bluuebunny/crossref_metadata_2025 huggingface dataset:
A Protocol to Develop Practical Guidelines for Management of Primary Dysmenorrhea with Moxibustion
Authors: Huang Shouqiang , Xiong Jun , Fu Yong , Hua Fanghui , Xiang Jie , Fan Hao , Jiang Yunfeng , Zhou Xiaohong , Liao Kai , Xu Lingling , Zhang Haifeng
Published: September 2020

Background: Primary dysmenorrhea (PD) is a common gynecological disease characterized by lower abdominal pain. Moxibustion as a traditional Chinese treatment, can effectively treat PD with few adverse reactions. Nowadays, there is still no standard guideline for moxibustion treatment of PD, so related clinical practice guidelines (CPG) need to be developed.Methods: This guideline will be developed in line with the latest guideline definition from Institute of Medicine(IOM), and that applies the GRADE system as well as the World Health Organization handbook to appraise the quality of evidence and develop recommendations. We will set up a Guideline working group, put forward the corresponding problems based on the principle of Population, Intervention, Comparison, Outcomes(PICO), and complete the literature retrieval. After achieving consensus through evidence syntheses and 2-3 rounds of Delphi process, we will also consider patients values and preferences and implement peer review in the guideline.Result: We will put forward evidence-based best practice recommendations and moxibustion standard to improve the symptoms caused by primary dysmenorrhea in a more efficient way. At present, the research is still in progress, and there is no result to report.Conclusions: This guideline will be helpful to clinical acupuncturists and other professionals to further improve clinical efficacy in treating PD with moxibustion. Moreover, we will also constantly update and evaluate the evidence to both support recommendations and identify gap areas for future research.Systematic Review registrations: registration number: IPGRP-2020CN021
Blockade of IDO-kynurenine-AhR pathway promotes cell apoptosis in carboxyamidotriazole-induced tumor cell dormancy-apoptosis oscillation
Authors: Shi Jing , Wang Qingzhu , Yang Lixing , Liu Qin , Ju Rui , Guo Lei , Ye Caiying , Zhang Dechang
Published: September 2020

Background: Some cancer cells may reshape their genetic make-up, adopt a special metabolism mode and undergo dormancy to endure drug attacks. Blocking survival signals in dormant cancer cells that survive a certain anticancer therapy and eradicating them while dormant may help prevent tumor recurrence and metastasis.Methods: Two colorectal cancer cell lines C26 and HCT116 were treated with carboxyamidotriazole. Sulforhodamine B assay and Ki67 staining were conducted to detect the cells proliferation response. Cell cycle distribution was measured with BrdU staining. Then treated with CAI, DMF, 1-MT or a combination and analyzed the apoptosis. The in vivo anti-tumor effects of each monotherapy or combination therapy were assessed according to their capability to slow tumor growth and extend the life span of tumor-bearing mice. Results: The colorectal cancer cells slow growth to escape the pressure of the anti-tumor drug CAI. Blocking the IDO-kynurenine-AhR pathway could promote CRC cells apoptosis in CAI-induced tumor cell dormancy-apoptosis oscillation, facilitating their eradication.Conclusion: The combination of 1-MT or DMF with CAI may prompt dormant cancer cell to enter an apoptotic state, which is triggered by STAT1 nuclear translocation but obscured by the dormancy-permissive metabolic fitness signals when the tumor cells are exposed to CAI alone.
Immunological Anti-Tumor Activity of Icariside I by Regulating Gut Microbiota and Its Derived Metabolites in a Melanoma Mouse Model
Authors: Chen Gui , Cao Zheng , Shi Zunji , Lei Hehua , Chen Chuan , Yuan Peihong , Wu Fang , Liu Caixiang , Dong Manyuan , Song Yuchen , Zhou Jinlin , Lu Yujing , Zhang Limin
Published: September 2020

Background

Emerging evidence has shown that gut microbiome plays important roles in antitumor immunotherapy by shaping systemic immune responses. Specifically, Lactobacillus spp. and Bifidobacterium spp. were previously reported to enhance host immunity and inhibit tumor growth. Furthermore, microbiota-derived metabolites such as short-chain fatty acids (SCFAs) and indole derivatives are gradually regarded as immunomodulatory molecules involved in metabolic signaling pathways.
Methods

A B16F10 melanoma model was selected as a tumor-bearing animal for the investigation of immunological anti-tumor activity of Icariside I. Gut microbiota structure and composition in cecal content of mice was firstly analyzed by 16S rRNA gene sequence with the goal of screening those bacteria highly associated with tumor immunotherapy. Subsequently, targeted metabolomics approach was employed to quantitatively determine microbiota-derived metabolites such as SCFAs and indole derivatives. The population of multiple lymphocyte subsets in peripheral blood were measured with flowcytometry to evaluate changes of host immunity.
Results

Icariside I significantly inhibited B16F10 melanoma growth in vivo through regulation of gut microbiota and host immune. Oral administration of icariside I improved the altered gut microbiota community with marked restoration of Lactobacillus spp. and Bifidobacterium spp. abundance. Icariside I was also able to improve the levels of microbiota-derived metabolites such as short-chain fatty acids (SCFAs) and indole derivatives, consequently repairing intestinal barrier and systemic inflammation of tumor-bearing mice. Furthermore, icariside I up-regulated multiple lymphocyte subsets including CD4 + and CD8 + T cells or NK and NKT cells in peripheral blood.
Conclusions

These results suggested that icariside I may be developed as a novel and natural anticancer adjuvant via microbiome remodeling and host immune regulation.
“An Emotional Roller-Coaster:" Stressors Faced by Peer Workers in Overdose Response Settings
Authors: Mamdani Zahra , McKenzie Sophie , Pauly Bernadette , Cameron Fred , Conway-Brown Jennifer , Edwards Denice , Howell Amy , Scott Tracy , Seguin Ryan , Woodrow Peter , Buxton Jane
Published: September 2020

Background
Experiential workers or ‘peers’ (workers with past or present drug use experience) are at the forefront of overdose response initiatives and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for experiential workers but is also stressful, with lasting emotional and mental health effects. Yet, little is known about the stressors experiential workers face and what interventions can be implemented to support them in their roles.
Methods
This project used a community-based mixed methods research design. Eight experiential worker-led focus groups (n = 31) were conducted between November 2018 and March 2019 to assess needs of experiential workers. The transcripts were thematically coded and analyzed using interpretative description. These results informed a survey which was conducted (n = 50) in September 2019 to acquire quantitative data on experiential workers’ perception of health, quality of life, working conditions and stressors. Frequency distributions were used to describe characteristics of participants. X2 distribution values with Yates correction were conducted to check for association between variables.
Results
Five themes emerged from the focus groups that point to stressors felt by experiential workers: (1) Financial insecurity; (2) lack of respect and recognition at work; (3) poor living conditions; (4) inability to access and/or refer individuals to resources; and (5) constant exposure to death and trauma. Consistent with this, the top four factors that survey participants picked as one of the “top three stressors” included financial situation, work situation, housing, and caring for others.
Conclusion
Experiential workers are faced with a diversity of stressors in their lives which often reflect societal stigmatization of drug use. Recognition of these stressors is critical in designing interventions to ease the emotional, physical and financial burden faced by experiential workers.
Do experimental pain individuals have special attention on pain words? The critical role of P2
Authors: Wang Kangling , Chen Yifei , Huang Shimin , Liu Howe , Wu Wen
Published: September 2020

BackgroundAttention bias is believed to be one of the important reasons for the generation, persistence and development of chronic pain. Though chronic pain patients are generally found to have attention bias towards pain words or pain faces, there is no consistent conclusion about experimental pain subjects. MethodsThis study was conducted to test whether experimental pain subjects have attention bias towards pain words and at which stage pain bias takes place. Twenty healthy adults (female=11) aged between 18 to 27 were recruited and sprayed 10% capsaicin paste to mimic a sense of acute pain. We accessed behavioral results and event-related data with repeated measure ANOVAs with IBM SPSS 20 in cognitive tasks that had pain words and other word categories as interfering factors.ResultsResponse time was longer under high cognitive load compared with low cognitive load(P<0.001). The accuracy rate for low cognitive load was higher compared with high cognitive load(P<0.001). P2 amplitude in pain words has the largest positive wave than other words(P<0.005), while N3 amplitude in neutral words has the largest negative wave than other words(P<0.005). P2 appears in the whole brain but has the largest power on posterior brain regions, while N3 has the largest negative power on anterior brain regions.ConclusionOur study provided evidence for attention bias toward pain words in experimental pain subjects and suggested an early bias with P2 as a stable differentiator. Further researches into neuroscience should be conducted to ascertain activated and responsible brain regions and networks.
Experimental study applied to the lime hydration process, in a thermoelectric coal power plant unit
Authors: Dantas Rodrigo Saraiva , Liendo Maria Alejandra , Ferreira Vera Lucia Duarte , Bortoluzzi Rodrigo
Published: September 2020

Coal Power Plants need to control SO 2 emissions to the atmosphere from the boiler flue gases, in order to reach standards according to guidelines determined by the Conselho Nacional de Meio Ambiente - CONAMA. For this purpose hydrated lime is used, which is, in fact, produced from lime at the power plant. Hydrated lime is injected into the equipment called desulphuriser that operates capturing the sulfur dioxide from the boiler flue gas. Due to the importance of this process, the present work aimed to evaluate several points that involve: the production of hydrated lime from lime, the analysis of the quality of lime received, the study of the hydration process. Moreover it was evaluated the impact of the temperature of reaction through to the hydration efficiency according to the methodology and routine proposed. In addition, complementary analysis were carried out on the characterization of lime and hydrated lime and the correlation between the main process parameters measured and recorded in lime hydration control system. In relation to the results of hydration efficiency, it was possible to observe its increase when the maximum temperature of the reaction stage was lower, reaching results up to 85%.
Identification and Profiling of microRNAs and Their Target Genes in Tibetan Hulless Barley in Response to Barley Leaf Stripe (BLS) Infection
Authors: Yao Xiaohua , Wang Yue , Yao Youhua , Bai Yixiong , Wu Kunlun , Qiao Youming
Published: September 2020

Background

Tibetan hulless barley is widely grown on the Qinghai-Tibet Plateau, where it has served as a staple food for Tibetan people since the 5th century CE. Barley leaf stripe (BLS) is one of the most severe fungal diseases affecting the yield and quality of Tibetan hulless barley.
Results

Here, we compared the miRNA profiles before and after BLS in two Tibetan hulless barley genotypes: Z1141, a BLS-sensitive wild variety, and Kunlun14, a BLS-tolerant hybrid variety. A total of 36 conserved and 56 novel miRNAs were identified. Of these, 10 conserved and 10 novel miRNAs exhibited significantly changed expression between the normal and infected leaves of Kunlun14, respectively, while 3 conserved and 5 novel miRNAs exhibited significantly changed expression between the normal and infected leaves of Z1141, respectively. A total of 24 miRNAs were found in Z1141 and Kunlun14, and a further 546 putative target genes were predicted. Transcriptome sequencing analysis showed that among the 546 candidate genes, 131 had significant differences in expression between the normal and infected leaves of Kunlun14 and Z1141. Gene ontology, pathway, and Blast analyses indicated 10 candidate target genes that were involved in the barley disease resistance. These 10 candidate target genes may be regulated by 7 miRNAs. According to quantitative real-time PCR results, the 10 targets were negatively correlated with their corresponding miRNAs after infection with BLS.
Conclusions

The miRNAs and their target genes expressed in Tibetan hulless barley were identified and found to be associated with BLS resistance. Thus, these miRNAs and their target genes may be exploited via breeding programs or genetic engineering to improve BLS resistance in Tibetan hulless barley.
Plasma Fibrinogen Acts as a Predictive Factor for Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer: A Retrospective Study of 1035 Chinese Breast Cancer Patients
Authors: Wang Yihua , Wang Yu , Chen Rui , Tang Zhenrong , Peng Yang , Liu Shengchun
Published: September 2020

Background: The aim of this study was to evaluate the relationship between pre-treatment plasma fibrinogen (Fib) level and pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients and to assess the role of plasma Fib as a predictive factor.Methods: Data from 1035 consecutive patients with invasive breast cancer who received NAC and subsequent surgery were retrospectively analysed. Both univariate and multivariate analyses were performed to identify clinicopathological factors associated with pCR to NAC.Results: The median value of Fib, rather than other plasma coagulation parameters, was significantly increased in non-pCR patients compared with pCR patients (P = 0.008). Based on the cut-off value estimated by the ROC curve analysis, samples were divided into low or high Fib groups (Fib < 3.145 g/L or ≥ 3.145 g/L). Low Fib status was significantly associated with premenopausal or perimenopausal status (P < 0.001), ≤ 5cm tumour size (P = 0.001), positive hormone receptor status (P = 0.003) and > 14% Ki67 index (P = 0.028). Adjusted for other clinicopathologic factors in the multivariate logistic regression model, low Fib status was strongly associated with pCR to NAC (OR = 2.365, 95% CI = 1.354-4.133, P = 0.002).Conclusions: This study demonstrates that low pre-treatment plasma Fib (Fib < 3.145 g/L) is an independent predictive factor for pCR to NAC in breast cancer patients.
Presence and Clinical Value of Vestibular Symptoms in Migraine
Authors: Liu Juan , Pan Qi , Fan Yulan , Zhang Yun , Fan Xiaoping , Tan Jiaze , Zhang Yixin , Zhou Jiying
Published: September 2020

Objective: To evaluate the correlations between the characteristics of vestibular symptoms and migraine, and to explore the clinical value of vestibular symptoms in patients with migraine.Methods: Consecutive patients who visited the outpatient Department of Neurology and presented with a principal complaint of headache were enrolled. Patients with primary headache diagnosed according to International Classification of Headache Disorders (ICHD-3) were divided into the episodic migraine group (EM), chronic migraine group (CM) and tension-type headache group (TTH). Information on clinical symptoms was collected with a semistructured questionnaire, and the characteristics of the vestibular symptoms were recorded.Results: 451 patients were recruited, with 235 EM, 187 CM and 29 TTH. The proportion of patients with vestibular symptoms in the migraine (108/422) was higher than that in the TTH (1/29), and the frequency of vestibular symptoms in the CM was higher. 2-8 days per month was the highest in the EM (131/235), and the migraine features and accompanying symptoms were the most typical. The highest proportion of patients with separate attacks of headache and vestibular symptoms was observed in the low-frequency headache (68.8%) (p<0.05). With an increase in headache frequency, the proportion of concurrent attacks of headache and vestibular symptoms gradually increased, a headache frequency of 8 days per month was a cut-off point for migraine.Conclusion: Vestibular symptoms occur frequently in patients with CM, and the presence of concurrent attacks of vestibular symptoms and headache was significantly related to the headache frequency. A headache frequency of 8 days per month is recommended as a warning sign for CM. Patients with headaches 2-8 days per month have the most typical characteristics and should be selected for clinical trial.
A Cross-sectional Study on the Burden and Impact of Migraine on Work Productivity and Quality of Life in Selected Workplaces in the Philippines
Authors: Haw Nel Jason , Cabaluna Ian Theodore , Kaw Germaine Erika , Cortez Joanna Feliz , Chua Maria Pamela , Guce Kristel
Published: September 2020

Background Migraine imposes a substantial personal and economic burden to many working age individuals. This study aimed to evaluate the burden and impact of migraine on work productivity in selected workplaces in the Philippines.Methods A cross-sectional survey was conducted among employees suspected or diagnosed with migraine February to May 2020. Volunteer employees were screened for migraine using the ID-Migraine™ test. Eligible employees were tested for migraine severity and impact on work productivity was measured using the Migraine Disability Assessment (MIDAS) questionnaire. Quality of life was also measured using the Short Form-36 (SF-36) questionnaire and additional questions on triggers, coping mechanisms, workplace assistance, and health care utilization were asked. Multiple logistic regression was used to identify significant predictors of migraine disability (high – MIDAS Grade III/IV vs. low – MIDAS Grade I/II). Differences in quality of life scores by migraine disability were measured using multiple linear regression. Productivity costs lost to migraine disability were calculated as the number of days lost to migraine multiplied by the self-reported wage rate, and costs according to migraine severity were measured using a two-part model (logistic then generalized linear model).Results A total of 511 positive migraine screens were included in the final sample. Females comprised two-thirds of all positive migraine screens and were more likely to have high migraine disability (odds ratio: 1.60, 95% CI: 1.03 - 2.49) than males. Those with high migraine disability scored lower on role limitations compared to those with low migraine disability. Stress and looking at computer screens were cited as the top trigger for migraine, while sleeping enough hours and getting a massage were cited as top coping mechanisms. Three in four (77%) visited their company clinic within the past three months, which meant that most doctors seen for migraine-related symptoms were general practitioners. Five in six (85%) took medication for migraine, almost all of which were over-the-counter medications. Mean annual productivity costs lost due to migraine disability were PHP27 794 (USD556).Conclusion Migraine poses a significant threat to work productivity in the Philippines. Many opportunities, such as disease management and introduction of alternative options for migraine treatment, may be introduced to help address these issues.
Parent-Perceived Barriers to Accessing Services for Their Child’s Mental Health Problems
Authors: Hansen Anna Sofie , Telléus Gry Kjærsdam , Mohr-Jensen Christina , Lauritsen Marlene Briciet
Published: September 2020

Background: Many children and adolescents with impairing mental health disorders are not in contact with specialized child and adolescent mental health services (CAMHS). In order to close the service gap, it is important to increase our knowledge of barriers to access. The aim of this study was to investigate parent perceived barriers to accessing services for their child’s mental health problems to identify potential areas for improvement of access to CAMHS. Method: In this cross-sectional observational study 244 parents of children and adolescents referred to outpatient psychiatric assessment were interviewed using the Children’s services interview regarding barriers to accessing child mental health services across healthcare, educational services and social services. Parent reported barriers were analyzed in relation to the child’s age, referral reason, symptom duration and impairment of the child. Results: The most commonly reported barriers were lack of information about were to seek help (60.3%), the perception that professionals did not listen (59.8%) and professionals refusing to initiate interventions or provide referral to services (53.7%). Lack of knowledge, stigmatization and unavailability of services were common themes across barriers to help-seeking. Long symptom duration and parent rated impairment was associated with increased risk of reporting several barriers to help-seeking. Conclusion: Parents seeking help for their child’s mental health encounter numerous barriers that could explain part of the treatment gap and long duration of mental health problems in children prior to referral to CAMHS.
A systematic review and meta-analysis of the prevalence, trends and spatiotemporal distribution of HIV/AIDS infection in Northern African countries.
Authors: Daw Mohamed A , Sifennasr Nadia E.M. , El-Bouzedi Abdallah , Ahmed Mohamed O
Published: September 2020

Background: Human immune deficiency virus (HIV) infection is a major global public health concern. Northern African countries carry a disproportionate burden of HIV, accounting for one of the highest prevalences in Africa. Here in, we sought to analyze the epidemiological characterization and spatial trends of HIV infection in the Northern African region.Methods: A systematic review was carried out on all the published data regarding HIV/AIDS in Northern African countries over a ten year period ( 2008-2017) following the PRISMA guidelines. We performed a comprehensive literature search using Medline PubMed, Embase, regional and international databases, and country-level reports were searched with no language restriction. The quality, quantity, and geographic coverage of the data were assessed at both the country and region levels. We used random-effects methods, spatial variables and stratified results by demographic factors. Only original data for the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.Results: A total of 721 records were identified by our data search , and only 41 that met our criteria were included in the meta-analysis during the study period. There was a considerable variability in the prevalence estimates of HIV within the countries of the region. The overall prevalence of HIV in northern African countries ranged from 0.9% (95% CI (0.8–1.27) to 3.8% (95% CI (1.17-6 .53)). The highest prevalence was associated with vulnerable groups, particularly drug abusers and sexual promiscuity. Dense HIV clustering was also reported during the study period, varying from one country to another. At least 13 HIV subtypes and recombinant forms were prevalent in the region. Subtype B was the most common variant , followed by CRF02_AG.Conclusion: This comprehensive review indicated that HIV infection in Northern African countries is an emerging threat. Effective strategies are needed both at national and regional levels to improve monitoring and controlling the transmission of HIV with a particular emphasis on geographic variability and HIV clustering.
Plateletpheresis Donation Trend and a Ban on Family/Replacement Donation in China: A Pseudo-Panel Data Approach Analysis
Authors: Chen Jinyan , Zhou Guoli , Fu Xuemei , Li Shijie , Li Ying , Kang Jiankun , Chen Huiyou , Zhou Liqiao , Fu Yongshui
Published: September 2020

Background A nationwide ban on family/replacement donation (FRD) went into effect on April 1, 2018 in China. To date, no reports relevant to the trend of plateletpheresis donations before and after a nationwide ban on FRD were found.Methods We used two independent full samples, consisting of 135851 and 82129plateletpheresis donors from Guangzhou and Chengdu between October 2012 and September 2019, respectively. A pseudo-panel dataset approach was applied by grouping three time-invariant covariates – gender, blood donation history, and birth year across 14 cross-sections (a 6-month interval each)to form a total of 24 cohort groups (14×24=336 cohorts, i.e., cells) with each having common covariates. The outcome was average apheresis platelet units per donor in each cell. We performed a two-piecewise linear mixed model with the cross-section (i.e., time) just right before the ban as a time breakpoint(i.e., 11th cross-section) to examine the trend of outcome with the adjustment of three time-invariant covariates. We removed the family/replacement donations in each of the first 11 cross-sections to detect its possible influence on the trend.Results The final model for the samples from Guangzhou presented a two-piecewise linear trend of the outcome over time with a horizontal line to the left of the breakpoint (βtimeBefore11=0.0111,p=0.0976) and a significantly positive linear trend to the right (βtimeAfter11=0.0404,p<0.0001). The male donors and the donors with plateletpheresis donation history had an increased baseline outcome and a significant outcome change over time after the ban. Such a two-piecewise linear trend pattern can be replicated using the samples from Chengdu with some minor variations. Removing the FRD before the ban can change the pattern.Conclusion The significant increase of the average apheresis platelet units per donor over time after the FRD ban may be related to the implement of the FRD ban and the improved donation behavior of male donors and/or donors with platelet donation history after the ban. Our findings may potentially motivate the policymakers in other countries where the FRD for plateletpheresis donation is still legitimate to phase out their FRD strategy and ultimately achieve 100% voluntary plateletpheresis donation.
A novel multi-scale bioinformatics strategy for identifying the molecular mechanism by insighting into ceRNA network integrating WGCNA and meta-analysis: compound kushen injection for treating gastric carcinoma as a proof
Authors: Zhou Wei , Zhang Jingyuan , Guo Siyu , Liu Xinkui , Jia Shanshan , Lu Shan , Wu Jiarui , You Rongli
Published: September 2020

BackgroundGastric carcinoma (GC) is a severe digestive system tumor with high morbidity and mortality and poor prognosis, of which the novel treatments are urgently needed. Compound kushen injection (CKI), a classic Chinese medicine injection, has been widely used to treat a variety of tumors in clinical for decades. In recent years, a growing number of studies have confirmed that CKI has a favorable therapeutic effect on GC, but there are few reports on the potential molecular mechanism of action.MethodsHere, using network pharmacology as the core concept, we identified the ceRNA network and key targets of CKI in the treatment of GC. In order to further explore the impact of key targets, we conducted a meta-analysis of them and compared the expression differences between GC tissues and normal tissues. Functional analysis was utilized to understand the biological regulation pathways involved in key genes. Moreover, we further detected the significance of key genes for the prognosis of GC through survival analysis and immune infiltration analysis. Finally, molecular docking simulation was adopted so as to verify the combination of CKI components and key targets.ResultsAnalysis of the ceRNA network of CKI on GC illustrated that the potential molecular mechanism of CKI was possible to regulate PI3K-AKT and Toll-like receptor signaling pathways by intervening hub genes including AKR1B1, MMP2 and PTGERR3.ConclusionsIn conclusion, this study not only partially highlighted the molecular mechanism of CKI in GC therapy but also provided a novel strategy for exploring the effective mechanisms of traditional Chinese medicine formulations.
Preferences of Medical Students for Rural Medical Internships in South Africa: A Discrete Choice Experiment
Authors: Jose Maria , Obse Amarech , Zuidgeest Mark , Alaba Olufunke
Published: September 2020

Background: Globally the proportion of medical doctors to population in rural areas in low- and middle-income countries remains insufficient to address their health care needs. Therefore, it is imperative to design strategies that attract medical doctors to rural areas to reduce health inequalities and achieve universal health coverage. Methods: This study assessed preferences of medical students for rural internships using a discrete choice experiment. Attributes of rural job were identified through literature and focus group discussions. A D-efficient design was generated with 15 choice sets, each with forced binary, unlabelled, rural hospital alternatives. An online survey was conducted, and data analysed using mixed logit models of main effects only and main effects plus interaction terms. Results: Majority of the respondents were females (130/66.33%) and had urban origin (176/89.80%). The main effects only model showed advanced practical experience, hospital safety, correctly fitting personal protective equipment, and availability of basic resources as the most important attributes influencing take up of rural internship, respectively. Respondents were willing to pay ZAR 2645.92 monthly (95%CI: 1345.90; 3945.94) to gain advanced practical experience (equivalent to 66.15% of current rural allowance). In contrast, increases in rural allowance and the provision of housing were the least important attributes. Based on the interaction model, female respondents and those intending general practise associated higher weight for hospital safety over advanced practical experience. Conclusion: In the context of limited budgets and resource constraints, policy makers and rural health facility managers are advised to prioritise meaningful internship practise environments that offer supervised learning environment, safety from physical and occupational hazards and the provision of basic resources for healthcare system-wide benefits to both staff and rural health facility users alike.
Visualizations of Combinatorial Entropy Index on Whole SARS-CoV-2 Genomes
Authors: Zheng Jeffrey , Zhou Yang
Published: September 2020

In this paper, a set of SARS-CoV-2 genomes from four countries are selected for visualizations under the C1 modules of the metagenomic analysis system MAS. Based on the variant construction and the theory of information entropy, the module makes statistics on the number of bases in SARS-CoV-2 sequences to calculate the base probability measures in segments to generate the combinatorial entropy index data from the base probability measures. Under visualization technology, the combinatorial entropy index is projected on 2D clustering genomic index maps and 1D histogram maps to provide projection results. The visual results provide intuitive and easy properties to analyze complicated clustering among genomes to support clustering analysis of SARS-CoV-2 genomes in batches, showing the distribution characteristics of SARS-CoV-2 genomes in different countries or regions conveniently.
Efficiency of damage control orthopaedics strategy in the management of military ballistic limb trauma
Authors: Khalil Amri , Ahmed Tounsi , Achraf Oueslati , Mouhamed Ben Salah , Rim Dhahri , Chadia Chourabi , Lotfi Nouisri
Published: September 2020

Background:

In conflict areas, orthopaedic surgeon adopted this concept of damage control orthopaedic (DCO) to face limb fracture due to ballistic trauma because of the gravity of the hurts, the limitation of equipment, and precarious conditions of asepsis. They use external fixation as an initial treatment at the nearest health centre. And they delay the definitive treatment to be realized in better conditions. Our study aims to assess the outcome of damage control orthopaedic (DCO) strategy in military ballistic limb trauma according to the experience of the Military Hospital of Tunisia.
Materials and methods:

This study is a retrospective study on patients who were hospitalized for a limb ballistic fracture. It includes military patients treated urgently with primary external fixation at the nearest health centre. We adapted Gustilo classification to describe the wound opening, Winquist and Hansen classification to define the fracture comminution and Grading system for bone loss to evaluate the bone loss. Then all victims were evacuated secondary, to the Military hospital to receive the definitive treatments. The conversion to internal osteosynthesis had taken place according to some criteria. They were the absence of local sepsis, a haemoglobin level (> 10 g/dl), a serum protein level (> 50 g/l) and a negative or falling CRP kinetics. We studied the delay of conversion from external fixation to an internal osteosynthesis, bone healing time and complications.
Result:

Our study included 32 patients, all men, mean age was 31 years. The average follows up was 33,2 months. 88% of trauma concerned lower limb. The average delay for conversion from external fixation to internal osteosynthesis was 7,8 days. The bone union was achieved in 26 cases, with an average delay of 4.23 months. Observed general complications were anaemia, pulmonary embolism and rhabdomyolysis. Local complications were essentially sepsis on osteosynthesis material and pseudarthrosis. These complications were significantly associated with a type III of Gustilo skin opening, a type III and IV of the Winquist fracture comminutions, a type II and III of the Grading system for bone loss, and the delay for conversion from external fixation to internal osteosynthesis.
Conclusion:

DCO is a global strategy which involves all measures participating in the acceleration of the wound healing and fighting against the infection. These measures shorten the delay of conversion from external fixation into an internal osteosynthesis, which constitutes a key parameter in the management of limb fracture due to ballistic trauma.
Gut microbiota signatures in Schistosoma japonicum infection-induced liver cirrhosis patients
Authors: Gui Qifeng , Zhu Feng , Xiao Chi , Lu Haifeng , Zhang Qin , Xu Jia , Jin Huilin , Yang Yunmei
Published: September 2020

Background: One of the serious complications induced by Schistosoma japonicum infection is the development of liver cirrhosis. Several studies have assessed the role of gut microbiota in cirrhosis of different etiologies, but none has done so in the context of S. japonicum infection in humans. Here, to explore the possible role of gut microbiota in S. japonicum infection-induced liver cirrhosis, we conducted an observational clinical study.Methods: Twenty-four patients with S. japonicum infection-induced liver cirrhosis and 25 age- and gender-matched controls from Zhejiang Province, China, were enrolled in the study. Fecal samples were collected and used for 16S rRNA gene hypervariable V4 region Illumina MiSeq sequencing.Results: Eight hundred seven operational taxonomic units (OTUs) were detected, of which 491 were common in the two groups, while 123 and 193 were unique for the control and cirrhosis groups, respectively. Overall, no significant differences in both alpha and beta diversities and overall microbiota structure were found in the two groups. However, Bacilli (Class) and Lactobacillales (Order) were significantly higher in patients with S. japonicum infection-induced liver cirrhosis than in healthy individuals.Conclusions: Altogether, our results suggest that the gut microbiota of S. japonicum infection-induced liver cirrhosis patients is similar to that of healthy individuals.
Visual Field Improvement Achieved by Decompression Surgery for Craniomaxillofacial Fibrous Dysplasia: A Case Report
Authors: Li Nana , Chen Xuhao , Tian Yanjie , Zhang Chun
Published: September 2020

BackgroundCraniomaxillofacial fibrous dysplasia (CFD) is a type of congenital benign bone disorder that progressively replaces the healthy bone marrow with fibrous tissue. When the optic nerve is influenced, the efficacy of therapeutic decompression is doubtful, as vision loss is irreversible with the thinning nerve fiber layer. Case presentationA 22-year-old female presented to our institution with left painless, slowly-progressing orbito-fronto-temporal swelling. She had undergone several plastic surgeries before. Enlargement in her left frontal area involving the orbital region was seen, with increased frontal contour and vertical dystopia and minimal inferior displacement of the globe. We observed significant visual field defects in her left eye, and her retinal fiber layer was thin on examination. She was therefore diagnosed as FD. Decompression operation was performed, and her visual acuity and central visual field improved in the 1-month follow-up.Conclusions Our case indicated that visual defect caused by prolonged time course of optic nerve compression by craniomaxillofacial fibrous dysplasia can be relieved partially by decompression surgery.
Delayed Intrathoracic Gastric Perforation after G-POEM for Treating Post-Operative Refractory Gastroparesis：A Case Report and Review of Literature
Authors: Dai Shenglan , Sun Zhiyue , Shi Yan , Wang Tao , Xu Yaping , Yao Jun
Published: September 2020

Background: Gastric peroral endoscopic pyloromyotomy(G-POEM) is introduced as a strategy to treat post-operative refractory gastroparesis. An intrathoracic gastric perforation is a rare complication of G-POEM. Case presentation: This report described the case of a patient who suffered with an intrathoracic gastric perforation about 10 days after a G-POEM procedure. A review of the PUBMED literature indexed in English with the key words of perforation and G-POEM was performed and the results were considered. The results indicated that delayed perforation was a rare complication after G-POEM. Overeating may cause the severe intrathoracic gastric dilation and perforation. Furthermore, successful nonsurgical management after G-POEM complicated by delayed perforation could be a highly feasible option, if intensive conservative treatments were used. Conclusions: Delayed perforation after G-POEM treating post-operative refractory can lead to severe mediastinal and thoracic infections. Fully prepared before the G-POEM procedure and effective suture instrument during the procedure may reduce the incidence of perforations. If perforation occurs after G-POEM, conservative treatment can be chosen if a patient’s general situation allows. However, the choice of surgical treatment must not be ignored if the patient's overall condition deteriorates.
WITHDRAWN: Assessment of Knowledge, Attitude and Associated Factors toward COVID-19 among Nurses Who Work in South Gondar Zone, Hospitals, Northwest Ethiopia 2020, Institution-based cross-sectional Study
Authors: Feleke Dejen Getaneh , Tassew Sheganew Fetene , Chanie Ermiase Sisay
Published: September 2020

BackgroundCoronavirus disease 2019 is an emerging respiratory disease that is caused by a novel coronavirus and was first detected in December 2019 in Wuhan, China. The world is affected by the Corona Virus Disease in 2019. In sub-Saharan Africa Including Ethiopia there is no study conducted on level of Knowledge, Attitude and Associated Factors toward Coronavirus disease in 2019 among Health care workers Specifically Nurses.ObjectiveThis study aims to assess the level of Knowledge, Attitude and Associated Factors toward Coronavirus disease in 2019 among Nurses Who Work in South Gondar Zone, Hospitals, Northwest Ethiopia, 2020.MethodsAn Institution-based cross-sectional study was conducted among 166 Nurses in South Gondar Zone, Ethiopia, From June 1st -30/2020. To select study participants after proportional allocation of study subjects to each Hospital, simple random sampling technique were to be used. The Data was entered into Epi info version 7.2.0.1, and exported to Statistical Package for Social Sciences window version 24 for analysis. Binary and Multivariable logistic regression wasl used to see the association between dependent and independent variables. Adjusted odds ratio with 95% confidence interval was computed. P-value < 0.05 was used to declare association. Finally; the result is presented in the form of texts, tables, and graphs.ResultsOf 166 Nurses, 166 (100% response rate) responded to the online interview questionnaire. From 166 nurses, 57.2% of the participants were Females and 42.8% were males, 41.6 % of the respondents were between the ages of 20 and 29 years. About 84.9 % had good knowledge and 63.3% favorable attitude of COVID-19. Wearing general medical masks can prevent one from acquiring infection by the co vid-19 virus (AOR = 0.44, 95% CI =0.005-0.362 were factors of knowledge about COVID-19. Whereas, strongly agree Medical staffs are ready to participate in antiepidemic in the community (AOR =0.08, 95% CI = (0.003-1.76 Were factors of attitude about COVID-19.ConclusionIn this study, most of the nurses had good knowledge and favorable attitude regarding COVID-19. Wearing general medical masks can prevent one from acquiring infection by the covid-19 virus were the factors in association with knowledge OF nurses on COVID-19. Similarly, Medical staffs are ready to participate in antiepidemic in the community factors association with attitudes of nurses on COVID-19.
Molecular Detection and Identification of “Candidatus Ehrlichia hainanensis”, A novel Ehrlichia Species in Rodents from Hainan Province, China
Authors: Liu Peipei , Zhao Hongqing , Xue Feng , Gao Yunfeng , Lu Miao , Li Kun
Published: September 2020

Background: Ehrlichia is a genus of Rickettsiales bacteria closely related to human/animal disease and it plays an important role in public health. Naturally they are hosted by mammals such as canines, bovines, wild rodents and vectored by ticks. Results: In this study, we collected 121 rodent samples including 67 Niviventer fulvescens, 27 Rattus tanezumi, 24 Chiromyscus sp., 2 Rattus nitidus and 1 Leopoldamys edwardsi from Hainan province, which consists of the second largest island in China. The presence and genetic diversity of Ehrlichia was evaluated and characterized by amplifying and sequencing the 16S rRNA, groEL and gltA genes. An Ehrlichia was detected in 5 of the 67 Niviventer fulvescens samples (7.46%). The 16S rRNA, groEL and gltA genes show highest 99.20%, 89.87% and 83.86% identity to known Ehrlichia sequences. In the phylogenetic trees they form a distinct cluster from any other species.Conclusions: We propose that this Ehrlichia present a putative novel species nominated as ‘Candidatus Ehrlichia hainanensis’. Its pathogenicity to human is still to be further researched and molecular surveillance in local populations is needed.
An evaluation of the effectiveness of a telephone assessment and advice service within an ED Physiotherapy clinic: A single-site cohort study
Authors: Kelly Marie , Higgins Anna , Murphy Adrian , McCreesh Karen
Published: September 2020

BackgroundIn response to issues with timely access for musculoskeletal physiotherapy, telephone assessment and advice services have been evaluated in primary care settings. It is unclear whether this service model can reduce wait times and non-attendance rates for Emergency Department (ED) physiotherapy, compared to usual care. A secondary aim was to evaluate service user acceptability.MethodsThis was a single-site cohort study that compares data on non-attendance rates, wait time to first physiotherapy contact and participant satisfaction between patients that opted for a service based on initial telephone assessment and advice, versus routine face-to-face appointments. 116 patients were referred for ED physiotherapy over the 3-month pilot at the ED and out-patient physiotherapy department, X, Ireland. 91 patients (78%) opted for the telephone assessment and advice service, with 40% (n=36) contacting the service. 25 patients (22%) opted for the face-to-face service. Data on non-attendance rates and wait time was gathered using the hospital data reporting system. Satisfaction data was collected on discharge using a satisfaction survey adapted from the General Practice Assessment Questionnaire. Independent-samples t-test or Mann Whitney U Test was utilised depending on the distribution of the data. For categorical data, Chi-Square tests were performed. A level of significance of p ≤ 0.05 was set for this study.ResultsThose that contacted the telephone assessment and advice service had a significantly reduced wait time (median 6 days; 3 – 8 days) compared to those that opted for usual care (median 35 days; 19 – 39 days) (p ≤ 0.05). There was no significant between-group differences for non-attendance rates or satisfaction.ConclusionGiven the faster access to ED physiotherapy, without compromising on service user satisfaction, this telephone assessment and advice service, which can be introduced rapidly, could be helpful in triaging referrals and minimising face-to-face consultations in line with COVID-19 recommendations. However, a large scale study is warranted to confirm these findings.
Unmet Need for Family Planning and Associated Factors Among Married Women of Reproductive Age in Shebedino District, Southern Ethiopia, 2020
Authors: Wonago Matewos Wotango , Hibstu Desalegn Tsegaw
Published: September 2020

Back Ground: The Ethiopia Demographic and Health Survey, report indicates that high level with slight decrement of unmet need for family planning among married women that is, 37%, 25%, and 22% in 2000, 2011 and 2016 respectively. One of the consequences of unmet need is unwanted pregnancy with its serious squeal of induced abortion, and ultimately results in high maternal morbidity and mortality. The risk would increase in developing countries considerably (10). Therefore, this study focused on assessing magnitude of unmet need for FP and associated factors among married women of reproductive age group in Shebedino district, Sidama Zone, South Ethiopia, 2019.Methods: Community-based cross-sectional study was conducted from April 12 to 28, 2019. Data on married reproductive age groups women were collected using a pre-tested and interviewer administered structured questionnaire from 447 women using systematic random sampling technique. The data were entered using Epi Data version 3.1 and then exported in to SPSS version 20.0 Software for analysis. The result of bi-variable and multi-variable was reported by Adjusted Odd Ratio with 95% confidence. Result: A total of 447 married reproductive age group (15-49 years) women were included in the study with 100 % response rate. Fifty Six (12.5%) 95% CI: 9.5%-15.5%) women had unmet need for family planning [42 (9.4%) for spacing and 14 (3.1%) for limiting]. Age of the respondents [AOR= 6.02, CI: 2.73, 13.27], Age at first marriage [AOR= 9.3, CI: 1.9, 45.42], birth interval, [AOR= 2.9, CI, 1.3, 6.3], Number of alive children, [AOR= 9.3, CI: 1.9, 45.42], and Age at first start to use family planning to control birth (AOR= 3.69, CI: 1.44, 9.45) were identified as a positively associated factors.Conclusion: The level of unmet need for family planning in this study (12.5%) was lower than both the national (22%) and South Regional State (21%). Thus, spacing among births for at least two or more years, enforcing the law on minimum age for the first marriage, involvement of men in shaping reproductive preferences, reducing early marriage and participating relevant stakeholders to minimize mistimed and unwanted pregnancies and unmet need for family planning are recommended.