bluuebunny/crossref_metadata_2025 huggingface dataset:
RELACIONAMENTO ENTRE FONTES E JORNALISTAS: estudo de caso de uma universidade pública
Authors: Silva Cruz Adriano Charles , Ferreira Gadelha Marina
Published: January 2020

Discutimos a relação das fontes da Universidade Federal do Rio Grande do Norte com jornalistas da cidade de Natal-RN. Após uma revisão de literatura, foi aplicado um questionário como instrumento de coleta de dados. O universo da pesquisa é composto por 74 jornalistas de quatro empresas de comunicação da capital potiguar. O estudo resultou em um mapeamento das principais características, lacunas e potencialidades dessas fontes, segundo a ótica dos respondentes. Os resultados apontam que o uso de linguagem técnica e desconhecimento das rotinas jornalísticas são atitudes que atrapalham o relacionamento entrevistador/entrevistado
TELE-SOLIDARIEDADE EM FAMÍLIA NAS TARDES DE SÁBADO DA TV GLOBO: um estudo sobre o Caldeirão do Huck e o Estrelas Solidárias
Authors: Kneipp Valquíria Aparecida , Ferreira de Moraes Renato
Published: January 2020

O presente artigo aborda as características do discurso de solidariedade intrínseco à linguagem dos programas “Estrelas Solidárias” e “Caldeirão do Huck”, ambos exibidos aos sábados na Rede Globo de Televisão em rede nacional. Aqui, o recorte para a análise qualitativa elenca os programas exibidos no dia 16 de junho de 2017. A hipótese é que o grotesco, codificado na carência das classes menos favorecidas ou em casos individuais de carência afetiva ou material, é a principal narrativa desse tipo de articulação, em que informação e entretenimento se fundem. As referências são os estudos de Sodré (1975, 2004, 2006) sobre o grotesco nos meios de comunicação de massa do Brasil. Além disso, soma-se o conceito de tele-solidariedade de García-Canclini (2008), diante do qual identificou-se um misto de solidariedade midiatizada com toques de um assistencialismo high tech.
A MORTE DA NARRATIVA E A NARRATIVA DA MORTE:uma conexão com Walter Benjamin
Authors: Xavier Ramiro Barbosa , Leite Amanda M.P.
Published: January 2020

As múltiplas formas de comunicação podem nos levar a um cenário de desinformação, sedução, solidão e de morte com aquilo que presumimos enxergar. Estar vivo, hoje, aponta para a condição de estar virtualizado, digitalizado. Aqui, busca-se provocar uma reflexão com base em dois ensaios do escritor Walter Benjamin (1892-1940) envolvendo-os com o universo experienciado pela população LGBTI+, de maneira a compreender como as narrativas desta população são construídas e apresentadas nos ambientes midiáticos.
SIBERIAN AND THE FAR EASTERN AMATEUR INTERNET PERIODICALS
Authors: Savenko N.
Published: January 2020

The influence of new information technologies on samizdat periodicals is considered. Understand the benefits of online media. The development trends of the regional amateur network press are analyzed. Characterized by the genre-thematic composition and the target audience of Siberian non-professional Internet newspapers and magazines.
TOPICS OF DISSERTATION RESEARCHES OF LIMITED DISTRIBUTION IN THE EARLY XXI CENTURY
Authors: Makhotina N. V.
Published: January 2020

The article is devoted to the results of the analysis of the situation on defense of dissertations marked «for official use» in the USSR and Russia. There were rules and regulations governing this process. Due to the numerous abuses associated with the reluctance of open publication of scientific works, the defense of dissertations without secret information, not posted on the Internet, has become impossible. Thus, the receipt of dissertations «DSP» and the authors’ papers into the library stocks has ceased.
Progesterone: An Enigmatic Ligand for the Mineralocorticoid Receptor
Authors: Baker Michael , Katsu Yoshinao
Published: January 2020

The progesterone receptor (PR) mediates progesterone regulation of female reproductive physiology, as well as gene transcription in non-reproductive tissues, such as brain, bone, lung and vasculature, in both women and men. An unusual property of progesterone is its high affinity for the mineralocorticoid receptor (MR), which regulates electrolyte transport in the kidney in humans and other terrestrial vertebrates. In humans, rats, alligators and frogs, progesterone antagonizes activation of the MR by aldosterone, the physiological mineralocorticoid in terrestrial vertebrates. In contrast, in elephant shark, ray-finned fishes and chickens, progesterone activates the MR. Interestingly, cartilaginous fishes and ray-finned fishes do not synthesize aldosterone, raising the question of which steroid(s) activate the MR in cartilaginous fishes and ray-finned fishes. The simpler synthesis of progesterone, compared to cortisol and other corticosteroids, makes progesterone a candidate physiological activator of the MR in elephant sharks and ray-finned fishes. Elephant shark and ray-finned fish MRs are expressed in diverse tissues, including heart, brain and lung, as well as, ovary and testis, two reproductive tissues that are targets for progesterone, which together suggests a multi-faceted physiological role for progesterone activation of the MR in elephant shark and ray-finned fish. The functional consequences of progesterone as an antagonist of some terrestrial vertebrate MRs and as an agonist of fish and chicken MRs are not fully understood. Indeed, little is known of physiological activities of progesterone via any vertebrate MR.
The effect of diverse nitrogen sources in the nutrient medium on the growth of the green microalgae Chromochloris zofingiensis in the batch culture
Authors: Minyuk G. S. , Dantsyuk N. V. , Chelebieva E. S. , Chubchikova I. N. , Drobetskaya I. V. , Solovchenko A. E.
Published: January 2020

The effect of three nitrogen (N) sources in the nutrient medium – sodium nitrate (NaNO3), urea (CO(NH2)2), and ammonium chloride (NH4Cl) – on the morphological and physiological characteristics of the green microalga Chromochloris (Chlorella) zofingiensis, a potential commercial producer of lipids and a ketocarotenoid astaxanthin, was studied. The alga was batch-cultivated in glass conical flasks from starting cell density (n) around 2.3·106 per mL and dry weight (DW) content of 0.06 g·L−1 in all variants at 120 μmol·m−2·s−1 PAR, +20…+21 °C, and air bubbling at a rate of 0.3 L·min−1·L−1. The concentration of nitrogen sources (as elemental N) in the modified BBM nutrient medium was 8.83 mmol·L−1, the cultivation duration was 17 days. The dynamics of n and cell volumes, DW content, chlorophylls a and b (Chla and Chlb), total carotenoids (Car), and lipids (Lip) in the cultures, concentration of N sources in the nutrient medium, and its pH were recorded. It was shown that the growth rate, size distribution of the cell populations, and the biomass chemical composition depended significantly on the nitrogen source in the nutrient medium. Using NH4Cl as N source caused on the second day growth inhibition, cell swelling, aggregation, and discoloration; by the seventh day, it caused culture crash. C. zofingiensis cells took up NaNO3 and CO(NH2)2 from the medium at a similar rate (0.626 and 0.631 mmol N·L−1·day−1, respectively), but the growth of the culture fed with CO(NH2)2 lagged; its cell volume and Chla, Chlb, and total Car contents declined profoundly. The average dry matter productivity (PDW) in the culture grown on CO(NH2)2 [(0.086 ± 0.004) g·L−1·day−1] was 32.6 % lower than in the culture grown on NaNO3 [(0.114 ± 0.005) g·L−1·day−1]. At the same time, lipid productivity (PLip) of the urea-fed culture was comparable with that of the nitrate-fed culture (PLip of 28 and 26 mg·L−1·day−1, respectively). The lipid DW percentage of the former exceeded significantly that of the nitrate-fed culture (31.6 % vs 23.1 %, respectively). From the standpoint of profitability, the lag in biomass accumulation recorded in the urea-fed culture on PDW is not critical since it is compensated by lowering the cost of nitrogen source for the nutrient medium (approximately by 230 %) and a higher biomass lipid content. C. zofingiensis grown in media with urea as the only N source deserves further investigation.
Microcystis wesenbergii (Komárek) Komárek ex Komárek, 2006 (Cyanophyceae) ― новый вид для прибрежья Крыма Чёрного моря
Authors: Мирошниченко Е. С.
Published: January 2020

Описан новый для крымского прибрежья Чёрного моря вид токсичной цианобактерии Microcystis wesenbergii (Komárek) Komárek ex Komárek, 2006, обнаруженный в результате исследования сообществ перифитона 45 образцов синтетических полимерных материалов из полиэтилентерефталата (PET), полиэтилена высокой плотности (HDPE) и полипропилена (PP), экспонированных в Карантинной бухте Чёрного моря в районе г. Севастополя (44°37′23.0″N, 33°29′38.5″E) в экспериментальной вертикальной установке с августа по сентябрь 2018 г., когда температура воды изменялась от +22,4 до +26,6 °C, а солёность воды — от 17 до 18 ‰. M. wesenbergii выявлен на глубине от 7,6 до 9,2 м на образцах из HDPE, PET зелёного цвета, PP и на фрагментах пластиковых контейнеров. M. wesenbergii — полиморфный, планктонный вид, который в небольших количествах встречается в стоячих и медленно текущих эвтрофных и мезотрофных пресноводных водоёмах; токсичен, иногда вызывает цветение; космополит, за исключением субполярных зон. Встречался в сложных колониях, которые состояли из субколоний, достигающих максимально 3700 мкм в длину. Диаметр молодых сферических колоний варьировал от 240 до 367 мкм. Диаметр клеток M. wesenbergii был больше диагноза [(10,19 ± 0,79) мкм], а цвет клеток — преимущественно светло-коричневым вместо сине-зелёного. Обнаружение токсичного M. wesenbergii в Карантинной бухте Чёрного моря свидетельствует о высоком скрытом разнообразии цианобактерий в этой акватории.
Long intergenic non-coding RNA 1939 inhibits proliferation and migration of human renal cell carcinoma (RCC) cells by down-regulation of miR-154
Authors: Zhang Rongyuan , Huang Yuhua , Xu Baocai , Lv Chuan , Hou Jianquan , Zhang Weijie
Published: January 2020

The authors have withdrawn the journal submission associated with this preprint and requested that the preprint also be withdrawn.
Development of a clinical prediction model of chronic kidney disease in primary Focal Segmental Glomerulosclerosis
Authors: Ossareh Shahrzad , Yahyaei Mansoureh , Asgari Mojgan , Afghahi Hanri
Published: January 2020

Background: Focal segmental glomerulosclerosis (FSGS) is one of the important causes of end stage kidney disease (ESKD). We evaluated the risk factors of progression of primary FSGS to chronic kidney disease (CKD) or ESKD with a predictive model including clinical and histological predictors. Methods: 201 patients with primary FSGS (59% male, mean age: 38±15 years), were studied. Time-dependent Cox model and C statistics were used for the predictive model. Interaction and correlation between independent variables were estimated. Results: During 55±27 months of follow-up, 82 patients (41%) developed CKD (46) or ESKD (36) patients. In adjusted model, 1 unit of higher serum creatinine (SCr) at baseline (HR:1.39, 95%CI: 1.15-1.70) and 1% increase in glomeruli with segmental glomerulosclerosis (SGS) (HR: 1.03, 95% CI: 1.02-1.04) or interstitial fibrosis/tubular atrophy (IF/TA) (HR: 1.03, 95% CI: 1.01-1.05) increased the risk of CKD/ESKD. In adjusted model, higher baseline proteinuria and collapsing variant were not associated with risk of CKD/ESKD. By adding SGS and IF/TA scores to baseline SCr in the model, discrimination by C statistics was 0.83 (95%CI: 0.77-0.90) for prediction of CKD/ESKD . Median renal survival was 3.1 years (95% CI: 2.2-4.1 years) in patients with highest risks score (baseline eGFR<25 ml/min/1.73 m 2 + IF/TA/SGS> 50%), and 8.1 years (95% CI: 7.7-8.6 years).in those with lowest score (baseline eGFR>75 ml/min/1.73 m 2 + IF/TA/SGS <5%). Conclusion: In primary FSGS, higher baseline SCr, increased SGS and IF/TA were the predictors for CKD/ESKD. Baseline proteinuria did not predict the risk of CKD/ESKD. Collapsing variant did not increase the risk of CKD/ESKD after adjustment for IF/TA score. These findings indicated the importance of baseline GFR and the degree of chronicity at biopsy as predictors of kidney outcome .
Application of A Classroom-Based Positive Psychology Education Course on Chinese Medical Students to Increase Their Psychological Well-Being: A Pilot Study
Authors: Zhang Xiao-Qin , Zhang Bao-Shuai , Wang Meng-Die
Published: January 2020

Background Anxiety and depression have been on rise in Chinese medical students due to the heavy academic pressure of medical practice and the deteriorating doctor-patient relationship in China. The psychological well-being of the Chinese medical students has become a critical focus of attention for the medical education community. Increasing evidence showed that positive psychology interventions can be effective in the enhancement of psychological well-being, and may help to prevent depressive symptoms in university students. In the present study, we aimed to explore the potential effect of positive psychology education on improving the mental health of Chinese medical students. Methods An 8-week classroom-based positive psychology intervention workshop, which was set as a selective course embedded in the regular school curriculum, was performed at School of Medicine, South China University of Technology (SCUT), China. Undergraduate medical students of the institute at year-2 or year-3 academic study took part in this training course voluntarily. Self-report data on hope scale, life satisfaction scale, subjective happiness scale, as well as depression and anxiety scale were collected and analyzed at pre-course (n=61) and post-course (n=49) among the participants. The investigation was also validated in an independent cohort of students who enrolled in the course in the following year of the preliminary study. Results The analyses showed that the psychology well-being of the participants were improved after the intervention. Their mean scores on hope scale, life satisfaction scale and subjective happiness scale were significantly improved (P<0.05), while the symptom levels of depression and anxiety were significantly reduced (P<0.01). Similar trend was also observed in the validation cohort. Conclusions These preliminary findings suggest that positive psychology education holds promise for improving the psychological well-being among Chinese medical students. Further investigations in larger and well-controlled sample cohorts may yield more convincible and reliable results.
In vivo model to study the impact of genetic variation on clinical outcome of mastitis in dairy uniparous cows
Authors: Rohmeier Laura , Petzl Wolfram , Koy Mirja , Eickhoff Tordis , Hülsebusch Alina , Jander Sebastian , Macias Laura , Heimes Annika , Engelmann Susanne , Hoedemaker Martina , Seyfert Hans-Martin , Kühn Christa , Schuberth Hans-Joachim , Zerbe Holm , Meyerholz Marie Margarete
Published: January 2020

Background: In dairy herds, mastitis causes detrimental economic losses. Genetic selection offers a sustainable tool to select animals with reduced susceptibility towards postpartum diseases. Studying underlying mechanisms is important to assess the physiological processes that cause differences between selected haplotypes. Therefore, the objective of this study was to establish an in vivo infection model to study the impact of selecting for alternative paternal haplotypes in a particular genomic region on cattle chromosome 18 for mastitis susceptibility under defined conditions in dairy uniparous cows. Results: At the start of pathogen challenge, no significant differences between the favorable (Q) and unfavorable (q) haplotypes were detected. Intramammary infection (IMI) with Staphylococcus aureus 1027 (S. aureus, n = 24, 96 h) or Escherichia coli 1303 (E. coli, n = 12, 24 h) was successfully induced in all uniparous cows. This finding was confirmed by clinical signs of mastitis and repeated recovery of the respective pathogen from milk samples of challenged quarters in each animal. After S. aureus challenge, Q-uniparous cows showed lower somatic cell counts 24 h and 36 h after challenge (P < 0.05), lower bacterial shedding in milk 12 h after challenge (P < 0.01) and a minor decrease in total milk yield 12 h and 24 h after challenge (P < 0.01) compared to q-uniparous cows. Conclusion: An in vivo infection model to study the impact of genetic selection for mastitis susceptibility under defined conditions in dairy uniparous cows was successfully established and revealed significant differences between the two genetically selected haplotype groups. This result might explain their differences in susceptibility towards IMI. These clinical findings form the basis for further in-depth molecular analysis to clarify the underlying genetic mechanisms for mastitis resistance.
Development and preliminary validation of a brief Nurses' Perceived Professional Benefit Questionnaire (NPPBQ)
Authors: Hu Yanli , Hu Jing , Li Liping , Zhao Bin , Liu Xiaohong , Li Fan
Published: January 2020

Background: With the increased empirical interest in the positive significance of improving nurses’ sense of professional benefits, there is a requirement for measures of nurses' perceived professional benefit (NPPB). Our objective was to develop and psychometrically test a brief Nurses' Perceived Professional Benefit Questionnaire (NPPBQ). Methods: After expert consultation and nurse interviews, a primary questionnaire was developed for an exploratory factor analysis (EFA). The seventeen items of the NPPBQ were used for verification of the theorized factor structure and content validity using a confirmatory factor analysis (CFA). The NPPBQ’s concurrent validity was evaluated. Three samples of nurses were collected in Shanghai, Hangzhou and Nanjing between November 2017 and August 2018. Results: The results of the EFA and CFA verified the five dimensions of nurses’ occupational benefit discovery. The results demonstrated that the NPPBQ has adequate internal consistency and is fully consistent with the theorized factor structure. This 5-factor solution explained an adequate percentage of the total variance. The Cronbach’s alpha of each dimension of the NPPBQ was good. The concurrent validity was significantly correlated with all aspects of the Maslach Burnout Inventory (MBI). Conclusion : The results suggest that the NPPBQ is a psychometrically sound measure for evaluating perceived professional benefits among a wide range of nurses. Keywords: Nurses, Psychometrics, Nurses' perceived professional benefit, Instrument development
The Methods and Baseline Characteristics of a VA Randomized Controlled Study Evaluating Supported Employment Provided in Primary Care Patient Aligned Care Teams
Authors: Davis Lori L. , Blansett Catherine M. , Mumba Mercy N. , MacVicar David , Toscano Richard , Pilkinton Patricia , Gay Whitney , Bartolucci Al
Published: January 2020

Background: This article describes the design and baseline sample of a single-site trial comparing Individual Placement and Support (IPS) supported employment delivered within a Veterans Health Administration (VHA) primary care Patient Aligned Care Team (PACT) to treatment-as-usual vocational rehabilitation (TAU-VR) that includes transitional work. Methods: Unemployed U.S. military veterans receiving care in a VHA PACT who were seeking competitive work, otherwise eligible for vocational rehabilitation, and diagnosed with a mental health condition other than a psychotic or bipolar I disorder were prospectively randomized to receive either IPS or TAU-VR. Employment outcomes and measures of quality of life, self-esteem, and community reintegration are being collected for 12 months.Results: The participant sample (n=119) is comprised of 18.5% female, 69.2% African-Americans, and 4.2% Hispanic. Average age is 38.2 (SD ± 8.41) years; 80.7% served in the military since 2001; 78% are receiving or applying for U.S. Department of Veterans Affairs (VA) service-connected disability; 26.9% have not held a competitive job in the past 3 years; and the average length of pre-randomization unemployment is 1.4 (SD ± 2.3) years. Conclusions: Unique design features include evaluating the efficacy of evidenced-based IPS within the primary care setting, having broad diagnostic eligibility, and defining the primary outcome criterion as “steady employment”, i.e. holding a competitive job for ≥26 weeks of the 12-month follow-up period. The findings illustrate the characteristics of a primary care veteran sample in need of employment services.Trial Registration: www.clinicaltrials.gov Identifier: NCT02400736
Incidence of Heart Failure among Diabetic Patients with Ischemic Heart Disease: A Cohort Study
Authors: Abdissa Senbeta Guteta , Deressa Wakgari , Shah Amit J
Published: January 2020

Background: In population studies of heart failure (HF), diabetes mellitus (DM) has been shown to be an independent risk factor. However, the evidence evaluating it as an independent risk factor in incident HF in patients with ischemic heart disease (IHD) is scarce. Our study aimed to assess the incidence of HF in diabetic IHD patients compared to non-diabetic IHD patients in Ethiopia. Methods: A retrospective cohort study was conducted among 306 patients with IHD followed-up at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. The IHD patients who did not have HF at baseline were followed for 24 months beginning from November 30, 2015. We assessed the incidence of HF in patients with diabetic IHD versus the non-diabetic IHD. Cox proportional hazards models were used to assess the association between diabetic IHD and HF after controlling for important covariates. Hypertension was examined as a possible effect modifier as well. Results: The mean age was 56.8 years, 69% were male, and 31% were diabetic. During the 24 months follow-up period, 196 (64.1%) had incident HF. On multivariate Cox regression, DM was significantly associated with incident HF [Hazard Ratio = 2.04, 95% confidence interval (CI): 1.32-3.14, p = 0.001]. Furthermore, when the patients were stratified by hypertension (HTN) status, DM was associated with worse prognosis, and the strongest association was in those with co-existing DM and HTN [HR = 2.57,95% CI =1.66-3.98, p<0.0001], followed by the presence of DM without HTN [HR 2.27, 95% CI = 1.38-3.71, p=0.001] (compared to those with neither). Conclusion: DM is the strongest predictor of incident HF, compared to other traditional risk factors, in Ethiopian patients with IHD. Those with both DM and HTN are at the highest risk. Key Words: Ischemic heart disease; Heart failure; Incidence; Diabetes Mellitus; Retrospective cohort study
Comparison of methods for detection of in vitro synergy in multidrug-resistant Gram-negative bacteria
Authors: Gaudereto Juliana Januario , Neto Lauro Vieira Perdigão , Leite Gleice Cristina , Sanchez Evelyn , Martins Roberta Cristina Ruedas , Prado Gladys Villas Boas do , Rossi Flavia , Guimarães Thais , Levin Anna Sara , costa silvia figueiredo
Published: January 2020

The use of combined antibiotic therapy has become an option for infections caused by multidrug-resistant (MDR) bacteria. The time-kill (TK) assay is considered the gold standard method for the evaluation of in vitro synergy, but it is a time-consuming and expensive method. The purpose of this study was to evaluate two methods for testing in vitro antimicrobial combinations: the disk diffusion method through disk approximation (DA) and the agar gradient diffusion method by MIC:MIC ratio. TK was included as the gold standard. Sixty-two MDR Gram-negative clinical isolates (28 Pseudomonas aeruginosa , 20 Acinetobacter baumannii , and 14 Serratia marcescens ) were submitted to TK, DA, and MIC:MIC ratio synergy methods. Overall, the agreement between the DA and TK assays ranged from 20 to 93%. As the isolates of A. baumannii showed variable results of synergism according to TK, the calculated agreement was statistically significant in this species against fosfomycin with meropenem, including colistin-resistant isolates. The MIC:MIC ratio method showed agreement range from 35 to 71% with TK assays. The kappa test showed a good agreement for the combination of colistin with amikacin (K = 0.58; P = 0.04) among the colistin-resistant A. baumannii isolates. The DA and MIC:MIC ratio methods are easier to perform and might be a more viable tool for clinical microbiology laboratories.
Leadership Training Programs in Graduate Medical Education: A Systematic Review
Authors: Kumar Bharat , Swee Melissa , Suneja Manish
Published: January 2020

Background: With the increasing recognition that leadership skills can be acquired, there is a heightened focus on incorporating leadership training as a part of graduate medical education. However, there is considerable lack of agreement regarding how to facilitate acquisition of these skills to resident, chief resident, and fellow physicians. Methods: Articles were identified through a search of Ovid MEDLINE, EMBASE, CINAHL, ERIC, PsycNet, Cochrane Systemic Reviews, and Cochrane Central Register of Controlled Trials from 1948 to 2019. Additional sources were identified through contacting authors and scanning references. We included articles that described and evaluated leadership training programs in the United States and Canada. Methodological quality was assessed via the MERSQI (Medical Education Research Study Quality Instrument). Results: 15 studies, which collectively included 639 residents, chief residents, and fellows, met the eligibility criteria. The format, content, and duration of these programs varied considerably. The majority focused on conflict management, interpersonal skills, and stress management. Twelve were prospective case series and three were retrospective. Seven used pre- and post-test surveys, while seven used course evaluations. Only three had follow-up evaluations after six months to one year. MERSQI scores ranged from 6 to 9. Conclusions: Despite interest in incorporating structured leadership training into graduate medical education curricula, there is a lack of methodologically rigorous studies evaluating its effectiveness. High-quality well-designed studies, focusing particularly on the validity of content, internal structure, and relationship to other variables, are required in order to determine if these programs have a lasting effect on the acquisition of leadership skills.
Iodine adequacy in reproductive age and pregnant women living in the Western region of Saudi Arabia
Authors: Azzeh Firas , Refaat Bassem Amr
Published: January 2020

Background:Despite the serious maternal and foetal complications associated with iodine deficiency during pregnancy, surveys related to pregnant women in the Kingdom of Saudi Arabia (KSA) are lacking. This study, therefore, measured urine iodine concentrations (UIC) alongside the potential socioeconomic factors contributing towards iodine inadequacy in reproductive age and pregnant Saudi women from the Western province of KSA.Methods:Spot urine samples were collected from 1222 pregnant and 400 age-matched non-pregnant/non-lactating reproductive age women. The socioeconomic characteristics were obtained through a structured questionnaire. The WHO criteria for iodine sufficiency in non-pregnant (100–199 μg/L) and pregnant (150–249 μg/L) women were applied.Results:The median UIC in the non-pregnant women (101.64 μg/L; IQR: 69.83 – 143.55) was at the lowermost WHO recommended cut-off, whereas the pregnant group were iodine deficient (112.99 μg/L; IQR: 81.01 – 185.57). Moreover, the median UIC was below adequacy across the different trimesters. Multiparity (OR = 3.091; 95%CI: 1.707–5.598) and earning below the minimum wage (2.520; 95%CI: 1.038–6.119) significantly increased the risk of iodine deficiency only in the non-pregnant women. Passive smoking, however, was an independent risk factor for iodine deficiency in the non-pregnant (OR = 1.818; 95%CI: 1.097–3.014) and pregnant (OR = 1.653; 95%CI: 1.043–2.618) groups. The use of non-iodised salt also significantly increased the risk of iodine deficiency in the non-pregnant (OR = 2.052; 95%CI: 1.118–3.766) and pregnant women (OR = 3.813; 95%CI: 1.992–7.297), whereas iodine supplements significantly lowered the risk in both groups (OR = 0.364; 95%CI: 0.172–0.771 and OR = 0.002; 95%CI: 0.001–0.005, respectively). Moreover, BMI correlated independently and significantly with median UIC in the non-pregnant in both study populations.Conclusions:This study is the first to show borderline iodine sufficiency in reproductive age Saudi women from the Western province, whereas mild iodine deficiency was observed in the pregnant population and could represent a serious public health problem. This study also advocates the necessity to establish routine iodine dietary advice services by the health authorities to foster adequate iodine intake in pregnant women to avoid the perilous maternal-foetal health consequences of iodine deficiency.
Biomechanical Changes of Degenerated Adjacent Segment and Intact lumbar Spine after lumbosacral Topping-off surgery: A Three-dimensional Finite Element Analysis
Authors: Cao Liangliang , Liu Yumei , Mei Wei , Xu Jian-guang , Zhan Shi
Published: January 2020

Background : Previous studies have revealed positive effect of Topping-off technique on upper adjacent segment after fusion surgery, while for the cases with fusion surgery on L5-S1 segment, owning maximal range of motion, and preexisting degenerated upper adjacent disc, it is necessary to clarify the superiority of Topping-ff technique and the effect exerted on the lumbar spine. Methods: A young healthy male volunteer was selected for thin-slice CT scanning. Then the image information was imported into the computer to establish the whole lumbar spine model as the health model. The medium degeneration model of intervertebral disc was established by changing the material properties of L4-S1 disc on the basis of the health model, and the fusion model and Topping-off model were respectively established on the basis of the degenerated model. The variation trend of ROM of L2-L5 and the stress changes of L4-L5 intervertebral disc, nucleus pulposus and facet joints were calculated respectively. Results: The L4-L5 ROM of fusion model increased significantly but the ROM of L2-L3 and L3-L4 segments did not change significantly. Compared with the degenerated model, L4-L5 activity of the Topping-off model decreased, and ROM of the L2-L3 and L3-L4 increased to some extent in the flexion and extension positions. the stress on the disc, nucleus pulposus and facet joint of the fusion model L4-L5 increased in four positions of flexion, extension, rotation and bending compared with the degenerated model, while the fiber stress on the Topping-off model decreased significantly in all four positions. Conclusion: Topping-off technology can decrease the stress and ROM of the adjacent upper degenerated segment, and increase the ROM of other upper segments, thereby protecting the degenerated upper adjacent segments and compensating the lumbar spine mobility.
MicroRNA-183-5p acts as a potential diagnostic biomarker for atherosclerosis and regulates the growth of vascular smooth muscle cell
Authors: Sun Bin , Shan Zhengkun , Sun Guoyu , Wang Xiaolong
Published: January 2020

Background Atherosclerosis (AS) is a multifactorial chronic disease, and vascular smooth muscle cells (VSMCs) plays an important role in the pathology of AS. MicroRNAs regulate multiple cellular biological processes. This study aimed to investigate the clinical value of miR-183-5p in AS patients, and further explored the effects of miR-183-5p on the proliferation and migration of VSMCs. Methods qRT-PCR was used to test the level of miR-183-5p. The diagnostic value of miR-183-5p for AS patients was assessed by a receiver operating characteristic (ROC) analysis. Cell proliferation and migration were determined via CCK-8 and Transwell assay. Results MiR-183-5p was highly expressed in AS patients compared with the healthy group. Serum miR-183-5p expression was positively associated with CIMT and CRP in AS patients. The ROC analysis suggested that miR-183-5p had quality to be used as a biomarker with high specificity and sensitivity for AS detection. Overexpression of miR-183-5p promoted the proliferation and migration of VSMCs. Downregulation of miR-183-5p attenuated ox-LDL stimulated VSMCs proliferation and migration. Conclusion MiR-183-5p is highly expressed in AS patients, and downregulation of miR-183-5p attenuated ox-LDL stimulated VSMCs proliferation and migration. MiR-183-5p may be a key molecular for the diagnosis and treatment of AS in the future.
Implementation of a National Electronic Health Information System in Gabon: A Survey of Healthcare Providers’ Perceptions
Authors: Bagayoko C.O. , Tcheente Jack , Traoré Diakaridia , Moukoumbi Gaetan , Ondzigue Raymond , Koumamba Aimé Patrice , Ondjani Myriam Corille , Ndjeli Olive Lea , Gagnon Marie-Pierre
Published: January 2020

Background: Health information System(HIS) is a set of computerized toolsfor the collection, storage, management and transmission of health data.Their role in supporting the modernization of health systems, improving access to quality healthcare and reducing costs in developing countries is unquestionable; but their implementation faces several challenges. In Gabon, a unique national electronic HIShas been launched.It will connect healthcare institutions and providers at all levels in the whole country.Objective: This study aims to explore and identify the factors influencing healthcare providers’ perceptions of the national electronic HIS. Methods: We adapted a questionnairebased on the Information System Success Model (ISSM).Twenty six hundreds(2600) healthcare providers,recruited across the country, took part in the research. We checked the reliability and validity of the application and performed a logistic regression to identify the factors influencing healthcare providers’ perceptions towards the system.Results: A total of 2327 questionnaires were completed (i.e. 89.5% response rate). The logistic regression identified five elements that significantly influenced perceived system impact: System Quality (Odds Ratio–OR=1.70), Information Quality (OR=1.69), Actual Use (OR=1.41), Support Quality (OR=1.37), and Useful Functions (OR=1.14). The model explained 30% of the variance in providers’ perceptionshow that the HIS leads to positive impacts. Discussion: The results show that healthcare providers’ perceptions regarding the positive impact are influenced by their use of a previous HIS, the scope of their usage and the quality of the system, information and support provided to users. These results could inform the development of strategies to ensure adequate change of management and user experience for the implementation of the national electronic HIS in Gabon, and eventually in other low resources environment.
Novel mutations of the SRF gene in Chinese sporadic conotruncal heart defect patients
Authors: Mengmeng Xu , Yuejuan Xu , Sun Chen , Yanan Lu , Fen Li , Kun Sun
Published: January 2020

Background: Conotruncal heart defects (CTDs) are a group of congenital heart malformations that cause anomalies of cardiac outflow tracts. In the past few decades, many genes related to CTDs have been reported. Serum response factor (SRF) is a ubiquitous nuclear protein that acts as transcription factor, and SRF was found to be a critical factor in heart development and to be strongly expressed in the myocardium of the developing mouse and chicken hearts. The targeted inactivation of SRF during heart development leads to embryonic lethality and myocardial defects in mice. Results: To illustrate the relationship between SRF and human heart defects, we screened SRF mutations in 527 CTD patients, a cross sectional study. Two novel mutations (Mut1: c.821A>G p.G274D, the adenine(A) was mutated to guanine(G) at position 821 of the SRF gene coding sequences (CDS), lead to the Glycine(G) mutated to Asparticacid(D) at position 274 of the SRF protein amino acid sequences; Mut2: c.880G>T p.G294C, the guanine(G) was mutated to thymine (T) at position 880 of the SRF CDS, lead to the Glycine(G) mutated to Cysteine (C) at position 294 of the SRF protein amino acid sequences.) of SRF (NM_003131.2) were identified. Western blotting and real-time PCR showed that there were no obvious differences between the protein expression and mRNA transcription of mutants and wild-type SRF. A dual luciferase reporter assay showed that both SRF mutants (G274D and G294C) impaired SRF transcriptional activity at the SRF promoter and atrial natriuretic factor (ANF) promoter (p<0.05), additionally, the mutants displayed reduced synergism with GATA4. Conclusion: These results suggest that SRF-p.G274D and SRF-p.G294C may have potential pathogenic effects.
Facilitators and Barriers of Managing Patients with Multiple Chronic Conditions in the Community: A Qualitative Study
Authors: Foo Kah Mun , Sundram Meena , Legido-Quigley Helena
Published: January 2020

Background
About one-third of all adults worldwide were diagnosed with multiple chronic conditions (MCCs). Literature had found several challenges of providers and patients coping with managing MCCs in the community, and yet limited research studies that consider their viewpoints in combination. A qualitative study involving healthcare providers and users was thus conducted to examine facilitators and barriers of managing patients with MCCs in the community in Singapore.

Methods
This involves 26 semi-structured interviews with 10 physicians, 2 caregivers and 14 patients seeking treatment in the polyclinics that provides subsidised primary care services. Topic guides were developed with reference from literature review, Chronic Care Model (CCM) and Framework for patient-centred access to healthcare.

Results
Despite perceived affordable charges and availability of support system, some patients still encountered financial difficulties in managing care. These include inadequacy of the nation-wide medical savings scheme to cover outpatient treatment and medications. Half of the healthcare users did not know where to seek help. While patients could access comprehensive services in polyclinics, those that did not turn up might not receive timely care. Furthermore, patients reported long consultation waiting time.
Physicians were able to propose and drive quality improvement projects to improve care quality. However, there were challenges of delivering safe and quality care with limited consultation duration due to the need to manage waiting time, inadequate communication with specialists to coordinate care, and resource constraints in managing complex patients.
Although providers could equip patients with self-management and lifestyle related guidelines, patients’ actions are influenced by multiple factors including work nature, beliefs and environment.

Conclusions
There were barriers on care access, delivery and self-management as reported. It is crucial to adopt whole-of-society approach involving individuals, community, institutions and policymakers to improve and support MCCs management. This study has also highlighted the importance to consider different viewpoints of healthcare providers and users in policy formulation and community care planning.
Blood signatures for second stage Human African Trypanosomiasis: A transcriptomic approach.
Authors: Mulindwa Julius , Matovu Enock , Enyaru John , Clayton Christine
Published: January 2020

Background: Rhodesiense sleeping sickness is caused by infection with T. b rhodesiense parasites resulting in an acute disease that is fatal if not treated in time. The global impact of active T. b rhodesiense infection on the patient’s immune response in the early and late stages of the disease is not known. Methods: RNASeq was carried out on blood and cerebral spinal fluid (CSF) samples obtained from T. b. rhodesiense infected patients. The control samples used were from healthy individuals in the same foci. The Illumina sequenced reads were analysed using the Tuxedo suite pipeline (Tophat, Cufflinks, Cuffmerge, Cuffdiff) and differential expression analysis carried out using the R package DESeq2. The gene enrichment and function annotation analysis were done using the ToppCluster, DAVID and InnateDB algorithms. Results: We previously described the transcriptomes of T. b rhodesiense from infected early stage blood (n=3) and late stage CSF (n=3) samples from Eastern Uganda. We here identify human transcripts that were differentially expressed (padj < 0.05) in the early stage blood versus healthy controls (n=3) and early stage blood versus late stage CSF. Differential expression in infected blood showed an enrichment of innate immune response genes whereas that of the CSF showed enrichment for anti-inflammatory and neuro-degeneration signalling pathways. We also identified genes (C1QC, MARCO, IGHD3-10) that were up-regulated (log 2 FC > 2.5) in both the blood and CSF. Conclusion: The data yields insights into the host’s response to T. b rhodesiense parasites in the blood and central nervous system. We identified key pathways and signalling molecules for the predominant innate immune response in the early stage infection; and anti-inflammatory and neuro-degeneration pathways associated with sleep disorders in second stage infection. We further identified potential blood biomarkers that can be used for diagnosis of late stage disease without the need for lumbar puncture.
Contextual and individual determinants of tooth loss in adults: a population-based multilevel study
Authors: Roberto Luana Leal , Silveira Marise Fagundes , De Paula Alfredo Mauricio Batista , Ferreira Efigênia Ferreira , Martins Andréa Maria Eleutério De Barros Lima , Haikal Desirée Sant'Ana
Published: January 2020

Background: Tooth loss represents a known marker of health inequality. The association between tooth loss and unfavorable socioeconomic conditions is evident when analyzed at an individual level. However, the effects of contextual characteristics on tooth loss need to be better investigated and understood. The objective of this study was to analyze tooth loss among Brazilian adults (35-44 years of age), in accordance with individual and contextual social characteristics. Methods: This was a multilevel cross-sectional study with data from 9,564 adult participants from the Brazilian Oral Health Survey - SBBrasil 2010. The dependent variable was the number of lost teeth and the independent variables were grouped into structural (socioeconomic & political context) and intermediary (socioeconomic position, behavioral & biological factors, and health services) determinants. Multilevel Hierarchical Negative Binomial Regression was conducted and the Mean Ratio (MR) was estimated. Results: Brazilian adults lost a mean of 7.57 (95% CI 7.1-8.1) teeth. Among the contextual variables, the number of teeth lost was higher among residents of municipalities with high and medium/low Municipal Human Development Index (MHDI) and in municipalities that did not have public water fluoridation. Among the individual variables, dental loss was higher among those who declared themselves yellow/black/brown/indigenous, were older, who had lower income, who had never visited a dentist, who had used dental services for more than a year and those whose most recent visit to the dentist was due to oral health problems. On the other hand, dental loss was lower among adults with higher education levels and males. Conclusions: The number of missing teeth was associated with unfavorable contextual and individual conditions, which reinforces the need to reduce social inequality and guarantee regular, lifetime access to dental services.
Gender Disparities in the Education Gradient in Self-Reported Health across Birth Cohorts in China
Authors: Zhu Bowen , Ye Yiwan
Published: January 2020

Background: Variation in the relationship between education and health has been studied intensely over the past few decades. Although there is research on gender disparity and cohort variations in educational effect on health using samples from the U.S. and Europe, research about China’s is limited. Given the specific social changes in China, our study is designed to analyze the gender and cohort patterns in the education-health gradient.
Method: The latent growth-curve modeling was used to analyze the gender and cohort variations in the education gradient in self-rated health among Chinese respondents. The study employed longitudinal and nationally representative data from the Chinese Family Panel Studies from the years 2010 to 2016. Each cohort is specified according to their distinct periods of social change in China. Following the analysis, we used latent growth-curve model to illustrate gender and cohort differences in the age-graded education and health trajectories.
Results: Although Chinese men have reported to have better health than women in general, women reported 1.6 percentage points higher in self-reported health for each additional year of schooling compared to that of men (P < 0.001). The latent growth curve model showed women’s extra education benefits were persistent overtime. Compared to the people born during the “Old China” (1908-1938), the education gradient in self-rated health did not change for cohorts born before 1955 and after 1977, but the education-health gap changed significantly in the 1956-1960 (O.R.=1.038, P<0.05), 1967-1976 (O.R.=1.058, P<0.001), and 1977-1983 (O.R.=1.063, P<0.001) cohorts. There was a gender difference for the cohort variations in the education-health gradient. For women, the education effect in the 1956-1960 (O.R.=1.063, P<0.05) , 1967-1976 (O.R.=1.088, P<0.001) and 1977-1983 (O.R.=1.102, P<0.001) cohorts was significantly higher than that of the 1908-1938 cohort. On the contrary, the education-health gradient remained the same across all cohorts for men.
Conclusion: Our study suggests that the education-health gradient varies across cohorts for women, but the size of education effect remains consistent for men across cohorts. The findings support the resource-substitution hypothesis and not the rising-importance hypothesis in China. We discussed the potential influences of the unique, social transformation and educational expansion in China.
Tumour Content Ratio Matters for Detecting Epidermal Growth Factor Receptor Mutation by Cobas Test in Small Biopsies; a Retrospective Study
Authors: Kogo Mariko , Fujimoto Daichi , Hosoya Kazutaka , Nagata Kazuma , Nakagawa Atsushi , Tachikawa Ryo , Yamashita Daisuke , Kitamura Yuka , Imai Yukihiro , Tomii Keisuke
Published: January 2020

Background Recent studies indicate the benefit of treatment with osimertinib over that with conventional epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) for untreated EGFR -mutated non-small cell lung cancer (NSCLC). Cobas ver2 is the only companion diagnostic method for detecting EGFR mutations with osimertinib treatment. We clinically experience false negative cases with this test, but its actual sensitivity is unknown. Moreover, no study has suggested the importance of tumour dissection, and most facilities do not routinely perform them on small biopsies. The purpose of this study was to evaluate the sensitivity of cobas in clinical practice and clarify the role of dissection as a component of the cobas testing. Methods We examined 132 patients with EGFR -mutated NSCLC diagnosed by bronchoscopy and confirmed with PCR clamp. Patients were tested with cobas and the EGFR -positive rate was calculated. Samples with undetected EGFR mutations were retested after tumour dissection and the rate of samples whose EGFR mutation was corrected to positive was assessed. To evaluate tumour cellularity, the tumour content ratio was assessed by calculating tumour cell count over the total cell count on the slide. Results The positive rate of EGFR mutation identification was 76% with cobas, although EGFR mutation-negative patients retained responses to TKI therapy equivalent to positive patients did; however, the tumour content ratio of negative samples was significantly lower than that of positive samples. Twenty-nine negative samples underwent dissection and 24% were corrected to positive. Moreover, 53% of the samples with a tumour content ratio below 10% was negative for cobas, but 33% of these turned positive after dissection. Conclusions Cobas had a high false negative rate in clinical practice, and tumour content ratio might be associated with this rate. Dissection could improve the sensitivity of cobas, especially in samples with low tumour cellularity.