bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Medical Students’ Knowledge of the Deaf Culture and Community in Puerto Rico: A Descriptive Study.
Authors: Lozano Andrea , Kung Michael , Rivera-González Lorena , Hernández-Blanco Yllen , Covas Vicente , Bonilla Anarys , Rodríguez-Ortiz Pedro , Durman Giovanna , Diaz-Algorri Yaritza , Vera Alexis , Chinapen Sandra
Published: May 2020

Background: Effective communication between health care professionals and Deaf and Hard of Hearing (D&HH) patients remains a challenge. Literature regarding health professionals’ knowledge of the D&HH community and their barriers towards health care access is limited in Puerto Rico and suggests a need for research. Therefore, this descriptive study aims to evaluate future physician’s knowledge about the Deaf culture and community in a student cohort at San Juan Bautista School of Medicine (SJBSM).Methods: A survey utilized in a previous study by Hoang et al. was targeted to 230 medical students to evaluate their knowledge of (D&HH) patients. The survey consisted of three parts testing awareness, exposure, and knowledge of the Deaf community. Responses from the Knowledge section were graded using an answer key, and correct answers were added to create an overall continuous sum score per participant, with higher scores meaning higher knowledge. Participants also were asked to write in possible issues deaf patients may face when hospitalized, excluding communication problems. All data were recorded and used for descriptive analysis.Results: 158 (68%) medical students participated. 63% reported exposure to D&HH people, and 80% were aware of the Deaf culture. 21% of students answered to have attended an American Sign Language (ASL) class, and 86% expressed interest in taking an ASL class. The overall percentage of correct answers of all the medical classes evaluated was 39%, with increasing percent knowledge as medical student year increased. The most frequently listed problem by respondents that deaf patients may face when hospitalized was dealing with an emergency in the hospital, such as the fire alarm.Conclusion: Students from clinical years (MSIII & MSIV) showed a better understanding of the Deaf culture when compared to students in pre-clinical years (MSI & MSII). Nevertheless, knowledge was limited in all groups. The information generated is not only valuable for our school but the health-care community as well. The literature related to Deaf culture, particularly in the medical setting in Puerto Rico, is limited. Therefore, there exists a need to continue investigating ways to improve medical students’ education of the Deaf culture and community.
Cystoplasty Combined Autologous Peritoneum with Ileal Seromuscular segment: a new model study
Authors: Shen Jun , Wu Junfeng , Zhao Qinyue , Li Chunfeng , Ruan Yingmao , Chen Xi , Ruan Yingmao
Published: May 2020

BackgroundAfter enterocystoplasty, some serious complications are presented, which are resulted from the chronic interaction between urine and intestinal epithelium. Composite cystoplasty is recommended as a method of surmounting these complications by replacing intestinal epithelium with autologous peritoneum.To develop a feasible surgical procedure for composite cystoplasty which can reduce serious complications postoperatively, keep sterility by excluding the possibility of contamination from the ileal contents, and provide a basis for the further clinical application of reconstruction bladder.MethodsSix female Chinese minipigs (CMP) were randomly chosen, weighted 28–33 kg. By intravenous anesthesia, bladder augmentation was carried out (implanting autologus peritoneum vascularized and, de-epithelialised ileal- seromuscular flaps. The composite cystoplasty used these flaps to mend and reconstruct bladders). Upon release of catheters and balloon at the fifth day, by monitoring the voiding behaviors of the pigs, routine pathology and immunohistochemistry were done by euthanizing the pigs at the 12th week.ResultsSix pigs experienced reconstruction, without complications. Ileum was 10 cm long, and the area of substitute peritoneum was 7 × 4 cm2. Voiding behavior was normal, and urine was clear in all animals after the catheter was taken out. Autopsy indicated that the fixed, bladder was in good condition, covered by continuous urothelium while the peritoneum disappeared, without regeneration of calculi, mucus, fibrosis, or ileal mucosa. Pathological examination demonstrated the success of the technique in developing the seromuscular flap without epithelial remnant. Bladders augmented with autologous peritoneum had fewer lymphocytes infiltration, indicating more effective urinary barrier function.Conclusion ﻿In this experimental porcine model, reconstruction bladder by autologous peritoneum and ileal seromuscular segment is an ideal approach since it can prevent regrowth of ileal epithelial cells and avoid the complications of conventional enterocystoplasty. The potential functions of the peritoneum are both protection and transitional support. This animal study provides a basis for further clinical application of the new enterocysplasty.
Does High and Intensive Care Reduce Coercion? Association of Hic Model Fidelity to Seclusion Use in the Netherlands
Authors: Melle A.L. van , Noorthoorn E.O. , Widdershoven G.A.M. , Mulder C.L , Voskes Y.
Published: May 2020

BackgroundA new inpatient care model has been developed in the Netherlands: High and Intensive Care (HIC). The purpose of HIC is to improve quality of inpatient mental healthcareand to reduce coercion.MethodsIn 2014, audits were held at 32 closed acute admission wards for adult patients throughout the Netherlands. The audits were done by trained auditors, who were professionals of the participating institutes, using the HIC monitor, a model fidelity scale to assess implementation of the HIC model. The HIC model fidelity scale (67 items) encompasses 11 domains including for example team structure, team processes, diagnostics and treatment, and building environment. Data on seclusion and forced medication was collected using the Argus rating scale. The association between HIC monitor scores and the use of seclusion and forced medication was analyzed, corrected for patient characteristics.ResultsResults showed that wards having a relatively high HIC monitor total score, indicating a high level of implementation of the model as compared to wards scoring lower on the monitor, had lower seclusion hours per admission hours (2.58 versus 4.20) and less forced medication events per admission days (0.0162 versus 0.0207).The HIC model fidelity scores explained 27% of the variance in seclusion rates (p< 0.001). Adding patient characteristics to HIC items in the regression model showed an increase of the explained variance to 40%. ConclusionsThis study showed that higher HIC modelfidelity was associated with less seclusion and less forced medication at acute closed psychiatric wards in the Netherlands.
Development and Validation of the Health-Friendly Activity Index: An Assessment Tool to Improve Consumers’ Health-Related Outcomes
Authors: Yun Young Ho , Oh Sinae , Sim Jin Ah , Lee Sujee , Sohn Eun-Jung
Published: May 2020

Objectives We developed the Health-Friendly Activity Index (HFAI) to measure the health-friendly activity of corporations or organizations comprehensively. We validated the developed tool and reported on its use as an assessment tool to improve consumers’ health-related outcomes.Study Design This is a cross-sectional studyPUBH-D-20-02610 Development of the HFAI questionnaire followed a three-phase process: item generation, item construction, and validation with field testing. Using relevance and feasibility criteria, we developed a 105-item questionnaire with six domains (Governance and Infrastructure, Needs Assessment, Planning, Implementation, Monitoring and Feedback, and Outcomes). To assess the sensitivity and validity of the questionnaire, we recruited two different groups. We assessed Group One (31 companies) based on their recent sustainability reports and compared their HFAI scores with the Contribution Assessment Tool for Consumer’s Health (CATCH) scores from 400 people from the general Korean population. For Group Two, we recruited 19 worksites and asked them to complete the HFAI and CATCH.Results Each domain of HFAI exhibited a Cronbach’s α coefficient between 0.382 and 1.000 for Group One and a Cronbach’s α coefficient between 0.676 and 0.938 for Group Two.
Consistency Between Optical Coherence Tomography and Humphrey Visual Field for Evaluating Glaucomatous Defects in High Myopic Eyes
Authors: Wen Wen , Zhang Yuqiu , Zhang Ting , Sun Xinghuai
Published: May 2020

Background:The study is to investigate the influence of high myopia on the consistency between optical coherence tomography (OCT) and visual field in primary open-angle glaucoma (POAG).Methods:We enrolled 37 patients with POAG with high myopia (POAG-HM group), 27 patients with POAG without high myopia (POAG group), and 29 controls with high myopia (HM group). All subjects underwent Humphrey perimetry (30-2 and 10-2 algorithms). The peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured using Cirrus HD-OCT. Spearman’s rank correlation analysis was used to determine correlations between OCT and perimetric parameters. Agreement was analyzed by cross-classification and weighted κ statistics. Results: In POAG group, the cross-classification analysis showed strong agreement between the inferior temporal GCIPL thickness and 10-2 MS (κ = 0.5447, P = 0.0048), and good agreement between the superior and inferior RNFL thicknesses and 30-2 MS (κ = 0.4407 and 0.4815; P< 0.05). In the POAG-HM group, only the inferior temporal GCIPL thickness showed good agreement with 10-2 MS (κ = 0.3155, P = 0.0289).Conclusions: In POAG patients with high myopia, changes in macular measurements were in accordance with visual field defects, and RNFL thickness did not consistently decline with visual field defects due to the effects of high myopia. This study suggests that during diagnosis and follow-up of glaucoma with high myopia, more attention need to be focused on structure and functional defects in macular areas.
Lessons Learned from Introducing the Characteristic of an Outstanding Medical Teacher: Its Implication in Role Modeling and Professionalism
Authors: Ahmady Soleiman , Namazi Hamidreza , Monajemi Alireza , Kohan Noushin
Published: May 2020

Background Role models play a crucial role in determining the professional development of medical trainees. The purpose of this qualitative descriptive study is to gain in-depth understanding of the outstanding qualities of one successful role model in Iran. We described his character, personality and merits as a conceptual framework for role modeling in medical education.Methods Qualitative descriptive study. Inductive content analysis was performed, and data were collected by conducting interviews. The study was done in the school of medicine of Tehran University of Medical Sciences in Iran. Twenty five medical students, medical graduates and faculty members participated in 25 interviews from April to December 2019. The participants were recruited via purposive sampling.Results Five themes, 13 subthemes, and 46 categories were extracted from the data, and the conceptual framework of role modeling in medical education was developed.Conclusion In this study, we designed a framework for role modeling in medical education Based on this framework, role models in medical education can function as mentors, medical leaders, clinical teachers, and professional instructors. Overall, role modeling is an important concept in medical education, and results of this article contributes to maintain the high quality of medical education.
The effect of COVID-19 pandemic on air quality caused by traffic in Istanbul
Authors: KASKUN Songül , ULUTAŞ Kadir
Published: May 2020

The COVID-19 pandemic has become global public health concern and the first death due to COVID-19 in Turkey occurred on 16 March 2020. Therefore, the Turkish governments took some precautions such as curfew, travel restriction, social isolation and shut down the schools and the universities within the scope of the fight of COVID-19. These precautions may cause a decrease in mobility, which in turn expectation to decrease in traffic-related emissions. In this study, the change in the amount of PM10 and NO2 pollutants were evaluated by dividing them in two periods before and after the virus in 2016 and 2020. Traffic-induced PM10 and NO2 concentrations were monitored at 4 stations located close to road traffic in Istanbul. As a result of the study, it was observed that there was no significant difference in PM10 concentration, however NO2 concentrations decreased by 11.8 percent in the after-virus period.
A survey of an eight-breed cross swine heterogeneous population demonstrates the associations among immune cell traits, lung lesions and Mycoplasma abundances
Authors: Zhang qing , Li jing , Huang tao , Zhang yifeng , Xu wenwu , Huang lusheng , Ai huashui , Yang bin
Published: May 2020

Background: Developments of pulmonary diseases, often accompanied by infections of bacteria, severely affect meat production and welfare of pigs. This study investigated the association of lung lesions and Mycoplasma levels inferred from 16S rRNA sequencing of bronchoalveolar lavage fluid with 57 immune cells and 25 hematological traits in 307 pigs at age of 240 days from an eight-breed heterogeneous cross.Result: At a false discovery rate threshold of 0.05, we found that the greater severity of lung lesions were significantly associated with higher CD8+ to CD3+ cell ratio (CD8+/CD3+), neutrophil to lymphocyte ratio (NLR), and standard deviation of red blood cell volume distribution width (RDW-SD), and lower CD4-CD8-/CD3+, CD3+CD4-CD8-/PBMCs, CD14-CD16-/PBMCs, mean corpuscular hemoglobin concentration (MCHC), lymphocyte count (LYM) and lymphocyte count percentage (LYMR), reflected an status of inflammation, immune suppression and hypoxia of the pigs accompanying the development of the lung lesion. The Mycoplasma abundance showed positive correlations with neutrophil count (NEU), neutrophil count percentage (NEUR), neutrophil-to-lymphocyte ratio (NLR), monocyte count (MON), RDW-CV, and RDW-SD, and negative correlations with MCHC, LYM, and LYMR, these correlations are largely consistent with those of lung lesions, supporting the comorbidity of lung lesions and Mycoplasma infection. We also observed a nonlinear association that the sharp increases in NEU and NEUR occurred only when Mycoplasma abundance raised to a level above the population-average. Conclusion: This study showed that the pigs from an eight-breed cross heterogeneous population reared under standardized housing conditions suffered lesion averagely covered 40% of lung, and the lung lesions were significantly linked to load of Mycoplasma in bronchoalveolar lavage fluid. We further demonstrated that the lung lesion and load of Mycoplasma perturb a large variety of immune and hematological traits. These associations provide helpful insights into the changes of host immune status in response to mycoplasma relevant lung diseases in pigs.
A new technique for ureteral reconstruction using lingual mucosa grafts in a beagle model
Authors: Xu Yujie , Sun Lin , Pan Qiufeng , Hua Xiaoliang , Li Bing
Published: May 2020

Background The ideal technique for ureteral reconstruction has not been established yet. We report our initial experiment to investigate the feasibility of ureteral reconstruction using lingual mucosa graft (LMG) and to evaluate the histological changes of the engrafted LMG in beagles.Methods Twelve male beagle dogs were randomly divided into groups A, B and C (n = 4). A ventral ureteral defect was created by excising half of the ureteral wall. The length of the defect was 3 cm, 6 cm and 10 cm in groups A, B and C, respectively. The LMGs were harvested and employed to repair the ureteral defects in an onlay fashion. Two dogs per group were sacrificed after 6 months, with an additional 2 dogs per group sacrificed after 12 months. Intravenous urography (IVU) and macroscopic examination were performed to evaluate renal function and ureteral patency. Histological changes in the engrafted LMGs during the tissue incorporation process were assessed by histological analysis.Results There were no postoperative complications. Only one dog in group C developed a mild stricture near the proximal anastomosis. In the remaining 11 animals, IVU showed normal renal function and a wide ureteral caliber without stricture or fistula. The diameter of the LMG-reconstructed ureter was greater than that of the proximal and distal ureter (each p value < 0.01). The LMGs survived in situ with newly formed capillaries. The epithelium of the lingual mucosa resembled the urothelium in postoperative 12 months.Conclusions This new technique for ureteral reconstruction using LMGs is feasible. This approach is a promising alternative clinical treatment for curing long ureteral strictures.
Traditional Chinese Medicine Might Reduce Risk of Dementia in Patients with Parkinson’s disease: A Population-based Nested Case-control Study
Authors: Liang Yun-Tzu , Lin Chia-Yang , Wang Yu-Hsun , Chou Hsi-Hsien , Wei James Cheng-Chung
Published: May 2020

Background Patients who have Parkinson’s disease (PD) comorbid with dementia is common. With the prolonged life expectancy, dementia is gradually becoming prevalent and affects most patients’ life qualities. However, the efficacy of current treatments in dementia of Parkinson’s disease is limited. Previous studies indicated the potential roles of Traditional Chinese Medicine (TCM) in treating dementia, yet its effects in preventing dementia from Parkinson’s patients are unknown.Methods This case–control study was nested within a national health insurance database of patients over 50 years old with newly diagnosed Parkinson’s disease from year 2000 to 2010. Among these PD patients, dementia and non-dementia groups were discussed respectively in terms of the duration of taking TCM (≥ 90 days versus < 90 days), age (50–64 versus ≥ 65) and gender.Results The risk of dementia in patients with Parkinson's disease is decreased by using TCM for < 90 days and ≥ 90 days, especially in the group who took TCM for more than 90 days. The use of TCM significantly reduces the risk of dementia in the subgroups of age ≥ 65 years, female patients using TCM for both < 90 days and ≥ 90 days, and male patients using TCM for < 90 days. Overall, we can see the protection tendency among all of the target population under TCM use.Conclusions The results showed that there is a significant reduction of nearly 38% in the risk of dementia for patients with Parkinson’s disease after the usage of Traditional Chinese Medicine. The beneficial effects for using TCM ≥ 90 days in women age ≥ 65 years are most prominent.Trial registration The study data were acquired from the Taiwan’s National Health Insurance (NHI) Research Database. The NHI-claimed data provide clinical information for population-based epidemiologic research. This study was approved by the Institutional Review Board of Chung Shan Medical University Hospital.
MusicCohort: Cross-sectional feasibility study of an assessment protocol for student musicians
Authors: Bruder Julius , Ballenberger Nikolaus , Villas Bethany , Haugan Charlotte , McKenzie Kimiko , Patel Zalak , Mevawala Amynah , Zalpour Christoff , Guptill Christine
Published: May 2020

This study examined the feasibility of employing an assessment battery developed in Germany, investigating mental and physical health of university music students, in Canada. Using a cross sectional design, first-semester music and control students were recruited at two university campuses. Eligibility criteria were: 1) first-semester, full-time undergraduate music major (case) or in another university program (control), 2) over the age of 16. Exclusion criteria were: 1) diagnosis of neurological, orthopaedic or psychological condition, 2) diagnosis of infection or systemic disease, 3) regular consumption of medication for pain or mental health diagnosis, 4) varsity athlete, 5) for controls only, enrollment in music courses where a grade is assigned for music performance (e.g. studio lessons). Both groups completed questionnaires and physical testing, including range of motion, core strength and pressure pain threshold. Data for 19 music and 50 control students were analysed. Musician participants demonstrated tendencies towards poorer mental and physical health. This German protocol is feasible in a Canadian university setting. Canadian music students demonstrate similar mental and physical health outcomes to those in the literature and in the parent study. The results of this feasibility study should be confirmed in a larger study.
The Evaluation of Dental English Education in China Based on ‘Guanghua Cup’ International Clinical Skill Exhibition Activity
Authors: Wang Xi , Liu Yangjingwen , Yang Le , Zhou Kai , Cao Yang , Hong Yun , Huang Shuheng , Lin Zhengmei
Published: May 2020

Objectives: To evaluate current Chinese dental English education based on the Chinese participants’ application ability of dental English during an international dental skill competition called ‘Guanghua Cup activity’.Methods: The enrollment ratio of English and Chinese volunteers, the answer rate and accuracy of English knowledge quiz of Chinese and international contestants were statistically described. A 5-point Likert scale questionnaire was delivered to contestants, English and Chinese volunteers. The data was analyzed using spearman test, Kruskal-Wallis rank sum test and Mann-Whitney U test.Results: Among the 194 students, the English and Chinese volunteer enrollment rate was 7.73% and 30.93%, respectively. The answer rate of Chinese participants and international participants in the English quiz was 25% and 75%, with an accuracy rate of 50% and 66.70%, respectively. The questionnaire was graded by Likert 5-level classification. There was a positive correlation between the use of English textbooks in classes and the communication with international teachers and students in the competition (Rs = 0.348, p = 0.016). English volunteers had more preparation in English before the competition, more opportunities to communicate with international peers, and greater improvement in English ability than the contestants and Chinese volunteers(p < 0.001). After the competition, all participants paid more attention to dental English (p < 0.001).Conclusions: Chinese dental students have difficulty in dental English application. The ‘Guanghua Cup’ helps to improve English proficiency of English volunteers and arouses the interest of dental English for all participants. Chinese dental school needs to strengthen and reach a consensus in dental English education.
Effect of a High Value Care Curriculum on Standardized Patient Exam in the Core Clerkship in Internal Medicine
Authors: Pahwa Amit K , Eaton Kevin , Apfel Ariella , Bertram Amanda , Ridell Rebecca , Cayea Danelle
Published: May 2020

Background: While there are increasing curricula on high value care, little is published on the effectiveness of curricula on medical students’ ability to practice high value care.Methods: In addition to the standard curriculum, the intervention group received two classroom sessions and three virtual patients focused on the concepts of high value care. The primary outcome was number of tests and charges for tests on standardized patients.Results: One hundred forty-one students enrolled in the Core Clerkship in Internal Medicine and 69 completed the high value care curriculum. There were no significant differences in ordering of appropriate tests (3.1 vs. 3.2 tests/students, p = 0.55) and inappropriate tests (1.8 vs. 2.2, p = 0.13) between the intervention and control. Students in the intervention group had significantly lower median Medicare charges ($287.59 vs. $500.86, p = 0.04) and felt their education in high value care was appropriate (81% vs. 56%, p = 0.02).Conclusions: This is the first study to describe the impact of a high value care curriculum on medical students’ ordering practices. While number of inappropriate tests were not significantly different, students in the intervention group refrained from ordering expensive tests.
Molecular and morphological clocks for estimating evolutionary divergence times
Authors: Barba-Montoya Jose , Tao Qiqing , Kumar Sudhir
Published: May 2020

Background: Matrices of morphological characters are frequently used for dating species divergence times in systematics. In some studies, morphological and molecular character data from living taxa are combined, whereas others use morphological characters from extinct taxa as well. We investigated whether morphological data produce time estimates that are concordant with molecular data. If true, it will justify the use of morphological characters alongside molecular data in divergence time inference. Results: We systematically analyzed three empirical datasets from different species groups to test the concordance of dates of species divergence inferred using molecular and discrete morphological data from extant taxa as test cases. We found a high correlation between their divergence time estimates, despite a poor linear relationship between branch lengths for morphological and molecular data mapped onto the same phylogeny. This was because node-to-tip distances showed a much higher correlation than branch lengths, because of an averaging effect over multiple branches. We found that nodes with a large number of taxa often benefit from such averaging, but some considerable discordance between time estimates from molecules and morphology may still occur because some deeper branches show large difference from two types of data. Conclusions: Our findings suggest that node- and tip-calibration approaches may be better suited for nodes with a large number of taxa. Nevertheless, we highlight the importance of evaluating the concordance of time structure in morphological and molecular data before any dating analysis using combined datasets.
Impact of High-Risk Fertility Behavior on Under-five Mortality in Asia and Africa: Evidence from Demographic and Health Surveys
Authors: Amir-ud-Din Rafi , Naz Lubna , Rubi Anila , Usman Muhammad , Ghimire Umesh
Published: May 2020

Background High-risk fertility behaviors (HRFBs) are common in African and South Asian countries and can potentially affect child survival. This study examines the high-risk fertility behaviors concerning child mortality across the countries. Method Data from a series of Demographic and Health Surveys from the year 1987 to 2016 from 24 South Asian and African countries (N=1,224,832) were included in this study. Four HRFB parameters - women’s age <18 or >=34 years at childbirth, birth spacing <24 months, and child order of birth >3, were categorized into three exposure levels: i) exposure to any HRFBs category (exposure to any of four parameters); ii) exposure to single and multiple HRFB category (a combination of two or more parameters); and iii) the specific type of HRFB category (either single or multiple HRFB categories). Bivariate descriptive analysis and a multivariate logistic regression model were used to examine the association between under-five child mortality and various measures of HRFBs. Results Our pooled data analysis reported that HRFBs was associated with an increased risk of under-five child mortality in Asian and African countries. Children of women exposed to HRFBs were at increased risk of under-five mortality by 77% (Adjusted Odds Ratio (AOR) = 1.771, 95% confidence interval (CI): 1.722 - 1.821). Children born within 24 months’ birth interval were four times more likely to die (AOR = 4.995, 95% CI: 4.842-5.152) than their counterparts. However, a single high-risk category was not associated with under-five mortality, and birth order was found to be a protective factor against under-five mortality. Age of women (<18 or >=34 years) was found to be a risk factor of Under-five child mortality in 16 countries. The association between under-five mortality risk and birth interval of less than 24 months was highly significant in all countries. Conclusion Women’s age at childbirth, birth interval, and birth order were significantly associated with under-five mortality. Quality care for women and newborns need to be ensured through investment in the healthcare system, and by promoting health services with more focus given to the valuable populations through sexual and reproductive health education programs and empowering women.
Effectiveness of Mulligan Joint Mobilizations and Trunk Stabilization Exercises Versus Isometric Knee Strengthening in the Management of Knee Osteoarthritis: Study Protocol for a Randomized Controlled Trial.
Authors: NAZIR SHAIKH NABI BUKHSH , Ali Syed Shahzad , Akhtar Saeed
Published: May 2020

BackgroundKnee Osteoarthritis (KOA) has a huge negative impact on gait parameters and on many components of biomechanics, including impairment of dynamic lower limb alignment and control of lumbopelvic movement. Specifically addressing these problems in treatment regimens is therefore critical but they must first be studied in detail before they can be used clinically to treat patients with KOA. This study protocol focuses on whether Mulligan joint mobilization with movement demonstrably decreases pain and restores healthy joint biomechanics and whether trunk stabilization exercises improve stability of the trunk, thereby distributing the weight of the body evenly on both feet. Because the treatment effects of neither treatment are conclusive, this study aims to determine their efficacy versus isometric knee strengthening.Method:The study protocol is a three-arm randomized controlled trial. After initial screening by a referring consultant, subjects who fulfil the study criteria will be randomly assigned to one of three groups. They will then be given an explanation of study objective and asked for their informed consent to participate in the study. Group 1 will receive Mulligan mobilization with kinesiotaping and knee strengthening. Group 2 will receive trunk stabilization exercises, knee strengthening, and kinesiotaping. Group 3 will receive knee strengthening along with kinesiotaping. All participants will be evaluated using a visual analogue scale, Knee injury and Osteoarthritis Outcome Score, stair climb test and 6-minute walk test at the baseline, 3rd and end of 6th week.DiscussionThe results of this study will answer focused questions concerning the relative efficacy of each treatment in KOA patients. The findings of this study will inform clinical decision-making by healthcare professionals and researchers.Trial registration: NCT04099017
FAM172A suppresses polymerization of tubulin and development of HCC (Hepatocellular Carcinoma)
Authors: Zhang Jin-qian , Xia Zheng-lin , Li Li , Li Dao-wei , Chen Yu , Chen Jinglong , Xiang Guo-an
Published: May 2020

BackgroundThe polymerization of tubulin play the vital role in development and pathogenesis of cancer. Our study will explain the role of FAM172A in tubulin polymerization of HCC cell line.MethodsFAM172A-interacting proteins were screened from cDNA library of human liver with the system of yeast two-hybrid, the combined protein of FAM172A was further identified with system of mammalian two-hybrid, CO-IP experiment, and assay of GST-pull down. Then cell line HepG2 of human hepatocellular carcinoma was transfected with AAV-FAM172A or FAM172A-shRNA, and then proliferation ability and cell cycle were assessed. The expression of FAM172A and β-tubulin polymerization were determined. The effect of FAM172A on development of hepatocellular carcinoma associated with polymerization of tubulin was studied, and we used xenograft mice in vivo experiment.ResultsSeveral clones were positively screened from library, which included β-tubulin cDNA. Further studies confirmed FAM172A could combine with β-tubulin. FAM172A suppressed polymerization of tubulin, meanwhile the proliferation and cell cycle of HepG2. Besides, AAV-FAM172A could inhibit the development of HCC in xenogarft mice. ConclusionsOur results indicated FAM172A might be the crucial mediator of polymerization tubulin and HCC development. It suggested that aim at FAM172A through suppressing the polymerizaton of tubulin maybe the viable strategy for treatment of HCC.
A five-step process for designing implementable complex interventions: A worked example using the Tailored intervention for ANxiety and DEpression Management (TANDEM) for patients with chronic obstructive pulmonary disease (COPD)
Authors: Steed Liz , Heslop-Marshall Karen , Sohanpal Ratna , Saqi-Waseem Sarah , Kelly Moira , Pinnock Hilary , Taylor Stephanie
Published: May 2020

Background

Healthcare interventions shown to be effective, are commonly then found to be poorly implemented in clinical practice. It is suggested that insufficient attention is given to the implementation process at the developmental phase of intervention. This study outlines a 5 step process for considering both implementation and effectiveness issues from the outset of intervention development. We use the development of a complex intervention Treatment of anxiety and or depression in patients with chronic obstructive disease (TANDEM) to illustrate this process.
Methods

Intervention development built upon the Medical Research Council framework for developing complex interventions and the Person Based Approach to development of behavioural interventions. Evidence synthesis, stakeholder engagement, qualitative data collection and pre-piloting were all critical steps in intervention development.
Results

Contact with experts in the field ensured efficiency of design. Qualitative work suggested guiding principles for the intervention such as introducing mood in relation to breathlessness, and providing flexible tailoring to patients’ needs, whilst implementation principles focused on training selected respiratory professionals and requiring supervision to ensure standards of care. Subsequent steps of intervention development, pre-piloting and intervention refinement led to an intervention that was deemed acceptable and if successful will be ready for implementation.
Conclusions

By following the 5-step process recommended, both effectiveness and implementation concerns can be addressed in developing health care interventions, with the likelihood that such interventions will have a more rapid translation in to health care benefits, if shown to be effective.
Knowledge, attitude and practice of healthcare workers towards COVID-19 and its prevention in Ethiopia: a multicenter study
Authors: Jemal Bedru , Ferede Zemedu Aweke , Mola Simeneh , Hailu Sileshi , Abiy Sileshi , Wolde Getahun Dendir , Tilahun Abere , Tesfaye Biruk , Lemma Diriba Teshome , Alimaw Agmuas Asichale , Neme Derartu , Regasa Teshome , Mulugeta Hailemariam , Moges Kassaw , Bedru Mohammedrabi
Published: May 2020

Background: An emerging respiratory disease was abbreviated as COVID 19, after it has been first reported in December 2019 in Wuhan city of China. The virus is zoonotic which has a tendency to be transmitted between animal to human and human to human. The major route of transmission of COVID-19 is droplet and close contact. Ethiopian ministry of health has initiated training for health care workers at a different level. WHO and CDC also initiated a multidisciplinary approach to tackle COVID-19 of which awareness creation is the main. Thus, the main objective of this study is to assess knowledge, attitude, and practices of health workers in Ethiopia towards COVID-19 and its prevention techniques.Method: an institutional-based multicenter cross-sectional study was conducted in each of eight teaching and referral hospitals. A total of 422 Ethiopian healthcare workers were selected for the assessment of knowledge, attitude, and practice towards COVID-19. Socio-demographic characteristics and data related to the KAP of the participants were collected using a structured questionnaire Logistic regression model was used to identify factors associated with the attitude and knowledge of healthcare workers towards COVID-19 at a significance level of p<0.05.Result: Three hundred ninety-seven healthcare workers participated in the study with a response rate of 94%. Among these, 88.2% and 94.7% of respondents had good knowledge and positive attitude respectively. A respondent with history of chronic medical illness (OR: 0.193, 95% CI: 0.063-0.593), social media, telecommunication, and television/radio as a source of information were significantly associated with knowledge (OR: 3.4, 95% CI: 1.5-7.4, OR: 4.3, 95% CI: 1.3-14.3 and OR: 3.2, 95% CI: 1.4-7.2). Additionally respondent with history of chronic medical illness was significantly associated with negative attitude towards COVID-19.Conclusion: The overall level of knowledge and attitude was good. However, the practice was relatively low. Source of information like social media, telecommunication, and television/radio were positively associated with healthcare workers' knowledge about COVID-19. Strategies for enhancing the capacity of healthcare workers to develop practice are needed.Keyword: COVID-19, Knowledge, Attitude, Practice, Healthcare worker, Ethiopia
Identification of a prognostic immune signature for esophageal squamous cell carcinoma to predict survival and inflammatory landscapes
Authors: He Jie , Zhang Chaoqi , Luo Yuejun , Zhang Zhen , Zhang Zhihui , Zhang Guochao , Wang Feng , Che Yun , Zhang Yi , Sun Nan
Published: May 2020

BackgroundImmunotherapy has achieved surprising success in the treatment of esophageal squamous cell carcinoma (ESCC). However, studies concerning immune phenotypes within the ESCC microenvironment and their relationship with prognostic outcomes are limited. Therefore, we aim to construct and validate an individual immune-related risk signature for patients with ESCC.MethodsWe collected 196 ESCC cases, including 119 samples from our previous public data (GSE53624) to use as a training set. We additionally collected an independent validation cohort consisting of 77 frozen tumor tissues with qPCR data. Head and neck squamous cell carcinoma (HNSCC) and lung squamous cell carcinoma (LUSC) cohorts were also collected for validation. A least absolute shrinkage and selection operator (LASSO) model and a stepwise Cox proportional hazards regression model were used to construct the immune-specific signature. The potential mechanism and inflammatory landscapes of the signature were explored by using bioinformatics and immunofluorescence assay methods.ResultsImmune-related genes were significantly altered in ESCC tissues, and 16 differentially expressed immune-related genes with the most prognostic value were filtered out (P<0.01). Then a six-gene-based signature (TSPAN2, AMBP, ITLN1, C6, PRLR, and MADCAM1) was generated from the training set. This signature classified the patients into two groups with significantly different overall and relapse-free survival. Furthermore, the signature showed similar prognostic values in different clinical subgroups and in the independent cohort, as well as in patients with HNSCC and LUSC. Multivariable Cox regression analysis confirmed that the signature was an independent prognostic factor for patients with ESCC in different cohorts. Pathway analysis showed that genes related to the signature were mostly involved in cell adhesion, leukocyte transendothelial migration, and cancer progression. Further analysis revealed that the signature was closely associated with specific inflammatory activities (activation of macrophages and T cells signaling transduction). Additionally, high-risk patients were found characterized by distinctive immune checkpoints panel and higher filtration of Tregs and fibroblasts. ConclusionWe constructed the first comprehensive immune-related risk signature for ESCC and furnished new hints of immune profiling of ESCC. Future prospective studies are needed to test the clinical utility of this signature in the individualized management of patients with ESCC.
Molecular evaluation of Toxocara infection in stray cats using loop-mediated isothermal amplification (LAMP) technique as a rapid, sensitive, and simple screening assay
Authors: Azimian Hamid , Shokrani Hamidreza , Fallahi Shirzad
Published: May 2020

Background: Toxocara species are parasitic nematodes of dogs and cats with a worldwide distribution. The adult worm lives in the intestine of dogs and cats, and infection occurs through eating paratenic host or embryonated eggs. These nematodes are considered as one of the common pathogens of humans and livestock, and in humans cause Visceral larva migrans (VLM) syndrome, which is accompanied by different clinical symptoms, sometimes lead to respiratory problems and even death. The present study aimed to investigate the molecular frequency of Toxocara species in stray cats using the loop-mediated isothermal amplification (LAMP) technique. Methods: During 3 months (July to September 2018) a total of 95 stool samples were randomly collected from stray cats in Khorramabad city, Lorestan province, West of Iran. To separate the parasite’s eggs, the flotation method with chlorine solution was applied to saturation. Microscopic examination was performed after the separation and extraction of supernatants. To rupture the four layers of Toxocara egg, and extraction of DNA, sonication and freeze and thaw processes were used. After DNA extraction from the stool specimens, the LAMP reaction was performed using the internal transcribed spacer 2 (ITS2) gene primers of Toxocara species and the appropriate LAMP master mix. Results: The overall prevalence of Toxocara spp. in stray cats of Khoramabad city was 20% (19/95) by parasitological and molecular assessments. The microscopic examination of stool samples revealed that 19 samples were positive for Toxocara spp. The same 19 positive samples were also positive in the LAMP experiments. Interestingly, based on the results of the LAMP assay, out of 95 studied samples, 18 (18.41%) specimens were belonged to Toxocara canis, while only 1 (0.5%) sample was diagnosed as Toxocara cati. Conclusion: Identification of Toxocara spp. in dogs and cats as the important sources of human infections especially for children is particularly important. The relatively high prevalence of Toxocara species, especially and interestingly the canis species in the studied cats shows the role of these animals in spreading the disease and the risk of transmission of infection to humans. Precautionary measures such as preventing cats from traveling in public places, especially children's playgrounds, as well as avoiding direct contact with stray cats are recommended.
Recombinant thrombomodulin does not promote bacterial propagation but alleviates oxidative stress in rats infected with methicillin-resistant Staphylococcus aureus
Authors: Ito Takashi , Shrestha Binita , Kakihana Yasuyuki , Maruyama Ikuro
Published: May 2020

Background

Recombinant thrombomodulin (rTM) has been used for treatment of sepsis-associated disseminated intravascular coagulation. Recent studies have suggested that anticoagulant therapy might dampen the protective role of immunothrombosis. We examined if rTM might worsen infectious diseases.
Methods

Male Sprague–Dawley rats with jugular-vein catheterization were divided into three groups: no anticoagulation; rTM pretreatment; rTM treatment at 6 h. Live methicillin-resistant Staphylococcus aureus (MRSA) was inoculated into the tail vein of rats. rTM was administered into the jugular-vein catheter before or 6 h after MRSA inoculation, while an equal volume of saline was administered in the no-anticoagulation group. Blood samples were collected from the jugular-vein catheter before, 6 h and 12 h after MRSA inoculation. Tissue samples were collected from anesthetized rats when moribund or 18 h after MRSA inoculation.
Results

The survival rate of rats in the no-anticoagulation group, rTM pretreatment group, and rTM treatment at 6-h group was 50%, 25%, and 75%, respectively. Bacterial burden in blood, lung, liver, and spleen was neither increased nor decreased in rats treated with rTM. The ratio of bacteria found in the extravascular space to those in the intravascular space was increased in rats treated with rTM. Metabolomics analysis revealed that rTM treatment alleviated oxidative stress, as evidenced by the decrease in levels of oxidized glutathione.
Conclusions

rTM does not promote bacterial propagation but alleviates oxidative stress in a rat model of bloodstream infection with MRSA.
A Newly Built rAAV-SaCas9 Genome Editing System Enables Muscle-Directed Gene Editing to Improve Muscular Atrophy
Authors: Weng Shaoting , Li Xingyu , Zhao Yitian , Gao Feng , Shi Mengmeng , Yang Haoxiang , Han Liqiang , Wang Jiang , Yang Guoyu
Published: May 2020

Background

At present, genome editing at specific sites in vivo is affected by many factors, including the choice of vector, the efficiency of editing proteins and the influence of the internal environment. These factors make gene editing ineffective and even have adverse effects.
Methods

Here, we report a single rAAV containing SaCas9 and guide RNAs under the control of subtle EF1a and tRNA promoters. The capacity of rAAV was compressed, and we inserted the sequence of the green fluorescent protein eGFP into rAAV. The efficiency of rAAV gene editing in vivo and in vitro was analyzed by time point and virus titer. In addition, we used the rAAV9-SaCas9 system to knock out the myostatin gene in the thigh muscles of muscle-atrophic mice.
Results

We demonstrated that the gene editing elements regulated by the rAAV-SaCas9 system can be expressed. By increasing the amount of rAAV and the reaction time, the editing efficiency of myostatin and the expression level of eGFP protein can be improved in vitro and vivo. Furthermore, We demonstrated that muscle cells were improved by knockout partial myostatin gene in a mouse model of muscular dystrophy.
Conclusions

The rAAV-SaCas9 system can be expressed in a stable and long-term manner. The system has substantial therapeutic potential in treating muscular atrophy.
Half graben inversion tectonics revealed by gravity modeling in the Mikawa Bay Region, Central Japan
Authors: Miyakawa Ayumu , Abe Tomoya , Sumita Tatsuya , Otsubo Makoto
Published: May 2020

The Mikawa Bay Region, central Japan, is characterized by many active faults recording Quaternary activity. It is, however, difficult to understand the overall tectonic character of the region due to the thick sediments in this region. We estimated the depth and the structure of the basement top in the Mikawa Bay Region through the analysis of gravity data, compiling publicly available gravity data and our own gravity measurements in the central part of the region. The gravity basement map shows the deepening of the basement top from the Nishi-Mikawa Plain to the Chita Peninsula. Two-dimensional modeling constrains the orientation of the Utsumi and Takahama faults. The fact that the basement top structure related to the Kou Fault is insignificant in the gravity data indicates that the geometry of the Kou Fault is small relative to that of the Utsumi Fault. The basement top structure from the Nishi-Mikawa Plain to the Chita Peninsula reveals a half graben structure bounded by the Utsumi Fault. The inverse motion of the Utsumi Fault, which underwent normal faulting during the Miocene followed by recent reverse faulting, is interpreted to reflect the inversion tectonics of the half graben. The timing of the inversion tectonics, i.e. the reverse faulting of the Miocene normal fault, can be compared to an episode of basin inversion observed at the eastern margin of the Japan Sea, northeastern Japan. The Takahama Fault in the center of the Nishi-Mikawa Plain is considered to have formed as a result of the backthrust of the Utsumi Fault under inversion tectonics. If the Takahama Fault is indeed the backthrust fault of the Utsumi Fault, the root of the Takahama Fault may be deep such that the Takahama Fault is seismogenic and linked to the 1945 Mikawa earthquake.