bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrative analysis of multi-omics data reveals the heterogeneity and signatures of immune therapy for small cell lung cancer
Authors: Chen Yabin , Fang Zhaoyuan , Tang Ying , Jin Yujuan , Guo Chenchen , Hu Liang , Xu Yang , Gao Jie , Xie Mei , Zang Xuelai , Ma Xi , Liu Sanhong , Chen Haiquan , Xue Xinying , Ji Hongbin , Chen Luonan
Published: January 2021

Small cell lung cancer (SCLC) is highly invasive and lethal. Genomic studies are beginning to characterize its genetic determinants and heterogeneity. Here we performed RNA-Seq and whoe exome sequencing (WES) in 19 Chinese SCLC clinical tumor specimens. Integration with other two public cohorts (n = 129 for RNA-seq, n = 171 for WES), we carried out gene co-expression network analysis and classified into four subgroups: ASCL1-high, NEUROD1-high, a novel variant subtype with CCSP/CC10-high, and a fourth subtype with high expression of NOTCH family and inflammatory genes. We further found that this fourth subtype was characterized by overexpression of immune-related pathways and immunosuppressive factors, referred to as immune subtype. In addition to transcriptomic signatures, specific genomic alterations were also significantly enriched in each subtype. We successfully built a machine learning model to predict the subtypes of newly coming specimens based on transcriptomic data. In particular, we found that POU2F3 protein was effective in distinguishing immunotherapy patients, i.e. the immune subtype, which was further validated by an independent data of chemo-resistant patients received 2nd -line immunotherapy. Collectively, our work systematically studied the transcriptomic and genomic heterogeneity of SCLC, and characterized an immune subtype that displayed features of sensitivity to immune checkpoint-based therapies.
A descriptive analysis of the impact of COVID-19 on Emergency Department attendance and visit characteristics in Singapore
Authors: Lim Mei Qiu , Siddiqui Fahad Javaid , Liu Nan , Saffari Seyed Ehsan , Lian Sherman Wei Qiang , Tan Boon Kiat Kenneth , Sim Nicole Simin , Shen Yuzhen , Ong Marcus Eng Hock
Published: January 2021

Introduction: It is yet to be understood how COVID-19 impacted utilisation of Emergency Department (ED) services in Singapore. This study aimed to describe the changes in attendance of a single ED and corresponding patient visit characteristics and outcomes before and during the COVID-19 period.Methods: In a single-centre retrospective cohort study, we used descriptive statistics to compare ED attendance, patient demographics and visit characteristics during the COVID-19 period (1 January – 28 June 2020) and its corresponding historical period in 2019 (2 January – 30 June 2019).Results: Mean ED attendance decreased from 342 visits/day in the pre-COVID-19 period, to 297 visits/day in the COVID-19 period. This was accompanied by reductions in P1 visits and presentations in nearly every ICD-10-CM diagnosis category except for respiratory-related diseases. We also noted a shift in ED patient case-mix from ‘Non-fever’ cases to ‘Fever’ cases, likely giving rise to two distinct trough-to-peak visit patterns during the pre-Circuit Breaker and Circuit Breaker period. Average ED admission rate during the Circuit Breaker period (48.3%) was higher as compared to pre-Circuit Breaker period (40.7%), however average daily admission remained stable.Conclusion: The COVID-19 pandemic caused a reduction in SGH ED attendances amongst patients with low-acuity conditions and those with highest priority for emergency care. This raises concern about treatment-seeking delays and possible impact on health outcomes. Our data provides insights that may be useful for ED crowd management planning in the post-COVID-19 era. There should be cautious use of ED admission rate as a metric in evaluating ED performance during an outbreak.
A Simple, Low-Cost and Reusable Microfluidic Gradient Strategy and Its Application in Modeling Cancer Invasion
Authors: Samandari Mohamadmahdi , Rafiee Laleh , Alipanah Fatemeh , Sanati-Nezhad Amir , Javanmard Shaghayegh Haghjooy
Published: January 2021

Microfluidic chemical gradient generators enable precise spatiotemporal control of chemotactic signals to study cellular behavior with high resolution and reliability. However, time and cost consuming preparation steps for cell adhesion in microchannels as well as the requirement of pumping facilities usually complicate the application of the microfluidic assays. Here, we introduce a simple strategy for the preparation of a reusable and stand-alone microfluidic gradient generator to study cellular behavior. Polydimethylsiloxane (PDMS) was directly mounted on the commercial polystyrene-based cell culture surfaces by manipulating the PDMS curing time to optimize bonding strength. The stand-alone strategy not only offers a pumpless application of this microfluidic device but also ensures minimal fluidic pressure and consequently a leakage-free system. Elimination of any surface treatment or coating significantly facilitates the preparation of the microfluidic assay and offers a detachable PDMS microchip that can be reused following a simple cleaning and sterilization step. The chemotactic signal in our microchip is further characterized using numerical and experimental evaluations and it is demonstrated that the device can generate both linear and polynomial signals. Finally, the feasibility of the strategy in deciphering cellular behavior is demonstrated by exploring cancer cell migration and invasion in response to chemical stimuli. The introduced strategy can significantly decrease the complexity of the microfluidic chemotaxis assays and increase their throughput for various cellular and molecular studies.
Bone Mineral Density and its Influencing Factors in Chinese Children with Spinal Muscular Atrophy types 2 and 3
Authors: Peng Xiaoyin , Qu Yujin , Li Xiaohui , Liu Junting , Shan Xinying , Wang Jia , Song Fang
Published: January 2021

Background: Patients with spinal muscular atrophy (SMA) are at risk of decreased bone mineral density (BMD). The bone status of Chinese patients with SMA has been poorly studied. We aimed to describe bone health of children with SMA types 2 and 3 in mainland China and to investigate the associated factors that influence BMD. Methods: Forty patients with a mean age of 5.5 years affected by SMA types 2 and 3 (n = 22 and n = 18, respectively) were enrolled between September 2017 and May 2019. Total body less head (TBLH) BMD, lumbar spine (LS) BMD, and body composition were measured using dual-energy X-ray absorptiometry. Serum bone metabolism markers and complete spinal radiographs were assessed. We utilized a linear regression model to explore the correlations between BMD and its related factors. Results: A total of 67.5% (27/40) patients were diagnosed with low BMD, 2.5% (1/40) were diagnosed with osteoporosis, and 5.0% (2/40) had low-trauma fractures. The mean Z-score was -3.0 ± 1.8 for TBLH BMD and -1.3 ± 1.4 for LS BMD. The TBLH BMD and LS BMD Z-scores in children with SMA type 2 were significantly lower than those with SMA type 3 (t = 3.344, P = 0.002; t = 3.266, P = 0.002, respectively). Vitamin D insufficiency and deficiency was found in 37.5% (15/40) of the patients. Phenotype and serum parathormone (PTH) levels were the factors associated with the TBLH BMD Z-scores (t = 2.847，P = 0.008; t = 2.572, P = 0.015, respectively), and the phenotype severity was the factor associated with the LS BMD Z-scores (t = 2.762, P = 0.009).Conclusions: Low BMD was highly prevalent in mainland Chinese children with SMA type 2 or 3. Phenotype and serum PTH levels were the factors associated with BMD. More than one-third of our patients also had vitamin D insufficiency or deficiency, which indirectly affected BMD despite their serum PTH levels being normal. We consider it to be necessary to carry out bone health screening in this population.
Potential Local Adaptation of Corals at Acidified and Warmed Nikko Bay, Palau
Authors: Kurihara Haruko , Watanabe Atsushi , Tsugi Asami , Mimura Izumi , Hongo Chuki , Kawai Takashi , Reimer James , Kimoto Katsunori , Gouezo Marine , Golbuu Yimnang
Published: January 2021

Ocean warming and acidification caused by the increase of atmospheric carbon dioxide are now thought to be major threats to coral reefs on a global scale. Here we evaluated the environmental conditions and benthic community structures in semi-closed Nikko Bay at the inner reef area in Palau, which has high pCO2 and seawater temperature conditions with high zooxanthellate coral coverage. This bay is a highly sheltered system with organisms showing low connectivity with surrounding environments, making this bay a unique site for evaluating adaptation and acclimatization responses of organisms to warmed and acidified environments. Seawater pCO2/Ωarag showed strong graduation ranging from 380 to 982 µatm (Ωarag: 1.79-3.66) and benthic coverage, including soft corals and turf algae, changed along with Ωarag while hard coral coverage did not. In contrast to previous studies, net calcification was maintained in Nikko Bay even under very low mean Ωarag (2.44). Reciprocal transplantation of the dominant coral Porites cylindrica showed that the calcification rate of corals from Nikko Bay did not change when transplanted to a reference site, while calcification of reference site corals decreased when transplanted to Nikko Bay. Corals transplanted out of their origin sites also showed the highest interactive respiration (R) and lower photosynthesis (P) to respiration (P:R). The results of this study give important insights about the potential local acclimatization and adaptation capacity of corals to different environmental conditions including pCO2 and temperature.
Varying Ecological Successions in Lakes Subdivided by Volcanic Eruption at Akan Caldera, Japan
Authors: Wakana Isamu , Kadono Yasuro , Urabe Jotaro , Tamura Yuki , Suzuki Yoshifusa , Yamada Hiroyuki , Oyama Yoichi , Wada Keiji , Hasegawa Takeshi , Ohara Masashi
Published: January 2021

It is difficult to continuously observe ecological succession processes within lakes occurring over long-time spans. Thus, the process is generally shown as “lake types” or "hydrarch succession" reflected by trophic levels or differing aquatic vegetation, based on inductive inference by comparison of many lakes. Alternatively, long-term changes are simulated via microcosms or mesocosms in experimental systems, or lake history can be reconstructed by sediment analysis. Here, we try to demonstrate lake ecological succession processes over thousands of years by showing an example of lakes with diverse trophic levels and aquatic vegetation which were formed by segmentation inside Akan Caldera in eastern Hokkaido, Japan, due to volcanic eruptions. We found oligotrophic, mesotrophic, eutrophic and dystrophic lake systems in the caldera, despite similar ages and process of origin. Total water phosphorus concentration, defining trophic level, was significantly correlated with the ratio of accumulated watershed area to lake area and volume. Twenty-one species of aquatic macrophytes were classified into five groups clearly corresponding to respective or combinations of trophic level. This study is the first to visualize lake serial stages by documenting a series of trophic levels and associated aquatic vegetation groups as a result of differing eutrophication rates over time.
Lumbar Spine Abnormalities in Patients With Obstructive Sleep Apnoea
Authors: Tarnoki Adam Domonkos , Tarnoki David Laszlo , Oláh Csaba , Szily Marcell , Kovacs Daniel , Dienes András , Piroska Marton , Forgo Bianka , Pinheiro Marina , Ferreira Paulo , Kostyál László , Meszaros Martina , Pako Judit , Kunos Laszlo , Bikov Andras
Published: January 2021

Previous studies suggested cervical spondylosis as a risk factor for development of obstructive sleep apnoea (OSA). We aimed to assess lumbar disc degeneration in patients with OSA and correlate the findings with symptoms and disease severity. Twenty-seven patients with OSA and 29 non-OSA controls underwent sleep studies and lumbar magnetic resonance imaging (MRI), and completed the Epworth Sleepiness Scale and the 24-item Roland‐Morris Disability Questionnaire questionnaires. Plasma klotho was determined with enzyme-linked immunosorbent assay.Patients with OSA had higher number of disc bulges (4.6±3.7 vs. 1.7±2.5, p<0.01) and anterior spondylophytes (2.7±4.2 vs. 0.8±2.1, p<0.01), increased Pfirrmann score (16.7±4.7 vs. 13.2±4.1, p<0.01) and vertebral fatty degeneration (7.8±4.7 vs. 3.8±3.7, p<0.01). Markers of OSA severity, including the apnoea-hypopnoea index, oxygen desaturation index and percentage of total sleep time spent with saturation <90% as well as plasma levels of klotho were correlated with the number of disc bulges and anterior spondylophytes following adjustment on age, gender and body mass index (all p<0.05). Markers of disc degeneration were related to chronic pain.OSA is associated with lumbar spondylosis likely through chronic intermittent hypoxaemia inducing inflammation in the lumbar discs. Our study highlights the importance of lumbar imaging in patients with OSA reporting lower back pain.
Effectiveness of adjunctive low frequency repetitive transcranial magnetic stimulation therapy over the left dorsolateral prefrontal cortex in refractory to medical treatment patients with obsessive-compulsive disorder: A double blind, randomized clinical trial
Authors: Jahanbakhsh Ghazal , Hajseyedjavadi Alireza , Majidi Mahnaz
Published: January 2021

Background: Obsessive-compulsive disorder (OCD) is a common neurotic disorder, In 2018 Application of repetitive transcranial magnetic stimulation (rTMS) for treating obsessive-compulsive disorder (OCD) has been approved by the Food and Drug Administration (28), since 2020 different methods has been tested, this study was designed to evaluate the effectiveness of adjunctive low frequency repetitive transcranial magnetic stimulation over the left dorsolateral prefrontal cortex in refractory to treatment patients suffering from obsessive compulsive disorder (OCD) Methods: This clinical trial was performed on 30 patients with OCD referred from the psychiatry clinic of 22 Bahman Hospital in Qazvin province from 2018 to 2020. Patients were randomly assigned to two groups. Intervention group received rTMS treatment at 1 Hz for 20 min (1200 (pulses / day) over the left DLPFC region as adjunctive to their medical treatment for 3 times a week and for 5 weeks while the control group received only sham condition in addition to their medical treatment. All the patients filled out the Yale Brown Questionnaire (YBOCS) Before the study, after sessions 5 and 10 during treatment, at the end of the treatment and 3 to 6 months after the treatment. The results were compared between the two groups using SPSS software version 16.Results: The mean score of post-intervention Yale Brown score was significantly lower in the intervention group. (P <0.05), it was also significant by gender (females), marital status ,taking antipsychotic agents in addition to the serotonergic agents and with more treatment sessions, within 3 to 6 months after intervention. Conclusion: adjunctive low frequency (1 Hz)rtms over the left DLPFC can be effective in reducing Yale Brown score in refractory to treatment patients suffering from OCD after 15 sessions. Gender, treatment sessions, usage of antipsychotic agents as adjuvant with standard treatment regiments, and marital status were identified as predictors for response to adjunctive rTMS therapy.
Roles of the 14-3-3 Gene Family in Cotton Flowering
Authors: Sang Na , Liu Hui , Ma Bin , Huang zhong , Zhuo Lu , Sun qiang
Published: January 2021

Background: In plants, 14-3-3 proteins, also called GENERAL REGULATORY FACTORs (GRFs), encoded by a large multigene family, are involved in protein–protein interactions and play crucial roles in various physiological processes. No genome-wide analysis of the GRF gene family has been performed in cotton, and their functions in flowering are largely unknown.Results: In this study, 17, 17, 31, and 17 GRF genes were identified in Gossypium herbaceum, G. arboreum, G. hirsutum, and G. raimondii, respectively, by genome-wide analyses and were designated as GheGRFs, GaGRFs, GhGRFs, and GrGRFs, respectively. A phylogenetic analysis revealed that these proteins were divided into ε and non-ε groups. Gene structural, motif composition, synteny, and duplicated gene analyses of the identified GRF genes provided insights into the evolution of this family in cotton. GhGRF genes exhibited diverse expression patterns in different tissues. Yeast two-hybrid and bimolecular fluorescence complementation assays showed that the GhGRFs interacted with the cotton FLOWERING LOCUS T homologue GhFT in the cytoplasm and nucleus, while they interacted with the basic leucine zipper transcription factor GhFD only in the nucleus. Transgenic studies in Arabidopsis demonstrated that GhGRF3/6/9/15 repressed flowering and that GhGRF14 promoted flowering.Conclusions: Here, 82 GRF genes were identified in cotton, and their gene and protein features, classification, evolutionary, and expression patterns were comprehensively and systematically investigated. The GhGRFs interacted with GhFT and GhFD to form florigen activation complexes, which either promoted or inhibited flowering. The results provide a foundation for further studies on the regulatory mechanisms of flowering.
Surgical and Oncological Outcomes of Robotic Resection for Sigmoid and Rectal Cancer: Analysis of 109 Patients from A Single Center in China
Authors: Peng Jianhong , Li Weihao , Tang Jinghua , Li Yuan , Li Xueying , Wu Xiaojun , Lu Zhenhai , Lin Junzhong , Pan Zhizhong
Published: January 2021

Background: Robotic colorectal surgery has been increasingly performed in recent years. The safety and feasibility of its application has also been demonstrated worldwide. However, limited studies have presented clinical data for patients with colorectal cancer (CRC) receiving robotic surgery in China. The aim of this study is to present short-term clinical outcomes of robotic surgery and further confirm its safety and feasibility in Chinese CRC patients.Methods: The clinical data of 109 consecutive CRC patients whoreceived robotic surgery at Sun Yat-sen University Cancer Center between June 2016 and May 2019 were retrospectively reviewed. Patient characteristics,tumor traits, treatment details, complications, pathological details, and survival status were evaluated.Results: Among the 109 patients, 35 (32.1%) had sigmoid cancer, and 74 (67.9%) had rectal cancer. Thirty-seven (33.9%) patients underwent neoadjuvant chemoradiotherapy. Ten (9.2%) patients underwent sigmoidectomy, 38 (34.9%) underwent high anterior resection (HAR), 45 (41.3%) underwent low anterior resection (LAR), and 16 (14.7%) underwent abdominoperineal resection (APR). The median surgical procedure time was 270 min (range 120 - 465 min). Pathologically complete resection was achieved in all patients. There was no postoperative mortality. Complications occurred in 11 (10.1%) patients, including 3 (2.8%) anastomotic leakage, 1 (0.9%) anastomotic bleeding, 1 (0.9%) pelvic hemorrhage, 4 (3.7%) intestinal obstruction, 2 (1.8%) chylous leakage, and 1 (0.9%) delayed wound union. At a median follow-up of 17 months (range 1–37 months), 1 (0.9%) patient developed local recurrence and 5 (4.6%) developed distant metastasis, with one death due to disease progression.Conclusions: Our results suggest that robotic surgery is technically feasible and safe for Chinese CRC patients, especially for rectal cancer patients who received neoadjuvant treatment. A robotic laparoscope with large magnification showed a clear surgical space for pelvic autonomic nerve preservation in cases of mesorectal edema.
Study of The Effect of pH on The Performance of Microbial Fuel Cell for Generation of Bioelectricity
Authors: Halim Md. Abdul , Rahman Md. Owaleur , Ibrahim Md. , Kundu Rituparna , Biswas Biplob
Published: January 2021

Background: Day by day microbial fuel cell (MFC) technology is becoming a thought-provoking topic to the researcher because for its simultaneous utilization e.g. electricity production and wastewater treatment. Since wastewater is an important source of electrolyte for MFC, the key tenacity of this study was to investigate the outcome of pH happening various (Municipal, Bhairab river and Hospital) wastewaters used as electrolyte in dual chamber MFC.Findings: The lab-scale experiment was conducted in batch mode, where zinc plate (0.0027m2) as anode and copper plate (0.0027m2) as cathode. In this study a single electrolyte (any one of earlier mentioned three electrolytes) was used in five dual-chambers MFC where the pH of the electrolyte was 6, 7, 8, 9 and 10. The MFC was worked on a temperature ranged from 27°C to 34°C. Maximum outputs were found in terms of current density (1288.9mAm-2), voltage (1132 mV) and power density (1459.02wmw-2) were obtained at pH 8 by using Bhairab river water as an electrolyte in MFC chamber. A substantial amount of COD removal (94%) was also achieved in the same MFC chamber at the same pH (i.e. pH 8). However, the optimum operating pH for MFC containing municipal wastewater and hospital wastewater was found to be 8 and 9, respectively.Conclusion: The results suggest that various wastewaters may act as feasible feedstocks for bioelectricity generation in MFC. The results also show that COD can be removed from wastewater that suggest a treatment possibility of wastewater.
Chronic Cerebral Toxoplasmosis Changes Brain Glutamate and D-Serine Levels, Impairs Startle Reflex But Not Social Preference in Mice
Authors: Acquarone Mariana , Poleto André , Perozzo Ananda , Gonçalves Patricia , Panizzutti Rogério , Menezes João , Neves Gilda , Barbosa Helene
Published: January 2021

Toxoplasma gondii is an opportunistic protozoan pathogen with a wide geographic distribution. The chronic phase of toxoplasmosis is often asymptomatic in humans and is characterized by tissue cysts throughout the central nervous system and muscle cells. T. gondii and other pathogens with tropism for the central nervous system are considered risk factors in the etiology of several neuropsychiatric disorders, such as schizophrenia and bipolar disorder, besides neurological diseases. Currently, it is known that cerebral toxoplasmosis increases dopamine levels in the brain and it is related to behavioral changes in animals and humans. Here we evaluate whether chronic T. gondii infection, using the cystogenic ME-49 strain, could induce behavioral alterations associated with neuropsychiatric disorders and glutamatergic neurotransmission dysfunction. We observed that the startle amplitude is reduced in the infected animals as well as glutamate and D-serine levels in prefrontal cortical and hippocampal tissue homogenates. Moreover, we did not detect alterations in social preference, spontaneous alternation, and tail suspension test despite severe motor impairment. Thus, we conclude that behavioral and cognitive aspects are maintained even though severe neural damage is observed by chronic infection of C57Bl/6 mice with the ME-49 strain.
Comparison of ARIMA and LSTM for Prediction of Hemorrhagic Fever at Different Time Scales in China
Authors: Zhang Rui , Chen Qiulan , Chen Qiang , Meng Yujie , Zheng Huan , Wang Yu , Song Hejia , Li Yonghong , Wang Songwang
Published: January 2021

ObjectivesThis study intends to build and compare two kinds of forecasting models at different time scales for hemorrhagic fever incidence in China.MethodsARIMA and LSTM model were adopted to fit monthly, weekly and daily incidence of hemorrhagic fever in China from 2013 to 2018. The two models, combined and uncombined with rolling forecast, were used to predict the incidence in 2019 to identify its stability and availability. ResultsARIMA (2, 1, 1) (0, 1, 1)12, ARIMA (1, 1, 3) (1, 1, 1)52 and ARIMA (5, 0, 1) was selected as the best fitted ARIMA model for monthly, weekly and daily incidence series respectively. The model with 64 neurons and SGDM for monthly incidence, 8 neurons and Adam for weekly incidence, and 64 neurons and RMSprop for daily incidence were selected as the best fitted LSTM models. The values of root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) of the models combined with rolling forecast in 2019 were lower than those of the direct forecast models for both ARIMA and LSTM. It was shown from the forecasting performance in 2019 that ARIMA was better than LSTM for monthly and weekly forecasting while the LSTM was better than ARIMA for daily forecasting in rolling models.ConclusionsBoth ARIMA and LSTM could be used to build a prediction model for the incidence of hemorrhagic fever meanwhile different models might be more suitable for the incidence prediction at different time scales.
The CAD risk locus 9p21 increases the risk of vascular calcification in an iPSC-derived VSMC model
Authors: Trillhaase Anja , Schmidt Beatrice , Maertens Marlon , Haferkamp Undine , Erdmann Jeanette , Aherrahrou Zouhair
Published: January 2021

Background: Coronary artery disease (CAD) is the leading cause of death worldwide. Chromosome locus 9p21 was the first to be associated with increased risk of CAD and coronary artery calcification (CAC). Vascular calcification increases the risk for CAD. Vascular smooth muscle cells (VSMCs) are one of the major cell types involved in the development of vascular calcification. Methods: So far, mainly animal models or primary SMCs have been used to model human vascular calcification. In this study, a human in vitro assay using iPSC-derived VSMCs was developed to examine vascular calcification. Human iPSCs were derived from a healthy non-risk (NR) and risk (R) donor carrying SNPs in the 9p21 locus. Additionally, 9p21 locus knockouts of each donor iPSC line (NR and R) were used. Following differentiation, the iPSC-derived VSMCs were characterized based on cell type, proliferation and migration rate, along with calcium phosphate (CaP) deposits. CaP deposits were confirmed using Calcein and Alizarin Red S staining and then quantified. Results: The data demonstrated significantly more proliferation, migration, and CaP deposition in VSMCs derived from the R and both KO iPSC lines than in those derived from the NR line. Molecular analyses confirmed upregulation of calcification markers. These results are consistent with recent data demonstrating increased calcification when the 9p21 murine ortholog is knocked-out. Conclusion: Therefore, in conclusion, genetic variation or deletion of the CAD risk locus leads to an increased risk of vascular calcification. This in vitro human iPSC model of calcification could be used to develop new drug screening strategies to combat CAC.
Mass Media and Social Media Impact on Health Literacy And Patient Empowerment of Diabetic Patients
Authors: Fouad Sarah Ahmed , Taher Ahmed , Shafei Ingy
Published: January 2021

This research assesses the role of health literacy in diabetic patient’s lifestyle modification and disease management as a form of patient empowerment. The study evaluated health literacy, patient empowerment, and sources of information for diabetic patients. The research utilized a quantitative methodology using purposive sampling for 408 diabetic patients in diabetes institutes and online social media platforms addressing diabetic patients. The study included two phases, offline and online, with comparisons of online versus offline diabetic literacy. A conceptual model assessing the role of health literacy in diabetic patient’s lifestyle modification and disease management as a form of patient empowerment was developed. The research will contribute to diabetic patient’s health literacy, promotion of creating social network models, educational and patient support initiatives, online literacy, and effective diabetic self-managers.
Willingness to Use a Wearable Device Capable of Detecting and Reversing Overdose Among People Who Use Opioids in Philadelphia
Authors: Kanter Katie , Gallagher Ryan , Eweje Feyisope , Lee Alexander , Gordon David , Landy Stephen , Gasior Julia , Soto-Calderon Haideliza , Cronholm Peter F , Cocchiaro Ben , Weimer James , Roth Alexis , Lankenau Stephen , Brenner Jacob
Published: January 2021

Background: The incidence of opioid-related overdose deaths has been rising for 30 years and has been further exacerbated amidst the COVID-19 pandemic. Naloxone can reverse opioid overdose, lower death rates, and enable a transition to medication for opioid use disorder. Though current formulations for community use of naloxone have been shown to be safe and effective public health interventions, they rely on bystander presence. We sought to understand the preferences and minimum necessary conditions for wearing a device capable of sensing and reversing opioid overdose among people who regularly use opioids.Methods: We conducted a combined cross-sectional survey and semi-structured interview at a respite center, shelter, and syringe exchange drop-in program in Philadelphia, Pennsylvania, USA during the COVID-19 pandemic in August and September 2020. The primary aim was to explore the proportion of participants who would use a wearable device to detect and reverse overdose. Preferences regarding designs and functionalities were collected via a questionnaire with items having Likert-based response options and a semi-structured interview intended to elicit feedback on prototype designs. Independent variables included demographics, opioid use habits, and previous experience with overdose.Results: A total of 97 adults with an opioid-use history of at least 3 months were interviewed. A majority of survey participants (76%) reported a willingness to use a device capable of detecting an overdose and automatically administering a reversal agent upon initial survey. When reflecting on the prototype, most respondents (75.5%) reported that they would wear the device always or most of the time. Respondents indicated discreetness and comfort as important factors that increased their chance of uptake. Respondents suggested that people experiencing homelessness and those with low tolerance for opioids would be in greatest need of the device.Conclusions: The majority of people sampled with a history of opioid use in an urban setting were interested in having access to a device capable of detecting and reversing an opioid overdose. Participants emphasized privacy and comfort as the most important factors influencing their willingness to use such a device.Trial Registration: NCT04530591
Physical activity intervention for rural middle-aged and older Australian adults: A pilot implementation study of the ecofit program delivered in a real-world setting
Authors: Wilczynska Magdalena , Jansson Anna K , Lubans David R , Smith Jordan J , Robards Sara L , Plotnikoff Ronald Cyril
Published: January 2021

Background: ecofit is an evidence-based multi-component physical activity intervention that integrates smartphone technology, the outdoor environment and social support. In a previous efficacy trial, significant improvements were found across several clinical, fitness, and mental health outcomes among adults at risk of (or with) type 2 diabetes.Methods: The aim of the present pilot study was to evaluate a number of health-related and feasibility outcomes of the ecofit intervention in a ‘real-world’ setting, using a scalable implementation model. ecofit was adapted and implemented by a rural municipal council in the Upper Hunter Shire, New South Wales, Australia and evaluated using a single-group pre-post design. Inactive middle-aged and older adults (N=59) were recruited and assessed at 6- (primary time-point) and 20-weeks (follow-up). Results: Improvements were found in this predominantly overweight and obese sample for aerobic fitness, functional mobility, upper and lower body muscular fitness, systolic blood pressure and waist circumference at 6-weeks. At 20-weeks, effects were found for aerobic fitness, functional mobility, upper and lower body muscular fitness, and systolic blood pressure. Overall, participants were satisfied with the ecofit program. Participants attended the 6-week primary time-point (66.1%) and follow-up at 20-weeks (41.6%).Conclusions: Our findings support the preliminary effectiveness and feasibility of the ecofit intervention delivered by municipal council staff following a brief training from the research team. This study provides valuable preliminary evidence to support of a larger implementation trial.
A longitudinal study of the turning points and trajectories of therapeutic relationship development in occupational and physical therapy
Authors: Horton Ayana , Hebson Gail , Holman David
Published: January 2021

BackgroundThe importance of the therapeutic relationship is widely recognised across healthcare professions. Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories in therapeutic relationships between occupational therapists and physical therapists and their patients. The implications for how a focus on these relational aspects can enhance clinical practice will be discussed.Methods Data collection was based on the Retrospective Interview Technique and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data.ResultsTherapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional.ConclusionThis study makes an important contribution to our understanding of therapeutic relationship dynamics in the occupational and physical therapy context. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.
Customer satisfaction in the digital era: evidence from Islamic banking
Authors: zouari Ghazi , Abdelhedi Marwa
Published: January 2021

Purpose: Based upon an extended SERVQUAL model, this paper attempts to contribute to the Islamic banking literature by examining the impact of digitalization, as a service quality dimension, on customer satisfaction.Design/methodology/approach: Two dimensions, i.e. digitalization and compliance are added to the existing SERVQUAL model of five dimensions. Results are drawn from a self-completed survey of a convenience sample of 145 Tunisian Islamic bank customers for the year 2018. Factor analysis and regression analysis are used to determine factor structure and determine the impact of service quality dimensions, especially digitalization, on customer satisfaction in Islamic banking.Findings: The factor analysis extracted five dimensions of service quality, i.e. confidence, compliance, digitalization, tangibles, and human skills. The paper demonstrates a positive and significant relationship between the main dimensions of customer service quality and customer satisfaction, except for tangibles.Research limitations/implications: Although the outcomes lend support to the extended SERVQUAL model, the results are derived based on a relatively average sample size in one country (Tunisia). It might also be useful to enlarge the study sample for better generalization of the findings in other countries and include a comparison between Islamic versus conventional banking about service quality and customer satisfaction. Moreover, we can applicate another original method for Measuring and Implementing Service Quality like the multicriteria method dubbed (MUSA).Managerial implications: To remain competitive, Tunisian Islamic banks need to pay attention to the way the services are delivered and not take it for granted that customers are only focusing on compliance. Dealing henceforth with Generation Y customers, they must persevere in bringing their customer service into the digital era.Originality/value: This study is one of few which try to investigate the drivers of customer satisfaction for Islamic banks in a Digital Era. It reveals that although customers pay special attention to Sharia laws, the way services are delivered matters to them too. From now on, digital banking must appear among the Islamic bank features to stay relevant in the Digital Era.
Production of bio-xylitol from D-xylose by an engineered Pichia pastoris expressing a recombinant xylose reductase did not require any auxiliary substrate as electron donor
Authors: Louie Michael , Louie Kailin , DenHartog Samuel , Gopishetty Sridhar , Subramanian Mani , Arnold Mark , Das Shuvendu
Published: January 2021

Background: Xylitol is a five-carbon sugar alcohol that has numerous beneficial health properties. It has almost the same sweetness as sucrose but has lower energy value compared to the sucrose. Metabolism of xylitol is insulin independent and thus it is an ideal sweetener for diabetics. It is widely used in food products, oral and personal care, and animal nutrition as well. Here we present a two-stage strategy to produce bio-xylitol from D-xylose using a recombinant Pichia pastoris expressing a heterologous xylose reductase gene. The recombinant P. pastoris cells were first generated by a low-cost, standard procedure. The cells were then used as a catalyst to make the bio-xylitol from D-xylose.Results: P. pastoris expressing XYL1 from P. stipitis and gdh from B. subtilis demonstrated that the biotransformation was very efficient with as high as 80% (w/w) conversion within two hours. The whole cells could be re-used for multiple rounds of catalysis without loss of activity. Also, the cells could directly transform D-xylose in a non-detoxified hemicelluloses hydrolysate to xylitol at 70% (w/w) yield.Conclusions: We demonstrated here that the recombinant P. pastoris expressing xylose reductase could transform D-xylose, either in pure form or in crude hemicelluloses hydrolysate, to bio-xylitol very efficiently. This biocatalytic reaction happened without the external addition of any NAD(P)H, NAD(P)+, and auxiliary substrate as an electron donor. Our experimental design & findings reported here are not limited to the conversion of D-xylose to xylitol only but can be used with other many oxidoreductase reactions also, such as ketone reductases/alcohol dehydrogenases and amino acid dehydrogenases, which are widely used for the synthesis of high-value chemicals and pharmaceutical intermediates.
Effects of mouth breathing on facial skeletal development in children: A systematic review and meta-analysis.
Authors: Zhao Ziyi , Zheng Leilei , Huang Xiaoya , Li Caiyu , Liu Jing , Hu Yun
Published: January 2021

BACKGROUND: Mouth breathing is closely related to the facial skeletal development and malocclusion. The purpose of this systematic review and meta-analysis was to assess the effect of mouth breathing on facial skeletal development and malocclusion in children.METHODS: An electronic search in PubMed, the Cochrane Library, Medline, Web of Science, EMBASE and Sigle through February 23rd, 2020, was conducted. Inclusion criteria were children under 18 years of age with maxillofacial deformities due to mouth breathing. The risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. The included indicators were SNA, SNB, ANB, SN-OP, SN-PP, PP-MP, SNGoGn, MP-H, 1-NA, 1. NA, 1. NB, 1-NB, Overjet, Overbite, SPAS, PAS, and C3-H. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. Review Manager 5.3, was used to synthesize various parameters associated with the impact of mouth breathing on facial skeletal development and malocclusion. RESULTS: Following full-text evaluations for eligibility, 10 studies were included in the final quantitative synthesis. In Sagittal direction, SNA (MD: -1.63, P <0.0001), SNB (MD: -1.96, P <0.0001) in mouth-breathing children was lower than that in nasal-breathing children. ANB (MD: 0.90, P <0.0001), 1. NA (MD: 1.96, P = 0.009), 1-NA (MD: 0.66, P = 0.004), and 1-NB (,MD: 1.03, P <0.0001) showed higher values in children with mouth breathing. In vertical direction, SN-PP (MD: 0.68, p=0.0050) ,SN-OP (MD: 3. 05, P <0.0001), PP-MP(MD: 4.92, P <0.0001)and SNGoGn (MD: 4.10, P < 0.0001) were higher in mouth-breathing individuals. In airway, SPAS (MD: -3.48, P = 0.0009), PAS (MD: -2.11, P < 0.0001), and C3-H (MD: -1.34, P < 0.0001) were lower in mouth breathing group.CONCLUSIONS: The results showed that the mandible and maxilla rotated backward and downward, and the occlusal plane was steep. In addition, mouth breathing presented a tendency of labial inclination of the upper anterior teeth. Airway stenosis was common in mouth-breathing children.
Artificial Intelligence for Good Health: A Scoping Review of the Ethics Literature
Authors: Murphy Kathleen , Ruggiero Erica Di , Upshur Ross , Willison Donald J. , Malhotra Neha , Cai Jia Ce , Malhotra Nakul , Lui Vincci , Gibson Jennifer
Published: January 2021

Background: Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods: Eight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed. Results: Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability and responsibility, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions: The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.
Characterization of the content and distribution of collagen and proteoglycan in the decellularized book-shaped enthesis scaffolds by SR-FTIR
Authors: Shi Qiang , Chen Can , Li Muzhi , Chen Yang , Xu Yan , Hu Jianzhong , Liu Jun , Lu Hongbin
Published: January 2021

Background: Bone-tendon interface (enthesis) plays a pivotal role in relaxing load transfer between otherwise structurally and functionally distinct tissue types. Currently, decellularized extracellular matrix (DEM) from enthesis provide a natural three-dimensional scaffold with tissue-specific orientations of extracellular matrix molecules for enthesis regeneration, however, the content and distribution of collagen and proteoglycan in the decellularized book-shaped enthesis scaffolds from rabbit rotator cuff by SR-FTIR have not been reported.Methods: Native enthesis tissues (NET) harvested from rabbit rotator cuff were sectioned into cuboid (about 30 mm × 1.2 mm × 10 mm) for decalcified. The decellularized book-shaped enthesis scaffolds were conducted and intrinsic ultrastructure was evaluated by histological staining and scanning electron microscopy (SEM), respectively. The content and distribution of collagen and proteoglycan in the decellularized book-shaped enthesis scaffolds from rabbit rotator cuff were also measured innovatively by SR-FTIR.Results: The decellularized book-shaped enthesis scaffolds from rabbit rotator cuff were successfully obtaine©d. Histomorphology and SEM evaluated the decellularized effect and the structure of extracellular matrix during decellularization. After mechanical test, we found the failure load in the NET group was higher than that in the DEM group (P < 0.05), reached 1.32 times as much as that in the DEM group. Meanwhile, the stiffness of the DEM group was significantly lower than the NET group. Furthermore, the distributions of collagen and PGs content in the decellularized book-shaped enthesis scaffolds were decreased obviously after decellularization by SR-FTIR quantitative analysis.Conclusion: SR-FTIR was applied innovatively to characterize the histological morphology of native enthesis tissues from rabbit rotator cuff. Moreover, it can be used for quantitative mapping of the content and distribution of collagen and PGs content in the decellularized book-shaped enthesis scaffolds.