bluuebunny/crossref_metadata_2025 huggingface dataset:
Sterile water; a novel and promising human experimental muscle pain model
Authors: Jounger Sofia Louca , Svedenlöf Johanna , Elenius Reija , Källkrans Christoffer , Scheid Emil , Ernberg Malin , Christidis Nikolaos
Published: May 2020

Background

Intramuscular injection of hypertonic saline evokes pain with similar characteristics as clinical myalgia and is thus, considered a valid human experimental model. The aim of this study was to investigate if intramuscular injection of sterile water can be used as a human experimental pain model by comparing it with hypertonic and isotonic saline, and to analyze if the effects differ between men and women.

Methods

This randomized double blind and placebo-controlled study included 15 healthy women and 15 healthy age-matched men (mean (SD) age of 23.6 (2.4) years). The study comprised of three separate sessions, with at least one week of wash out between each session. Sterile water (i.e. the test-substance), hypertonic saline (active control), and isotonic saline (passive control) were injected intramuscularly into one of the masseter muscles in a randomized order. Pain intensity (VAS) was assessed every 15 th s after the injection and pain duration (s) as well as pain drawing area (au) were recorded. Pressure pain thresholds (kPa) were assessed every 5 min after injection during 30 min.

Results

All substances evoked pain ( P < 0001), but sterile water and hypertonic saline induced pain with higher intensity ( P < 0.001), longer duration ( P < 0.001), and larger pain drawing area ( P < 0.001) than isotonic saline. The pain intensity was higher for hypertonic saline than sterile water 45-165 s after injection ( P < 0.015), but there were no significant differences between them regarding maximum pain intensity, pain duration or pain drawing area. There was no significant difference in PPT values with time or between substances. The pain duration was longer in the men compared to the women for all substances ( P < 0.006), while the pain drawing area was larger in women after injection of hypertonic saline ( P < 0.003), but not after injection of the other substances. No other sex differences were found.

Conclusion

Injection of sterile water had similar effects as hypertonic saline on pain variables, but no effect on PPT. Hence, the model mimics clinical myalgia and may offer a novel and simpler alternative to hypertonic saline injections.
Geomagnetic core field models and secular variation forecasts for the 13th International Geomagnetic Reference Field (IGRF-13)
Authors: Wardinski Ingo , Saturnino Diana , Amit Hagay , Chambodut Aude , Langlais Benoit , Mandea Mioara , Thebault Erwan
Published: May 2020

Observations of the geomagnetic field taken at Earth's

surface and at satellite altitude were combined to construct

continuous models of the geomagnetic field and its secular variation

from 1957 to 2020. From these parent models, we derive candidate

main field models for the epochs 2015 and 2020 to the 13th

generation of the International Geomagnetic Reference Field

(IGRF). The secular variation candidate model for the period 2020 -

2025 is derived from a forecast of the secular variation in 2022.5,

which results from a multi-variate singular spectrum analysis of the

secular variation from 1957 to 2020.
High-efficiency and ultra-thin electromagnetic wave absorption xAl2O3-(1-x)Sr0.85Gd0.15TiO3 ceramics in X-band
Authors: Xie Hui , Yang Chaoqun , Zhou Yingying , Ren Zhaowen , Liu Ping
Published: May 2020

xAl2O3-(1-x)Sr0.85Gd0.15TiO3(x=0.2, 0.3, 0.4, 0.5) ceramics were fabricated by hot-press sintering. Their morphology, phase composition, conductivity, dielectric properties as well as microwave absorption performance were examined by scanning electron microscopy (SEM), X-ray diffraction (XRD), multifunction digital four-probe meter and vector network analysis, respectively. The microwave absorption of as-prepared xAl2O3-(1-x)Sr0.85Gd0.15TiO3 ceramics demonstrates excellent microwave absorbability. It is unexpectedly found that with a thickness of only 0.346 mm, xAl2O3-(1-x)Sr0.85Gd0.15TiO3 (x=0.2) ceramic exhibits an absorption bandwidth of 3.7 GHz (8.7-12.4 GHz), being consequential to reflection loss less than -10 dB (over 90% of microwave absorption). It is as well discovered that the minimum reflection loss and absorption peak frequency of xAl2O3-(1-x)Sr0.85Gd0.15TiO3 (x=0.3) with a thickness of 0.436 mm were -45.43 dB and 11.3 GHz, respectively. The prominent microwave absorption performance of the ceramic with such a thin thickness can be attributed to strong interfacial polarization, dielectric frequency dispersion, and good electromagnetic impedance matching. It indicates that the xAl2O3-(1-x)Sr0.85Gd0.15TiO3 ceramics with appropriate Al2O3 mass fraction and thickness showing good potential for effective microwave absorbing materials.
Incidence and determinants of mortality among HIV infected adult patients on antiretroviral therapy in Ethiopia: A systematic review and Meta-analysis
Authors: Lijalem Habtamu , Workie Shimelash Bitew , Suleiman Mohammed , Gutulo Muluken Gunta , Tadesse Takele
Published: May 2020

Background
Antiretroviral therapy has been highly associated with reduction in the incidence of mortality in HIV/AIDS patients over time. However, there is a regional variation in the extent of reducing the incidence of mortality in many developing countries including Ethiopia. Hence, this study was conducted to generate summary evidences-based data for incidence of mortality and determinants of mortality.
Methods
Articles were comprehensively searched on Pub Med, Google Scholar, Cochrane library, Scopus, and DOAJ databases using Boolean operators. A Dersimonian and Laird methods of random effect model was used to estimate incidence and determinants of mortality. Heterogeneity, publication bias and quality of each study were checked. Subgroup analysis was employed. Relevant data from each study were extracted. STATA software version 14 was used for all statistical analysis.
Result
A total of 21 articles were finally reviewed and analyzed. Incidence of mortality was found to be 5/100-person year of observation (95% CI: 4–5/100pyo). Most of the death (67%) occurred during the first year of HAART initiation. Baseline Advanced WHO clinical stage (PHR (Pooled Hazard Rate) 2.88; 95%CI: 2.2–3.8), low CD4 cells count (PHR 1.88; 95% CI: 1.5–2.4), low body weight (PHR 1.6; 95% CI: 1.2–2.2), low hemoglobin level (PHR 2.4; 95% CI: 1.7–3.4), presence of TB infection (PHR 2.9; 95% CI: 2.13–4.61), non – working functional status (PHR 3.9; 95% CI: 2.8–5.4), bad medication adherence (PHR 4.8; 95% CI: 3.2–7.2), lack of cotrimoxazole preventive therapy (PHR 1.5; 95% CI: 1.2–2.0), being male (PHR 1.4; 95% CI: 1.2–1.8) and older age (PHR 1.2; 95% CI: 1.04–1.41) were significantly associated with increased mortality in this study.
Conclusion
Incidence of mortality was high particularly early in the course of therapy. Advanced WHO clinical stage, CD4 cells count low body weight, low hemoglobin level presence of TB infection, bad medication adherence older age and non-working functional status were significant determinants of incidence of mortality. Comprehensive service and strict follow up should be given to avert this high rate of mortality.
MicroRNA-138-5p targets pro-apoptotic factors and favours neural cell survival
Authors: Maza Rodrigo M , Silvan Agata , Muñoz-Galdeano Teresa , Reigada David , Águila Ángela del , Barreda-Manso M. Asuncion , Soto Altea , Nieto-Diaz Manuel
Published: May 2020

Background The central nervous system-enriched microRNA miR-138-5p becomes significantly downregulated after spinal cord injury (SCI). miR-138-5p modulates essential biological processes in the Central Nervous System (CNS). It also overcomes apoptosis by inhibiting the expression of proteins, including the effector CASP3, key in different cell death pathways. Therefore, we hypothesize that miR-138-5p downregulation following SCI underlies the overexpression of apoptotic genes and sensitizes neural cells to noxious stimuli. To confirm this hypothesis, this study aims a) to identify and validate miR-138-5p targets among the pro-apoptotic genes overexpressed following SCI; and b) to confirm that the miR-138-5p is able to modulate cell death in neural cells Methods We employed computational tools to identify potential pro-apoptotic targets of miR-138-5p. Dysregulation of selected targets after SCI and its relationship to changes in miR-138-5p expression were analysed through qRT-PCR in a rat SCI model. Validation of the regulation of those apoptotic targets was carried out by luciferase reporter, qRT-PCR, and immunoblot assays in cultures of neural cell lines transfected with a mimetic of the microRNA. The functional effects of modifying the expression of miR-138-5p were later examined in cultures of the rat neural cell line C6 employing enzymatic assays to measure the activity of effector CASP3 and CASP7 together with MTT and flow cytometry assays to estimate cell death. Results Consensus among different algorithms identified 209 potential targets of miR-138-5p. A total of 176 of them become dysregulated after SCI, including proteins basic to apoptosis process such as CASP3 and CASP7, or BAK (Bcl-2 homologous antagonist/killer). Downregulation of miR-138-5p after SCI correlates with the overexpression of these three targets. Cell culture analyses confirm that miR-138-5p targets their 3’UTRs and reduces their expression after microRNA transfection. Transfection of miR-138-5p in C6 cell line results in a reduced effector caspase activity and protects cells from apoptotic stimulation. Conclusions Our results demonstrate that downregulation of miR-138-5p after SCI can be deleterious to spinal neural cells. A mixture of direct effects mediated by the upregulation of apoptotic targets and indirect effects related to the upregulation of cell cycle proteins can be expected.
Malaria Parasites in Macaques in Thailand: Stump-Tailed Macaques (Macaca Arctoides) are New Natural Hosts for Plasmodium Knowlesi, P. Inui, P. Coatneyi and P. Fieldi.
Authors: Fungfuang Wirasak , Udom Chanya , Tongthainan Daraka , Kadir Khamisah Abdul , Singh Balbir
Published: May 2020

Background:Certain species of macaques are natural hosts ofPlasmodium knowlesi and P. cynomolgi, which can both cause malaria in humans, and P. inui, which can be experimentally transmitted to humans. A significant number of zoonotic malaria cases have been reported in humans throughout Southeast Asia, including Thailand. There have been only two studies undertaken in Thailand to identify malaria parasites in non-human primates in 6 provinces. The objective of this study was to determine the prevalence of P. knowlesi, P. coatneyi, P. cynomolgi, P. inui and P. fieldiin non-human primates from 4 new locations in Thailand. Methods:A total of 93 blood samples from Macaca fascicularis, M. leonina and M. arctoides were collected from four locations in Thailand: 32 were captive M. fascicularisfrom Chachoengsao Province (CHA), 4 were wild M. fascicularis from Ranong Province (RAN), 32 were wildM. arctoidesfromPrachuap Kiri Khan Province (PRA), and 25 were wild M. leoninafrom Nakornratchasima Province (NAK). DNA was extracted from these samples and analysed by nested PCR assays to detect Plasmodium, and subsequently to detectP. knowlesi, P. coatneyi, P. cynomolgi, P. inui and P. fieldi.Results:Twenty-seven of the 93 (29%) samples were Plasmodium-positive by nested PCR assays. Among wild macaques, all 4 M. fascicularis at RAN were infected with malaria parasites followed by 50% of 32 M. arctoides at PRA and 20% of 25 M. leonina at NAK. Only 2 (6.3%) of the 32 captive M. fascicularisat CHA were malaria-positive. All 5 species of Plasmodium were detected and 16 (59.3%) of the 27 macaques had single infections, 9had double and 2 had triple infections.The composition of Plasmodium species in macaques at each sampling site was different. Macaca arctoides from PRA were infected with P. knowlesi, P. coatneyi, P. cynomolgi, P. inui and P. fieldi. Conclusions:The prevalence and species of Plasmodiumvaried among the wild and captive macaques, and betweenmacaques at 4 sampling sites in Thailand. Macaca arctoidesis a new natural host for P. knowlesi, P. inui,P. coatneyi and P. fieldi.
Lack of knowledge and awareness on cervical cancer vaccination hinders the administration of HPV vaccination among the health care professionals.
Authors: Myneni Sindhura , Chellapandian Poongodi , Kumar Divya Ravi , Baluswamy Gayathri , Sivagnanam Poonguzhali , Balu Pandian , Chelladurai Udayakumari Meesala , James Kavin Mozhi , Kamineni Ravi Teja , Arokiasamy Christina Puthota , Padmanabhan Padmavathy , Surapaneni Krishna Mohan
Published: May 2020

Background: Cervical cancer is the second most common cancer among females in India. This study was conducted regarding current awareness about cervical cancer, which is helpful in designing educational programs and to overcome barriers associated for knowledge enhancement about cervical cancer and its screening & vaccination. Methods : This is a cross-sectional study conducted among 318 health care professionals working in tertiary hospitals across Chennai, Tamil Nadu, India. A semi-structured questionnaire with 31 items was developed by the researchers to explore the knowledge and attitudes on cervical cancer, cervical cancer prevention and HPV(Human Papilloma Virus)vaccination. Results: Among the 318 respondents, 90.6% were aware of cervical cancer, but only 29.2% had done screening against cervical cancer and 19.8% got vaccinated. 94.7% of the study subjects heard of HPV and 86.2% knew that HPV causes cervical cancer. 83.3% people knew that PAP( Papanicolaou) smear test detects the cervical cancer. But, only 29.2% had PAP test. 68.2% of the study subjects knew that cancer cervix can be prevented by vaccination. But only 19.8% got vaccinated .Only 34.9% know that HPV vaccine can be given to boys. Most common reason for not getting vaccination was lack of awareness. 77.2% in our study are willing for vaccination and recommendation to their friends and family members. Conclusion: Lack of awareness with regard to the cervical cancer could be the possible hurdle for the HPV vaccination among the health professionals.
Challenges to effective governance in a low income healthcare system: a qualitative study of stakeholder perceptions in Malawi
Authors: Masefield Sarah C , Msosa Alan , Grugel Jean
Published: May 2020

Background: All countries face challenging decisions about healthcare coverage. The scare resources of low income countries prevent improvements in equitable access and quality. Malawi, one of the poorest countries in the world, has committed to achieving Universal Health Coverage (UHC) by 2030. The health sector is highly dependent on donor contributions, but recent poor governance of government-funded healthcare saw donors withdraw funding, limiting services and resources. The 2017 updated National Health Plan II and accompanying Health Strategic Plan II identify the importance of improved governance and strategies to achieve it, including greater harmonisation with health stakeholders. This study explores health sector stakeholders’ perceptions of challenges to improving governance in the national health system. Methods: A qualitative study design was used. Interviews were conducted with 22 representatives of the major international and faith-based non-government organisations, civil society organisations, local government and government-funded organisations, and governance bodies operating in Malawi. Open questions were asked about experiences and perceptions of the functioning of the health system and healthcare decision-making. The transcripts and field notes were analysed using inductive content analysis.Results: Stakeholders view governance challenges as a barrier to achieving a more effective and equitable health system. Three types of challenges were identified: accountability (enforceability; answerability; stakeholder-led initiatives); health resource management (healthcare financing; drug supply); influence in decision-making (unequal power; stakeholder engagement).Conclusions: Health sector stakeholders see a range of serious challenges to improving governance in the national health system in Malawi which will impact on the government’s goal of achieving UHC by 2030. These can be categorised as political, structural, and financial challenges. Stakeholders identify the need for improved oversight, implementation, service delivery and social accountability of government-funded service providers to communities. Eighteen months after the introduction of the NHP II and HSSP II, they see little evidence of improved governance and have little or no confidence in the government’s ability to deliver UHC in the timeframe set out by the Sustainable Development Goals (SDGs). The difficulties stakeholders perceive in relation to building equitable and effective health governance in Malawi have relevance for other resource-limited countries which have also committed to the goal of UHC.
Perception of the healthcare professionals towards the current trauma and emergency care system in Kabul, Afghanistan: A mixed method study
Authors: Khudadad Umerdad , Aftab Wafa , Ali Asrar , Khan Nadeem Ullah , Razzak Junaid , Siddiqi Sameen
Published: May 2020

Background: Trauma and injury contribute to 11% of the all-cause mortality in Afghanistan. We aimed to explore the perceptions of the stakeholders of the public and private health sectors to identify the challenges in the provision of an effective trauma care in Kabul, Afghanistan.Methods: We utilized a mixed method design, including key-informant interviews of the trauma management stakeholders (N=18) and subsequent structured emergency care system assessment questionnaire (N = 35). Interviews were analyzed using thematic analysis and questionnaire data were descriptively analyzed. Results: We identified four themes that describe the challenges: 1) pre-hospital care, 2) cohesive trauma management system, 3) physical and human resources and 4) stewardship. We found some key challenges related to scene and transportation care, in-hospital care and emergency preparedness within the wider trauma care system. Less than 25% of the population is covered by the pre-hospital ambulance system (n=23, 65.7%) and no communication process between health care facilities to facilitate transfer (n=28, 80%). Less than 25% of patients with an injury requiring emergent surgery have access to surgical care in a staffed operating theatre within two hours of injury (n=19, 54.2%) and there is no regular assessment of the ability of the emergency care system to mobilize resources (human and physical) to respond to disasters, and other large-scale emergencies (n=28, 80%). Conclusion: This study highlighted major challenges in the delivery of trauma care services across Kabul, Afghanistan. Systematic improvement in the workforce training, structural organization of the trauma system and implementing externally validated clinical guidelines for trauma management could possibly enhance the functions of the existing trauma care services. However, an integrated state-run trauma care system will address the current burden of traumatic injury more effectively within the wider healthcare system of Afghanistan.
Effects of pre-emptive pregabalin and multimodal anesthesia on postoperative opioid requirements in patients undergoing robot-assisted laparoscopic prostatectomy
Authors: Sisa Katrin , Huoponen Saara , Ettala Otto , Antila Heikki , Saari Teijo I. , Uusalo Panu
Published: May 2020

Introduction: Previous findings indicate that pre-emptive pregabalin as part of multimodal anesthesia reduces opioid requirements compared to conventional anesthesia in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). However, recent studies show contradictory evidence suggesting that pregabalin does not reduce postoperative pain or opioid consumption after surgeries. We conducted a register-based analysis on RALP patients treated over a five-year period to evaluate postoperative opioid consumption between two multimodal anesthesia protocols. Materials and Methods: We retrospectively evaluated patients undergoing RALP between years 2015 and 2019. Patients with American Society of Anesthesiologists status 1-3, age between 30 and 80 years and treated with standard multimodal anesthesia were included in the study. Pregabalin (PG) group received 150 mg of oral pregabalin as premedication before anesthesia induction, while the control (CTRL) group was treated conventionally. Postoperative opioid requirements were calculated as intravenous morphine equivalent doses for both groups. The impact of pregabalin on postoperative nausea and vomiting (PONV), and length of stay (LOS) was evaluated.Results: We included 245 patients in the PG group and 103 in the CTRL group. Median (IQR) opioid consumption over 24 postoperative hours was 15 (8-24) and 17 (8-25) mg in PG and CTRL groups (p = 0.44). We found no difference in postoperative opioid requirement between the two groups in post anesthesia care unit, or within 12 hours postoperatively (p=0.16; p = 0.09). The length of post anesthesia care unit stay was same in each group and there was no difference in PONV Similarly, median postoperative LOS was 31 hours in both groups. Conclusion: Patients undergoing RALP and receiving multimodal analgesia do not need significant amount of opioids postoperatively and can be discharged soon after the procedure. Pre-emptive administration of oral pregabalin does not reduce postoperative opioid consumption, PONV or LOS in these patients.
Usefulness of Surgical Lung Biopsies after Cryobiopsies when Pathological Results Are Inconclusive or show a Pattern Suggestive of a Nonspecific Interstitial Pneumonia
Authors: Bondue Benjamin , Leduc Dimitri , Froidure Antoine , Pieters Thierry , Taton Olivier , Heinen Vincent , Alexander Patrick , Hoton Delphine , Dome Florence , Remmelink Myriam
Published: May 2020

BACKGROUND The equivalence of transbronchial lung cryobiopsies (TBLCs) and surgical lung biopsy (SLB) in the diagnosis of diffuse parenchymal lung diseases (DPLDs) is still debated. The aim of this study was to evaluate the benefit of SLBs performed in selected patients after TBLCs.METHOD We conducted a multicentric Belgian prospective trial in which SLBs were performed after TBLCs when the pathological diagnosis was uncertain or if a nonspecific interstitial pneumonia (NSIP) pattern was observed hypothesizing that SLB could provide additional information and that a co-existent UIP pattern could be missed.RESULTS 81 patients with TBLCs performed for a DPLD were included in the study between April 2015 and December 2019. A specific histological diagnosis was obtained in 52 patients (64%) whereas no pathological diagnosis following TBLCs was obtained in 13 patients (16%) and a pattern suggestive of a NSIP observed in 16 patients (20%). 14 of these 29 patients had SLBs after TBLCs. SLBs showed a UIP pattern in 11 (79%), a pattern suggestive of a hypersensitivity pneumonitis in two and a NSIP pattern in one patient. Among the 16 patients with pathological NSIP following TBLCs, six benefited from SLBs showing a UIP in five and confirming a NSIP in only one patient. A retrospective pathological analysis of patients having both procedures showed lower diagnostic confidence and agreement among pathologists for TBLCs compared to SLBs. Major determinants underlying the added value of SLBs were, as expected, the bigger size and the subpleural localization of the biopsies.CONCLUSIONS TBLCs are useful in the setting of DPLDs with a good diagnostic yield. However, our study suggests that SLB provides critical additional information in case TBLCs are inconclusive or show a pattern suggestive of a NSIP, questioning the accuracy of TBLC to identify adequately this histological pattern.
Overexpression of CXCR7 Enhances Metastasis on Lung Cancer Cell
Authors: Huan Liu , Qian Cheng , sheng Xu Dong , Wen Wang , Zheng Fang , Dong Xue Dong , Ya Zheng , H Chang Alex , jun Lei Yan
Published: May 2020

Background
Under physiological conditions, CXCL12 modulates cell proliferation, survival, angiogenesis, and migration mainly through CXCR4. Interestingly, the newly discovered receptor CXCR7 for CXCL12 is highly expressed in many tumor cells as well as tumor-associated blood vessels, although the level of CXCR7 in normal cells is low. Recently, many studies have suggested that CXCR7 promotes cell growth and metastasis in more than 20 human malignancies, among which lung cancer is the leading cause of cancer-associated deaths worldwide. Thus, the mechanism of CXCR7 in the progression of lung cancer is urgently needed.
Methods
First, we explored CXCR4 and CXCR7 expression in human lung cancer specimens and cell lines by immunohistochemistry, western blot and flow cytometry. Then, we chose the human lung adenocarcinoma cell line A549 that stably overexpressed CXCR7 through the way of lentivirus-mediated transduction. Next, “wound healing” assay and transwell assay were applied to compare the cell migration and invasion ability, and stripe assay was used to evaluate the cell polarization. Last, our team established a mouse xenograft model of human lung cancer and monitored tumor proliferation and metastasis by firefly luciferase bioluminescence imaging in SCID/Beige mice.
Results
In clinical lung cancer samples, CXCR7 were highly expressed in lung tumor tissue compared with normal tissue, and, CXCR4 highly expressed in both normal and tumor tissues. Furthermore, overexpression of CXCR7 enhanced A549 cell migration and polarization in vitro. Besides, mouse xenograft model of human lung cancer showed that CXCR7 promoted primary lung tumor’s growth and metastasis to the second organ, such as liver or bone marrow in SCID/Beige mice in vivo.
Conclusions
This study describes the multiple functions of CXCR7 in lung cancer. Thus, these results suggest that CXCR7 may be a malignancy marker and may provide a novel target for anticancer therapy.
Investigating the effect of TRPV4 inhibition on pulmonary-vascular barrier permeability following segmental endotoxin challenge
Authors: Mole Sarah , Harry Anya , Fowler Andrew , Hotee Sarah , Warburton Joseph , Waite Sarah , Beerahee Misba , Behm David J , Badorrek Philipp , Müller Meike , Faulenbach Cornelia , Lazaar Aili L , Hohlfeld Jens M
Published: May 2020

Background
Acute Respiratory Distress Syndrome (ARDS) is associated with increased pulmonaryvascular permeability. In the lung, transient receptor potential vanilloid 4 (TRPV4), a Ca2+-permeable cation channel, is a regulator of endothelial permeability and pulmonary edema. We performed a Phase I, placebocontrolled, doubleblind, randomized, parallel group, proofofmechanism study to investigate the effects of TRPV4 channel blocker, GSK2798745, on pulmonaryvascular barrier permeability using a model of lipopolysaccharide (LPS)induced lung inflammation.
Methods
Healthy participants were randomized 1:1 to receive 2 single doses of GSK2798745 or placebo, 12 hours apart. Two hours after the first dose, participants underwent bronchoscopy and segmental LPS instillation. Total protein concentration and neutrophil counts were measured in bronchoalveolar lavage (BAL) samples collected before and 24 hours after LPS challenge, as markers of barrier permeability and inflammation, respectively. The primary endpoint was baseline adjusted total protein concentration in BAL at 24 hours after LPS challenge. A Bayesian framework was used to estimate the posterior probability of any percentage reduction (GSK2798745 relative to placebo). Safety endpoints included the incidence of adverse events (AEs), vital signs, 12-lead electrocardiogram, clinical laboratory and haematological evaluations, and spirometry.
Results
Forty-seven participants were dosed and 45 completed the study (22 on GSK2798745 and 23 on placebo). Overall, GSK2798745 was well tolerated. Small reductions in mean baseline adjusted BAL total protein (~ 9%) and neutrophils (~ 7%) in the LPS-challenged segment were observed in the GSK2798745 group compared with the placebo group; however, the reductions did not meet pre-specified success criteria of at least a 95% posterior probability that the percentage reduction in the mean 24hours post LPS BAL total protein level (GSK2798745 relative to placebo) exceeded zero. Median plasma concentrations of GSK2798745 were predicted to inhibit TRPV4 on lung vascular endothelial cells by ~ 7085% during the 24 hours after LPS challenge; median ureacorrected BAL concentrations of GSK2798745 were 3.0 to 8.7fold higher than those in plasma.
Conclusions
GSK2798745 did not affect segmental LPS-induced elevation of BAL total protein or neutrophils, despite blood and lung exposures that were predicted to be efficacious.
Risk of Transmission and Knowledge Gap for Novel Coronavirus Disease 2019 (Covid-19) in Addis Ababa: Risk Estimation and Control Strategies
Authors: Begashaw Getnet Bogale , Yohannes Yordanos
Published: May 2020

Background

A novel coronavirus disease 2019 is pandemic infectious disease. It is neither SARS nor influenza; rather it is a zoonotic virus that can be transmitted to humans. COVID-19 was emerged at the end of 2019 in China in Wuhan, the capital of Hubei China. Physical contact and respiratory routs are the two most important well established routs of transmission of the virus. This study is aimed to evaluate knowledge gap and risk activities against Covid-19 in Addis Ababa.
Methods

The study used a primary data collected from 431 individuals with analysis of descriptive statistics and multivariate binary logistic regression. Explanatory variables practicing health care service, age, sex, family size, working place, lock down, safe working environment, use transportation, contacting density population, health status and flight history; and knowledge gap and carefulness is response variable at 5% level of significance.
Results

In this work practicing health care service & physical distance, safe working environment and Contacting density population are statistically significant predictors in describing risk transmission of Covid-19. Intercept (OR = 1.429, 95% CI: 1.199, 1.659), Practicing health care service & Physical Distance (OR = 6.885, 95% CI: 6.765, 7.005), Working Place (OR = 1.206, 95% CI: 0.961, 1.451) and Safe working environment (OR = 4.013, 95% CI: 3.768, 4.258) were factors significantly associated with increased risk of Covid-19 transmission.
Conclusions

To control disease transmission in Addis Ababa we need to encourage inhabitants to practice health care service & physical distance, to work their jobs at home and preparing national guidelines to safe working environment and usage transportation.
Characterization of the belowground microbial community in a poplar-assisted bioremediation strategy for restoring a multi-contaminated soil
Authors: Caracciolo Anna Barra , Grenni Paola , Garbini Gian Luigi , Rolando Ludovica , Campanale Claudia , Aimola Giorgia , Fernandez-Lopez Manuel , Fernandez-Gonzalez Antonio José , Villadas Pablo José , Ancona Valeria
Published: May 2020

Background: Due to their widespread use in industrial applications in recent decades, Polychlorobiphenyls (PCBs) and heavy metals (HMs) are the most common soil contaminants worldwide, posing a risk for both ecosystems and human health.Results: a poplar-assisted bioremediation strategy has been applied for more than four years to a historically contaminated area (PCBs and HMs) in Southern Italy using the Monviso poplar clone. This clone was effective in promoting a decrease in all contaminants and an increase in soil quality in terms of organic carbon and microbial abundance. Moreover, a significant shift in the structure and functioning of the belowground microbial community was also observed when analysing both DNA and cDNA sequencing. In fact, an increase in bacterial genera belonging to Proteobacteria and able to degrade PCBs and resist HMs was observed. Moreover, the functional profiling of the microbial community predicted by PICRUSt2 made it possible to identify several genes associated with PCB transformation (e.g. bphAa, bphAb, bphB, bphC), response to HM oxidative stress (e.g. catalase, superoxide reductase, peroxidase) and HM uptake and expulsion (e.g. ABC transporters).Conclusions: This work demonstrated the effectiveness of the poplar clone used in stimulating the natural belowground microbial community to remove contaminants (phyto-assisted bioremediation) and improve the overall soil quality. It is a practical example of a nature based solution involving synergic interactions between plants and the belowground microbial community.
Do high levels of Amylase following laparoscopic sleeve gastrectomy predict devastating complications?
Authors: Horn Amyt , Assalia Ahmad , Sayida Sa'd , Mahajna Ahmad
Published: May 2020

Background

Gastric leak post laparoscopic sleeve gastrectomy (LSG) is a severe complication that may lead to sepsis and even to patient's death. Early diagnosis and treatment are critical. It was hypnotized that the appearance of high levels of amylase, especially in the drain, may indicate a leak from the gastric staple line. The purpose of this prospective study was to examine the incidence of Amylase increase in the blood, urine and drain fluid, after LSG and to examine whether the appearance of high levels of Amylase indicates the existence of a major complication and especially a leak from the staple line.
Methods

From 161 patients whom underwent Sleeve gastrectomy, we prospectively evaluated the demographic information, including Body-mass-index (BMI), comorbidities, complications during the surgery or hospitalization, laboratory data including complete blood count, liver function tests, glucose and Amylase levels in blood, urine and drain. Testing for the normal distribution of the variables was performed using Kolmogorov-Smirnov test. Based on the results of this test we performed T- test or Mann-Whitney test to find differences between groups. Multivariate analysis using logistic regression was performed to examine the independent variables which can predict a rise in Amylase values above the upper limit number (ULN).
Results

Of 161 patients in this study, 35 patients (21.8%) had a rise in the Amylase values in blood, urine and/or drain, and 126 patients (78.2%) had normal values of Amylase until discharge. Amylase rise has been found to be correlated with Neutrophilia (OR = 5.4, p = 0.003), indirect hyperbilirubinemia (OR = 3.9, p = 0.022) and a decline in phosphate level (OR = 2.48, p = 0.019). Furthermore, a rise in Amylase is significantly associated to a rise in Aspartate and Aspartate transaminase transaminases (AST and ALT), Gamma-Glutamyl Transferase (GGT), Creatine-phosphokinase (CPK), Glucose and leukocytes, and a decline in lymphocytes and Calcium. No significant change was found in the duration of the operation and neither in the length of hospitalization. No specific complication was found to be significantly higher in any of the groups. One patient suffered from staple line leak and was treated conservatively. The diagnosis was done in post- operative day three by abdominal CT-scan. The amylase levels in the blood and the drain were normal and only a slight increase of amylase in urine was measured.
Conclusions

Increase in Amylase after LSG doesn't necessarily indicate a major complication such as staple line leak and in the vast majority of cases, it seems to have no clinical relevancy. Therefore, it should not automatically lead to a full clinical investigation in the absence of further clinical signs. Our results suggest that there is no clinical justification for Amylase tests in any method after LSG.
Weight maintenance interventions for people with type 2 diabetes mellitus: A systematic review protocol
Authors: Sauchelli Sarah , Bradley Julia , Cox Jennifer , England Clare , Perry Rachel
Published: May 2020

Background: Weight loss maintenance is a challenge for people with Type 2 Diabetes Mellitus (T2DM), which attenuates the long-term benefits of weight loss for diabetes management. Medication, specific dietary requirements, and the psychosocial burden of T2DM signify that weight loss maintenance designed for obesity may not suit people with T2DM. The primary objective of this review is to comprehensively evaluate existing weight maintenance interventions for people with or at high risk of T2DM. Methods: Web of Science, Medline, PsychINFO, Embase and international trials registers will be used to search for studies assessing the effects of weight maintenance interventions in adults with a clinical diagnosis of T2DM or pre-diabetes. Studies with glucose control and/or weight as primary outcomes will be eligible. Human screening and study inclusion using Rayyan will be run in parallel to semi-automated screening with AbstrackR. Eligible studies will be scrutinised for risk of bias using the Cochrane Risk of Bias Version 3 tool or the ROBINS-I tool, and methodological quality will be evaluated via the GRADE system.Discussion: This review will critically appraise existing weight maintenance interventions targeting T2DM. Findings will inform future intervention development to support people with T2DM delay weight regain and prolong successful diabetes management. Systematic Review Registration (PROSPERO): 168032
Cost of Revision Total Knee Replacement: A Protocol For Systematic Review And Meta Analysis
Authors: Okafor Charles Ebuka , Nghiem Son , Vertullo Christopher , Byrnes Joshua
Published: May 2020

Background A major limitation of Total Knee Replacement (TKR) as to other joint replacements is the risk is revision. Revision TKR is associated with high risk and economic burden to patients, healthcare provider and the society. It will be worthwhile to analyze how close or far the economic burden of revision TKR vary across countries or already existing studies. It is important to compare the studies characteristics and identify factors that are determinants of cost and outcome variability in the management in order to inform decisions for future revision TKR. This study aim to review the literature on the cost of revision TKR to assess cost variation across countries and studies; estimate a pooled cost estimate; identify factors that contribute the high cost and provide recommendation for cost minimization; identify limitation and gaps in cost burden assessment of existing studies and provide recommendations for future research.Methods We will search MEDLINE (OvidSp), Embase, Cochrane Library, EconLit, Google Scholar and Scopus to identify relevant studies. We will use an advanced search approach to search for relevant studies. EndNote library will be used to manage searched studies. Selection will done in two phase: screening and eligibility. Selection, data extraction assessment of risk of bias will be done in duplicates after which the data will be analysed descriptively and a meta-analysis performed.Discussion This protocol provides a proposed stepwise plan in conducting a systematic review and meta-analyses of cost of revision total knee replacement. Findings from this systematic review will provide information about factors associated with high costs of revision TKR, proffer recommendations to minimize cost and inform where future knee arthroplasty management decisions and future research should focus.Systematic Review Registration: PROSPERO CRD42020171988
Validity of two-dimensional analyses for the assessment of dynamic foot alignment during walking
Authors: Miyazaki Takasuke , Kawada Masayuki , Kiyama Ryoji , Yone Kazunori
Published: May 2020

Background Several studies indicate that static foot posture bears a low relevance to dynamic foot alignment during walking. Thus, dynamic alignment assessment capable of being utilized in a clinical practice is required for an accurate estimation of foot function. This study aimed to examine the validity of two-dimensional analysis using a tablet computer for estimation of foot alignment during walking, by making a comparison with a motion capture system and static foot alignment screenings.Methods Validity of two-dimensional (2D) analysis of foot alignment during walking using a tablet computer, by making a comparison with a motion capture system and static screenings in healthy subjects. Fourteen healthy males and 15 healthy females participated in this study. Arch height of the right foot while walking was measured using a tablet computer and a motion capture system simultaneously. Arch height at the mid-stance (Mst) and pre-swing (PSw) phase were calculated from kinematic data measured by the tablet computer and motion analysis system, respectively. Static foot alignment also was assessed through the use of a screening test including arch height index and foot posture index. To examine the validity of foot assessment using 2D analysis, we conducted correlation analysis between the arch height at Mst and PSw as measured by a tablet computer and a motion capture system. Meanwhile, FPI and AHI were used to test the relation to arch height at Mst as measured by a motion capture system.Results Arch height, as measured by the motion capture system, showed a significant correlation with that measured using a tablet computer at Mst (r = 0.90, p < 0.001) and PSw (r = 0.94, p < 0.001), and arch height index (r = 0.50, p = 0.005), especially the former. Meanwhile, foot posture index (r = − 0.34, p = 0.075) showed no relation to arch height as measured by the motion capture system.Conclusion These results demonstrate the high validity of 2D analysis using a tablet computer for estimation of foot alignment during walking. Such gait analysis can be effective in assessing dynamic foot alignment in clinical practice.
Research on the effect of the size of the wall-hanging air-conditioner indoor unit on the indoor thermal comfort
Authors: Caozhu Kuanbing , Ji Changfa
Published: May 2020

The geometrical dimension of the wall-hanging air-conditioner indoor unit affects the indoor thermal comfort. In this paper, fluent software is used and standard k-e two equation turbulent model is chosen to carry out the simulation of the indoor temperature field and flow field of six different sizes of the single wall-hanging indoor air-conditioner in the room. The temperature distribution, velocity distribution and PMV distribution of the plane which is 1.8 m from the ground are given. It can be known that under the condition of six kinds of sizes of the wall-hanging air-conditioner indoor unit, when the size of the air-conditioner indoor unit is 0.4m × 0.2m × 0.2 m, the temperature variation at the z = 1.8 m section is relatively small, the temperature distribution is more uniform. When the size of the air-conditioner indoor unit is 0.5m × 0.2m × 0.2 m, the temperature difference at the z = 1.8 m section is relatively smaller, PMV is closest to 0, and the thermal sensation is almost moderate. Therefore when the size of the air-conditioner indoor unit is 0.5m × 0.2m × 0.2 m, better indoor comfort can be achieved.
A common approach for absolute quantification of short chain CoA thioesters in industrially relevant gram-positive and gram-negative prokaryotic and eukaryotic microbes
Authors: Gläser Lars , Kuhl Martin , Jovanovic Sofija , Fritz Michel , Vögeli Bastian , Erb Tobias , Becker Judith , Wittmann Christoph
Published: May 2020

Background: Thioesters of coenzyme A participate in 5% of all enzymatic reactions and at least one third of all cellular carbon is typically metabolized through a CoA thioester. In microbial cell factories, they function as building blocks for products of recognized commercial value, including natural products such as polyketides, polyunsaturated fatty acids, biofuels, and biopolymers. A core spectrum of approximately 5 – 10 short chain thioesters is present in many microbes, as inferred from their genomic repertoire. The relevance these metabolites explains the high interest to trace and quantify them in microbial cells.Results: Here, we describe a common workflow for extraction and absolute quantification of short chain CoA thioesters in different gram-positive and gram-negative bacteria and eukaryotic yeast, i.e. Corynebacterium glutamicum, Streptomyces albus, Pseudomonas putida, and Yarrowia lipolytica. The approach detected CoA thioesters down to the level of 40 attomole and exhibited high precision and reproducibility for all microbes as shown by principal component analysis. Furthermore, it provided interesting insights into microbial CoA-spectra. A succinyl-CoA synthase defective mutant of C. glutamicum, exhibited an unaffected level of succinyl-CoA, which indicated a complete compensation of the l-lysine pathway to bypass the disrupted TCA cycle. Methylmalonyl-CoA, an important building block of high-value polyketides, was identified as dominant CoA thioester in the microbe. S. albus revealed a more than 10,000-fold difference in the abundance of intracellular CoA thioesters. A recombinant strain of S. albus, which produced different derivatives of the antituberculosis polyketide pamamycin, revealed a significant depletion of CoA thioesters of the ethylmalonyl CoA pathway, influencing product level and spectrum. Conclusions: The high relevance of short chain CoA thioesters to synthetize industrial products and the interesting insights gained from the examples shown in this work, suggest analyzing these metabolites in microbial cell factories more routinely than done so far. Due to its broad application range, the developed approach appears useful to be applied this purpose. Hereby, the possibility to use on single protocol promises to facilitate automatized efforts, which rely on standardized workflows.
An analytic perspective of a mixed methods study during humanitarian crises in South Sudan: translating facility- and community-based newborn guidelines into practice
Authors: Sami Samira , Amsalu Ribka , Dimiti Alexander , Jackson Debra , Kenneth Kemish , Kenyi Solomon , Meyers Janet , Mullany Luke C , Scudder Elaine , Tomczyk Barbara , Kerber Kate
Published: May 2020

Background: In South Sudan, civil war worsened in 2016 leading to massive displacement in Juba that rapidly spread to other regions of the country. Access to health care is sparse due to attacks on health facilities and workers; pregnant women and newborns are amongst the most vulnerable in this context. The feasibility of implementing a new package of community- and facility-based newborn health interventions was assessed in displaced person camps during periods of sudden violence from 2016 to 2017. The case study aimed to understand implementation research outcomes such as acceptability, adoption, and other factors influencing implementation.Discussion: Countries with the highest neonatal mortality have recently experienced humanitarian emergencies and the translation of newborn guidelines into public health practice, particularly during periods of on-going violence, are not well understood or operationalized in these contexts. Unique challenges to conducting research in South Sudan included violent attacks against health facilities and workers that required implementing partners to modify modes of service delivery on an ongoing basis to ensure staff and patient safety. South Sudan faced devastating outbreaks such as a cholera and measles that shifted response priorities and then a new wave of displacement due to conflict resulted in staff relocation. Costs associated with transporting study staff and equipment kept rising due to hyperinflation, and study co-investigators were unable to return to South Sudan for some months following the July 2016 violence to conduct refresher trainings or monitor data collection. Strategies used to address these challenges were: collaborating with diverse partners to identify creative solutions; hiring locally-based research staff; maintaining flexible budgets and timelines; using mobile data collection to conduct timely data entry and remote quality checks; and utilizing a cascade training approach to train field researchers. Conclusions: The study provides lessons that are applicable to similar humanitarian settings, including the need for adaptable research methods, flexible budgets, innovative training, remote supervision, local researchers, and careful consideration of sociopolitical factors that impact access and safety of research staff. Engagement of community stakeholders can ensure data collection and interventions continue and findings translate to public health action, even in contexts facing extreme and unpredictable insecurity.