bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatio-temporal distribution of malaria one year after the implementation of additional preventive strategies in Bandiagara, Mali
Authors: Coulibaly Drissa , Guindo Boureima , Maiga Fayçal , Konate Salimata , Diallo Astou , Antar Abdou Tahirou Mohamed , Niangaly Amadou , Kone Abdoulaye Kassoum , Traore Karim , Laurens Matthew B , Doumbo Ogobara K , Thera Mahamadou Ali
Published: November 2020

BackgroundEvaluation of local transmission epidemiology to characterize malaria risk is essential for planning malaria control and elimination programmes. The use of geographical information systems (GIS) has been a major asset to this approach. This study aimed to characterize the local spatio-temporal pattern of malaria infection and clinical disease after implementation of Seasonal Malaria Chemoprevention (SMC) and Indoor Residual Spraying (IRS) in Bandiagara, a Malian town.MethodsFrom October 2017 to December 2018, an active and passive surveillance system was established in a cohort study of three hundred children aged from 6 months to 15 years old. Weekly time-series of clinical malaria and monthly time-series of asymptomatic Plasmodium carriage and rainfall were plotted. Numbers of clinical malaria episodes and asymptomatic parasite carriers were mapped using Quantum Geographic Information System (QGIS). Landscape features of Bandiagara were obtained from Google earth. Clusters of high or low risk were identified under SaTScan® software using a Bernoulli model. ResultsFrom October 2017 to December 2018, 167 clinical malaria cases were recorded, mostly from July to December, while asymptomatic parasite carriage was observed during the entire study period. Three clusters of clinical episodes were found. All were hotspots. They were located in the north-east, south and west. No low risk cluster was identified. Three significant high-risk clusters of asymptomatic parasite carriage were identified in the south, north-east and north. These clusters were located near standing water. ConclusionThis study confirms the seasonality of clinical malaria in Bandiagara. The continued presence of asymptomatic parasite carriers maintains malaria transmission. To advance malaria elimination, control strategies must also target hotspots of asymptomatic parasite carriage. There was a spatial heterogeneity of clinical and asymptomatic malaria. Despite the implementation of additional preventives strategies, the locations of high-risk clusters were stable.
Costing Electronic Private Sector Malaria Surveillance in the Greater Mekong Subregion
Authors: Levin Ann , Potter Rebecca , Tesfazghi Kemi , Phanalangsy Saysana , Keo Phally , Filip Elijah , Phone Si Hein , Eliades M. James
Published: November 2020

Background: Private sector malaria programs contribute to government-led malaria elimination strategies in Cambodia, Lao PDR, and Myanmar by increasing access to quality malaria services and surveillance data. However, reporting from private sector providers remains suboptimal in many settings. To support surveillance strengthening for elimination, a key program strategy is to introduce electronic surveillance tools and systems to integrate private sector data with national systems, and enhance the use of data for decision-making. During 2013-2017, an electronic surveillance system based on open source software, District Health Information System 2 (DHIS2), was implemented as part of a private sector malaria case management and surveillance program. The electronic surveillance system covered 16,000 private providers in Myanmar (electronic reporting conducted by 200 field officers with tablets), 710 in Cambodia (585 providers reporting through mobile app), and 432 in Laos (250 providers reporting through mobile app).Methods: We conducted a study to document the costs of introducing electronic surveillance systems and mobile reporting solutions in Cambodia, Lao PDR, and Myanmar, comparing the cost in different operational settings, the cost of introduction and maintenance over time, and assessing the affordability and financial sustainability of electronic surveillance. The data collection methods included extracting data from PSI’s financial and operational records, collecting data on prices and quantities of resources used, and interviewing key informants in each setting. The costing study used an ingredients-based approach and estimated both financial and economic costs.Results: Annual economic costs of electronic surveillance systems were $130,293 in Laos, $221,749 in Cambodia, and $504,456 in Myanmar. The annual economic cost per private provider surveilled was $32 in Myanmar, $379 in Cambodia, and $521 in Laos. Cost drivers varied depending on operational settings and number of private sector outlets covered in each country; whether purchased or personal mobile devices were used; and whether electronic (mobile) reporting was introduced at provider level or among field officers who support multiple providers for case reporting. Conclusion: The study found that electronic surveillance comprises less than 1% of National Malaria Strategic Plan cost and 6%-8% of surveillance budgets and deemed to be affordable and financially sustainable.
Single Cell RNA Sequencing Identifies IGFBP5 And QKI In Ciliated Epithelial Cell Genes Associated With Severe COPD
Authors: Li Xiuying , Noell Guillaume , Tabib Tracy , Gregory Alyssa D , Bittar Humberto E Trejo , Vats Ravi , Kaminski Tomasz , Sembrat John , Snyder Mark E , Chandra Divay , Chen Kong , Zou Chunbin , Zhang Yingze , Sundd Prithu , McDyder John F , Sciurba Frank , Rojas Mauricio , Lafyatis Robert , Shapiro Steven D , Faner Rosa , Nyunoya Toru
Published: November 2020

Background: Whole lung tissue transcriptomic profiling studies in chronic obstructive pulmonary disease (COPD) have led to the identification of several genes associated with the severity of airflow limitation and/or the presence of emphysema, however, the cell types driving these gene expression signatures remain unidentified.Methods: To determine cell specific transcriptomic changes in severe COPD, we conducted single-cell RNA sequencing (scRNA seq) on n= 29,961 cells from the peripheral lung parenchymal tissue of nonsmoking subjects without underlying lung disease (n=3) and patients with severe COPD (n=3). The cell type composition and cell specific gene expression signature was assessed. Gene set enrichment analysis (GSEA) was used to identify the specific cell types contributing to the previously reported transcriptomic signatures.Results: T-distributed stochastic neighbor embedding and clustering of scRNA seq data revealed a total of 17 distinct populations. Among them, the populations with more differentially expressed genes in cases vs. controls (log fold change >|0.4| and FDR=0.05) were: monocytes (n=1499); macrophages (n=868) and ciliated epithelial cells (n= 590), respectively. Using GSEA, we found that only ciliated and cytotoxic T cells manifested a trend towards enrichment of the previously reported 127 regional emphysema gene signatures (normalized enrichment score [NES] = 1.28 and =1.33, FDR= 0.085 and =0.092 respectively). Among the significantly altered genes present in ciliated epithelial cells of the COPD lungs, QKI and IGFBP5 protein levels were also found to be altered in the COPD lungs. Conclusions: scRNA seq is useful to identify transcriptional changes and possibly individual protein levels that may contribute to the development of emphysema in a cell-type specific manner.
Synthesis of tobacco-derived cembratriene-ol and cembratriene-diol in yeast using engineered enzymes
Authors: Zhang Yu , Bian Shiquan , Liu Xiaofeng , Fang Ning , Wang Chunkai , Liu Yanhua , Du Yongmei , Timko Michael P. , Zhang Zhongfeng , Zhang Hongbo
Published: November 2020

Background: Cembranoids are one kind of diterpenoids with multiple biological activities, and the tobacco cembatriene-ol (CBT-ol) and cembatriene-diol (CBT-diol) have high anti-insect and anti-fungal activities, which is attracting great attention for their potential usage in sustainable agriculture. Cembranoids have been supposed to be formed through the 2-C-methyl-D-erythritol-4- phosphate (MEP) pathway, yet the involvement of mevalonate (MVA) pathway in their synthesis remains unclear. Exploring the roles of MVA pathway in cembranoid synthesis could contribute not only to the technical approach but also to the molecular mechanismfor cembranoid biosynthesis. Results: We constructed a vector to express an engineered protein fusion of cembranol synthase (CBTS1) and the GAL4 AD domain as a N-terminal translation leader. Eventually, the engineered enzyme AD-CTBS1 was successfully expressed, which further resulted in the production of CBT-ol in yeast with an optimized MVA pathway for geranyl-geranyl diphosphate (GGPP) production, but not in other yeast strains with low GGPP supply. Subsequently, CBT-diol was also synthesized by co-expression of engine-ered cembranol synthase (CBTS1) and cytochrome P450 hydroxylase (CYP450) in the yeast enhanced MVA pathway. Conclusions: We demonstrated that yeast could be applied to the production of tobacco-derived CBT-ol and CBT-diol, which are anti-fungal compounds. And, established a new way to produce the tobacco-derived CBT-ol and CBT-diol in yeast with optimized MVA pathway for GGPP production. Thus, this study established a feasibility for cembranoid production via the MVA pathway and provided an alternative bio-approach for the production of cembranoids in microbes.
Recruitment and Retention of Participant and Study Partner Dyads in Two Multinational Alzheimer’s Disease Registration Trials
Authors: Bernstein Olivia M , Grill Joshua D. , Gillen Daniel L.
Published: November 2020

Background: Early study exit is detrimental to statistical power and increases the risk for bias in Alzheimer’s disease clinical trials. Previous analyses in early phase academic trials demonstrated associations between rates of trial incompletion and participants’ study partner type, with participants enrolling with non-spouse study partners being at greater risk.Methods: We conducted secondary analyses of two multinational phase III trials of semagacestat, an oral gamma secretase inhibitor, for mild-to-moderate AD dementia. Cox’s proportional hazards regression model was used to estimate the relationship between study partner type and the risk of early exit from the trial after adjustment for a priori identified potential confounding factors. Additionally, we used a random forest model to identify top predictors of dropout.Results: Among participants with spousal, adult child, and other study partners, respectively, 35%, 38%, and 36% dropped out or died prior to protocol-defined study completion, respectively. In unadjusted models, the risk of trial incompletion differed by study partner type (unadjusted p-value=0.027 for test of differences by partner type), but in models adjusting for potential confounding factors the differences were not statistically significant (p-value=0.928). In exploratory modeling, participant age was identified as the primary characteristic to explain the relationship between study partner type and the risk of failing to complete the trial. Participant age was also the strongest predictor of trial incompletion in the random forest model.Conclusions: After adjustment for age, no qualitative differences in the risk of incompletion were observed when comparing participants with different study partner types in these trials. Differences between our findings and the findings of previous studies may be explained by differences in trial phase, size, geographic regions, or the composition of academic and non-academic sites.
Operational challenges of engaging development partners in district health planning in Tanzania
Authors: Ukio Kusirye B , Charles James , Hoffman Axel , Kalolo Albino
Published: November 2020

Background: Development assistance for health represents an important source of health financing in many low and middle-income countries. However, there are few accounts on how priorities funded through Development assistance for health are integrated with district health priorities. This study aimed at understanding the operational challenges of engaging development partners in district health planning in Tanzania Methods: This explanatory mixed methods study was conducted in Kinondoni and Bahi districts. A structured checklist to 35 participants collected quantitative data whereas a semi-structured guide collected qualitative from 20 key informants (the council health planning team members and the development partners) to obtain information related to engagement of development partners in the planning processes and subsequent implementation of the district plan. We used descriptive analysis for quantitative data and thematic analysis for qualitative data Results: Majority (86%) of the development partners delivering aid in the studied districts were Non Governmental Organizations. We found high engagement of Development partners (DPs) (87.5%) in Bahi district and very low in Kinondoni district (37.5%). Guidance on district priorities to be included in Development partner’s plans as part of the Comprehensive Council Health Plan (CCHP) was given to 36% of the Development partners. Submission of written plans to be integrated in the District plans was done by only 56% of Development partners, with majority (77.7%) from Kinondoni district not submitting their plans. Only 8% of the submitted plans appeared in the final District plan document. Qualitative findings reported operational challenges to engagements such as differences in planning cycles between the government and donors, uncertainties in funding from the prime donors, lack of transparency, limited skills of district planning teams, technical practicalities on planning tools and processes, inadequate knowledge on planning guidelines among DPs and poor donor coordination at the district level. Conclusions: We found low engagement of Development partners in planning. To be resolved are operational challenges related to differences in planning cycles, articulations and communication of local priorities, donor coordination, and technical skills on planning and stakeholder engagement.
Association between insulin resistance and lung function change: Analysis from the community-based prospective Ansan-Ansung cohort in Korea
Authors: Kim Sang Hyuk , Min Hyang Ki , Kim Hyun Sam , Lee Sung Woo
Published: November 2020

Background: Diabetes mellitus and hyperglycemia are associated with respiratory dysfunction. Although several studies have reported that insulin resistance is related to decreased lung function, the association between insulin resistance and lung function changes has been rarely studied. This study aimed to investigate the effect of insulin resistance on the annual lung function change using a large-scale prospective cohort.Methods: We analyzed a community-based prospective cohort in Korea comprising 7,536 participants whose serial lung functions were assessed. Exposure was baseline insulin resistance estimated with homeostatic model assessment-insulin resistance (HOMA-IR), and outcomes were annual changes in forced expiratory volume in 1 second (FEV1), functional vital capacity (FVC), and FEV1/FVC ratio.Results: In the multivariate linear regression, the increased in the logarithmic HOMA-IR was associated with a decrease in FEV1 (β: -0.23; 95% CI: -0.32 to -0.13; P < 0.001), and FVC (β: -0.29; 95% CI: -0.39 to -0.19; P < 0.001), but not in FEV1/FVC ratio (β: 0.05; 95% CI: 0.00 to 0.11; P = 0.051). In the generalized additive model plot, L-shaped association between HOMA-IR and changes in FEV1 and FVC were observed with a HOMA-IR threshold of 2.4. Age modulated the effect of HOMA-IR on the change in FEV1, and increased HOMA-IR was associated with decreased annual FEV1 change only in the older population.Conclusions: Insulin resistance was a novel risk factor for the decrease in FEV1 and FVC. The aging process may modulate the effect of insulin resistance on the decline in lung function.
A Risk-Sensitive Task Offloading Strategy for Edge Computing in Industrial Internet of Things
Authors: Hao Xiaoyu , Zhao Ruohai , Yang Tao , Hu Yulin , Hu Bo , Qiu Yuhe
Published: November 2020

Edge computing has become one of the key enablers for ultra-reliable and low-latency communications in the industrial Internet of Things in the fifth generation communication systems, and is also a promising technology in the future sixth generation communication systems. In this work, we consider the application of edge computing to smart factories for mission-critical task offloading through wireless links. In such scenarios, although high end-to-end delays from the generation to completion of tasks happen with low probability, they may incur severe casualties and property loss, and should be seriously treated. Inspired by the risk management theory widely used in finance, we adopt the Conditional Value at Risk to capture the tail of the delay distribution. An upper bound of the Conditional Value at Risk is derived through analysis of the queues both at the devices and the edge computing servers. We aim to find out the optimal offloading policy taking into consideration both the average and the worst case delay performance of the system. Given that the formulated optimization problem is a non-convex mixed integer non-linear programming problem, a decomposition into sub-problems is performed and a two-stage heuristic algorithm is proposed. Simulation results validate our analysis and indicate that the proposed algorithm can reduce the risk in both the queueing and end-to-end delay.
Eye in the process: Formation of “triple cation” perovskite thin films rationalized by in-situ optical monitoring
Authors: Merdasa Aboma , Rehermann Carolin , Hirselandt Katrin , Li Jinzhao , Maus Oliver , Mathies Florian , Unold Thomas , Dagar Janardan , Munir Rahim , Unger Eva
Published: November 2020

Record performance Metal-Halide Perovskite (MHP) based solar cells have been achieved by incremental optimization of deposition procedures based on spin-coating. We here provide unprecedented insight into the formation process of MHP thin films of the “triple cation” (Cs,MA,FA)Pb(Br,I)3 perovskite from multi-modal in-situ optical process monitoring during spin-coating and annealing. This report details small-footprint fiber-optics based optical spectroscopy setup that enables monitoring of thin-film formation processes by UV-Vis reflectance and photoluminescence spectroscopy with a sub-second time resolution. Complementary information can be obtained from optical features during different stages of film formation: 1) During the first, flow regime dominated, stage of spin-coating, the wet-film thinning can be analyzed from UV-Vis interference, 2) the onset of bulk perovskite formation is clearly observed from the evolution of the semiconductor absorption edge, and 3) Photoluminescence (PL) measurements provide complementary information on nucleation and growth processes. We here provide a comprehensive picture that rationalizes the conditions to obtain a high quality “triple cation” perovskite thin-film during spin-coating and subsequent annealing.
Prevalence and associated risk factors for childhood strabismus in Lhasa, Tibet, China: a cross-sectional, school-based study
Authors: He Hailong , Fu Jing , Meng Zhaojun , Chen Weiwei , Li Lei , Zhao Xinyu
Published: November 2020

Background: To estimate the prevalence of strabismus and associated risk factors among grade one school children in Lhasa, Tibet, China.Methods: The Lhasa Childhood Eye Study (LCES) was a cross-sectional, school-based childhood study conducted in Grade one students from primary schools in Lhasa, Tibet, China. Comprehensive ophthalmic examinations and basic systemic examinations were evaluated. A questionnaire survey containing information about children, as well as parents’ information, was sent to the corresponding parents of eligible children. The prevalence of strabismus and its 95% confidence interval was estimated. Univariate and multivariate logistic regression analyses were conducted to determine the associated risk factors.Results: A total of 1942 eligible grade one students were enrolled, of which 1856 participants completed all examinations. The average age was 6.83±0.46 years, 53% of participants were boys and 1762 were the Tibetan Minority. Over all, the prevalence of strabismus was 68/1856 (3.7%) (95%CI: 2.81,4.52), with no difference between the ages, genders, ethnicities and body mass index, while tilting one's head when writing may be a risk factor for strabismus (P=0.004). Strabismus students had mean best corrected visual acuity of 0.16±0.28(LogMAR), over 50% patients with esotropia were hyperopic, and participants who had stereopsis impairments showed a significant difference between esotropia and exotropia (P=0.026).Conclusions: The prevalence of strabismus in LCES was 3.7%, which is higher than previous reports from Chinese childhood epidemiology studies. Strabismus is a common contributing factor to amblyopia. Tilting one's head when writing may be a risk factor. Esotropia is more likely to affect stereopsis and be associated with the refractive state of hyperopia. Trial registration: The study has finished the clinical registration on Chinese Clinical Trial Registry. (http://www.chictr.org.cn , ChiCTR1900026693).
Virtual Barriers: Unpacking the Sustainability Implications of Online Food Spaces and the Yellowknife Farmers Market’s Response to COVID-19
Authors: Radcliffe Josalyn , Skinner Kelly , Spring Andrew , Picard Lise , Benoit France , Dodd Warren
Published: November 2020

Background: Through their support of local agriculture, relationships, and healthy diets, Farmers Markets can contribute to a sustainable food system. Markets like the Yellowknife Farmers Market (YKFM) are social spaces that support local food, yet the COVID-19 pandemic has forced changes to their current model. We explore the potential of online marketplaces to contribute to a resilient, sustainable food system through a case study of the YKFM.Methods: In 2019, a collaborative mixed-method evaluation was initiated by the YKFM and university partners in the Northwest Territories (NWT), Canada. The evaluation included an in-person Rapid Market Assessment dot survey and questionnaire of market patrons from two YKFM dates prior to the pandemic. Due to COVID-19, a vendor survey and interviews were deferred. Data collected from the two patron surveys, alongside researcher observations, available literature, public announcements, and informal email and phone discussions, inform the discussion. Results: For the patron surveys, 59 dot survey and 31 questionnaire participants were recruited. The top motivators for attendance were eating dinner, atmosphere, and supporting local businesses, and most patrons attended as couples and spent over half of their time talking to others. The YKFM did not move online; instead, they proposed and implemented a “Shop, don’t stop” market. Informal conversations suggested the small scale of the market and technology challenges were perceived barriers to moving online. The physically-distanced market was well-attended and featured in local media. Conclusions: NWT food strategies rely on Farmers Markets to nurture a local food system. Data suggests a potential incongruence between an online model and important market characteristics such as the event-like atmosphere. Available literature suggests online markets can support local food by facilitating purchasing and knowledge-sharing, yet they do not replicate the open-air or social experience. The decision not to move online for the YKFM reflects market patron characteristics and current food context in Yellowknife and the NWT. While online adaptation does not fit into the YKFM plan today, online markets may prove useful as a complementary strategy for future emerging stressors to enhance the resiliency of local systems.
Factors contributing to psychological distress in the working population, with a special reference to gender difference - a population-based study
Authors: Viertiö Satu , Kiviruusu Olli , Piirtola Maarit , Kaprio Jaakko , Korhonen Tellervo , Marttunen Mauri , Suvisaari Jaana
Published: November 2020

BackgroundPsychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences.MethodsWe used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study (ATH) collected in the years 2012–2016 (target population participants aged 20 +, n=96 668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 of age (n=34 468). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5) (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having children under18 years of age, lifestyle-related factors, social support, helping others outside of the home and work-related factors. We used logistic regression analysis to examine association between having work-family conflict with the likelihood for psychological distress. We first performed the models separately for men and women. Then interaction by gender was tested in the combined data for those independent variables where gender differences appeared probable in the analyses conducted separately for men and women.ResultsWomen reported more psychological distress than men (11.0% vs. 8.8%, respectively, p<0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one’s work was associated with distress in women (OR 1.30 (95% CI 1.00–1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66–4.41).ConclusionsSatisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population.
Radiomic model for differentiating parotid pleomorphic adenoma from parotid adenolymphoma based on MRI images
Authors: Song Le-le , Chen Shun-jun , Chen Wang , Shi Zhan , Wang Xiao-dong , Song Li-na , Chen Dian-sen
Published: November 2020

Background: Distinguishing parotid pleomorphic adenoma (PPA) from parotid adenolymphoma (PA) is important for precision treatment, but there is a lack of readily available diagnostic methods. In this study, we aimed to explore the diagnostic value of radiomic signatures based on magnetic resonance imaging (MRI) for PPA and PA. Methods: The clinical characteristic and imaging data were retrospectively collected from 252 cases (126 cases in the training cohort and 76 patients in the validation cohort) in this study. Radiomic features were extracted from MRI scans, including T1-weighted imaging (T1WI) sequences and T2-weighted imaging (T2WI) sequences. The radiomic features from three sequences (T1WI, T2WI and T1WI combined with T2WI) were selected using univariate analysis, LASSO correlation and Spearman correlation. Then, we built six quantitative radiomic models using the selected features through two machine learning methods (multivariable logistic regression, MLR, and support vector machine, SVM). The performances of the six radiomic models were assessed and the diagnostic efficacies of the ideal T1-2WI radiomic model and the clinical model were compared.Results: The T1-2WI radiomic model using MLR showed optimal discriminatory ability (accuracy = 0.87 and 0.86, F-1 score = 0.88 and 0.86, sensitivity= 0.90 and 0.88, specificity=0.82 and 0.80, positive predictive value=0.86 and 0.84, negative predictive value=0.86 and 0.84 in the training and validation cohorts, respectively) and its calibration was observed to be good (p>0.05). The area under the curve (AUC) of the T1-2WI radiomic model was significantly better than that of the clinical model for both the training (0.95 vs. 0.67, p=0.000) and validation (0.90 vs. 0.68, p=0.001) cohorts.Conclusions: The T1-2WI radiomic model in our study is complementary to the current knowledge of differential diagnosis for PPA and PA.
The Objective Structured Clinical Examination as an assessment strategy for clinical competence in Novice Nursing Practitioners in Taiwan
Authors: Chen Sue-Hsien , Chen Shu-Ching , Lai Yo-Ping , Chen Pin-Hsuan , Yeh Kun-Yun
Published: November 2020

Background: The conventional written tests and professional assessment have limitation in fair judgement of clinical competence. Because the examiners may not have total objectivity and may lack standardization throughout the assessment process. We sought to design a valid method of competence assessment in medical and nursing specialties. This work was aimed to develop an Objective Structured Clinical Exam (OSCE) to evaluate novice nursing practitioners’ clinical competency, work stress, professional confidence, and career satisfaction. Methods: A Quasi-experimental study (pre-post). Fifty-five novice nursing practitioners received the OSCE three-months following their graduation, which consisted of four stations: history taking, physical examination, problem-directed management, interpersonal communication, and the required techniques of related procedures. The examiners had to complete an assessment checklist, and the participants had to complete a pre-post questionnaire (modified from a Nursing Competency Questionnaire, a Stress scale, and Satisfaction with Learning scale). Results: Among the novice nursing practitioners, 41 of them (74.5%) passed the exam with a mean score of 61.38 ± 8.34. There was a significantly higher passing rate among nurses who were working in medical-surgical wards (85.7%) and the intensive care unit-emergency department (77.8%) compared to novice nursing practitioners working in other units. All the novice nursing practitioners at Station A had poor performance in assessing patients with a fever. OSCE performance was more associated with educational attainment and work unit, rather than the gender. Finally, the participants showed statistically significant increases in their clinical competency, confidence in their professional competence, satisfaction with the clinical practice, and decreased work stress after the OSCE. Conclusions: We found that the OSCE process had a positive educational effect, in providing a meaningful and accurate assessment of the competence of novice nursing practitioners. Although the implementation of an OSCE remains costly, the consequent benefits for novice nursing practitioners, educators, and administrators can outweigh its costs, demonstrated by the increased competence and workforce stability following OSCE training.
Enhanced xylitol production using non-detoxified xylose rich pre-hydrolysate from sugarcane bagasse by newly isolated Pichia fermentans
Authors: Prabhu Ashish A , Bosakornranut Ekkarin , Amraoui Yassin , Agarwal Deepti , Coulon Frederic , Vivekanand Vivekanand , Thakur Vijay Kumar , Kumar Vinod
Published: November 2020

Background: Integrated management of hemicellulosic fraction and its economical transformation to value-added products is the key driver towards sustainable lignocellulosic biorefineries. In this aspect, microbial cell factories are harnessed for the sustainable production of commercially viable biochemicals by valorising C5 and C6 sugars generated from agro-industrial waste. However, in the terrestrial ecosystem, microbial systems can efficiently consume glucose. On the contrary, pentose sugars are less preferred carbon source as most of the microbes lack metabolic pathway for their utilization. The effective utilization of both pentose and hexose sugars is key for economical biorefinery.Results: Bioprospecting the food waste and selective enrichment on xylose-rich medium led to isolation and purification of yeast which was phylogenetically identified as Pichia fermentans. The newly isolated xylose assimilating yeast was explored for xylitol production. The wild type strain robustly grew on xylose and produced xylitol with >40% conversion yield. Chemical mutagenesis of isolated yeast with ethyl methanesulphonate (EMS) yielded seven mutants. The mutant obtained after 15 min exposure, exhibited best xylose bioconversion efficiency. This mutant under shake flask conditions produced maximum xylitol titer and yield of 34.0 g/L and 0.68 g/g, respectively. However, under same conditions, the control wild type strain accumulated 27.0 g/L xylitol with a conversion yield of 0.45 g/g. Improved performance of the mutant was attributed to 34.6% activity enhancement in xylose reductase with simultaneous reduction of xylitol dehydrogenase activity by 22.9%. Later, the culture medium was optimized using statistical design and validated at shake flask and bioreactor level. Bioreactor studies affirmed the competence of mutant for xylitol accumulation. The xylitol titer and yield obtained with pure xylose were 98.9 g/L and 0.67 g/g, respectively. In comparison, xylitol produced using non-detoxified xylose rich pre-hydrolysate from sugarcane bagasse was 79.0 g/L with an overall yield of 0.54 g/g.Conclusion: This study demonstrates the potential of newly isolated P. fermentans in successfully valorising the hemicellulosic fraction for sustainable xylitol production.
Clinical characteristics and predictive value of low CD4+T cell count in patients with moderate and severe COVID-19: A multicenter retrospective study
Authors: Wen Xue-song , Gao Lei , Jiang Dan , Cheng Xiao-cheng , He Bin , Chen Yue , Lei Peng , Tan Wei-xiao , Qin Shu , Cai Guo-qiang , zhang dongying
Published: November 2020

BackgroundIn December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei, China. And, it has become a global pandemic. Describe the patient's clinical symptoms in detail, finding markers that predict the prognosis of patients with COVID-19 are of great value.MethodsIn this multicenter, retrospective study, 476 patients with COVID-19 were recruited from a consecutive series. After screening, a total of 395 patients were included in this study. All-cause death was the primary endpoint. All patients were followed up from admission till discharge or death.ResultsThe dominant symptoms observed in the study included fever on admission, cough, fatigue, and shortness of breath. The most frequent comorbidities were hypertension and diabetes. Compared with patients with higher CD4+T cell levels, patients with lower CD4+T cell levels were older and were more frequently male. Reduction of CD8+T cell is an indicator of the severity of COVID-19. Both decreased CD4+T cell [HR:13.659; 95%CI: 3.235-57.671] and CD8+T cell [HR: 10.883; 95%CI: 3.277-36.145] were associated with in-hospital death in COVID-19 patients, but only decreased CD4+T cell was an independent predictor of in-hospital death in COVID-19 patients.ConclusionsReductions in lymphocytes and lymphocyte subsets were common in COVID-19 patients, especially in severe cases. It was the CD8+T cell, not the CD4+T cell, that reflected the severity of the patient’s disease. Only CD4+T cell reduction was independently associated with increased in-hospital death in COVID-19 patients.Trial registration: Prognostic Factors of Patients With COVID-19, NCT04292964. Registered 03 March 2020. https://clinicaltrials.gov/ct2/show/NCT04292964.
Present and Future Suitability of the Lake Tana Biosphere Reserve in Ethiopia for the Nile monitor (Varanus niloticus) using the MaxEnt Model
Authors: Ejigu Dessalegn , Tassie Nega
Published: November 2020

Introduction The Nile monitor (Varanus niloticus) is the largest lizard native to Sub-Saharan Africa along the Nile River. The species inhabits a wide variety of habitats including woodlands, grasslands, mangroves, and swamps. Although the practice is not common in the Lake Tana Biosphere Reserve, the species is being hunted in Sahelian Africa for its leather, food, and pet trade. Consequently, the species is listed under the Convention on International Trade in Endangered Species. Methodology Data collection was based on onsite GIS aided presence recording. Each record of the species was first vetted for data quality. A multicollinearity analysis was conducted before fitting the MaxEnt model to the 19 bioclimatic variables. Since it provides good coverage for Africa, the Hadley Global Environment Model 2-Atmosphere Ocean (HadGEM2-AO) model was used for extracting future climate scenarios. The implementation of change factor was to correct the modeled mean climate from the climate models. The jackknife test was selected to measure the contribution of each environmental predictor variable. Area under the curve of the receiver operating characteristic was used to evaluate the performance of MaxEnt model. Results On average 2750 individuals of Nile monitor were recorded within the Lake Tana Biosphere Reserve. Mean annual temperature, precipitation and temperature were the most important predictors that limit the potential distribution of Nile monitor in the area. Most of the suitable habitats of Nile monitor were mainly predicted in the northern parts of Lake Tana. The ecological niche model produced an average AUC of 0.85. Notable records of the species were found in the vicinity of the lake and the nearby wetlands. Future projection of potential suitable areas revealed that the currently available suitable area to Nile monitor will decline in both 2050 and 2070 under both RCP 6.5 and RCP 8.5, of which the decline in suitable area under the business as usual scenario is the greatest. Conclusion The potential distribution map for Nile monitor in the Lake Tana Biosphere Reserve can help in planning land use management around its existing habitat range, discover new populations or set priorities to restore its natural habitat for more effective conservation. Extensive reductions in the amount of suitable areas under future climate scenarios suggest that the species may become threatened in future if effective conservation measures are not implemented.
Balance and motion coordination parameters can be improved in patients with type 2 diabetes with physical balance training – non-randomized controlled trial
Authors: Stolarczyk Artur , Jarzemski Igor , Maciąg Bartosz M. , Stolarczyk Magda
Published: November 2020

BackgroundDiabetes mellitus type II (DMII) causes many complications, including retinopathy and peripheral neuropathy. These complications are well understood and believed to contribute to gait instability and increase the risk of falls. Poor balance control and increased falling risk have also been reported in people with diabetic peripheral neuropathy (DPN). Patients with DPN are at an increased risk of falling due to the decreased proprioceptive feedbacks. Effective balance training should improve instabilities of postural control in patients with DPN. For this purpose, evaluations and balance training was designed. MethodsThe goal of our study was to establish values for proprioception, balance, muscle coordination and strength in patients with DMII and analyze whether biofeedback balance training using the Biodex Balance System can improve those parameters. To predict fall risk parameters such as overall stability index, the index of frontal-posterior and medial-lateral stability measurements were obtained. 37 patients with diagnosed type II diabetes mellitus were recruited to this study. Their results were compared with control group consisting of 41 healthy participants who were homogenic to the study group in terms of age and body mass index (BMI). ResultsStatistically significantly worse results for all three stability indexes in patients with diabetes compared to healthy subjects. For both the overall stability index and the index of frontal-posterior and medial-lateral stability (p < 0.05). There was statistically significant improvement in static balance with visual control in study group who received training with biological feedback. A statistically significant improvement was observed for all 3 stability indices (p <0.05). There was a statistically significant increase in the risk of falling in people with diabetes compared to healthy individuals. Statistically significant decrease in the risk of falling was observed in the study group who had undergone training with biofeedback (p <0.05). ConclusionsThis study found decreased balance and motor coordination and an increasing risk of falling in patient with type II diabetes that improved after training with biofeedback. Furthermore we established an age-dependent deprivation of static balance and an increased risk of falling as a result of increasing BMI. Trial registrationThis study was registered on ClinicalTrials.gov. Registration number: NCT04484480
Epidemiology of pediatric uveitis and associated systemic diseases
Authors: Shin Yoonkyeom , Kang Ji-Man , Lee Junwon , Lee Christopher Seungkyu , Lee Sung Chul , Ahn Jong Gyun
Published: November 2020

Background: The early detection of uveitis associated with systemic inflammatory disease in children is important for proper treatment and prognosis. However, the diagnosis may be delayed because of difficulties in childhood examinations and early minor systemic symptoms. The objective of our study was to identify the pattern of childhood uveitis and investigate the frequency and clinical features of rheumatic diseases in pediatric patients with uveitis.Methods: This retrospective observational study reviewed the medical records of children (age ≤18 years) with uveitis at a Korean tertiary hospital between January 2005 and December 2018. Data collected included the age at onset of uveitis, sex, anatomic location of ocular inflammation, comorbid disease (including systemic inflammatory disease), ocular complications, relevant laboratory data, and treatment. Fisher’s exact test was used to compare categorical variables and the Mann–Whitney U test was used to compare continuous variables. A p-value of <0.05 was considered statistically significant.Results: A total of 155 pediatric patients with uveitis were included in this study. The median age at diagnosis was 13.0 years (interquartile range, 9.5–16.0 years). The male-to-female ratio was 1.09. The process was unilateral in 51.6% of children. Anterior uveitis, panuveitis, intermediate uveitis, and posterior uveitis represented 51.6%, 26.5%, 6.5%, and 1.9% of the cases, respectively. Idiopathic uveitis (65.2%) was the most frequent type of uveitis. Systemic rheumatic disease associations were responsible for 28.4% of the cases, among which juvenile idiopathic arthritis (JIA) was the most frequent cause (14.8%). Human leukocyte antigen (HLA)-B27 and antinuclear antibody (ANA) positive rates were significantly higher in patients with JIA than in those with idiopathic uveitis (p=0.006 and p=0.007, respectively).Conclusions: Approximately one-third of children with uveitis in Korea have a systemic rheumatic disease, of which JIA accounts for the majority of cases. HLA-B27 and ANA can serve as risk factors for JIA-associated uveitis.
Retrospective Study on Effectiveness of Activ L Total Disc Replacement
Authors: Sun Wenzhi , Wang Peng , Hu Hailiang , Kong Chao , Hai Yong , Lu Shibao
Published: November 2020

Background: The effectiveness of lumbar total disc replacement (TDR) with different prostheses for sagittal alignment has been reported previously. However, there are only few reports on Activ L TDR and no specific evidence regarding whether sagittal alignment affects the clinical outcomes.Methods: 87 patients who underwent mono- or bi-segmental lumbar TDR with ActivL were studied. The films of upright anteroposterior and lateral spine in neutral, flexion, and extension positions were obtained before surgery and at 1 month, 1 and 3 years after surgery. The radiographic parameters such as lumbar lordosis (LL), index level lordosis (IL), pelvic incidence (PI), pelvic tilt (PT), segmental lordosis (SL) and sacral slope (SS) were measured based on the lateral upright radiographs. Clinical outcomes were evaluated using the Oswestry Disability Index (ODI) and visual analogue scale (VAS) pre- and post-operatively.Results: 87 patients with complete radiographic data were available for a 3-year follow-up period. Of these, 66 received a single-level TDR, and 21 received 2-level TDR. At 1 month, the mean LL was similar to the pre-operative data, and then was significantly increased to 45.1° at 3 years. On an average, the IL tended to significantly increase, while the mean SL at L4-5 was increased from 16.5° pre-operatively to 21.0° at 3 years. The mean SL at L1-2, L2-3, L3-4, and L5-S1, PI, PT and the SS showed no obvious difference after 3 years. In contrast, VAS and ODI scores showed significant improvement after surgery.Conclusions: Activ L TDR showed favorable affect on sagittal alignment, enhancing the IL while preserving the LL and SS. However, satisfactory clinical results for over a 3-year follow-up were not affected by sagittal alignment.
Elevated expression of lncRNA MEG3 induces endothelial dysfunction on HUVECs of IVF born offspring via epigenetic regulation
Authors: Jiang Ying , Zhu Hong , Chen Hong , Yang Meng-Meng , Yu Yi-Chen , He Sai-Nan , Xu Ye-Tao , Liu Fang , Sagnelli Matthew , Zhu Yi-Min , Luo Qiong
Published: November 2020

Background: The cardiovascular dysfunction in children born after in vitro fertilization (IVF) has been of great concern, in our study, we aim to explore potential molecular mechanisms for such long-term outcomes.Methods：Real-time qPCR was used to test long non-coding RNA MEG3 and endothelium-derived factors such as endothelial nitric oxide synthase (eNOS), endothelin-1(ET1), and vascular endothelial growth factor (VEGF). ELISA was used to determinate levels of the first and second oxidation products of NO (nitrite, nitrate), ET1 and VEGF. Primary HUVECs collected after caesarean section were treated with different estradiol concentrations in vitro. Additionally, knockdown of MEG3 on HUVEC provided further evidence between MEG3 expression and alteration of NO, ET1, VEGF. Then, by using pyrosequencing, we uncovered the methylation status of the MEG3 region.Results: We found that the expression level of MEG3 was higher in human umbilical vein endothelial cells (HUVECs) of IVF offspring than that in spontaneously born offspring. Furthermore, we found decreased expression of eNOS and VEGF along with elevated expression of ET1 in HUVECs from IVF offspring compared to spontaneously born offspring, accompanied by lower secretion of nitrite, VEGF, and higher secretion of ET1 in the umbilical cord serum of IVF offspring. We confirmed the results from in vivo experiments by demonstrating that high estradiol intrauterine environments lead to abnormal expression of MEG3 and endothelium derived factors. Meanwhile, silencing MEG3 expression decreased ET1 expression, and increased nitrite, nitrate, and VEGF secretion, which could account for the effects we observed in vivo. With pyrosequencing technology, we found that elevated expression of MEG3 in IVF offspring derived HUVECs was the result of hypomethylation of the MEG3 promoter.Conclusions: Our results demonstrated that increased expression of MEG3 in IVF-born HUVECs, accompanied by lower secretion of eNOS and VEGF along with higher secretion of ET1, which is closely related with endothelial dysfunction, together provide a potential mechanism addressing high risk of hypertension in IVF offspring.