bluuebunny/crossref_metadata_2025 huggingface dataset:
Plains Apache Tipis: Residential and Ceremonial Lodges
Authors: Stokely Michelle
Published: August 2020

For many Americans, tipis symbolize the nomadic Native American culture and lifestyle. This understanding has been so extensively advanced by paintings, advertising, films, and television that tipis have come to be associated with Native American groups in almost all geographical regions. Tipis were, however, an integral part of residential and ceremonial life in the Great Plains where both construction and use were closely tied to indigenous social organization, politics, war, and spirituality. Among the Kiowa and Plains Apache, residents of the Southern Plains, some tipi covers were painted to reflect war deeds or spiritual blessings. This paper examines the construction, decoration, ownership, and destruction of historic Plains Apache tipis, as well as modern uses of the iconic structures.
Ceramic Types from Late Prehistoric Sites along the East Fork of the Trinity River
Authors: Crook Wilson , Houghston Mark
Published: August 2020

Ceramics are one of the key diagnostic artifacts that define the Late Prehistoric culture of the peoples that lived along the East Fork of the Trinity and its tributaries. We are completing a 42 year re evaluation of the Late Prehistoric period of the area and have st udied nearly 32,000 artifacts, of which over 10,200 are ceramic sherds. From this study, 20 distinct ceramic types have been recognized. Plain ware, both shell tempered and sandy paste/grog tempered, are the predominant ceramic types present, comprising ov er 90 percent of the total ceramic assemblage. While there is little direct evidence for indigenous manufacture, the abundance of these types suggests they were produced locally. Lesser quantities of decorated ware of distinct Caddo ceramic types from the Red River and East Texas suggest they are likely the product of exchange. There is also a small amount of Puebloan material indicative of a longer distance exchange.
Theories on the Blue Wing Road Burial (41BX34) in the Context of the Gutiérrez-Magee Expedition
Authors: Richards Brandon
Published: August 2020

In 1968, the skeletal remains of an individual believed to have been involved in the Gutiérrez-Magee expedition of 1812-1813 were exhumed south of San Antonio. Since then, the circumstances surrounding what became known as the “Blue Wing Road burial” have remained somewhat of a mystery. This article introduces a new theory that posits that the burial is not directly related to the major battles fought in the region (the Battles of Rosalis and Medina), but more likely an incident involving a Republican detachment encountering Royalists stationed along a well-travelled route.
Forgotten Soldiers: Burials on the Texas Frontier and Shifting Perceptions of Military Interment
Authors: Schienschang Anthony
Published: August 2020

This research examines the interrelation between civilian and military burials on the Texas frontier in the 1850s with further discussion about the drivers for changing military burial practices. A soldier’s life on the Texas frontier is briefly outlined along with some of the difficulties facing service members living in border forts. Special focus is placed on examining the socio-economic differences between officers and enlisted personnel, as well as the recording of deaths on the frontier. As a case study, the condition of the proposed location of the Fort Gates cemetery is explored and brief analysis of data gathered from the site is presented. The condition of the Fort Gates location is then compared to the nearby Sheridan Family Cemetery. The paper concludes by exploring how the American Civil War shifted civilian perceptions about military dead, leading to increased care for the remains of these deceased soldiers. Primary field research was conducted in Coryell County, Texas around the former site of Fort Gates, on the Fort Hood military installation, and in Gatesville, Texas.
Adapting the Sudden Landslide Identification Product (SLIP) and Detecting Real-Time Increased Precipitation (DRIP) algorithms to map rainfall-triggered landslides in the West-Cameroons’ highlands (Central-Africa)
Authors: MFONDOUM ALFRED HOMERE NGANDAM , Nguet Pauline Wokwenmendam , Mfondoum Jean Valery Mefire , Tchindjang Mesmin , Hakdaoui Sofia , Cooper Ryan , Gbetkom Paul Gérard , Penaye Joseph , Bekoa Ateba , Moudioh Cyriel
Published: August 2020

Background – NASA’s developers recently proposed the Sudden Landslide Identification Product (SLIP) and Detecting Real-Time Increased Precipitation (DRIP) algorithms. This method uses the Landsat 8 satellite images and daily rainfall recordings for a real-time mapping of this geohazard. This study adapts the processing to face the issues of data quality and unavailability/gaps for the mapping of the recent landslide events in west-Cameroon’s highlands. Methods – The SLIP algorithm is adapted, by integrating the inverse NDVI to assess the soil bareness, the Modified Normalized Multi-Band Drought Index (MNMDI) combined with the hydrothermal index to assess soil moisture, and the slope inclination to map the recent landslide. Further, the DRIP algorithm uses the mean daily rainfall to assess the thresholds corresponding to the recent landslide events. Their probability density function (PDF) curves are superimposed and the intersections are used to propose sets of dichotomous variables before (1948-2018) and after the 28 October 2019 landslide event. In addition, a survival analysis is performed to correlating the occurrence date of the landslide with the rainfall since the first known event in Cameroon, through the Cox model. Results – The outcome of the SLIP adapted model is the Landslide Hazard Zonation (LHZ) map, with an overall accuracy of 96%. Further, the outcome of the DRIP adapted model states that the probability of rainfall-triggered landslides is 99.99%, for 6/9 ranges of probability between June and October. Finally, the survival probability for a known site is up to 0.68 for the best value and between 0.38 and 0.1 for the lowest value through time. Conclusions – The proposed approach is an alternative based on data (un)availability, completed by the site’s lifetime.
The Vietnamese Version of the Nursing Critical Thinking in Clinical Practice Questionnaire: Translation and Psychometric Evaluation
Authors: Nguyen Tuan Van , Liu Hsueh-Erh
Published: August 2020

Background: Many instruments measure critical thinking ability in nursing education. The Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice) is a new tool to measure the level of critical thinking ability of nurses in a clinical setting. However, no study has evaluated the psychometric properties of the N-CT-4 Practice in Vietnam. Therefore, this study translated and evaluated the validity and reliability of the Vietnamese version of the Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice (V-v)).Results: The N-CT-4 Practice (V-v) questionnaire retained the meaning of the original English version and was clear, explicit and easy for nurses to understand. The item content validity index of the N-CT-4 Practice (V-v) was 1.0. The Cronbach’s alpha for the overall scales was .98. The intraclass correlation coefficient was .81. Confirmatory factor analysis indicated that this Vietnamese version fit the proposed model.Conclusions: The findings suggested that the N-CT-4 Practice (V-v) has acceptable reliability and validity for Vietnamese nurses in a clinical setting. Nurse managers and educators can use the N-CT-4 Practice (V-v) to measure the level of critical thinking ability of Vietnamese clinical nurses and make international comparisons possible.
Long-term outcomes of early initiated antiretroviral therapy in sub-Saharan children: A Cameroonian cohort study
Authors: Ndongo Francis Ateba , TEJIOKEM Mathurin Cyrille , PENDA Calixte IDA , NDIANG Suzie TETANG , NDONGO Jean-Audrey , GUEMKAM Georgette , SOFEU Casimir Ledoux , TAGNOUOKAM-NGOUPO Paul Alain , KFUTWAH ANFUMBOM , MSELLATI Philippe , FAYE Albert , WARSZAWSKI Josiane
Published: August 2020

Background: In most studies, the virological response is assessed during the first two years of antiretroviral treatment initiated in HIV-infected infants. However, early initiation of antiretroviral therapy exposes infants to very long-lasting treatment. Moreover, maintaining viral suppression in children is difficult. We aimed to assess the virologic response and mortality in HIV-infected children after five years of early initiated antiretroviral treatment (ART) and identify factors associated with virologic success in Cameroon. Methods: In this cohort study, we included 149 children who were still alive after two years of early ART. Virologic response was assessed after 5 years of treatment. The probability of maintaining virologic success between two and five years of ART was estimated using Kaplan-Meier curve. Factors associated with a viral load < 400 copies/mL in children still alive at five years of ART were studied using logistic regressions.Results: The viral load after five years of early ART was suppressed in 66.8% (60.1 - 73.5) of the 144 children still alive and in care. Among the children with viral suppression after two years of ART, the probability of maintaining viral suppression after five years of ART was 64.0% (54.0 - 74.0). The only factor associated with viral suppression after five years of ART was achievement of confirmed virological success within the first two years of ART (OR = 2.7 (1.1-6.8); p = 0.033).Conclusions: This study reported difficulty in maintaining virologic success in sub-Saharan HIV-infected children between two and five years of early initiated ART. It also highlighted the importance of initial viral suppression for achieving and maintaining virologic success in the long-term.
Intensity-modulated radiation therapy versus three-dimensional conformal radiotherapy in head and neck squamous cell carcinoma: long-term and mature outcomes of a prospective randomized trial
Authors: Gupta Tejpal , Sinha Shwetabh , Laskar Sarbani Ghosh , Budrukkar Ashwini , Mummudi Naveen , Swain Monali , Phurailatpam Reena , Prabhash Kumar , Agarwal Jai Prakash
Published: August 2020

Purpose: To compare long-term disease-related outcomes and late radiation morbidity between intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in head and neck squamous cell carcinoma (HNSCC) in the setting of a prospective randomized controlled trial. Methods: Previously untreated patients with early to moderately advanced non-metastatic squamous carcinoma of the oropharynx, larynx, or hypopharynx (T1-T3, N0-N2b, M0) planned for comprehensive irradiation of primary site and bilateral neck nodes were randomly assigned to either IMRT or 3D-CRT after written informed consent. Patients were treated with 6MV photons to a total dose of 70Gy/35 fractions over 7 weeks (3D-CRT) or 66Gy/30 fractions over 6 weeks (IMRT). A sample size of 60 patients was estimated to demonstrate 35% absolute difference in the incidence of ≥grade 2 acute xerostomia between the two arms. All time-to-event outcomes were calculated from date of randomization until the defined event using the Kaplan-Meier method. Results: At a median follow-up of 140 months for surviving patients, 10-year Kaplan-Meier estimates of loco-regional control (LRC); progression-free survival (PFS); and overall survival (OS) with 95% confidence interval (95%CI) were 73.6% (95%CI: 61.2-86%); 45.2% (95%CI: 32-58.4%); and 50.3% (95%CI: 37.1-63.5%) respectively. There were no significant differences in 10-year disease-related outcomes between 3D-CRT and IMRT for LRC [79.2% (95%CI: 62.2-96.2%) vs 68.7% (95%CI: 51.1-86.3%), p=0.39]; PFS [41.3% (95%CI: 22.3-60.3%) vs 48.6% (95%CI: 30.6-66.6%), p=0.59]; or OS [44.9% (95%CI: 25.7-64.1%) vs 55.0% (95%CI: 37-73%), p=0.49]. Significantly lesser proportion of patients in the IMRT arm experienced ≥grade 2 late xerostomia and subcutaneous fibrosis at all time-points. However, at longer follow-up, fewer patients remained evaluable for late radiation toxicity reducing statistical power and precision. Conclusions: IMRT provides a clinically meaningful and sustained reduction in the incidence of moderate to severe xerostomia and subcutaneous fibrosis compared to 3D-CRT without compromising disease-related outcomes in long-term survivors of non-nasopharyngeal HNSCC.
Identifying the Community-Engaged Translational Research Collaboration Experience and Health Interests of Community-Based Organizations Outside of Metropolitan Atlanta
Authors: Greteman Breanna Blaess , Rollins Latrice , Penn Allisen , Berg Alison , Nehl Eric , Llewellyn Nicole , Weber Amber , George Melissa , Sabbs Darrell , Mubasher Mohamed , Akintobi Tabia Henry
Published: August 2020

Rural health research has increased over the last two decades, but there are still unknowns regarding health priorities from the perspective of rural community-based representatives. The Georgia Clinical and Translational Science Alliance (CTSA), a collaboration between four research institutions, statewide, includes a Community Engagement (CE) Program facilitating community-academic research partnerships. This study aimed to assess the health priorities, research experience, and interests from community respondents outside of Metropolitan Atlanta through the Community Engagement Facilitation Survey (CEFS). CE Program members disseminated the 11-item survey statewide at community events and professional organization meetings. Descriptive statistics were analyzed, and GIS mapping was conducted. Four-hundred six (406) surveys were analyzed, representing 83.6% of rural Georgia counties. Most frequently identified health priorities and research interests were diabetes, cancer, high blood pressure, and mental health. Results will be used to support those within rural Georgia organizations seeking to forge community-academic partnerships to address health priorities.
Precarious Work and Poor Occupational Health: A Cross-sectional Study in Luxembourg
Authors: Majery Nicole , Shadi Jemima Wangata , Trandafir Paula Camelia
Published: August 2020

BackgroundIn the literature, an increase in precarious work in Luxembourg as well as in other countries, has been associated to poor health. Therefore, the Occupational Health Physicians of the “Service de Santé au Travail Multisectoriel” (STM), considering the comfortable financial situation during unemployment in Luxembourg, compared the health and lifestyle data of precarious workers to those with stable work.MethodsThis cross-sectional study involved 1472 workers (910 in stable and 562 in precarious work), who were examined at the STM in 2019. Lifestyle and health were self-reported by the workers. The qualitative variables (frequencies and percentage) related to demographic, health, lifestyle and employment factors were analyzed in each group. Pearson’s chi-square test was used to compare both groups and multivariate logistic regression to evaluate the associations between health issues (cardiovascular, mental health, musculoskeletal disorders [MSD]) and employment contract type. ResultsRegarding lifestyle, there were significant differences in age, tobacco smoking, type of work, and mental health disorders between the two groups. Precarious workers had a higher prevalence of poor health in the entire sample. As for mental health disorders, the prevalence was significantly higher in precarious than in stable work (8.5% vs 4.1%, p<0.0001). The difference was not significant in both groups for cardiovascular (6.9% vs 5.8%) and musculoskeletal (15.1% vs 13.7%) disorders. Multivariate logistic regression for the total sample revealed a positive association of precarious work and poor health. The odds ratios were 2.36 (CI: 1.50-3.73) for mental health 1.37 (CI: 0.87-2.17) for cardiovascular, and 1.04 (CI: 0.76-1.43) for musculoskeletal disorders. The association was significant only for mental health disorders. The results by gender showed up a higher risk for mental disorders for women in precarious work (OR=3.41, CI: 1.43-7.82) than for men (OR= 2.99, CI: 1.33-6.74). Men in precarious work had a positive association for cardio-vascular disorders (OR =1.84, CI: 1.03-3.29), and women a negative one (OR= 0.88, CI: 0.40-1.95).ConclusionsOur study revealed an association between precarious work and poor health. For mental health, this association was significant for both genders, but particularly so for women. Cardiovascular disorders were positively significantly associated only for men.
Edge sparse PCA based on gene network for correcting cell type heterogeneity in epigenome-wide association studies
Authors: Rui Miao , Qi Dang , Hui Huang Hai , Yong Xia Liang , Liang Yong
Published: August 2020

Background: In epigenome-wide association studies (EWAS), the mixed methylation expression caused by the combination of different cell types may lead the researchers to find the false methylation site related to the phenotype of interest. In order to fix this problem, researchers have proposed some non-reference methods based on sparse principle component analysis (PCA) to correct the EWAS false discovery. However, the existing model assumes that all methylation site have the same a priori probability in each PC load, but it is known that there already has network structure in the genetic variable corresponding to the methylation site. In this paper, we show that the results of the existing EWAS correction model are still not good enough. If we can integrate the existing methylation network as prior knowledge into the sparse PCA model, we can effectively improve the correction ability of the existing model. Result: Based on the above ideas, we propose GN-ReFAEWAS, a model which uses the prior methylation gene network structure into the PCA framework for feature extraction. This model can be used to correct the false discovery in EWAS. GN-ReFAEWAS model does not need cell counting data and can estimate cell type composition through methylation principal component data. The key of this model is to solve a sparse regularize problem of methylation network. This paper uses regularize and random sampling algorithm to solve this problem. We used one simulated data set and three real data sets for experiments and compared four existing EWAS calibration models. The experimental results show that the GN-ReFAEWAS model is superior to existing models. Conclusion: The result proved that GN-ReFAEWAS model can provide a better estimation of cell-type composition and reduce the false positives in EWAS.
Optimal Cut-Off Values for Anthropometric Indices of Obesity as Discriminators of Cardiovascular Risk Factors in a Health Examinees Study: a Cross-Sectional Study
Authors: Cho Sooyoung , Shin Aesun , Choi Ji-Yeob , Park Sang Min , Kang Daehee , Lee Jong-Koo
Published: August 2020

Background: Obesity is well known as a risk factor for cardiovascular disease. We aimed to determine the performance of and the optimal cutoff value for obesity indices to discriminate the presence of cardiovascular risk factors in a Health Examinees study. Methods: The current study analyzed 134,195 participants with complete anthropometric and laboratory information in a Health Examinees study. The presence of cardiovascular risk factors was defined as having at least one of the following: hypertension, hyperglycemia or hyperlipidemia. The area under the receiver operating characteristic curve (AUC) and 95% confidence intervals were calculated for body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR), waist circumference (WC) and conicity index (C index). Results: AUC of cardiovascular risk factors was the highest for WHtR (0.677 [0.672-0.683] among men; 0.691 [0.687-0.694] among women), and the lowest for the C index (0.616 [0.611-0.622] among men; 0.645 [0.641-0.649] among women) among both men and women. The optimal cutoff values were 24.3kg/m2 for BMI, 0.887 for WHR, 0.499 for WHtR, 84.4cm for WC and 1.20m3/2/kg1/2 for the C index among men, compared with 23.4kg/m2 for BMI, 0.832 for WHR, 0.496 for WHtR, 77.0 cm for WC and 1.18m3/2/kg1/2 for the C index among women. Conclusion: Obesity indices can be considered a plausible discriminator of metabolic risks.
Neuregulin 4 (NRG4) – the batokine with clinical relevance in Gestational Diabetes Mellitus
Authors: Attique Hira , Baig Saeeda , Ishtiaque Shahina , Rehman Rehana , Ahmed Tousif , Shahid Moazzam Ali
Published: August 2020

Background: Neuregulin4 (NGR4) is a brown fat adipokine that modulates carbohydrate and lipid metabolism, regulate insulin sensitivity. The relationship between NGR4 and gestational diabetes mellitus (GDM) remains unclear due to discrepancy in studies. The objective of this study was to find out association between NRG4 and insulin level in women with GDM and their relationship with other metabolic parameters. Methods: In this comparative cross sectional study, pregnant women (n=80), coming for regular antenatal check-ups between 24 and 28 weeks of gestation were recruited. After informed signed consent, interview based proforma was filled with demographic data and antenatal history. Anthropometric measurements were taken; weight recorded on first visit was considered pre-pregnancy weight. Blood (5ml) was drawn after 12 hours fast for estimation of fasting blood sugar (FBS), insulin, NRG4 and lipid profile and secondly after one hour post-consuming 50gm glucose, for glucose challenge test. Statistical analysis was done using SPSS version20, Mann Whitney and Spearman correlation for finding association between variables, whereas, Kruscal Wallis Test for differences between groups. Results: Median NRG4 level (0.98) in healthy group was significantly high (p<0.038) compared to GDM (0.94). The NRG4 had inverse weak association with GDM. The mean insulin and homeostasis assessment model of insulin resistance (HOMA IR) values had weak direct association with NRG4. Cholesterol, LDL had inverse relationship with NRG4. All parameters of lipid profile were high in GDM compared to non GDM, but only cholesterol was statistically significant (p<0.03). The FBS in healthy group was significantly low (p<0.02) compared to GDM. The association between insulin and HOMA IR was statistically significant (p<0.05). The difference between BMI was statistically significant with age (p<0.015), parity (p<0.035). The difference between FBS and education was found significant (p<0.049). Conclusion: Serum NRG4 level were found low in GDM compared to non-GDM (p<0.03), with a week and direct association with insulin. Future studies are required with bigger sample size to establish NRG4 as a potential biomarker for GDM.
Prohibitin 1 is essential to preserve mitochondria and myelin integrity in Schwann cells.
Authors: Nunes Gustavo Della-Flora , Wilson Emma , Marziali Leandro , Hurley Edward , Silvestri Nicholas , He Bin , O'Malley Bert , Beirowski Bogdan , Poitelon Yannick , Wrabetz Lawrence , Feltri M. Laura
Published: August 2020

Myelin is required for nervous system function. In the peripheral nervous system, Schwann cells (SCs) form myelin and trophically support the axons they ensheath. We previously showed that the mitochondrial protein prohibitin 2 (PHB2) can localize to the axon-SC interface and is required for developmental myelination. Whether the homologous protein PHB1 has a similar role, and whether prohibitins also play important roles in SC mitochondria is unknown. Here we show that deletion of Phb1 in SCs only minimally perturbs development, but later triggers a severe demyelinating peripheral neuropathy. Moreover, mitochondria are heavily affected by ablation of Phb1 and demyelination occurs preferentially in cells with apparent mitochondrial loss. Furthermore, in response to mitochondrial damage, SCs trigger the integrated stress response (ISR), but, contrary to what was previously suggested, the ISR is not detrimental and may be beneficial in this context. These results identify a new role for PHB1 in myelin integrity and advance our understanding of how SCs respond to mitochondrial damage.
The Relationships Between Fall Risk, Depression, Executive Dysfunctions and Daily Life of Older Adults
Authors: Yeger Batya Engel , Zilbershlag Yael
Published: August 2020

Background: Falling is a major problem in older adults that may significantly reduce health and quality of life (QOL). Body dysfunctions that include depression, cognitive decline and executive dysfunctions may elevate fall risk and impair daily activities and QOL. Yet, most studies evaluate these body dysfunctions using laboratory measures in clinical settings. The present study aimed to: (1) compare these body dysfunctions between high/low risk fallers (2) examine the relationship between these body dysfunctions among the high risk fallers (3) explore the specific contribution of fall risk as a mediator between depression, executive dysfunctions and daily life. Methods: Participants were 123 older adults who live in the community. Depression and cognitive status were measured by the GDS-15 and the MoCA. Fall risk was determined by a questionnaire supported by the Time Up and Go test (TUG). Executive functions (EF) were assessed by the BRIEF-A and the aEFPT medication management assessment. Daily activity performance was measured by the Barthel Index of ADL and the Instrumental ADL Scale. QOL was measured by the World Health Organization Quality of Life Brief Questionnaire. Results: High fall risk was prevalent among 32% of the sample. High risk fallers had significantly lower cognitive level, higher depression, lower EF, lower daily activity performance and lower QOL. Among the high risk group, lower EF as measured in BRIEF-A scales correlated with lower performance of daily activities and lower QOL. SEM model revealed that fall risk mediated between depression, executive dysfunctions and daily life. Conclusions: Depression and executive dysfunctions are more prevalent in older adults with high fall risk and are significantly related to their daily activity performance and to their QOL. Community fall-prevention and rehabilitation programs should screen for fall risk and related body dysfunctions as expressed during daily activity performance and understand their impacts on people’s QOL.
Process Evaluation of the Sophia Step Study-A Primary Care Based Three-Armed Randomized Controlled Trial Using Self-Monitoring of Steps With and Without Counseling in Prediabetes and Type 2 Diabetes
Authors: Rossen Jenny , Hagströmer Maria , Yngve Agneta , Brismar Kerstin , Ainsworth Barbara , Johansson Unn-Britt
Published: August 2020

Background Describing implementation features of an intervention is required to compare interventions and to inform policy and best practice. The aim of this study was to conduct a process evaluation of the first 12 months of the Sophia Step Study: a primary care based RCT evaluating a multicomponent (self-monitoring of daily steps plus counseling) and a single component (self-monitoring of steps only) physical activity intervention to standard care on cardiometabolic health. Methods The evaluation was guided by the Medical Research Council Guidance for complex interventions. To describe the implementation communication with the health professionals implementing the interventions, attendance records and tracking of days with self-monitored pedometer-determined steps were used. Change in physical activity behaviour was measured at baseline, 6 and 12 months as daily steps by accelerometry. Results From April 2013 to January 2018 188 participants were randomized. Response rate was 49% and drop out was 10%. The interventions were delivered as intended with minor deviation from the protocol and dose received was satisfying for both the multicomponent and single component group. The mean [95% Confidence Interval (CI)] change in daily steps from baseline to 6 months was 941(227, 1655) steps/day for the multicomponent intervention group, 990 (145, 1836) step/day for the single component group and -506 (-1118, 107) for the control group. The mean (95% CI) change in daily steps from baseline to 12 months was 31(-507, 570) steps/day for the multicomponent intervention group, 144 (-566, 853) step/day for the single component group and -890 (-1485, -294) for the control group. There was a large individual variation in daily steps at baseline as well as in step change in all three groups.Conclusions Applying self-monitoring of steps is a feasible method to implement as support for physical activity in the primary care setting both with and without counseling support. While physical activity levels increased after 6 months, maintenance of physical activity is a more realistic expectation in the long term. Physical activity behavior varies among individuals and support for physical activity should be tailored to the person. Trial registration ClinicalTrials.gov, NCT02374788. Registered 2 March 2015 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02374788
Activation of the plant mevalonate pathway by extracellular ATP
Authors: Cho Sung-Hwan , Tóth Katalin , Kim Daewon , Vo Phuc , Lin Chung-Ho , Handakumbura Pubudu , Rivas-Ubach Albert , Evans Sterling , Pasa-Tolic Ljiljana , Stacey Gary
Published: August 2020

The mevalonate (MVA) pathway plays a critical role in multiple cellular processes in both animals and plants. In plants, the products of this pathway impact growth and development, as well as the response to environmental stress. A forward genetic screen of Arabidopsis thaliana using Ca2+ imaging identified mevalonate kinase (MVK) as a critical component of plant purinergic signaling. MVK interacts directly with the plant extracellular ATP (eATP) receptor P2K1 and is phosphorylated by P2K1 in response to eATP. Mutation of P2K1-mediated phosphorylation sites in MVK eliminates the ATP-induced cytoplasmic calcium response, MVK enzymatic activity, and suppresses pathogen defense. The data demonstrate that the plasma membrane associated P2K1 directly impacts plant cellular metabolism by phosphorylation of MVK, a key enzyme in the mevalonate pathway. The results underline the importance of purinergic signaling in plants and the ability of eATP to influence the activity of a key metabolite pathway with global effects on plant metabolism.
The Effect of Phased Written Health Education Combined With Healthy Diet on the Quality of Life of Patients After Heart Valve Replacement
Authors: Li Dan , Liu Pujuan , Zhang Huijun , Wang Li
Published: August 2020

Background: To observe the effect of phased written health education combined with healthy diet on the quality of life of patients after heart valve replacement. Methods: 130 patients who underwent heart valve replacement surgery in our hospital from January 2019 to January 2020 were enrolled as the research subjects. They were randomly divided into study group (65 patients, phased written health education combined with health Diet) and control group (65 cases, routine health education). The drug compliance and the degree of anticoagulant drugs knowledge were compared between the two groups in the first and second stage rehabilitation and the recovery stage. The health behavior ability and quality of life at different phases were also observed. Results: During the first and the second stage rehabilitation, and the recovery stage, the drug compliance of the study group was superior to that of the control group, with statistical significance (P<0.05). Meanwhile, the knowledge of anticoagulant drugs in the study group was better than that in the control group, with statistical significance (P<0.05). Before intervention, there was no significant difference in health behavior ability and quality of life between the two groups (P>0.05). The healthy behavior ability of study group for each stage was superior to the control group, the difference was significant (P<0.05). The healthy behavior ability and quality of life showed the same results with statistical significance (P<0.05). Conclusions: The use of phased written health education combined with healthy diet in patients after heart valve replacement can effectively improve patients' medication compliance, anticoagulant drugs knowledge, healthy behavior ability and quality of life at different stages, and is worthy of clinical application.
Increases in Social Support Co-Occur with Decreases in Depression and Substance Use Problems Among Adults in Permanent Supportive Housing: An 18-Month Longitudinal Study
Authors: Tan Zhengqi , Mun Eun-Young , Nguyen Uyen-Sa D. T. , Walters Scott T.
Published: August 2020

Background: Social support is a well-known protective factor against depression and substance use problems, but very few studies have examined its protective effects among Permanent Supportive Housing (PSH) residents. We utilized unconditional latent growth curve models (LGCMs) and parallel process growth models to describe univariate trajectories of social support, depression, and substance use problems, and to examine their longitudinal associations in a large sample of adults residing in PSH.Methods: Participants were 653 adult PSH residents in North Texas (56% female; 57% Black, 35% White, 8% other; mean age: 51 years) who participated in a monthly health coaching program from 2014 to 2017. Their health behaviors were assessed at baseline and tracked every six months at three follow-up visits.Results: Unconditional LGCMs indicated that over time, social support increased, whereas depressive symptoms and substance use problems decreased. However, their rates of change slowed over time. Further, in parallel process growth models, we found that at baseline, individuals with greater social support tended to have less severe depression and substance use problems (coefficients: –0.67, p<0.01; –0.52, p<0.01, respectively). Individuals with a faster increase in social support tended to have steeper rates of reduction in both depression (coefficient: –0.99, p<0.01) and substance use problems (coefficient: –0.98, p<0.01), respectively.Conclusions: This study suggests that increases in social support, though slowing over time, still positively impact depression and substance use problems among PSH residents. Future PSH programs could emphasize social support as an early component as it may contribute to clients’ overall health.
Impact of the COVID-19 pandemic on emergency eye care provision: A perspective from the Manchester Royal Eye Hospital
Authors: Chaturvedi Ritu , Ku Jae Yee , Zhu Wenyue , Dhawahir-Scala Felipe Eduardo
Published: August 2020

Background: The COVID-19 pandemic has posed global health care challenges. This paper examines the effect of the pandemic on patient numbers, demographics, type and severity of presentations to the emergency eye department (EED) at one of the largest tertiary referral eye hospitals in the United Kingdom (UK) and discusses the management strategies developed.Methods: Retrospective data was collected to compare a four week time frame during the pre-COVID-19 period (PCP; 6/1/20 to 2/2/20) with the COVID-19 period (CP; 23/3/20 to 19/4/20). Results: 2,664 patients were seen during the PCP and this decreased to 759 patients during the CP. This represented a significant decline in mean±SD daily patient presentations from 74±16 during the PCP to 27±7 during the CP (U=18.7, p<0.001). This is equivalent to a decrease by a factor of 2.71 (95% CI: 2.49-2.96). There were proportionally fewer patients at both ends of the age spectrum (≤19 years and 70-89 years) during the CP compared to the PCP but these differences in age distribution were not significantly different (χ2=1.37, p=0.50). There were 73 presentations with sight-threatening conditions during the PCP and 51 during the CP. The mean±SD number of patients who presented with sight-threatening conditions during the PCP (2.6±1.8) was not significantly different from the CP (1.8±1.4) (U=289.5, p=0.09).Conclusion: These findings reassure that current measures at the Manchester Royal Eye Hospital (MREH) are sufficiently robust for patients to access eye care services and ensure patient safety during the CP. Moreover, telemedicine has emerged as an effective tool to meet increasing demand in times of limited resources and may serve an important role in future patient care.
Analysis of accreditation standards for undergraduate medical studies in Serbia through the lens of the National Health Workforce Accounts
Authors: Buljugic Biljana , Milicevic Milena Santric
Published: August 2020

Background Understanding the importance of educational accreditation standards for health and health workforce policymaking is needed more than ever given the growing circulation of physicians, cross-border care and pandemics. The World Health Organization National Health Workforce Accounts (NHWA) for education and training could support the achievement of health care quality through health workforce strategies.Objective To perform a qualitative and quantitative analysis of the effect of accreditation standards on undergraduate medical studies through the lens of NHWA indicators on education and training, and to assess their potential to support quality improvement in health workforce education and health policy planning.Methods Accreditation standards for medical undergraduate studies at the Faculty of Medicine University of Belgrade, Serbia (FMUB) were analyzed using the NHWA indicators on education and training, in addition to the results of surveys of students and employers on the quality of accredited study programs in 2013 and 2016.Results Compulsory accreditation mechanism entails standards for the quality of education at FMUB including continuing professional development and in-service training but not for interprofessional education. Standards partly cover social determinants and social accountability. Students optionally participate in regulatory making. Alike healthcare managers who also serve as providers for training placement for students during the studies, students take part in FMUB accreditation surveys. Based on the results of the survey, the quality of undergraduate medical studies at FMUB has slightly improved from 2013 to 2016. A ten-year quantitative analysis showed a declining trend in freshman enrollment. The average duration of a six-year undergraduate study of medicine is extended to 7.2 ± 0.4 years.Conclusion For improving medical students' practical, organizational skills and independent work, as well as social accountability, and social determinants must be taken as priority standards in the future revisions of accreditation mechanism in Serbia. Health workforce organizations, civil society and the community should participate in accreditation regulatory bodies for establishing a foundation for socially accountable and interprofessional education. If implemented at institutional, local and national level, system of NHWA indicators can support the alignment of higher education standards and plans with the national health and health workforce standards and strategy/plan.
Xenacoelomorpha flatworms are basal Deuterostome
Authors: Wang Yi
Published: August 2020

Background: Whether position Xenacoelomorpha as an early branch of Bilateria (Protostomes + Deuterostomes) has been intensely debated during last several decades. Considering Darwin’s “tree of life”, with the “Phylogenetic Species Concept”, we choose mitochondrial genome as the subject to predict phylogenetic position of Xenacoelomorpha, by genes genealogy. Results: Herein, we sequence Heterochaerus australis’s mitochondrial genome and infer intrinsic relationships of Metazoan with Xenacoelomorpha. The optimal tree under the popular maximum likelihood (ML) and Bayesian phylogenetic reconstructions are consensus with each other being strongly supported. The relationship between Chordates, Ambulacrarians and Xenoturbella/Acoelomorph is resolved. To avoid previous query about alignment process, the datasets are alignmented and trimmed automatically. Reducing taxon or cutting outgroups can not affect the relationship between Xenacoelomorpha and other Metazoan. Meanwhile, analysis using CAT model and Dayhoff groups also supporting the prediction made by mtZOA, relaxing the restriction of alignment criteria ( MAFFT, strategy G–ins–1, BLOSUM 62, 45, 30 ) introducing potential misleading signals can not challenge the tree topology indicating our auto-alignmented mitochondrial dataset is not artificially restricted one. Conclusions: Finally, a repeatable prediction of the genes genealogy with reliable statistical support places Xenacoelomorpha as a basal Deuterostome. Let's enjoy the elegent metapher about Tree of LIfe—— "As buds give rise by growth to fresh buds, and these, if vigorous, branch out and overtop on all sides many a feebler branch, so by generation we believe it has been with the great Tree of Life, which fills with its dead and broken branches the crust of the earth, and covers the surface with its ever branching and beautiful ramifications". (Darwin 1964 [1859], p. 130).
Health-related Quality of Life Among Patients With Chronic Kidney Disease of Unknown Etiology (CKDu) of an Agricultural Community in Kebithigollawa, Sri Lanka  
Authors: Suriyakumara Vindika , Samarathunga Thilina Anuradha , Gunaratne Dhanuja , Karunarathne Chaminda , Gajanayaka Raveena , Kumarasinghe Nishantha
Published: August 2020

BACKGROUND – The significant increase in the burden of chronic kidney disease of unknown etiology (CKDu) of Sri Lanka has led to evaluate the factors related to physical, social and mental aspects of health related quality of life (HRQOL) in CKDu patients. METHOD – The quality of life of 84 CKDu patients (stages 1-5) were assessed by means of the Kidney Disease Quality of Life Short-Form survey (KDQOL™-36) Version 1.3 along with biomarkers and patient demographics. The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula. Patients were divided into four groups according to their eGFR; group A with eGFR range 90-60 ml/min/1.73 m2, group B with eGFR range 30–59 ml/min/1.73m2, group C with eGFR range 15–29 ml/min/1.73m2 and group D with eGFR<15 ml/min/1.73m2. RESULTS – The KDQOL™-36 scores impaired substantially across all stages of CKDu and comparatively lower scores were present in latter stages of the disease than the initial stages. The mental composite summary (MCS) scores were more impaired when compared to physical composite summary (PCS) scores during the early stage of disease. Poor KDQOL™-36 scores were present in males than in females. A significant variance in scores was not observed between the gender and younger (<65 years) and elderly (≥65 years) populations. Biochemical parameters showed a statistically significant correlation with majority of KDQOL™-36 dimensions while interestingly urine albumin to creatinine ratio did not. CONCLUSION - Our findings reveals that CKDu patients in any stage of the disease despite their age and gender have a significant physical and mental health burden, and this burden is alarmingly increased among patients as the disease worsens. Thereby, early assessment of health related quality of life will help to identify high risk patients and modifying these factors may provide better active and a healthy lifestyle.
Fibrinogen Level Predicts Prognosis of Patients with Acute Ischemic Stroke or TIA
Authors: Hou Huiqing , Xiang Xianglong , Pan Yuesong , Li Hao , Meng Xia , Wang Yongjun
Published: August 2020

Background: Fibrinogen is involved in acute stroke. This study aimed to investigate the association between fibrinogen and prognosis in patients with acute ischemic stroke or transient ischemic attack (TIA). Methods: Using data from the CNSR-Ⅲ (Third China National Stroke Registry), this sub-study included 10 518 (69%) consecutive patients who had fibrinogen levels measured. The primary outcome was a poor functional outcome defined as modified Rankin Scale score of 3 to 6 within 90 days. The secondary outcomes were stroke recurrence, ischemic stroke recurrence, composite vascular events, and poor functional outcome during the 1-year follow-up and a new vascular event at 90 days. Multivariate logistic regression and Cox regression analyses were used to assess the associations between fibrinogen and prognosis of patients. Results: In total, 1446 (13.9%) patients had a poor functional outcome at 90 days. High fibrinogen levels were associated with poor functional outcome (adjusted odds ratio [OR], 1.35; 95% confidence interval [CI], 1.12-1.64) at 90 days after adjustment for confounding risk factors. High fibrinogen levels also independently predicted poor functional outcome during the 1-year follow-up. Stroke recurrence occurred in 657 (6.3%) patients at 90 days. High fibrinogen levels were associated with stroke recurrence, ischemic stroke recurrence, and composite vascular events in the crude model, but further adjustment eliminated these associations in the multivariate models. Conclusion: Our study showed that high fibrinogen level was independently associated with poor functional outcome but not with stroke recurrence in patients with acute ischemic stroke or TIA.
Interfacial stabilization for inverted perovskite solar cells with long-term stability
Authors: He Zhubing , Chen Wei , Han Bing , Hu Qin , Gu Meng , Zhu Yudong , Yang Wenqiang , Zhou Yecheng , Luo Deying , Liu Fangzhou , Cheng Rui , Zhu Rui , Feng Shien-Ping , Djurišić Aleksandra , Russell Thomas
Published: August 2020

Perovskite solar cells (PSCs) commonly exhibit significant performance degradation due to ion migration through the top charge transport layer and ultimately metal electrode corrosion. Here, we demonstrate an interfacial management strategy using a boron chloride subphthalocyanine (Cl6SubPc)/fullerene electron-transport layer, which not only passivates the interfacial defects in the perovskite, but also suppresses halide diffusion as evidenced by multiple techniques, including visual element mapping by electron energy loss spectroscopy. As a result, we obtain inverted PSCs with an efficiency of 22.0% (21.3% certified), shelf life of 7000 hours, T80 of 816 h under damp heat stress (compared to less than 20 h without Cl6SubPc), and initial performance retention of 98% after 2000 hours at 80 oC in inert environment, 90% after 2034 h of illumination and MPP tracking in ambient for encapsulated devices and 95% after 1272 h outdoor testing ISOS-O-1, which is among the top device performance for the inverted PSCs.
DNA Methylation Changes in Endometrium and Correlation with Gene Expression During Ovarian Hyper-stimulation
Authors: Sun Bo , Ma Yujia , Wang Fang , Hu Linli , Dai Shanjun , Zhang Yile , Sun Yingpu
Published: August 2020

Persistent supraphysiological serum estradiol (E2) levels during controlled ovarian hyper-stimulation (COH) have a detrimental effect on endometrial receptivity. In this study, we explored RNA expression and DNA methylation profiles from patients’ endometrium. The patients were divided into two groups: the COH cycle (n=3, hCG+7) group and normal cycle group (n=3, LH+5). Quantitative RT-PCR was used to validate the expression of selected differentially expressed genes (DEGs). Comparing natural and stimulated endometrium transcriptome profiles revealed 640 DEGs, with a > 2-fold change (FC) and p < 0.01. The DEGs were reported to be involved in endometrial receptivity and epithelial-mesenchymal transition (EMT). The expression of IGFBP-1, MMP9, FGF9, LIF, WNT4, HAND2, and immune system-related genes were significantly up-regulated. By clustering and KEGG pathway analysis, molecules and pathways associated with endometrial receptivity (PI3K-Akt signaling pathway) were identified. DNA methylation was partially correlated to gene expression. In conclusion, RNA-seq COH affected endometrial receptivity and EMT/MET process by accelerated the decidualization process and broken the balance of estrogen and progesterone receptors expression. However, this was not associated with changes in DNA methylation.