bluuebunny/crossref_metadata_2025 huggingface dataset:
Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial
Authors: Adegboye Amanda Rodrigues Amorim , Cocate Paula G , Benaim Camila , Carvalho Maria Claudia da Veiga , Schlüssel Michael M , Castro Maria Beatriz T , Kac Gilberto , Heitmann Berit L
Published: January 2020

Background: There are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aim of this study is to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy (PT) and describe the patient-, study protocol- and setting-related factors related to women’s ineligibility and refusal to participate in the study.

Methods: A mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2x2 factorial feasibility clinical trial were used. 18 women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions and data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies.

Results: Of all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (>20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Non-participation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, unresponsive to phone calls, and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthy and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation cost) could hinder participation in the study.

Conclusion: Engagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related socio-demographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings.
Global diastolic strain rate for the assessment of left ventricular diastolic dysfunction in young peritoneal dialysis patients: a case control study
Authors: Zhu Jing , Shi Fei , You Tao , Tang Chao , Chen Jianchang
Published: January 2020

Background: Left ventricular (LV) myocardial longitudinal diastolic strain rate measured by two-dimensional speckle tracking imaging (2D-STI) was proved to have a better correlation with the LV diastolic function. We aimed to use this sensitive tool to predict LV myocardial diastolic dysfunction in young peritoneal dialysis (PD) patients with preserved LV ejection fraction (LVEF).

Methods: We enrolled 30 PD patients aged ≤60 with LVEF ≥54% and classified as normal LV diastolic function by conventional echocardiography, and 30 age- and sex-matched healthy people as the control group. The left atrial maximum volume index (LAVI), LV mass index (LVMI), LVEF, LV posterior wall thickness (LVPWT), interventricular septal thickness (IVST), peak velocity of tricuspid regurgitation (TR), peak early diastolic velocity/late diastolic velocity(by Pulsed Doppler) (E/A) and E/peak velocity of the early diastolic wave (by Pulsed-wave tissue Doppler) (E/e’) were recorded by conventional echocardiographic. Next, the average LV global longitudinal systolic strain (GLS avg) and the average LV global longitudinal diastolic strain rate (DSr avg) during early diastole (DSrE avg), late diastole (DSrA avg) and isovolumic relaxation period (DSrIVR avg) were obtained from 2D-STI. Combined them with E, the new noninvasive indexes (E/DSrE avg, E/DSrA avg and E/DSrIVR avg) were derived.

Results: The PD group ’s LVEF, E/e¢, TR and LAVI were in the normal range compared with the controls, and only e¢ (p<0.001) was decreased. The LVMI (p<0.001), LVPWT (p<0.001), IVST (p<0.001) increased while E/A (p<0.001) decreased. The GLS avg (p=0.008) was significantly decreased in PD patients compared with the controls. DSrA avg (p=0.006) and E/DSrE avg (p=0.006) were increased, while DSrE avg (p<0.001), DSrIVR avg (p=0.017) and E/DSrA avg (p<0.001) decreased. After the multivariable regression analysis, the correlation between DSrE and the conventional parameters including LVPWT (p<0.001), E/A (p<0.001) still remained significant.

Conclusions: Young PD patients with preserved LVEF already exhibited myocardial diastolic dysfunction. Global diastolic strain rate indexes were valuable parameters to evaluate diastolic dysfunction. Additionally, LVPWT was highly correlated with DSrE, such parameter should be taken into account for predicting the early LV diastolic dysfunction in clinical practice.
Elevated glycosylated hemoglobin levels and its interactive effects on hypertension risk in non-diabetic population: a cross-sectional survey in China
Authors: song jian , wei nana , zhao yingying , jiang yuhong , wu xuesen , gao huaiquan
Published: January 2020

Background Abnormal glucose metabolism have been suggested to be involved in the development of hypertension. The present study aimed to investigate the associations and potential interactions of hemoglobin A1c (HbA1c) with other factors on the risk of hypertension among Chinese non-diabetic adults. Methods As a cross-sectional survey, the current work provided questionnaire survey, anthropometric tests and biochemical measure for each of the eligible participants. The HbA1c levels were quantified and grouped by quartiles. The correlation between HbA1c and hypertension risk in non-diabetic was investigated by univariate and multivariate analyses. For evaluating the interactive effects, the parameters of Relative Excess Risk due to Interaction (RERI), Attributable Proportion due to Interaction (AP) and Synergy Index (SI) were calculated, respectively. Results In the current study, 1462 non-diabetic subjects were enrolled. Totally, the prevalence of hypertension was 22.4% (n=327) in the individuals without diabetes. When the HbA1c levels were grouped by quartiles, it was revealed that the prevalence of hypertension substantially elevated across groups ( P for trend <0.001). In the multivariable logistic regression analyses, in comparison with the first quartile of HbA1c, the normalized OR for hypertension risk were 1.90 (95% CI:1.28-2.80) for the highest quartile. Also, the risk of ISH also significantly increased with HbA1c levels in the highest quartile as compared with the bottom quartile(OR: 2.23,95% CI:1.47-3.71). Besides, the ROC curve analysis indicated that the best threshold of HbA1c as the predictor for hypertension risk was 4.95 in non-diabetic subjects, with the AUC of 0.60 (0.58-0.63). Eventually, it was demonstrated from the interactive effect analysis that the HbA1c significantly interacted with abdominal obesity (RERI: 1.48, 95% CI: 0.38-2.58; AP: 0.37, 95% CI: 0.14-0.60 and SI: 1.96, 95% CI: 1.06-3.62) and family history of hypertension (AP: 0.37, 95% CI: 0.05-0.70) on the risk of hypertension in non-diabetic participants. Conclusion The risk of hypertension was aggravated by the up-regulated HbA1c in an independent and synergistic manner with abdominal obesity and family history of hypertension in Chinese subjects without diabetes.
EPIDEMIC RIBOTYPES OF CLOSTRIDIUM (NOW CLOSTRIDIOIDES) DIFFICILE ARE LIKELY TO BE MORE VIRULENT THAN NON-EPIDEMIC RIBOTYPES IN ANIMAL MODELS
Authors: Vitucci John C. , Pulse Mark , Tabor-Simecka Leslie , Simecka Jerry W.
Published: January 2020

Background . Clostridioides difficile infections have become more frequently diagnosed and associated with greater disease severity, which has resulted in an increase burden on the healthcare system. These increases are attributed to the increased prevalence of hypervirulent strains encompassing select ribotypes. These epidemic ribotypes were characterized as hypervirulent due to higher in vitro spore and toxin production, as well as increased incidence, severity and mortality within patients. However, it is unclear whether epidemic ribotypes are truly more virulent than non-epidemic ribotypes in vivo. Furthermore, there is conflicting evidence about the ability of a strain’s in vitro phenotype to be predictive of their in vivo virulence. The goals of the current studies were to determine if epidemic ribotypes are more virulent than other ribotypes in animal models, and whether the in vitro virulence phenotype of an isolate or ribotype predict in vivo virulence.
Results. To determine if epidemic strains were truly more virulent than other non-epidemic strains, the in vivo virulence of thirteen C. difficile isolates (7 non-epidemic and 6 epidemic ribotype isolates) were determined in murine (C57BL/6 mice) and hamster (golden Syrian hamster) models of C. difficile infections. The isolates of epidemic ribotype of C. difficile were found to be more virulent in both the murine and hamster models than non-epidemic isolates. In particular, the group of epidemic ribotypes of C. difficile had lower LD 50 values in hamsters. The increased severity of disease was associated with higher levels of Toxin A and Toxin B production found in fecal samples, but not numbers of organisms recovered. The isolates were further characterized for their in vitro virulence phenotypes, e.g. toxin production, growth rates, spore formation and adherence of spores to intestinal epithelial cell lines. Although there were higher levels of toxins produced and greater adherence for the group of epidemic ribotypes, the in vitro profiles of individual isolates were not always predictive of their in vivo virulence.
Conclusions. Overall, the group of epidemic ribotypes of C. difficile were more virulent in vivo despite individual isolates having similar phenotypes to the non-epidemic isolates in vitro .
Integrative analyses of gene expression profile reveal potential crucial roles of mitotic cell cycle and microtubule cytoskeleton in pulmonary artery hypertension
Authors: Luo Jing , Liu Zhenwei , Li Chenlu , Wang Ruochen , Fang Jinxia , Lu Saisai , Guo Jing , Zhu Xiaochun , Wang Xiaobing
Published: January 2020

Background: Pulmonary arterial hypertension (PAH) is a life-threatening condition that gets worse over time. Despite advances in the development of strategies for treating PAH, prognosis of the disease remains unsatisfactory, especially for advanced PAH. The aim of this study was to explore potential crucial genes and pathways associated with PAH based on integrative analyses of gene expression and shed light on the identification of biomarker for PAH.
Results: Gene expression profile of pulmonary tissues from 27 PAH patients and 22 normal controls were downloaded from public database (GSE53408 and GSE113439). A total of 521 differentially expressed genes (DEGs), including 432 up-regulated DEGs and 89 down-regulated DEGs were identified using “limma” package in R. Functional enrichment analysis showed that these DEGs were mainly enriched in mitotic cell cycle process, mitotic cell cycle and microtubule cytoskeleton organization. Moreover, five key genes (CDK1, SMC2, SMC4, KIF23, and CENPE) were identified based on the comprehensive evaluation of protein-protein interaction (PPI) network analysis, modular analysis and cytohubba’s analysis, then further validated in another transcriptomic data set associated with PAH from public database (GSE33463). Furthermore, these hub genes were mainly enriched in promoting mitotic cell cycle process, which may be closely associated with the pathogenesis of PAH. We also found that the predicted micro-RNAs (miRNAs) targeting these hub genes were found to be enriched in TGF-β and Hippo signaling pathway.
Conclusion:These findings are expected to gain a further insight into the development of PAH and provide a promising index for the detection of PAH.
Integrated proteomic and metabolomic analysis to study the effects of spaceflight on Candida albicans
Authors: Wang Jiaping , Liu Yu , Zhao Guangxian , Gao Jianyi , Liu Junlian , Wu Xiaorui , Xu Chong , Li Yongzhi
Published: January 2020

Background: Candida albicans is an opportunistic pathogenic yeast, which could become pathogenic in various stressful environmental factors including the spaceflight environment. In this study, we aim to explore the phenotypic changes and possible mechanisms of C. albicans after exposure to spaceflight conditions.
Results: The effect of C. albicans after carried on the "SJ-10" satellite for 12 days was evaluated by proliferation, morphology, environmental resistance and virulence experiment. The result showed that the proliferation rate, biofilm formation, antioxidant capacity, cytotoxicity and filamentous morphology of C. albicans were increased in the spaceflight group compared to the control group. Proteomics and metabolomics technologies were used to analyze the profiles of proteins and metabolites in C. albicans under spaceflight conditions. Proteomic analysis identified 548 up-regulated proteins involved in the ribosome, DNA replication, base excision repair and sulfur metabolism in the spaceflight group. Moreover, 332 down-regulated proteins related to metabolic processes were observed. The metabolomic analysis found five differentially expressed metabolites. The combined analysis of proteomic and metabolomic revealed the accumulation of cysteine and methionine in C. albicans after spaceflight.
Conclusions: Mechanisms that could explain the results in the phenotypic experiment of C. albicans were found through proteomic and metabolomic analysis. And our data provide an important basis for the assessment of the risk that C. albicans could cause under spaceflight environment.
3-hydroxy-3-methylglutaryl-coenzyme A lyase deficiency: One disease- many faces
Authors: Grünert Sarah Catharina , Sass Jörn Oliver
Published: January 2020

Background 3-hydroxy-3-methylglutaryl-coenzyme A lyase deficiency (HMGCLD) is an autosomal recessive disorder of ketogenesis and leucine degradation due to mutations in HMGCL . Method We performed a systematic literature search to identify all published cases. 211 patients of whom relevant clinical data were available were included in this analysis. Clinical course, biochemical findings and mutation data are highlighted and discussed. An overview on all published HMGCL variants is provided. Results More than 95 % of patients presented with acute metabolic decompensation. Most patients manifested within the first year of life, 42.4 % already neonatally. Very few individuals remained asymptomatic. The neurologic long-term outcome was favorable with 62.6 % of patients showing normal development. Conclusion This comprehensive data analysis provides a systematic overview on all published cases with HMGCLD including a list of all known HMGCL mutations.
Development and Evaluation of a Physical Activity Intervention Informed by Participatory Research- A Feasibility Study
Authors: Ramji Rathi , Carlson Elisabeth , Kottorp Anders , Shleev Sergey , Awad Eman , Rämgård Margareta
Published: January 2020

Background: Despite numerous interventions aiming to improve physical activity in socially disadvantaged populations, physical inactivity remains to be a rising challenge to public health globally, as well as, in Sweden. In an effort to address this challenge, a community-based participatory intervention was developed through active community engagement and implemented in a socially disadvantaged neighborhood in Sweden. The current study aims to present the development and initial evaluation of a participatory research driven physical activity intervention.
Methods : Fifteen participants (11 females and 4 males) aged 17-59 years volunteered to participate in the physical activity intervention program. The intervention program was evaluated using a longitudinal mixed methods design measuring health impact changes over time through focus group discussions and quality of life surveys. Further additional biomedical health parameters such as levels of glycosylated hemoglobin, blood pressure, levels of oxygen saturation and body mass index were monitored before and after the intervention. Focus group data were analyzed using content analysis with an inductive approach. The pre-and post-test scores from the survey-based quality of life domains, as well as the health parameters were compared using non-parametric and parametric statistics.
Results : Four themes emerged from the analysis of the focusgroup discussions including sense of fellowship, striving for inclusion and equity, changing the learner perspective and health beyond illness. The scores for the domains Physical Health, Psychological Health, Social Relationships and Health Satisfaction where significantly higher after participation in the physical activity intervention program compared to the pre-test scores ( p <.05)s. There were however, no significant changes in the scores for the environmental domain and overall quality of life after intervention compared to that prior to intervention start. Overall, the biomedical health parameters remained stable within the normal ranges during intervention.
Conclusion : The focusgroup discussions and results from the surveys and biomedical measures reveal important findings to understand and further develop the intervention program to promote health equity among citizens in disadvantaged areas. Evaluating the feasibility of such an intervention using multiple approaches contributes to effective implementation of it for larger communities in need.
The Efficacy and Tolerability of Ubrogepant for Acute Migraine: A Systematic Review and Meta-Analysis
Authors: Diao Yun , Yang Hang , Zhou Yang Chun , Du Biao
Published: January 2020

Objective: The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. Methods: We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that:compared to the control group, the percentage of participants with PF, the percentage of participants with PR, the percentage of participants with SPF, the percentage of participants with SPR,the absence of phonophobia in sound，the absence of phonophobia in light and the absence of nausea (RR=1.31,95%CI:1.18~1.45，P<0.00001, RR=1.63,95%CI:1.46~1.82，P<0.00001, RR=1.22,95%CI:1.15~1.29，P<0.00001, RR=1.32,95%CI:1.22~1.42，P<0.00001, RR=1.16,95%CI:1.05~1.27，P=0.002), all the differences were statistically significant. Conclusions: For adult patients with acute migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for acute migraine.
The role of social network support on treatment outcomes for medication for opioid use disorder: a systematic review protocol
Authors: Kumar Navin , Howell Benjamin A. , Alexander Marcus , O'Connor Patrick G.
Published: January 2020

Background Although medications for opioid use disorder (MOUD) models are the most efficacious evidence-based treatment for opioid use disorder, there remains a high percentage of patients experiencing unfavorable treatment outcomes. Greater understanding of how social network support functions with respect to MOUD treatment outcomes may possibly increase treatment outcomes. Social network support are the kinds of support, such as assistance or help, that people receive from friends, family, peers and neighbors, paid or unpaid, in their social network. We aim to provide quality evidence to understand the role of social network support on MOUD treatment outcomes. Methods A systematic review of experimental and observational studies will be conducted. PubMed, MEDLINE, Embase, PsycINFO and Sociological Abstracts will be searched, updated to capture current literature. Primary outcomes will include adherence to MOUD, defined as continuation in or completion of an MOUD program; and opioid use, defined as the percentage of urine samples negative for opioids and/or self-reported drug use. The systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Quality assessments will be conducted using criteria from the Cochrane Handbook. A narrative synthesis will be conducted for all included studies. Discussion This systematic review seeks to provide policymakers, administrators, practitioners and researchers with a systematic and reproducible strategy to query the literature around the role of social network support on MOUD treatment outcomes. Systematic review registration International Prospective Register for Systematic Reviews (PROSPERO), CRD42018095645.
Perpetration of intimate partner violence among HIV positive couples: A Systematic Review
Authors: Apiribu Felix , Kuupiel Desmond , Ncama Busisiwe Purity
Published: January 2020

Background Intimate partner violence (IPV) is a key public health and social concern among couples in countries globally. A systematic review was conducted to find out information that is found in relation to literature on perpetration of IPV among couples infected with human immunodeficiency virus (HIV).Objective The main objective of this study was to search for evidence of IPV among couples infected with HIV. Specifically, we reviewed literature related to the types of violence perpetrated by intimate partners who are infected with HIV and literature on their experiences.Methods The literature review was guided by the frame work of Arksey and O’Maley (2005). The search engines used in the review include PubMed, CINAHL, MEDLINE, PsycINFO, and Google Scholar and was focused on perpetration of violence among HIV infected concordant or discordant couples.Results Four main categories of violence were identified in the scoping review, namely psychological abuse, physical abuse, sexual victimization or abuse as well as other forms of abuse. We identified 61 literature related to the topic. Fifty-eight (58) articles were left after duplicates were removed, title and abstract screening brought the number to 9 for full article screening. Nine (9) full text studies were assessed out of the 58 and only 4 were included as they contained data on all the three categories of IPV: physical IPV, sexual IPV, and psychological IPV experienced as a result of being HIV positive. Other IPV identified included financial deprivation, prevention of the partner from meeting colleagues, and verbal abuse such as shouting and scornful looks.Conclusions The results of the systematic review showed limited studies on the perpetration of IPV among HIV infected couples. It is recommended that further studies be done on exploring experiences of couples who perpetrate IPV among HIV seroconcordant or serodiscordant infected couples.Systematic review registration PROSPERO CRD42017062190
Effect of Health Insurance Program for the Poor on Out-Of-Pocket Inpatient Care Cost in India
Authors: Sri Shyamkumar , Khan Mahmud
Published: January 2020

Background In India, Out-of-pocket expenses accounts for about 62.6% of total health expenditure - one of the highest in the world. Lack of health insurance coverage and inadequate coverage are important reasons for high out-of-pocket health expenditures. There are many Public Health Insurance Programs offered by the Government that cover the cost of hospitalization for the people below poverty line (BPL), but their coverage is still not complete. The objective of this research is to examine the effect of Public Health Insurance Programs for the Poor on hospitalizations and inpatient Out-of-Pocket costs. Methods Data from the recent national survey by the National Sample Survey Organization, Social Consumption in Health 2014 are used. Propensity score matching was used to identify comparable non-enrolled individuals for individuals enrolled in health insurance programs. Binary logistic regression model, Tobit model, and a Two-part model were used to study the effects of enrolment under Public Health Insurance Programs for the Poor on the incidence of hospitalizations. duration of hospitalization, and Out-of-Pocket payments for inpatient care respectively.Results There were 64,270 BPL people in the sample. Individuals enrolled in poor people health insurance program have 1.21 higher odds of incidence of hospitalization compared to matched poor individuals not having health insurance coverage. Enrollment under the poor people health insurance program did not have any effect on duration of hospitalization and inpatient Out-of-Pocket health expenditures. Logistic regression model showed that chronic illness, household size, and age of the individual had significant effects on hospitalization incidence. Tobit model results showed that individuals who had chronic illnesses and belonging to other backward social group had significant effects on duration of hospitalization. Two-part regression model showed that days of hospital stay, graduate level education, specific age groups, using a private hospital for treatment, admission in a paying ward, and having some specific ailments had significant positive effect on out-of-pocket costs. Conclusions Enrolment in the public health insurance programs for the poor increased the utilization of inpatient health care facilities. Health insurance coverage must be expanded to cover outpatient services, and the coverage must not be limited by the number of family members.
Conservative non-pharmacological management of knee osteoarthritis in Switzerland: a survey among medical specialists
Authors: Ettlin Lea , Nast Irina , Huber Erika O. , Niedermann Karin
Published: January 2020

Background: International Guidelines recommend self-management, exercise and weight management if appropriate as first line conservative treatment for patients with knee osteoarthritis (OA). The objective of this study was to survey the conservative non-pharmacological management of patients with knee OA in Switzerland and to explore perceived barriers and facilitators for the application of guideline recommendations. Methods: Based on the results of semi-structured interviews with selected general practitioners (GPs), rheumatologists and orthopaedic surgeons, a survey was performed across their scientific societies. Questions addressed diagnostic measures, treatment options, reasons for referral to exercise as well as barriers and facilitators. Results: In total, 234 members responded. They indicated that usually patients presented due to pain (n=222, 98.2%) and functional limitations of the knee (n=151, 66.8%). Additionally to clinical assessment X-ray (n=214, 95.5%) and MRI (n=70, 31.3%) were used as diagnostic measures. The referral to exercise, was driven by the patients’ expectation/high level of suffering (n=73, 37.1%), as well as by their own clinical experience (n=49, 24.9%). They estimated to refer 54% of their patients to exercise. Further, the specialists rated as the most important barriers for the referral to exercise ‘disinterest of patient’ (n=88, 46.3%) and ‘physically active patient’ (n=59, 31.1%). As most important facilitators, they rated ‘priority to mention exercise during short time of consultation’ (n=170, 89.4%) and ‘insufficiently physically active patient’ (n=165, 86.9%). Conclusion: A substantial evidence-performance gap in the management of patients with knee OA seems to be present. To successfully support systematic referral to exercise as first line intervention, it may be important to not simply suggest exercise in general, but a specific best-practice exercise and education programme for knee OA.
Unresolved Challenges in Health Service Delivery in Tanzania under Public Private Partnership: Stakeholders Views from Dar es Salaam Region
Authors: Nuhu Said , Mpambije Chakupewa Joseph , Ngussa Kinamhala
Published: January 2020

Background: The public-private partnership in the health sector, which was introduced to improve the delivery of health services, has existed for decades in Tanzania. Contrary, the anticipated outcomes have not been realised. This paper attempts to underscore the challenges that have permeated the provision of health services under public-private partnerships. Methods: A qualitative case study design was used. Institutional arrangements under public-private partnerships in the delivery of health services was used as a case. Fifteen (n=15) in-depth interviews were conducted with participants from both the public and private sector. Relevant documents were also reviewed to inform this study. Results: Findings revealed that, although public-private partnerships is hailed for supplementing government’s efforts in the provision of health services, institutional arrangements for the smooth provision of these services is lacking. Several challenges including inadequate resources, ineffective monitoring and evaluation of public-private partnerships performance, insufficient consultations between partners as well as varying goals and strategies were noted. Conclusion: Challenges facing institutional arrangements for public-private partnerships may either be influenced by inadequate legal and policy framework as well as ineffective implementation practices. Therefore, effective and smooth interface can be achieved by strengthening implementation practices through development of strong and adequate supportive policy framework that can ensure adherence to contractual agreements.
Healthy Weight Services in England before, during and after pregnancy: a mixed methods approach
Authors: Fair Frankie , Marvin-Dowle Katie , Arden Madelynne , Soltani Hora
Published: January 2020

Background: Maternal overweight and obesity are associated with numerous adverse outcomes including higher rates of maternal and infant mortality and morbidity. Overweight and obesity before, during and after pregnancy are therefore a significant public health priority in England. This project explored and mapped healthy weight service availability at different stages of the childbearing cycle.Methods: A mixed methods approach included a questionnaire-based survey disseminated through Local Maternity Systems and semi-structured interviews or focus groups with providers and commissioners. Current maternal weight service provision was explored along with some of the barriers and facilitators for providing, delivering and accessing healthy weight services. Descriptive statistics were reported for quantitative data and content analysis was used for thematic reporting of qualitative data. Results: A total of 88 participants responded to the survey. All services were offered most frequently during pregnancy; with healthy eating and/or weight management services offered more often than physical activity services. Few services were targeted specifically at women with a raised body mass index. There was a high degree of inconsistency of service provision in different geographical areas. Several themes were identified from qualitative data including "equity and variation in service provision", "need for rigorous evaluation", "facilitators” to encourage better access or more effective service provision, including prioritisation, a change in focus and co-design of services, "barriers" encountered including financial and time obstacles, poor communication and insufficiently clear strategic national guidance and "the need for additional support”.Conclusions: There is a need to reduce geographical variation in services and the potential health inequalities that this may cause. Improving services for women with a raised body mass index as well as services which encourage physical activity require additional emphasis. There is a need for more robust evaluation of services to ensure they are fit for purpose. An urgent need for clear national guidance so that healthcare providers can more effectively assist mothers achieve a healthy weight gain was identified. Commissioners should consider implementing strategies to reduce the barriers of access identified such as childcare, transport, location and making services free at the point of use.
Work-Family Conflict, Social Support, Depression and Suicidal Ideation among Medical Staffs in Shandong, China: A Conditional Process Analysis
Authors: Xu Meixia , Sun Long , Zhang Wen , Gui Zhen
Published: January 2020

Background Suicidal ideation has been explored in different populations. However, few studies were conducted among medical staff. Besides, the effect of work-family conflict on suicidal ideation was less reported in previous studies. In the current study, we aim to clarify the relations among work-family conflict, social support, depression, and suicidal ideation for Chinese medical staffs.Methods We collected 3,426 valid questionnaires based on a cross-sectional design. Suicidal ideation, work-family conflict, social support, depression, social-demographic characteristics, and work-related variables were evaluated. Conditional process analysis was used to analyze the association among these variables.Results We found that factors associated with lifetime suicidal ideation were male (OR=0.54), doctor (OR=4.32), physical disease (OR=1.58), work-family conflict (OR=1.03), and depression (OR=1.09). Factors associated with one-year suicidal ideation were male (OR=0.46), doctor (OR=4.21), master (OR=1.79), physical disease (OR=1.51), work-family conflict (OR=1.02), and depression (OR=1.10). Depression can mediate the association between work-family conflict and suicidal ideation, but mediate effect of social support was not supported in the current study.Conclusion We should pay more attention to work-family conflict problems, and depression is an important factor associated with suicidal ideation among Chinese medical staff. Both of them should be scanned for identification and treatment of suicide.
The Bdkrb2 Gene Family Provides a Novel View of Viviparity Adaption in Sebastes schlegelii
Authors: Niu Jingjing , Song Weihao , Li Rui , Yu Haiyang , Guan Jian , Qi Jie , He Yan
Published: January 2020

Background: Black rockfish ( Sebastes schlegelii ) is a viviparous teleost . In the prior study, we reported a chromosome-level black rockfish genome assembly and proposed that the rockfish ovarian wall has a similar function to the uterus of mammals. In the present study, the well-developed vascular system was observed in the ovary wall and the exterior surface of the egg membrane. Adaptation of the ovary vasculature to the rising needs of the embryos occurs through both vasodilation and neovascularization. Bdkrb2 encodes a receptor for bradykinin. The two play a critical role in the control of vasodilatation by regulating NO production. Results: Eight Bdkrb2 genes were identified in the black rockfish genome. These genes are located on chromosome 14, which are arranged in a tandem array, forming a gene cluster spanning 50 kb. Protein structure prediction, phylogenetic analysis, and tissue expression pattern analysis was done to clarify the relationship of the Bdkrb2 genes and a preliminary exploration of function was conducted. The results show that the eight Bdkrb2 genes evolved two kinds of protein structure and three kinds of tissue expression pattern. Furthermore, some have a relatively high expression in ovarian wall, especially in stages of pre-fertilization and pre-hatching. Conclusions: Our study characterizes eight Bdkrb2 genes in the black rockfish, which have a regulatory role in the preparation for fertilization and hatching. This research provides a novel view of viviparity adaption and lays the groundwork for future research into vascular regulation of ovarian in the breeding cycle in black rockfish.
The Effects of the Sex Chromosomes on the Inheritance of Species Specific Traits of the Shape of the Copulatory Organ in Drosophila virilis and Drosophila lummei
Authors: Kulikov Alex M , Sorokina Svetlana Yu , Melnikov Anton I , Gornostaev Nick G , Seleznev Dmitriy G , Lazebny Oleg E.
Published: January 2020

Background. It is well known that the shape of the male copulatory system is strongly associated with mating behavior in Drosophila. The shape of the male genitalia is also known as the most rapidly evolving structure among all morphological characters. However, only a part of the male copulating system, namely epandrium, has actually been used as the only model to study the genetic basis of species-specific differences in the shape of the copulatory system in D. simulans and D. mauritiana. Almost nothing is known about the effects of both sex chromosomes on the shape of the male mating organ. Results. Seven factors were isolated that describe variation of different parts of the male mating organ. The shape of the male mating organ depends on the combination of the sex chromosome status, the autosome status, and the male parent identity as an epigenetic factor. The effect of the male parent identity is possibly mediated through the epigenetic marking of chromosomes in interspecific hybrids during gametogenesis and a subsequent effect of the resulting signatures on the ontogeny of offspring. Epistatic interactions of the sex chromosomes and autosomes and epigenetic effects of the male parent origin from interspecific crosses influence the expression of species-specific traits in the shape of the male copulatory system. Conclusions. Epistatic interactions of the sex chromosomes and autosomes and epigenetic effects of the male parent origin from interspecific crosses influence the expression of species-specific traits in the shape of the male copulatory system. It can be assumed that sexual selection for specific genes associated with male traits implemented in the courtship ritual prevents the well-known effect of demasculinization of the X chromosome.
GLV-1h68 vaccinia virus therapy of neuroendocrine tumors
Authors: Kloker Linus D , Berchtold Susanne , Smirnow Irina , Beil Julia , Krieg Andreas , Sipos Bence , Lauer Ulrich M
Published: January 2020

Background: Oncolytic virotherapy is an upcoming treatment option for many tumor entities. But so far, a first oncolytic virus only was approved for advanced stages of malignant melanomas. Neuroendocrine tumors (NETs) constitute a heterogenous group of tumors arising from the neuroendocrine system at diverse anatomic sites. Due to often slow growth rates and (in most cases) endocrine non-functionality, NETs are often detected only in a progressed metastatic situation, where therapy options are still severely limited. So far, immunotherapies and especially immunovirotherapies are not established as novel treatment modalities for NETs.
Methods: In this immunovirotherapy study, pancreatic NET (BON-1, QGP-1), lung NET (H727, UMC-11), as well as neuroendocrine carcinoma (NEC) cell lines (HROC-57, NEC-DUE1) were employed. The well characterized genetically engineered vaccinia virus GLV-1h68, which has already been investigated in various clinical trials, was chosen as virotherapeutical treatment modality.
Results: Profound oncolytic efficiencies were found for NET/NEC tumor cells. Besides, NET/NEC tumor cell bound expression of GLV-1h68-encoded marker genes was observed also. Further­more, a highly efficient production of viral progenies was detected by sequential virus quantifications. More­over, prospects of a combinatorial treatment of GLV-1h68 with the mTOR inhibitor everolimus, licensed for treatment of metastatic NETs, were assessed successfully.
Conclusions: In summary, the oncolytic vaccinia virus GLV-1h68 was found to exhibit promising antitumoral activities, replication capacities and a potential for future combinatorial approaches. This has been shown in a widespread spectrum of cancers in a preclinical setting and now has to be further evaluated for treatment of metastatic neuroendocrine cancer.
ICU delirium:what is different between the type of diseases?
Authors: Feng Qing , Ai Yuhang , Ai Meilin , Deng Songyun , Peng Qianyi , Zhang Lina
Published: January 2020

Background: Delirium is an acute neurological disorder that is quite common complication in intensive care unit (ICU) patients. However, there are no studies to focus on risk factors vary from disease to disease. The purpose of our study was to identify the risk factors and prognosis of delirium in patients with different disease types. Method: We conducted an observed study of consecutive patients from September to November 2016, who underwent surgical operation or with poor conservative treatment were admitted to the ICU. The patients were screened for delirium by using the diagnostic tools of Richmond Agitation Sedation Scale (RASS score) and the Confusion Assessment Method ICU (CAM-ICU). Results: A total of 406 patients met the inclusion criteria in our study. The overall incidence of ICU delirium was 45.8% (186/406), the delirium was highest in patients with brain disease (68%), followed by pulmonary disease (63%) and sepsis/shock (49%). The risk factors are different for different types of disease, for heart and vascular disease subgroup, only sleep quality (OR=0.236, p＜0.001) was independent risk factor for delirium. For abdominal disease subgroup, age (OR=2.514, p=0.002), vasoactive drugs (OR=13.799, p=0.002), and sleep quality (OR=0.114, p＜0.001) were risk factors for the delirium. And for sepsis and septic shock subgroup, age(OR=1.100, p=0.022), APACHE II scores(OR=1.255, p＜0.001) and sleep quality (OR=0.090, p=0.034) were risk factors for the delirium. ICU delirium is associated with worse outcomes including ICU stays(P<0.001) and 28-day mortality(P=0.001). The difference of ICU stays between delirium and non-delirium groups in the subgroup of heart and vascular disease(P<0.001), pulmonary disease(P=0.011), sepsis/septic shock(P<0.001) and cerebral disease(P=0.011) were consistent with the general population. But subgroup of sepsis/septic shock was the only one whom has the significant difference in the 28-day mortality (P=0.006) between delirium and non-delirium groups. Conclusion: The incidence and risk factors of delirium varied greatly with the type of disease. Age and sleep quality were independent risk factors for the development of delirium in most subgroup diseases. The prognosis of delirium was different in different disease types, among them, patients with sepsis/septic shock associated delirium have the worst prognosis.
Personalised REsponses to DIetary Composition Trial (PREDICT): an intervention study to determine inter-individual differences in postprandial response to foods
Authors: Berry Sarah , Drew David , Linenberg Inbar , Wolf Jonathan , Hadjigeorgiou George , Davies Richard , Khatib Haya Al , Hart Deborah , Surdulescu Gabriella , Yarand Darioush , Nessa Ayrun , Sheedy Alyce , Vijay Amrita , Asnicar Francesco , Segata Nicola , Chan Andrew , Franks Paul , Valdes Ana , Spector Tim
Published: January 2020

The Personalised REsponses to DIetary Composition Trial (PREDICT) was a single-arm, single-blind intervention study that utilized both standardized “test” meals and captured “free-living” non-standardized food consumption, to predict an individual’s metabolic response to foods based on the person’s characteristics (including their metabolomic and gut microbiome profiles), meal composition (macronutrients and energy content) and meal context (including time of day, sleep and exercise). The initial study commenced in June 2018 and targeted 1,000 generally healthy participants between the ages of 18 and 65 years for enrollment in the United Kingdom, and recruited from the existing and ongoing TwinsUK research cohort and the general population. In December 2018, an independent trial mirroring the UK protocol was launched in parallel at Massachusetts General Hospital to serve as a US-based validation cohort including 100 healthy individuals in the general population. The overall objective of these trials was to predict glucose, insulin, lipid and other postprandial responses to foods based on the individual’s characteristics, including molecular biomarkers and lifestyle factors as well as the nutritional composition of the food. The studies, collectively termed PREDICT 1, were completed in May 2019. The study has delivered highly-dimensional multi-omic data from which the predictors of individual postprandial responses have been determined. These findings will be used to design personalized dietary interventions focused on key health outcomes. This protocol is registered with the US National Institutes of Health trial registry, ClinicalTrials.gov: NCT03479866.
Using lipidomics to reveal details of lipid accumulation in developing Siberian apricot (Prunus sibirica L.) seed kernels
Authors: Mai Yiting , Huo Kaisen , Yu Haiyan , Zhou Nan , Shui Lanya , Liu Yang , Wang Nenglong , Zhang Chengxin , Niu Jun , Wang Libing
Published: January 2020

Background: The oil content of Siberian apricot seed kernel (SASK) is generally as high as 50%, and biodiesel fuel properties of SASK oil were conformed to EN 14214 and GB/T 20828-2007 standards. Thus, Prunus sibirica is a novel non-crop feedstock for biodiesel production in China. We have been addressing this issue by studying the regulation of oil accumulation in SASK. Results: As part of this research we have carried out a detailed lipidomic analysis in developing SASK. Here, oil contents and fatty acid (FA) compositions were studied in developing SASK from AS-80 and AS-84, at intervals of 1 week from 3 weeks after anthesis (WAA) to 9 weeks. The major differences between the two germplasms are higher contents of C18:1 and C18:2 in AS-80 than in AS-84 at a mature stage. The SASKs of 4, 6 and 8 WAA, respectively representing early, mid and late phases of oil accumulation, were selected as optimal samples for lipidomic analysis. The molecular species in individual lipid classes between AS-80 and AS-84 were similar, and exhibited quite distinct patterns with SASK development. Additionally, the lipidomic data coupled with qRT-PCR analysis suggested that three mechanisms allow the flux of FA through phosphatidylcholine that influenced the molecular composition of eventual TAG. Conclusions: The first report on lipidomic analysis during seed development in wood oilseed plants. Our data contribute significantly to understand the underlying mechanisms of lipid accumulation in P. sibirica, and may also present strategies for engineering oil accumulation in oilseed plants.