bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis
Authors: Shao Peng , Guo Shujuan , Li Guimei , Qin Daogang , Li Sen , Ying Luan
Published: August 2020

Background: Euthyroid sick syndrome (ESS) frequently arises in children admitted with diabetic ketoacidosis/diabetic ketosis (DKA/DK). This study evaluates the interplay of various metabolic factors with occurrence of deranged thyroid function tests in children suffering from DKA/DK.Methods: 98 DKA and 96 DK pediatric patients were selected from hospital records. Those on thyroxine replacement, with overt hypothyroidism, or with positive anti-thyroperoxidase (TPO) antibody were excluded. Tests for liver function, renal function, lipid profile, serum osmolarity, thyroid function, c-peptide levels, and glycosylated hemoglobin were done on all patients. Children were divided into euthyroid (n=88) and ESS groups (n=106).Results: The ESS group had a higher level of white blood cell count (WBC), plasma glucose (PG), beta-hydroxybutyric acid (β-HB), triglyceride (TG), anion gap (AG), glycosylated hemoglobin (HbA1c) and a lower level of HCO3-, prealbumin (PA), and albumin (ALB) compared with the euthyroid group (P<0.05). Free T3 (FT3) levels were significantly correlated to β-HB, HCO3-, AG, PA, and HbA1c (r=-0.642, 0.681, -0.377, 0.581, -0.309, respectively; P<0.01). Free T4 (FT4) levels were significantly correlated to β-HB, HCO3-, and ALB levels (r=-0.489, 0.338, 0.529, respectively; P<0.01). TSH levels were significantly affected by HCO3– only (r=-0.28; P<0.01). HCO3– level was the most important factor deciding euthyroid or ESS on logistic regression analysis (OR=0.844, P=0.004, 95%CI=0.751-0.948).Conclusions: Lower levels of free thyroid hormones and occurrence of ESS were associated with a higher degree of acidosis in children with DKA/DK.
The aceE involves in mycolic acid synthesis and biofilm formation in Mycobacterium smegmatis
Authors: Chen Suting , Teng Tianlu , Wen Shuan , Zhang Tingting , Huang Hairong
Published: August 2020

Background: The integrity of cell wall structure is highly significant for the in vivo survival of mycobacteria. We hypothesized that changes in morphology may indicate changes in cell wall metabolism and identified an aceE gene mutant ( aceE -mut) which presented a deficient colony morphology on 7H10 agar by screening transposon mutagenesis in Mycolicibacterium smegmatis , basonym Mycobacterium smegmatis ( M. smegmatis ). This study aimed to identify the functional role of aceE gene in cell wall biosynthesis in M. smegmatis.

Results: We observed that the colony morphology of aceE -mut was quite different, smaller and smoother on the solid culture medium than the wild-type (WT) strain during the transposon library screening of M. smegmatis . Notably, in contrast with the WT, which aggregates and forms biofilm, the aceE -mut lost its ability of growing aggregately and biofilm formation, which are two very important features of mycobacteria. The morphological changes in the aceE -mut strain were further confirmed by electron microscopy which indicated smoother and thinner cell envelope images in contrast with the rough morphology of WT strains. Additionally, the aceE -mut was more fragile to acidic stress and exhibited a pronounced defects in entering the macrophages as compared to the WT. The analysis of mycolic acid (MA) using LC-MS indicated deficiency of alpha-MA and epoxy-MA in aceE -mut strain whereas complementation of the aceE -mut with a wild-type aceE gene restored the composition of MA.

Conclusions: Over all, this study indicates that aceE gene plays a significant role in the mycolic acid synthesis and affects the colony morphology, biofilm formation of M. smegmatis and bacteria invasion of macrophage.
Flexible Fibreoptic Intubation in Swine – Improvement for Resident Training and Animal Safety Alike
Authors: Ruemmler Robert , Ziebart Alexander , Ott Thomas , Dirvonskis Dagmar , Hartmann Erik Kristoffer
Published: August 2020

Background: Efficient airway management to facilitate tracheal intubation encompasses essential skills in anaesthesiologic and intensive care. The application of flexible fibreoptic intubation in patients with difficult airways has been identified as the recommended method in various international guidelines. However, providing the opportunity to adequately train residents can be challenging. Using large animals for practice during ongoing studies could help to improve this situation, but there is no recent data on fibreoptic intubation in swine available. Methods: 30 male German landrace pigs were anesthetized, instrumented and randomized into two groups. The animals were either intubated conventionally using direct laryngoscopy or a single-use flexible video-endoscope. The intervention was carried out by providers with 3 months experience in conventional intubation of pigs and a brief introduction into endoscopy. Intubation attempts were supervised and aborted, when SpO2 dropped below 93%. After three failed attempts, an experienced supervisor intervened and performed the intubation. Intubation times and attempts were recorded and analysed.Results: Flexible fibreoptic intubation showed a significantly higher success rate in first attempt endotracheal tube placement (75% vs. 47%) with less attempts overall (1.3±0.6 vs. 2.1±1.3, P=0.043). Conventional intubation was faster (42s±6s vs. 67s±10s, P<0.001), but showed a higher complication rate and more desaturation episodes during the trial.Conclusions: Flexible fibreoptic intubation in swine is feasible and appears to be a safer and more accessible method for inexperienced users to learn. This could not only improve resident training options in hospitals with animal research facilities but might also prevent airway complications and needless animal suffering.
Person-centred care in practice: Perspectives from a short-course regimen for multi-drug resistant tuberculosis in Karakalpakstan, Uzbekistan
Authors: Horter Shona , Stringer Beverley , Gray Nell , Parpieva Nargiza , Safaev Khasan , Tigay Zinaida , Singh Jatinder , Achar Jay
Published: August 2020

Introduction: Person-centred care, an internationally recognised priority, describes the involvement of people in their care and treatment decisions, and the consideration of their needs and priorities within service delivery. Clarity is required regarding how it may be implemented in practice within different contexts. The standard multi-drug resistant tuberculosis (MDR-TB) treatment regimen is lengthy, toxic and insufficiently effective. 2019 World Health Organisation guidelines include a shorter (9-11-month) regimen and recommend that people with MDR-TB be involved in the choice of treatment option. We examine the perspectives and experiences of people with MDR-TB and health-care workers (HCW) regarding person-centred care in an MDR-TB programme in Karakalpakstan, Uzbekistan, run by Médecins Sans Frontières and the Ministry of Health.Methods: A qualitative study comprising 48 interviews with 24 people with MDR-TB and 20 HCW was conducted in June-July 2019. Participants were recruited purposively to include a range of treatment-taking experiences and professional positions. Interview data were analysed thematically using coding to identify emerging patterns, concepts, and categories relating to person-centred care, with Nvivo12.Results: People with MDR-TB were unfamiliar with shared decision-making and felt uncomfortable taking responsibility for their treatment choice. HCW were viewed as having greater knowledge and expertise, and patients trusted HCW to act in their best interests, deferring the choice of appropriate treatment course to them. HCW had concerns about involving people in treatment choices, preferring that doctors made decisions. People with MDR-TB wanted to be involved in discussions about their treatment, and have their preference sought, and were comfortable choosing whether treatment was ambulatory or hospital-based. Participants felt it important that people with MDR-TB had knowledge and understanding about their treatment and disease, to foster their sense of preparedness and ownership for treatment, and it appeared important to have evidence of treatment need and effect.Conclusions: There is a preference for doctors choosing the treatment regimen, linked to shared decision-making unfamiliarity and practitioner-patient knowledge imbalance. Involving people in their care, through discussions, information, and preference-seeking could foster ownership and self-responsibility, supporting sustained engagement with treatment.
Gender, reproductive output covariation and their role on gene diversity of Pinus koraiensis seed orchard crops
Authors: Kang Kyu-Suk , Park Ji-Min , Kang Hye-In , Yeom Da-Bin , El-Kassaby Yousry A. , Lee Kyung-Mi
Published: August 2020

Background: Gender and fertility variation have an impact on mating dynamics in a population because they affect the gene exchange among parental members and the genetic composition of the resultant seed crops. Fertility is the proportional gametic contribution of parents to their progeny. An effective number of parents, derivative of effective population size, is the probability that two alleles randomly chosen from the gamete gene pool originated from the same parent. The effective number of parents is directly related to the fertility variation among parents, which should be monitored for manipulating gene diversity of seed crops. We formulated a fundamental equation of estimating the effective number of parents and applied it to a seed production population.Results: Effective number of parents (Np) was derived from fertility variation (Ψ) considering covariance (correlation coefficient, r) between maternal and paternal fertility. The Ψ was calculated from the coefficient of variation in reproductive outputs and divided into female (ψf ) and male (ψm) fertility variation in the population under study. The Np was estimated from the parental Ψ estimated by the fertility variation of maternal (ψf ) and paternal (ψm) parents. The gene diversity of seed crops was monitored by Ψ and Np in a 1.5 generation Pinus koraiensis seed orchard as a case of monoecious species. A large variation of female and male strobili production was observed among the studied 52 parents for four consecutive years, showing statistically significant across all studied years. Parental balance curve showed greater distortion in paternal than maternal parents. The Ψ ranged from 1.879 to 4.035 with greater ψm than ψf , and the Np varied from 14.8 to 36.8. When pooled, the relative effective number of parents was improved as 80.0% of the census number.Conclusions: We recommend the use of fertility variation (CV, Ψ), Person’s product-moment correlation (r) and effective number of parents (Np) as tools for gauging gene diversity of seed crops in production populations. For increasing Np and gene diversity, additional management options such as mixing seed-lots, equal cone harvest and application of supplemental-mass-pollination are recommended.
Diesel Exhaust Particle Exposure Reduces Expression of the Epithelial Tight Junction Protein Tricellulin
Authors: Smyth Timothy , Veazey Janelle , Eliseeva Sophia , Chalupa David , Elder Alison , Georas Steve
Published: August 2020

Background: While exposure to diesel exhaust particles has been linked to aberrant immune responses in allergic diseases such as asthma, little attention has been paid to their effects on the airway epithelium. In this study, we sought to determine the effect of diesel exhaust exposure on airway epithelial barrier function and composition using in vitro and in vivo model systems.

Methods: 16HBE14o- human bronchial epithelial cells were grown on collagen coated Transwell inserts and exposed to 5 to 50 µg/cm2 SRM 2975 diesel particulate matter (DEP) suspended in cell culture medium or vehicle controls. Changes in barrier function were assessed by measuring transepithelial electrical resistance (TEER) and permeability to 4 kDa FITC Dextran. Neonatal BALB/c mice were exposed to aerosolized DEP (255 ± 89 µg/m3; 2 hours per day for 5 days) and changes in the tight junction protein Tricellulin were assessed two weeks post exposure.

Results: A six-hour incubation of epithelial cells with diesel exhaust particles caused a significant concentration-dependent reduction in epithelial barrier integrity as measured by decreased TEER and increased permeability to 4 kDa FITC-Dextran. This reduction in epithelial barrier integrity corresponded to a significant reduction in expression of the tight junction protein Tricellulin. siRNA mediated knockdown of Tricellulin recapitulated changes in barrier function caused by DEP exposure. Neonatal exposure to aerosolized DEP caused a significant reduction in lung Tricellulin two weeks post exposure at both the protein and mRNA level.

Conclusion: Short term exposure to DEP causes a significant reduction in epithelial barrier integrity through a reduction in the tight junction protein Tricellulin. Neonatal exposure to aerosolized DEP caused a significant and sustained reduction in Tricellulin protein and mRNA in the lung, suggesting that early life exposure to inhaled DEP may cause lasting changes in airway epithelial barrier function.
Can technology optimise the pre-operative pathway for elective hip and knee replacement surgery: A qualitative study.
Authors: Sharif Faraz Salman , Rahman Ammar , Tonner Emma , Ahmed Hanad , Haq Iqraa , Abbass Rami , Asinger Shad , Sbai Magda
Published: August 2020

Background: An ageing population has resulted in a rise in the number of hip and knee replacement surgeries in the UK. The pre-operative pathway is plagued with issues causing long delays and cancellations. Virtual healthcare technologies have a growing evidence base to help solve these issues. One problem of implementing these technologies is the resistance to change mentality from healthcare professionals. By getting their opinions on the place of these technologies within the pre-operative pathway, a united front can be formed to help deliver change. Methods: 16 semi-structured interviews were conducted with key stakeholders within the orthopaedic pre-operative pathway at Imperial College Healthcare NHS Trust. General topics included the different technologies that could be used within the pathway, their uses and associated benefits and problems. Interviews were audio-recorded, before being manually transcribed and then analysed to form categories and themes. Results: Various uses, benefits and problems were identified by healthcare professionals for each modality of technology. E-forms were seen as a high reward, low risk intervention. Remote patient monitoring and teleconsultations had their bonuses, but feasibility was a primary concern. Web-based interventions were seen as an intervention of the past, whereas virtual reality was seen as perhaps being ahead of its time. M-health was very positively viewed due to its all-encompassing nature. Digital illiteracy emerged as a consistent problem for most technologies. Conclusions: Current literature, the results from this study and technology trends within society highlight both M-health and E-forms as the 2 most promising virtual healthcare technologies for use in the pre-operative pathway for orthopaedics. Areas such as pre-operative assessment, triaging and prehabilitation are prime candidates for virtual intervention. Future research should also consider including patient opinions on any proposed interventions, as well as taking into account barriers to implementation.
Deep Double-Pilot-Based Hybrid Precoding in UAV-Enabled MmWave Massive MIMO
Authors: Hong Ziyao , Li Ting , Li Fei
Published: August 2020

Unmanned aerial vehicle (UAV) enabled communication system provides flexibility and reliability compared to conventional ones. Millimeter wave and massive MIMO have widely been researched since recent years, which are promising techniques for the next and even the later generation communication system. Hybrid precoding, as a method to reduce the high cost in hardware and power brought by massive antenna array, develops fiercely and is often combined to deep learning, a kind of popular optimization tool, which brings overwhelming performance. On the other hand, there are not so many attentions about the hybrid precoding in time-varying millimeter wave massive MIMO, which is necessary to be considered in a UAV-enabled communication scenario because the performance will degrade seriously if the channel changed while the transmitter and receiver use the precoding matrix corresponding to the expired channel, yet. In this paper, we propose a double-pilot-based hybrid precoding system, which completes analog precoding and digital precoding separately--predicting the previous one using deep learning structure and updating equivalent channel frequently for the post one by enhancing the frequency of equivalent channel estimation.
Three redescriptions in Tintinnopsis (Protista：Ciliophora: Tintinnina) from coastal waters of China, with cytology and phylogenetic analyses based on ribosomal RNA genes
Authors: Bai Yang , Wang Rui , Song Wen , Li Lifang , Santoferrara Luciana F. , Hu Xiaozhong
Published: August 2020

Background: The taxonomy of tintinnine ciliates is vastly unresolved because it has traditionally been based on the lorica (a secreted shell) and it has only recently incorporated cytological and molecular information. Tintinnopsis, the most speciose tintinnine genus, is also the most problematic: it is known to be non-monophyletic, but it cannot be revised until more of its species are studied with modern methods. Results: Here, T. hemispiralis Yin, 1956, T. kiaochowensis Yin, 1956, and T. uruguayensis Balech, 1948, from coastal waters of China, were studied. Lorica and cell features were morphometrically investigated in living and protargol-stained specimens, and sequences of three ribosomal RNA (rRNA) loci were phylogenetically analyzed. The three species show a complex ciliary pattern (with ventral, dorsal, and posterior kineties and right, left, and lateral ciliary fields), but differ in lorica morphology, details of the somatic ciliature and rRNA gene sequences. Tintinnopsis hemispiralis is further distinguished by a ciliary tuft (a ribbon of very long cilia originating from the middle portion of the ventral kinety and extending out of the lorica) and multiple macronuclear nodules. Both T. kiaochowensis and T. uruguayensis have two macronuclear nodules, but differ in the number of somatic kineties and the position of the posterior kinety. Two neotypes are fixed for T. hemispiralis and T. kiaochowensis to stabilize the species names objectively, mainly because of the previous unavailability of type materials. By phylogenetic analysis and comparison with closely-related species, we infer that the ciliary tuft and details such as the commencement of the rightmost kinety in the lateral ciliary field are synapomorphies that may help clarify the systematics of Tintinnopsis-like taxa. Conclusion: The redescriptions of three poorly known Tintinnopsis species, namely T. hemispiralis, T. kiaochowensis, and T. uruguayensis firstly revealed their ciliary pattern and rRNA sequences. This study expands knowledge and database of tintinnines and helps in identifying potential synapomorphies for future taxonomic rearrangements.
BK polyomavirus infection promotes growth and aggressiveness in bladder cancer
Authors: Zeng Yigang , Sun Jiajia , Bao Juan , Zhu Tongyu
Published: August 2020

Background: Recent studies have confirmed the integration of the BK polyomavirus (BKPyV) gene into the cellular genome of urothelial carcinomas in transplant recipients, further confirming the correlation between BKPyV and urothelial carcinomas after transplantation. However, the role BKPyV infections play in the biological function of bladder cancer remains unclear. Methods: We developed a BKPyV-infected bladder cancer cell model and a mice tumor model to discuss the role of BKPyV infections. Results: Our research proves that BKPyV infections promote the proliferation, invasion and migration of bladder cancer cells, while the activation of β-catenin signaling pathway is one of its mediation mechanisms. Conclusions: We first described BKPyV infection promotes the proliferation, invasion and migration of bladder cancer. We verified the role of β-catenin signaling pathway and Epithelial-Mesenchymal Transition effect in BKPyV-infected bladder cancer. These results provide meaningful information towards the diagnosis and treatment of clinical bladder cancer.
Extensively drug-resistant Alcaligenes faecalis infection
Authors: Huang Chienhsiu
Published: August 2020

Background: Alcaligenes faecalis is usually opportunistic infection in humans. Alcaligenes faecalis infection is often challenging to treat due to its increased resistance to many antibiotics. The results from a clinical study of Alcaligenes faecalis infection may help improve patients’ clinical care. Methods: We conducted a retrospective analysis of all patients presenting with Alcaligenes faecalis infection from January 2014 through December 2019. The medical records of all patients were reviewed for demographic information, clinical symptoms and signs, comorbidities, use of intravenous antibiotics within the past 3 months, bacterial culture, antibiotics sensitivity test, and clinical outcomes.Results: Sixty-one cases of Alcaligenes faecalis infection were seen during the study period, including 25 cases of cystitis, 9 cases of diabetic foot ulcer with infection, 8 cases of pneumonia, 7 cases of acute pyelonephritis, 3 cases of bacteremia, 9 cases of infection at specific sites. Thirty-seven patients (60.7%) had a history of receiving intravenous antibiotics within 3 months of the diagnosis. Fifty-one (83.6%) cases were mixed with other bacterial infections. Extensively drug-resistant infections have been reported since 2018. The highest antibiotic sensitivity rate for Alcaligenes faecalis, 66.7%, was reported in 2019. Ciprofloxacin and piperacillin/tazobactam are not good choices for empiric therapy of Alcaligenes faecalis infection. Conclusions: The most frequent Alcaligenes faecalis infection sites were in the urinary tract, skin and soft tissue, and lung. Alcaligenes faecalis showed markedly decreased sensitivity to commonly used antibiotics and, more recently, extensively drug-resistant Alcaligenes faecalis infections have emerged.
Diclazuril-Induced Expression of CDK-Related Kinase 2 in the Second-Generation Merozoites of Eimeria Tenella
Authors: Zhou Bian-hua , Ding Hai-yan , Yang Jing-yun , Chai Jun , Guo Hong-wei , Tian Er-jie
Published: August 2020

Background：Coccidiosis caused by Eimeria tenella infection, directly or indirectly leads to great loss to poultry industry. With the emergence of drug-resistance in chicken coccidia, it is imperative to develop new drugs. Cyclin-dependent kinases (CDKs) regulate cell cycle progression in numerous organisms by acting as key molecular switches. Results: In the present study, a diclazuril anticoccidiosis animal model was established and CDK-related kinase 2 (CRK2) in the second-generation merozoite of E. tenella (EtCRK2) gene was amplified through reverse transcription-polymerase chain reaction (RT-PCR) and expressed in Escherichia coli Rosetta (DE3). Purified recombinant protein was used for antiserum preparation. Subsequently, EtCRK2 transcription and translation levels were detected through quantitative real-time PCR and Western blot analysis, respectively. The localization of EtCRK2 in merozoites was examined via immunofluorescence techniques. Results showed that the mRNA and protein expression levels of EtCRK2 decreased in the infected/diclazuril group compared with those in the infected/control group. In addition, immunofluorescence analysis showed that EtCRK2 was localized in the cytoplasm of merozoites. The fluorescence intensity of EtCRK2 in the infected/diclazuril group was significantly weaker than that in the infected/control group. Conclusions: This study demonstrated that the anticoccidial drug diclazuril against E. tenella by affecting the expression pattern of EtCRK2 molecule, and EtCRK2 may be used as a candidate target for new drug development.
Influencing Factors for Early Detection and Prevention of Postpartum Hemorrhage in The Northern Province of Rwanda: Beneficiary and Health Worker Perspectives.
Authors: Bazirete Oliva , Nzayirambaho Manassé , Umubyeyi Aline , Uwimana Marie Chantal , Marilyn Evans
Published: August 2020

Background: Reduction of maternal mortality and morbidity is a major global health priority.However, much remains unknown regarding factors associated with postpartum hemorrhage (PPH) among childbearing women in the Rwandan context. The aim of this study is to explore the influencing factors for early detection and prevention of PPH as perceived by beneficiaries and health workers in the Northern Province of Rwanda. Methods: A qualitative descriptive exploratory study was drawn from a larger sequential exploratory‐mixed methods study. Semi‐structured interviews were conducted with 11 women who experienced PPH within the 6 months prior to interview. In addition, focus group discussions were conducted with: women’s partners or close relatives, community health workers (CHWs) in charge of maternal health and health care providers . A socio ecological model was used to develop interview guides to describe factors related to early detection and prevention of PPH in consideration of individual attributes, interpersonal, family and peer influences, intermediary determinants of health and structural determinants. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board. Results: We generated four interrelated themes:Meaning of PPH: beliefs, knowledge and understanding of PPH:Organizational factors; Caring and family involvement and Perceived risk factors and barriers to PPH prevention. The findings from this study indicate that PPH was poorly understood by women and their partners. Family members and CHWs feel that their role for the prevention of PPH is to get the woman to the health facility on time. The main factors associated with PPH as described by participants were multiparty and retained placenta. Low socioeconomic status and delays to access health care were identified as the main barriers for the prevention of PPH. Conclusions: Addressing the identified factors could enhance early prevention of PPH among childbearing women. Placing emphasis on developing strategies for early detection of women at higher risk of developing PPH, continuous professional development of health care providers, developing educational materials for CHWs and family members could improve the prevention of PPH. A further case control study is warranted to develop a screening tool for early detection predictors to PPH.
Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: A meta-analysis of Randomized Trials
Authors: Fan Yinuo , Li zhongfeng , Zhang Haitao , Hong Guoju , Wu Zhongshu , Li Weifeng , Chen Lixin , Wu Yunlong , Wei Qiushi , He Wei , Chen Zhenqiu
Published: August 2020

Background: KOA, with a high incidence in old-age population, adversely affects their life quality. The valgus knee bracing is an important physical therapy for KOA, but its clinical effects on pain release and functional improvment are remained unclear. This meta-analysis is to systematically evaluate the clinical outcomes of valgus knee bracing in patients with knee osteoarthritis (KOA). Methods : A meta-analysis of clinical randomized controlled trials (RCTs) on pain and functional changes in patients with KOA after using valgus knee braces. The search period was ranged from the inception of the database to May, 2020. The enrolled research databases included PubMed, Embase, and Web of Science databases. Two investigators independently formulated inclusion criteria and exclusion criteria, screened and determined the final enrolled literatures. Then the outcome indicators were extracted and organized from the included literature, and the risk of bias was assessed by Cochrane Handbook 5.0.1.Results :A total of 10 articles were included in this study, including 739 patients. Eight articles were related to the Visual Analogue Scale (VAS) pain score, the results showed that RR = -0.29, 95% CI [-0.73, 0.15], P = 0.20; Four articles were related to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score, the results showed that RR = -0.15, 95% CI [-0.41,0.11], P = 0.26; Two articles were related to the Knee Injury and Osteoarthritis Outcome Score (KOOS), the results showed that RR = 0.58, 95% CI [-4.25, 5.42], P = 0.81; Three articles were related to the KOOS activities of daily living (KOOS-ADL), the results showed that RR = 0.04, 95% CI [-0.62,0.69], P = 0.91.These results indicated that the valgus knee bracing have no statistically significant in pain and functional activity improvement of patients with KOA. The subgroup analysis showed that the follow-up time was the source of the heterogeneity of the VAS pain score. Conclusion : Our current evidence suggests that valgus knee bracing may not improve pain release and function activates in KOA patients in the long-term period, but only being beneficial to the short-term rehabilitation.
Socioeconomic status inequity in inpatient service utilization based on need among migrants: Evidence from a national study in China
Authors: Wang Yi , Jing Zhengyue , Ding Lulu , Tang Xue , Feng Yuejing , Li Jie , Chen Zhuo , Zhou Chengchao
Published: August 2020

Background: Providing equal treatment for those who have the same need for healthcare, regardless of their socioeconomic and cultural background, has become a shared goal among policymakers who strive to improve healthcare. This study aims to identify the socioeconomic status (SES) inequities in inpatient service utilization based on need among migrants by using a nationally representative study in China.Methods: The data used in this study was derived from the 2014 National Internal Migrant Population Dynamic Monitoring Survey collected by the National Health Commission of China. The sampling frame for this study was taken using the stratified multistage random sampling method. All provincial urban belt and key cities were stratified, and 119 strata were finally determined. We used logistic regression method and Blinder-Oaxaca decomposition and calculated the concentration index to measure inequities of SES in inpatient service utilization based on need. Sample weights provided in the survey were applied in all the analysis and all standard errors in this study were clustered at the strata level.Results: The total number of the migrants who needed inpatient service told by doctors was 7,592, of which, 1,667 (18.75% of total population) unmet the inpatient service need. Results showed that inpatient service utilization concentrated among high-SES migrants (Concentration Index: 0.036, p<0.001) and the decomposition results suggested that about 44.16% of the total SES gap in inpatient service utilization could be attributed to the gradient effect. After adjusting for other confounding variables, those had high school degree and university degree were more likely to meet the inpatient services need, and the OR values were 1.48 (95% CI 1.07, 2.03, p=0.017) and 2.04 (95% CI 1.45, 2.88, p=0.001), respectively. The OR values for Quartile 3 and Quartile 4 income groups was 1.28 (95% CI 1.01, 1.62, p=0.044) and 1.37 (95% CI 1.02, 1.83, p=0.035), respectively.Conclusion: This study observed an inequity in inpatient service utilization where the utilization concentrates among high SES migrants. It is important for policy makers to be aware of them and more intervention should be conducted.
Humic-acid-driven escape from eye parasites revealed by RNA-seq and target-specific metabarcoding
Authors: Noreikiene Kristina , Ozerov Mikhail , Ahmad Freed , Kõiv Toomas , Kahar Siim , Gross Riho , Sepp Margot , Pellizzone Antonia , Vesterinen Eero J. , Kisand Veljo , Vasemägi Anti
Published: August 2020

Background: Next generation sequencing (NGS) technologies are extensively used to dissect the molecular mechanisms of host-parasite interactions in human pathogens. However, ecological studies have yet to fully exploit the power of NGS as a rich source for formulating and testing new hypotheses. Methods: We studied Eurasian perch (Perca fluviatilis) and its eye parasite (Trematoda, Diplostomidae) communities in 14 lakes that differed in humic content in order to explore host-parasite-environment interactions. We hypothesised that high humic content along with low pH would decrease the abundance of the intermediate hosts (gastropods), thus limiting the occurrence of diplostomid parasites in humic lakes. This hypothesis was initially invoked by whole eye RNA-seq data analysis and subsequently tested using PCR-based detection and a novel targeted metabarcoding approach.Results: Whole eye transcriptome results revealed overexpression of immune-related genes and the presence of eye parasite sequences in RNA-seq data obtained from perch living in clear-water lakes. Both PCR-based and targeted-metabarcoding approach showed that perch from humic lakes were completely free from diplostomid parasites, while the prevalence of eye flukes in clear-water lakes that contain low amounts of humic substances was close to 100%, with the majority of NGS reads assigned to Tylodelphys clavata. Conclusions: High intraspecific diversity of T. clavata indicates that massively parallel sequencing of naturally pooled samples represents an efficient and powerful strategy for shedding light on cryptic diversity of eye parasites. Our results demonstrate that perch populations in clear-water lakes experience contrasting eye parasite pressure compared to those from humic lakes, which is reflected by prevalent differences in the expression of immune-related genes in the eye. This study highlights the utility of NGS to discover novel host-parasite-environment interactions and provide unprecedented power to characterize the molecular diversity of cryptic parasites.
Evaluation of the Content Validity Index of the Australian/Canadian Osteoarthritis Hand Index, the Patient-Rated Wrist/Hand Evaluation and the Thumb Disability Exam in People with Hand Arthritis
Authors: Bobos Pavlos , MacDermid Joy C , Boutsikari Eleni C. , Lalone Emily A. , Ferreira Louis , Grewal Ruby
Published: August 2020

BackgroundThe Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Patient-Rated Wrist/Hand Evaluation (PRWHE) and the Thumb Disability Exam (TDX) are patient-reported outcome measures (PROM) used to assess pain and hand function in patients with hand arthritis. This study evaluated the content validity of PRWHE, AUSCAN and TDX. MethodsThis study enrolled participants with hand arthritis to rate the items of all 3 PROM in terms of relevance and clarity. The Content Validity Index (CVI) was computed for each item in each scale (I-CVI) as well as for the overall scale (S-CVI). Kappa was used to determine the inter-rater agreement among the raters. ResultsOverall, 64 individuals with hand arthritis (27% with OA, 67% with rheumatoid arthritis and 6% with psoriatic arthritis) participated in the study. The I-CVI for all items and all scales was very high (I-CVI > 0.76) and the modified Kappa agreement among the raters demonstrated excellent agreement (k>0.76).The S-CVI for all PROMs was found very high for relevance (PRWHE = 0.85, 95% CI 0.82 to 0.88; TDX = 0.87, 95% CI 0.85 to 0.89 and AUSCAN = 0.92, 95% CI 0.90 to 0.94) and for clarity (PRWHE = 0.95, 95% CI 0.93 to 0.97; TDX = 0.91, 95% CI 0.89 to 0.94 and AUSCAN = 0.99, 95% CI 0.98 to 1.00) respectively. ConclusionsThis study demonstrated very high content validity indices for the PRWHE, AUSCAN, and TDX; with strong consensus across raters. This augments prior statistical evidence supporting statistical measurement properties, to provide support for the content validity.
A New Postural Stability-Indicator to Predict the Level of Fear of Falling in Parkinson’s Disease Patients
Authors: Pourghayoomi Ehsan , Behzadipour Saeed , Ramezani Mehdi , Joghataei Mohammad Taghi , Shahidi Gholamali
Published: August 2020

Background: Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error.Objectives: In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods: Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results: FTR1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = −0.63, P < 0.001), Pull Test (r = −0.65, p < 0.001), Timed Up and Go test (r = −0.57, p < 0.001), and Berg Balance Scale (r = 0.62, p < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions: Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.
Knowledge, attitude and self-efficacy program intended to improve public health professionals’ ability to identify and manage perinatal depressive symptoms: A quasi-experimental study
Authors: Phoosuwan Nitikorn , Lundberg Pranee C.
Published: August 2020

Background: During the perinatal period women lack screening and treatments for perinatal depressive symptoms, while public health professionals (PHPs) in primary care centres (PCCs) need training for identification and management of such symptoms. This quasi-experimental study was aimed at evaluating knowledge, attitudes and self-efficacy among PHPs after participating in a Knowledge, Attitude, and Self-efficacy (KAS) program for identification and management of perinatal depressive symptoms.Method: The KAS-program, carried through in Sakonnakhon in north-eastern Thailand, comprised one day of theory and a four-week period of field practice. Thirty-three PHPs from PCCs participated in the program. Twenty-three of them participated in focus group discussions (FGDs). Chi-square for trend, paired-sample T-tests and content analysis were used. Results: Knowledge, attitude and self-efficacy scores increased after the PHPs had fully participated in the KAS-program. Four categories emerged from the FGDs: increased understanding and knowledge, being aware and having a positive attitude, having confidence and ability to work, and need of regular training and feedback.Conclusion: The KAS-program may contribute to giving PHPs in PCCs the knowledge, positive attitude and self-efficacy they need to identify and manage perinatal depressive symptoms. Implementation of the KAS-program to other healthcare professionals such as nurses/midwives is great of interest.
The “State of Implementation” Progress Report (SIPREP):A Pilot Demonstration of a Navigation System for Implementation
Authors: Miech Edward J , Larkin Angela , Lowery Julie C , Butler Andrew J , Pettey Kristin M , Rattray Nicholas A , Penney Lauren S , Myers Jennifer , Damush Teresa M
Published: August 2020

Background: Implementation of new clinical programs across diverse facilities in national healthcare systems like the Veterans Health Administration (VHA) can be extraordinarily complex. Implementation is a dynamic process, influenced heavily by local organizational context and the individual staff at each medical center. It is not always clear in the midst of implementation what issues are most important to whom or how to address them. In recognition of these challenges, implementation researchers within VHA developed a new systemic approach to map the implementation work required at different stages and provide ongoing, detailed and nuanced feedback about implementation progress.Methods: This observational pilot demonstration project details how a novel approach to monitoring implementation progress was applied across two different national VHA initiatives. Stage-specific grids organized the implementation work into columns, rows and cells, identifying specific implementation activities at the site level to be completed along with who was responsible for completing each implementation activity. As implementation advanced, item-level checkboxes were crossed off and cells changed colors, offering a visual representation of implementation progress within and across sites across the various stages of implementation. Results: Applied across two different national initiatives, the SIPREP provided a novel navigation system to guide and inform ongoing implementation within and across facilities. The SIPREP addressed different needs of different audiences, both described and explained how to implement the program, made ample use of visualizations, and revealed both what was happening and not happening within and across sites. The final SIPREP product spanned distinct stages of implementation. Conclusions: The SIPREP made the work of implementation explicit at the facility level (i.e., who does what, and when) and provided a new common way for all stakeholders to monitor implementation progress and to help keep implementation moving forward. This approach could be adapted to a wide range of settings and interventions, and is planned to be integrated into the national deployment of two additional VHA initiatives within the next 12 months.
Significant progressive heterobeltiosis in banana crossbreeding
Authors: Batte Michael , Nyine Moses , Uwimana Brigitte , Swennen Rony , Akech Violet , Brown Allan , Hovmalm Helena Persson , Geleta Mulatu , Ortiz Rodomiro
Published: August 2020

Background: Heterobeltiosis is the phenomenon when the hybrid’s performance is superior to its best performing parent. Banana ( Musa spp. AAA) breeding is a tedious, time-consuming process, taking up to two decades to develop a consumer acceptable hybrid. Exploiting heterobeltiosis in banana breeding will help to select breeding material with high complementarity, thus increasing banana breeding efficiency. The aim of this study was therefore to determine and document the level of heterobeltiosis of bunch weight and plant stature in the East African highland bananas, in order to identify potential parents that can be used to produce offspring with desired bunch weight and stature after a few crosses.Results: This research found significant progressive heterobeltiosis in cross-bred ‘Matooke’ (highland cooking) banana hybrids, also known as NARITAs, when grown together across years with their parents and grandparents in Uganda. Most (all except 4) NARITAs exhibited positive heterobeltiosis for bunch weight, whereas slightly more than half of them had negative heterobeltiosis for stature. The secondary triploid NARITA 17 had the highest heterobeltiosis for bunch weight: 249% versus its matooke grandparent and 136% against its primary tetraploid parent. Broad sense heritability (across three cropping cycles) for yield potential and bunch weight were high (0.84 and 0.76 respectively), while that of plant stature was very low (0.0035). There was a positive significant correlation ( P < 0.05) between grandparent heterobeltiosis for bunch weight and genetic distance between parents (r = 0.39, P = 0.036), bunch weight (r = 0.7, P < 0.001), plant stature (r = 0.38, P = 0.033) and yield potential (r = 0.59, P < 0.001). Grandparent heterobeltiosis for plant stature was significantly, but negatively, correlated to the genetic distance between parents (r = -0.6, P < 0.001).Conclusions: Such significant heterobeltiosis exhibited for bunch weight is to our knowledge the largest among main food crops. Since bananas are vegetatively propagated, the effect of heterobeltiosis is easily fixed in the hybrids and will not be lost over time after the release and further commercialization of these hybrids.
RICE CENTRORADIALIS 1, a TFL1-like gene, Responses to Drought Stress and Regulates Rice Flowering Transition
Authors: Wang Yan , Lu Yuyang , Guo Ziyu , Ding Yanfeng , Ding Chengqiang
Published: August 2020

Background: The initiation of flowering transition in rice (Oryza sativa) is a complex process regulated by genes and environment. In particular, drought can interfere with flowering; therefore, many plants hasten this process to shorten their life cycle under water scarcity, and this is known as drought-escape response. However, rice has other strategies; for example, drought stress can delay flowering instead of accelerating it. RICE CENTRORADIALIS 1 (RCN1) is a TERMINAL FLOWER-like gene that influences rice flowering transition and spike differentiation. It interacts with 14-3-3 proteins and transcription factor OsFD1 to form a florigen repression complex that suppresses flowering transition in rice.Results: In this study, we explored the role of RCN1 in the molecular pathway of drought-regulated flowering transition. The rcn1 mutant plants displayed early heading under both normal water and drought stress conditions, and they were more insensitive to drought stress than the wild-type plants. Abscisic acid (ABA) signaling-mediated drought-induced RCN1 is involved in this process.Conclusions: Thus, RCN1 plays an important role in the process of drought stress inhibiting flowering transition. It may worked by suppressing the protein function rather than transcription of HEADING DATE 3a.
Integrated analysis identifies a pathway-related competing endogenous RNA network in the progression of Pancreatic cancer
Authors: Zu Fuqiang , Liu Peng , Wang Huaitao , Zhu Ting , Sun Jian , Sheng Weiwei , Tan Xiaodong
Published: August 2020

Background: It is well acknowledged that cancer-related pathways play pivotal roles in the progression of pancreatic cancer (PC). Employing Integrated analysis, we aim to identify the pathway-related ceRNA network associated with PC progression.Methods: We divided eight GEO datasets into three groups according to their platform, and combined TCGA and GTEx databases as a group. Additionally, we screened out the differentially expressed genes (DEGs) and performed functional enrichment analysis in each group, and recognized the top hub genes in the most enriched pathway. Furthermore, the upstream of miRNAs and lncRNAs were predicted and validated according to their expression and prognostic roles. Finally, the co-expression analysis was applied to identify a pathway-related ceRNA network in the progression of PC.Results: A total of 51 significant pathways that common enriched in all groups were spotted. Enrichment analysis indicated that pathway in cancer was greatly linked with tumor formation and progression. Next, the top 20 hug genes in this pathway were recognized, and stepwise prediction and validation from mRNA to lncRNA, including 11 hub genes, 4 key miRNAs, and 2 key lncRNAs, were applied to identify a meaningful ceRNA network according to ceRNA rules. Ultimately, we identified the PVT1/miR-20b-/CCND1 axis as a promising pathway-related ceRNA axis in the progression of PC.Conclusion: Overall, we elucidate the pathway-related ceRNA regulatory network of PVT1/miR-20b-/CCND1 in the progression of PC, which can be considered as therapeutic targets and encouraging prognostic biomarkers for PC.