC4+) and giving birth in a facility were derived using mixed-effects logistic regression models adjusted for ideational and sociodemographic variables.ResultsAmong 3,039 women, 23.6% (95% CI: 18.0%-30.3%) attended ANC4+ times and 15.5% (95% CI: 11.8%-20.1%) gave birth in a facility. Among women who did not attend ANC4+ times or have a facility-based delivery during their last pregnancies, the most commonly cited reasons were lack of perceived need (42% and 67%, respectively) and spousal opposition (25% and 27%, respectively). Women who knew any ANC benefit or the recommended number of ANC visits were 3.2- and 2.1-times more likely to attend ANC4+ times. Women who held positive views about health facilities for childbirth had 1.2- and 2.6-times higher likelihood of attending ANC4+ times and facility delivery, while women who believed ANC was only for sickness or pregnancy complications had 17% lower likelihood of attending ANC4+ times. Self-efficacy and supportive spousal influence were also significantly associated with both outcomes.ConclusionsTo improve pregnancy and childbirth practices in northwestern Nigeria, programs should address a range of psychosocial factors – across cognitive, emotional and social domains – that were significantly associated with pregnancy and childbirth behaviors: raising knowledge and dispelling myths, building women’s confidence to access services, engaging spousal support in decision-making, and improving perceived (and actual) maternal health services quality.
Can Lockdown Reduce Infection Growth in Developing Countries? Evidence from COVID-19 Cases
Authors: Shimul Shafiun Nahin
Published: December 2020

Background: When crippled with COVID-19 infection, a substantial number of countries have adopted ‘lockdown’ or similar measures to suppress the spread. This instrument is often considered as the only viable option for curbing infection spread both in developed and developing countries; however, some experts have a cynical view on its effectiveness. Exploiting cross-country lockdown information, effectiveness of lockdown on slowing the pace of COVID-19 can be elicited. Methods: The study intends to understand whether lockdown or similar measures can suppress infection growth in developing countries. In this pursuit, the study uses panel regression-based difference in difference and GMM estimation method. Results: This study finds that lockdown type measures are not as effective in developing countries as in developed nations. Nevertheless, staying at home order, income support programs, and other social distancing measures are found to be effective for both developed and developing countries. Also, the timing of the lockdown is found to be vital. One the one hand, enforcing a nationwide lockdown too early, i.e., when cases are very low, may not yield expected outcome; on the other hand, enforcing lockdown too late is also ineffective. Conclusion:Even though this study does not find strong evidence of the effectiveness of lockdown in curbing infection growth in developing countries, these findings do not necessarily suggest that lockdown should not be enforced in developing countries. Rather it indicates that lockdown should be combined with other complementary measures such as contact tracing, extensive testing, income support for the poor, effective management of informal and migrant workers to make the lockdown effective. Merely declaring lockdown, without accompanying other must-have measures, will hurt the economy without contributing much to reducing the growth of infection.JEL Codes: H2, H3, I1, I3
Drought tolerance molecular responses of two cultivated varieties Jerusalem artichoke (Helianthus tuberosus L.) as revealed by RNA-Seq
Authors: Yang Shipeng , Wang Lihui , Zhong Qiwen , Zhang Guangnan , Zhang Haiwang , Zhang Dengshan , Sun Xuemei
Published: December 2020

Background

Jerusalem artichoke (Helianthus tuberosus L.) is a highly stress-resistant crop, especially it grows normally in the desertified land of Qinghai-Tibet Plateau in the past two years, and has become a crop with agricultural, industrial and ecological functions. However, there are few studies on drought resistance of Jerusalem artichoke at present, and studies on the mechanisms of stress resistance of Jerusalem artichoke breeding and fructan are seriously lagging behind. In this study, we selected two differentially resistant cultivars for drought stress experiments with different concentration gradients, the aim was finding DEGs and metabolic pathways associated with drought stress.
Results

Based on an additional analysis of the metabolic pathways under drought stress using MapMan, the most different types of metabolism included secondary metabolism, light reaction metabolism and cell wall. As a whole, QY1 and QY3 both had a large number of up-regulated genes in the flavor pathway. It was suggested that flavonoids could help Jerusalem artichoke to resist drought stress and maintain normal metabolic activities. In addition, the gene analysis of the abscisic acid (ABA) key metabolic pathway showed that QY3 had more genes in NAC and WRKY than QY1, but QY1 had more genes in response to drought stress as a whole. By combining RNA-Seq and WGCNA, a weighted gene co-expression network was constructed and divided into modules. By analyzing specifically the expressed modules, four modules were found to have the highest correlation with drought. Further research on the genes revealed that all 16 genes related to histone, ABA and protein kinase had the highest significance in these pathways.
Conclusions

These findings represent the first RNA-Seq analysis of drought stress in Jerusalem artichoke, which is of substantial significance to explore the function of drought resistance in Jerusalem artichoke and the excavation of related genes.
Acceleration of emergence of E. coli antibiotic resistance in a simulated sublethal concentration of copper and tetracycline co-contaminated environment
Authors: Li Jinmei , Phulpoto Irfan Ali , Zhang Guilong , Yu Zhisheng
Published: December 2020

A co-contaminated environment with metals and antibiotics ultimately provides exposing of bacteria to metals and antibiotics at the same time and prevails co-contamination in the environment. This study objective, to explore the efficacy of sublethal concentrations of copper ions contaminated with tetracycline to antibiotic resistance in sensitive strain E. coli K12. We proved that copper ions and tetracycline co-contaminated environments could considerably enhance the mutation frequencies of chloramphenicol and polymyxin B resistance in antibiotic susceptible E. coli; however, the corresponding copper ions and tetracycline alone showed weaker effects. Results also demonstrated that the relatively high sublethal concentrations of copper ion and tetracycline co-contaminated environment could induce much higher antibiotic resistance compared to the low sublethal and the control groups. Whole-genome characterization results indicated the variability of genotype and phenotype involved in antibiotic resistance. In addition, the evolved resistant strains displayed hereditary resistance after 5 round culture cycles in LB broth over 5 days. Results implied that co-contamination with metals and antibiotics environment could fortify the resistance, and might further contribute to the induction and dissemination of antibiotic resistance in metal and antibiotic co-contaminated environment.
Bacteria-derived ferrichrome inhibits tumor progression in sporadic colorectal neoplasms and colitis-associated cancer
Authors: IWAMA TAKUYA , Fujiya Mikihiro , Konishi Hiroaki , Tanaka Hiroki , Murakami Yuki , Kunogi Takehito , Sasaki Takahiro , Takahashi Keitaro , Ando Katsuyoshi , Ueno Nobuhiro , Kashima Shin , Moriichi Kentaro , Tanabe Hiroki , Okumura Toshikatsu
Published: December 2020

BACKGROUND: Colorectal cancers develop through several pathways, including the adenoma–carcinoma sequence and colitis-associated carcinogenesis. An altered intestinal microflora has been reported to be associated with the development and progression of colorectal cancer via these pathways. We identified Lactobacillus casei-derived ferrichrome as a mediator of the bacterial anti-tumor effect of colorectal cancer cells through the upregulation of DDIT3. In this study, we investigated the anti-tumor effects of ferrichrome on precancerous conditions and cancer cells associated with sporadic as well as colitis-associated colorectal cancer.METHODS: SRB and MTT assays were performed to assess growth inhibition in vitro. Eighteen organoids were prepared from biopsy specimens obtained by colonoscopy. An AOM-DSS carcinogenesis model and xenograft model of colorectal cancer cells were generated for the assessment of the tumor suppressive effect of ferrichrome in vivo. RESULTS: Ferrichrome inhibited the cell growth of colorectal cancer cells in vitro and in in vivo xenograft models. Ferrichrome exerted a strong tumor-suppressive effect that was superior to that of currently available anti-tumor agents, including 5-FU and cisplatin, both in vitro and in vivo. The tumor-suppressive effect of the combination of ferrichrome and 5-FU was superior to that of single treatment with either drug. The tumor suppressive effects of ferrichrome were confirmed through the upregulation of DDIT3 in patient-derived organoids of adenoma and carcinoma. Ferrichrome inhibited the tumor progression in the AOM-DSS model while exhibiting no anti-inflammatory effect in the DSS-colitis model, suggesting that ferrichrome inhibited cancer cells, but not a precancerous condition, via the colitis-associated pathway.CONCLUSIONS: Ferrichrome exerts a tumor suppressive effect on precancerous conditions and cancer cells associated with sporadic as well as colitis-associated colorectal cancer. The anti-tumor effect of ferrichrome was mediated by the upregulation of DDIT3, and was superior to that of 5-FU or cisplatin. These results suggest that Lactobacillus brevis-derived ferrichrome may be a candidate anti-tumor drug for the treatment of colorectal neoplasms.
Developing an inter-professional transition course to improve team-based HIV care for Sub-Saharan Africa
Authors: Kiguli-Malwadde Elsie , Budak Jehan Z , Chilemba Evelyn , Semitala Fred , Von Zinkernagel Deborah , Mosepele Mosepele , Conradie Hoffie , Khanyola J , Haruruvizhe Clara , Martin Shayanne , Kazembe Abigail , De Villiers M , Reid Michael J A
Published: December 2020

Background With funding from the United States Health Resources Service Administration (HRSA), a consortium of health professional training institutions from Africa developed HIV-specific, interprofessional, team-based educational resources to better support trainees during the transition period between pre-service training and professional practice.Methods Ten faculty members representing nine medical and nursing schools in sub-Saharan Africa (SSA) developed a training package of modules focused on core clinical, public health, interprofessional education (IPE), and quality improvement (QI) domains related to HIV service delivery. Curriculum development was informed by a rapid needs assessment of existing tools and future needs for HIV education across 27 SSA health professions training institutions. A total of 17 modules were developed, targeted at newly qualified health care professionals to be taught in a series of two-day workshops meant to complement existing institution specific HIV-curricula. Results Between April and July 2019, a comprehensive case-based HIV training package was developed to support trainees in transition from pre-service training to independent professional practice. Each module, addressing different elements of interprofessional practice, was intended to be delivered in an interprofessional format. Thus far, 70 health professions training institutions in 14 countries have implemented the program; 547 educators facilitated STRIPE workshops, with a total of 5,027 learners trained between September 2019 and September 2020.Conclusions To our knowledge this is the first IPE HIV-specific curriculum explicitly focused on enhancing the quality of training provided to graduating health care professionals working in SSA. The collaborative, cross-institutional, interprofessional approach to curriculum development provides a benchmark for how best-practice approaches to education can be disseminated in SSA.
The yearly financing need of providing paid maternity leave in the informal sector in Indonesia
Authors: Siregar Adiatma , Pitriyan Pipit , Hardiawan Donny , Zambrano Paul , Vilar-Compte Mireya , Belismelis Graciela Ma Teruel , Moncada Meztli , Tamayo David , Carroll Grace , Perez-Escamilla Rafael , Mathisen Roger
Published: December 2020

Background The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15-49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia.Method The costing methodology used is the adapted version of the World Bank methodology by Vilar-Compte et al, following pre-set steps to estimate costs using national secondary data. We used the 2018 Indonesian National Socio-Economic Survey to estimate the number of women working informally who gave birth within the last year. The population covered, potential cash transfer’s unitary cost, the incremental coverage of the policy in terms of time and coverage, and the administrative costs were used to estimate the cost of MCT for the informal sector. Result At 100% coverage for 13 weeks of leave, the yearly financing need of MCT ranged from US$175million (US$152/woman) to US$669million (US$583/woman). The share of the yearly financing need did not exceed 0.5% of Indonesian Gross Domestic Product (GDP).Conclusion The yearly financing need of providing MCT for eligible WRA working in the informal sector is economically attractive as it amounts to less than 0.5% of GDP nominal of Indonesia. While such a program would be perceived as a marked increase from current public health spending at the onset, such an investment could substantially contribute to the success of breastfeeding and substantial corresponding public health savings given that more than half of working Indonesian WRA are employed in the informal sector. Such policies should be further explored while taking into consideration realistic budget constraints and implementation capacity.