bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic Responses and Predictors of Low-Dose Interleukin-2 in Systemic Lupus Erythematosus
Authors: Miao Miao , Li Yimin , Xu Dan , Zhang Ruijun , He Jing , Sun Xiaolin , Li Zhanguo
Published: January 2021

Objective. Interleukin-2 (IL-2) is effective and well tolerated in patients with systemic lupus erythematosus (SLE). However, patient response to IL-2 therapy varies. Therefore, biomarkers are needed to efficiently identify patients who may respond well to IL-2 treatment. We investigated clinical and immunological biomarkers to predict low-dose IL-2 responses.Methods. A pooled post-hoc analysis was performed in SLE patients who received low-dose IL-2 treatment in two clinical trials. Factors predicting responses in clinical and T-cell subset changes were evaluated by logistic regression. Good response (GR) and poor response (PR) were defined according to whether patients achieved or did not achieve an SLE Responder Index-4 (SRI-4), respectively.Results. A good response at 68% of patients was achieved in the lower Treg group, compared to 0% in the higher Treg group. A good response at 68% was achieved in patients with lower Treg, compared to 0% in patients with higher Treg. In comparison to PR, GR was more strongly associated with low Treg proportions at baseline (12.85±6.07% vs. 9.43±2.82%, P<0.01). There were more patients with skin rash in the GR group than in the PR group (68.75% vs. 30.77%, P=0.042). Multivariate analysis showed that low Treg proportions and skin rash presence were both independently associated with GR to low-dose IL-2 treatment. A nomogram to identify GR probability exhibited a clear discrimination (concordance index, 0.812; 95% confidence interval, 0.64-0.97). Based on the area under the receiver operating characteristic (ROC) curve (AUC) of 0.813, the specificity of a low regulatory T cells (Tregs) proportion (≤13.35%) plus skin rash to predict GR to IL-2 therapy was 100%, with a sensitivity of 68.75%.Conclusion. A low Treg proportion and skin rash indicate GR to low-dose IL-2 treatment in SLE patients.Trial registration number ClinicalTrials.gov Registries ((NCT02465580 and NCT02084238).
Validation of the Relationship Between Coagulopathy and Localization of Hydroxyethyl Starch on the Vascular Endothelium in a Rat Hemodilution Model
Authors: Azumaguchi Ryu , Tokinaga Yasuyuki , Kazuma Satoshi , Kimizuka Motonobu , Hamada Kosuke , Sato Tomoe , Yamakage Michiaki
Published: January 2021

BackgroundVarious anticoagulant properties have been associated with hydroxyethyl starch (HES), including coagulation disorders measured by point-of-care devices, decreases in von Willebrand factor and coagulation factor VIII, and inhibition of the interactions between platelet-membrane glycoproteins and of coagulation factors by coating of platelets. However, the mechanism for these properties remains unclear. The aim of this study was to test the hypothesis that coagulopathy induced by HES is caused by endothelial or glycocalyx damage as a result of localization of HES on the endothelium, due to the high shear viscosity of blood, using a rat model.MethodsWe compared blood coagulability measured by Sonoclot®, levels of endothelial and glycocalyx damage markers and coagulation factors, and blood shear viscosity when hemodilution was performed with physiological saline (PS), 6% HES 130/0.4 in PS (HES130) and 10% HES 200/0.5 in PS (HES200). To precisely evaluate the basic mechanism of coagulopathy induced by HES, we performed hemodilution with an emphasis on dilutional equality by taking into consideration the intravascular residual rates of the infusion preparations. We also evaluated the localization rates of fluorescently labeled HES on endothelium in the isolated aorta. Statistical analyses were performed by one-way ANOVA followed by Tukey’s test or Kruskal–Wallis test, and then Dunn’s test for multiple comparisons.ResultsSonoclot® measurements revealed that HES130 and HES200 decreased the fibrin gel formation rate to a greater extent than PS, and HES200 decreased the rate more than HES130. Similarly, HES130 and HES200 decreased von Willebrand factor levels to a greater extent than PS. HES130 and HES200 had a more protective effect than PS, with no evidence of damage to the endothelium or glycocalyx. Shear viscosity was variable between all pairs, and was lowest for PS and highest for HES200. HES130 and HES200 demonstrated comparable degrees of localization on the endothelium.ConclusionsHES was shown to cover the endothelium, possibly due to its high shear viscosity, and this mechanism potentially acted to protect the endothelium and glycocalyx. However, this covering effect may be the cause of coagulopathy due to inhibition of von Willebrand factor secretion from the endothelium.
Effects of Humic Acid-Irrigation Coupling Techniques on Temperature, Radiation and Rice Growth in Songnen Plain China
Authors: Zheng Ennan , Zhu Yinhao , Hu Jianyu , Xu Tianyu , Zhang Zhongxue
Published: January 2021

In the past decades, the application of organ fertilizer in agricultural soils has attracted wide attention. However, few studies have carefully explored the effects of humic acid on soil and canopy temperature, radiation, the physiological process of plant leaves, especially coupling with the different irrigation methods. To provide a better growing environment for crops and explore the best regulation mode of humic acid and irrigation coupling techniques in the farmland soil environment in the Songnen Plain Heilongjiang Province, through field experiment, we selected rice as the test crop and applied humic acid in the soil with different irrigation methods. The temperature conditions, radiation, agronomic and fluorescence characteristics were monitored by different stages. The effects of different humic acid and irrigation coupling techniques on the temperature and radiation changes during different growth stages were discussed, and the subtle differences of agronomic and fluorescence characteristics in different growth stages of rice plants were compared. The results showed that the humic acid application with different irrigation methods was not beneficial to the maintenance of soil temperature, the differences among the different treatments, were no found significant at 5% probability statistically. However, the differences of radiation interception was obvious, and the best value was CT5 treatment, there were also similarities to plant height. The fluorescence indexes and leaf chlorophyll relative content (SPAD) had the differences with the change of humic acid application rate and irrigation methods. Over all, under the humic acid application rate of 1500 kg·ha-1 with the control irrigation method, could bring the best humic acid and irrigation effects.
High-Fat Diet Attenuates the Improvement of Hypoxia-induced Pulmonary Artery Hypertension in Mice During Reoxygenation.
Authors: Sugimoto Koichi , Yokokawa Tetsuro , Misaka Tomofumi , Kaneshiro Takashi , Yoshihisa Akiomi , Nakazato Kazuhiko , Takeishi Yasuchika
Published: January 2021

Background: It has been widely recognized that metabolic disorder is associated with pulmonary hypertension. It is known that elevated pulmonary artery pressure induced by hypoxia in mice returns to normal pressure under reoxygenation. However, it is still unclear how metabolic disorder affects the reverse remodeling of pulmonary arteries. In this study, we investigated the effects of a high-fat diet (HFD) on the decrease of pulmonary artery pressure and reverse remodeling of pulmonary arteries in mice with hypoxia-induced pulmonary hypertension.Methods: We used female C57/Bl6 mice aged 8 weeks. After the mice were exposed to hypoxia (10% oxygen for 4 weeks) for induction of pulmonary hypertension. Then, they were returned to normoxic conditions and randomized into a normal diet (ND) group and a HFD group. Both groups were fed their respective diets for 12 weeks.Results: The right ventricular systolic pressure measured by a micro-manometer catheter and the Fulton index were significantly higher in the HFD group than in the ND group at 12 weeks after reoxygenation. The medial smooth muscle area was larger in the HFD group. Caspase 3 activity in lung tissue of the HFD group was decreased, and an apoptosis of pulmonary smooth muscle cells was suppressed after reoxygenation. Moreover, the expression levels of peroxisome proliferator-activated receptor-γ and apelin were lower in the HFD group than in the LFD group.Conclusion: Our results suggest the metabolic disorder may suppress pulmonary artery reverse remodeling in mice with hypoxia-induced pulmonary hypertension under reoxygenation.
Difference of Binding Modes Among Three Ligands to a Receptor mSin3B Corresponding to Their Inhibitory Activities
Authors: Hayami Tomonori , Kamiya Narutoshi , Kasahara Kota , Kawabata Takeshi , Kurita Jun-ichi , Fukunishi Yoshifumi , Nishimura Yoshifumi , Nakamura Haruki , Higo Junichi
Published: January 2021

A preceding experiment suggested that a compound, which inhibits binding of the REST/NRSF segment to the cleft of a receptor protein mSin3B, can be a potential drug candidate to ameliorate many neuropathies. We have recently developed an enhanced conformational sampling method, genetic-algorithm-guided multi-dimensional virtual-system-coupled canonical molecular dynamics, and in the present study, applied it to three systems consisting of mSin3B and one of three compounds, sertraline, YN3, and acitretin. Other preceding experiments showed that only sertraline inhibits the binding of REST/NRSF to mSin3B. The current simulation study produced the spatial distribution of the compounds around mSin3B, and showed that sertraline and YN3 bound to the cleft of mSin3B with a high propensity, although acitretin did not. Further analyses of the simulation data indicated that only the sertraline–mSin3B complex produced a hydrophobic core similar to that observed in the molecular interface of the REST/NRSF–mSin3B complex: An aromatic ring of sertraline sunk deeply in the mSin3B’s cleft forming a hydrophobic core contacting to hydrophobic amino-acid residues located at the bottom of the cleft. The present study proposes a step to design a compound that inhibits competitively the binding of a ligand to its receptor.
Modelling Deep Habits in Iranian Economy using a Markov-Switching DSGE Model
Authors: Davoudi Narmin , Heidari Hassan
Published: January 2021

This paper attempts to solve and estimate a Markov-Switching Dynamic Stochastic General Equilibrium (MS-DSGE) model with deep habit-adjusted consumption in both private and public sectors for Iranian data from 1991 to 2015. A comprehensive New Keynesian Philips Curve (NKPC) is also extracted, including stock of private and public habit consumption in firm's profit maximization problem as a constraint. The model is estimated both with constant parameters and regime switching in monetary reaction function, and it is concluded that the model with regime switching is able to fit the Iranian data better. The results of estimating parameters indicate that the degree of habit formation, together with the persistence of habit stock, are significant parameters. However, it is shown that deep habits do not succeed in reducing inflation in Iranian economy in reaction to a monetary shock. The results confirm that consumption increases and inflation decreases, simultaneously in response to fiscal shocks.
Morphological and Molecular Characteristics of Spheroid Formation in HT-29 and Caco-2 Colorectal Cancer Cell Lines
Authors: Gheytanchi Elmira , Naseri Marzieh , Karimi-Busheri Feridoun , Atyabi Fatemeh , Mirsharif Ensie Sadat , Bozorgmehr Mahmood , Ghods Roya , Madjd Zahra
Published: January 2021

Background: Relapse and metastasis in colorectal cancer (CRC) are often attributed to cancer stem-like cells (CSCs), as small sub-population of tumor cells with ability of drug resistance. Accordingly, development of appropriate models to investigate CSCs biology and establishment of effective therapeutic strategies is warranted. Hence, we aimed to assess the capability of two widely used and important colorectal cancer cell lines, HT-29 and Caco-2, in generating spheroids and their detail morphological and molecular characteristics.Methods: CRC spheroids were developed using hanging drop and forced ﬂoating in serum-free and non-attachment condition and their morphological features were evaluated by scanning electron microscopy (SEM). Then, the potential of CSCs enrichment in spheroids was compared to their adherent counterparts by analysis of serial sphere formation capacity, real-time PCR of key stemness genes (KLF4, OCT4, SOX2, NANOG, C-MYC) and the expression of potential CRC-CSCs surface markers (CD166, CD44, and CD133) by flow cytometry. Finally, the expression level of some EMT-related (Vimentin, SNAIL1, TWIST1, N-Cadherin, E-Cadherin, ZEB1) and multi-drug resistant (ABCB1, ABCC1, ABCG2) genes was evaluated.Results: Although with different morphological features, both cell lines were formed CSCs-enriched spheroids, indicated by ability to serial sphere formation, significant up-regulation of stemness genes, SOX2, C-MYC, NANOG and OCT4 in HT-29 and SOX2, C-MYC and KLF4 in Caco-2 spheroids (p-value<0.05) and increased expression of CRC-CSC markers compared to parental cells (p-value<0.05). Additionally, HT-29 spheroids exhibited a signiﬁcant higher expression of both ABCB1 and ABCG2 (p-value=0.02). The significant up-regulation of promoting EMT genes, ZEB1, Twist1, E-cadherin and SNAIL1 in HT-29 spheroids (p-value=0.03), SNAIL1 and Vimentin in Caco-2 spheroids (p-value<0.05) and N-cadherin down-regulation in both spheroids were observed.Conclusion: Based on enrichment of CSC-related features in HT-29 and Caco-2 spheroids, our findings suggest CRC spheroids culture as simple, cost-effective and efficient model to imitate the complexity of in vivo CRC tumors including self-renewal, drug resistance and invasion potential for CSC research.
Resuscitative Endovascular Balloon Occlusion of the Aorta in a Normovolemic Rabbit Model: a Pilot Study
Authors: Liu Juanfang , Zhang Jianhao , Xie Shanshan , Liu Yingxia , Zhou Xueliang , Li Zhaonan , Han Xinwei
Published: January 2021

Background: The purpose of this study was to verify physiological, end-organ and systemic inflammatory changes in zone II after resuscitative endovascular balloon occlusion of the aorta (REBOA) in a normovolemic rabbit model.Methods: Anaesthetized rabbits were subjected to aortic balloon occlusion for different times (15 min, 30 min, 60 min and 90 min) followed by 2 h of reperfusion. Rabbits with no balloon occlusion were set as the control group. ELISAs were used to examine the serum levels of ALT, AST, Cr, BUN, MDA, SOD, IL-8, IL-6, and TNF-α; HE staining was used to identify the morphological changes in the kidney; RT-PCR was used to detect the mRNA levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus; and Western blotting was used to measure the protein expression levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus.Results: Plasma concentrations of liver markers, kidney markers, inflammatory factors and oxidative stress indicators were significantly increased at the end of reperfusion in the 30 min, 60 min and 90 min groups. Damage to the kidney occurred in the 30 min, 60 min and 90 min groups. The mRNA and protein expression levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus were significantly increased at the end of reperfusion in the 30 min group, and as the time of occlusion extended, these levels continued to increase.Conclusion: Activation of systemic inflammation and ischaemia-reperfusion injury of end-organs occurred when the occlusion time reached 30 min. Therefore, 15 min should be regarded as a safe period of REBOA in zone II.
HTR7 Promotes Laryngeal Cancer Growth Through Activating PI3K/AKT Pathway
Authors: Sheng Xiaoli , Liu Wenlin , Lu Zhongming , Xu Mimi , Li Rui , Zhong Rong , Li Yunxian , Liu Tao , Zhang Siyi
Published: January 2021

Background: Laryngeal cancer is a common malignancy of the head and neck, G protein-coupled receptors (GPCRs) are easily druggable in diseases. The 5-hydroxytryptamine receptor 7 (HTR7) belongs to the GPCR family; however, its role in laryngeal cancer remains unknown.Methods: MTT, Colony formation assay, BrdU incorporation assay, soft agar growth assay and xenograft tumor in nude mice were used to analyze the effect of HTR7 expression level on laryngeal cancer proliferation and growth.Results: We found that HTR7 was significantly upregulated in laryngeal cancer tissues and cells, and patients with high HTR7 expression had shorter survival time than those with low HTR7 expression. Univariate and multivariate Cox regression models showed HTR7 was an independent predictive factor for the prognosis of patients with laryngeal cancer. Cell proliferation assays and an animal model showed that HTR7 overexpression promoted laryngeal cancer proliferation and growth, while HTR7 knockdown inhibited laryngeal cancer proliferation and growth. Further analysis showed HTR7 activated the PI3K/AKT pathway, characterized by increased phosphorylation of AKT, luciferase reporter activity of FOXO factors and target expression. Inhibition of the PI3K/AKT pathway in HTR7-overexpressing cells suppressed proliferation and growth, suggesting HTR7 promoted laryngeal cancer proliferation and growth by activating the PI3K/AKT pathway.Conclusions: In summary, HTR7 is not only a target for laryngeal cancer therapy, but also a prognostic factor for the prognosis of patients with laryngeal cancer.
Resveratrol Protects Human Nucleus Pulposus Cells from Degeneration by Blocking IL-6/JAK/STAT3 Pathway
Authors: Wu Cenhao , Ge Jun , Yang Ming , Yan Qi , Wang Yingjie , Yu Hao , Yang Huilin , Zou Jun
Published: January 2021

Background: Nucleus pulposus cells’ (NPCs’) degeneration is mainly responsible for the intervertebral disc degeneration (IDD), which is closely related to inflammatory response. Among the major proinflammatory factors that are related to NPCs’ degeneration, interleukin-6 (IL-6) and its downstream JAK/STAT3 pathway have received recent attention. The goal of our study is to figure out whether or how resveratrol (RSV) can protect NPCs from degeneration by affecting IL6/JAK/STAT3 pathway. Methods: Different concentrations of RSV were added to NPCs’ mediums. Cell viability was measured by MTT assay and crystal violet staining. Cell cycle and apoptosis were analyzed by flow cytometry. Protein expression level was determined by western blot. mRNA expression level was measured by qPCR.Results: Our study showed that RSV improved NPCs’ cell viability. It also inhibited cell apoptosis and cell cycle arrest, which were accompanied by the increased expression level of heat shock protein 90 (HSP90) and N-Cadherin. What’ more, RSV also improved the NPCs’ degeneration which was reflected in the increase of extracellular matrix (collagen II, Aggrecan). Moreover, RSV significantly attenuated the level of IL-6 secretion, which was accompanied by less phosphorylation of the transcription factors janus kinase 1 (JAK1) and signal transducer and activator of transcription 3 (STAT3). Conclusion: RSV exerted its protective effect on HNPCs’ degeneration by improving cell survival and function. The possible mechanism may be associated with the suppression of JAK/STAT3 phosphorylation and the decreased IL-6 production, which could be explained by a blockage of the positive feedback control loop between IL-6 and JAK/STAT3 pathway.
The pattern of gene copy number variations (CNVs) in hepatocellular carcinoma; in silico analysis
Authors: Shahrisa Arman , Tahmaseby Maryam , Ansari Hossein , Mohammadi Zahra , Carloni Vinicio , Asl Javad Mohammadi
Published: January 2021

Recent studies showed that genetic lost or gain in the genome can predispose cells toward malignancy. Hepatocellular carcinoma (HCC) is the most common type of liver cancer which occurs predominantly in patients with underlying chronic liver disease and cirrhosis. Prognosis of HCC is strongly connected with diagnostic delay. To date, no ideal screening modality has been developed for HCC. Recent findings demonstrated that Copy number variation (CNVs) can lead to activation of oncogenes and inactivation of tumor suppressor genes in cancers. In this study, CNV profile of 361 HCC samples was evaluated to reveal the potent - chromosomal regions involved in the disease. The obtained data showed that the chr1q and chr8p were two hotspot regions for gene amplifications and deletions in studied samples respectively. In this research, YY1AP1 (Yin Yang-1 Associated Protein 1) on chr1q22 was the most amplified gene in HCC samples and showed the positive correlation with tumor grade. Deletion of CHMP7 (Charged Multivesicular Body Protein 7) on chr8p21.3 was another frequently observed CNV among HCC patients. Both genes were interacted with variety of well-known oncogenes and tumor suppressor genes including YY1 (Yin Yang 1), CCND1 (Cyclin D1), HDAC1 (Histone deacetylase 1), VHL (von Hippel-Lindau tumor suppressor), MAD2L2 (Mitotic Arrest Deficient 2 Like 2), CEBPA (CCAAT/enhancer-binding protein alpha), CHMP4A, CHMP5, CHMP2A, CHMP3 and ENSG00000249884 (RNF103-CHMP3 gene), all of them are well-known in carcinogenesis. Although this study was based on in silico evaluations, our findings can open a new window for researchers of HCC to focus on such candidate genes during experimental assays.
Self-reported interpersonal and educational/vocational difficulties in young adults with a history of transient psychotic experiences: findings from a population-based study
Authors: Coughlan Helen , Walton-Ball Erin , Carey Eleanor , Healy Colm , O’Regan-Murphy Grace , Uidhir Aoife Nic , Clarke Mary , Cannon Mary
Published: January 2021

BackgroundPsychotic experiences (PEs) are not uncommon in young people and are associated with both psychopathology and compromised global functioning. Although psychotic experiences are transient (short-lived, self-resolving and non-recurring) for most people who report them, few studies have examined the association between early transient PEs and later functioning in population samples. Additionally, studies using self-report measures of interpersonal and educational/ vocational difficulties are lacking. The aim of this study was to examine the relationship between transient psychotic experiences and self-reported interpersonal and educational/vocational difficulties in adolescence and young adulthood. Methods Participants were 103 young people from a longitudinal population-based study cohort of mental health in Ireland. They attended for baseline clinical interviews in childhood (age 11-13) and were followed up in young adulthood (age 19-25). Participants who reported psychotic experiences at baseline but not at follow-up were classified as having transient psychotic experiences. Data from both time-points were used to examine the association between transient psychotic experiences and self-reported interpersonal and educational/ vocational difficulties in young adulthood using poisson regression modelling.Results Young people with a history of transient psychotic experiences reported significantly higher interpersonal (adj IRR: 1.83, 95%ileCI: 1.10- 3.02, p = .02) and educational/vocational (adj IRR: 2.28, 95%ileCI: 1.43- 3.64, p = .001) difficulties during adolescence. However, no significant differences in interpersonal (adj IRR: 0.49, 95%ileCI: 0.10-2.30, p = .37) or educational/vocational (adj IRR: 0.88, 95%ileCI: 0.37-2.08, p = .77) difficulties were found in young adulthood. Self-reported interpersonal and educational/vocational difficulties in young people both with and without a history of transient psychotic experiences decreased between adolescence and young adulthood.ConclusionsYoung people with transient psychotic experiences have increased interpersonal and educational/vocational difficulties in adolescence but these may not persist into the young adult years. This finding indicates that early psychotic experiences may not confer high risk for long-term interpersonal or educational/vocational deficits among young people who experience these phenomena transiently.
Predicting the Incidence of COVID-19 Using Data Mining
Authors: Ahouz Fatemeh , Golabpour Amin
Published: January 2021

Background: The high prevalence of COVID-19 has made it a new pandemic. Predicting both its prevalence and incidence throughout the world is crucial to help health professionals make key decisions. In this study, we aim to predict the incidence of COVID-19 within a two-week period to better manage the disease.
Methods: The COVID-19 datasets provided by Johns Hopkins University, contain information on COVID-19 cases in different geographic regions since January 22 and are updated daily. Data from 252 such regions were analyzed as of March 29, 2020, with 17,136 records and 4 variables, namely latitude, longitude, date, and records. In order to design the incidence pattern for each geographic region, the information was utilized on the region and its neighboring areas gathered two weeks prior to the designing. Then, a model was developed to predict the incidence rate for the coming two weeks via a Least-Square Boosting Classification algorithm.
Results: The model was presented for three groups based on the incidence rate: less than 200, between 200 to 1000, and above 1000. The model evaluation error rates were 4.71%, 8.54%, and 6.13%, respectively. Also, comparing the forecast results with the actual values in the period in question showed that the proposed model predicted the number of globally confirmed cases of COVID-19 with a very high accuracy of 98.45%.
Conclusion: Using data from different geographical regions within a country and discovering the pattern of prevalence in a region and its neighboring areas, our boosting-based model was able to accurately predict the incidence of COVID-19 within a two-week period.
Breastfeeding knowledge of mothers in protracted crises: The Gaza Strip example
Authors: Iellamo Alessandro , Monaghan Emily , Moghany Samar AL , Latham Jonathan , Nassereddin Nihal
Published: January 2021

Background: The protection, promotion and support of breastfeeding is the most effective intervention to prevent child morbidity and mortality in all contexts. During Palestine-Israel conflict that started in the middle of the 20 th century, healthcare services are understaffed and lack basic resources, with frequent power cuts and stock-outs of essential drugs and equipment. This case study seeks to answer the questions: (1) How does the protracted crisis in Gaza affect the breastfeeding practices of the most vulnerable population; and (2) What is the role that midwives can play in improving breastfeeding practices? A mixed method (qualitative and quantitative) study was used to collect data. A total of 1044 respondents had a child less than 24 months at the time of the study. A total of 62.75 percent practice early initiation of breastfeeding and 42 percent confirmed that their new-borns were given liquids other than breast milk during the first three days of life. Fifty percent of mothers addressed breast milk insufficiency by drinking additional fluids and 40 percent by using infant formula. Discussion: This study confirms the need to a) implement the IYCF-E operational guidance in the Gaza strip and b) review the pre-service and in-service training for midwives. For vulnerable populations in humanitarian contexts, the impact of this cannot be underestimated. Conducting research in humanitarian settings is particularly challenging. Our experience included integration and linkage with international organizations security officers on the ground, co-ordination of activities with authorities and communities, regular supportive supervision during data collection, allocation of buffer days and geographical areas and in-country and remote assistance to data collection teams Conclusions: This research focuses on a protracted emergency in insecure populated areas. The unpredictable security situation meant that the team adopted a flexible approach during data collection. Lessons learned throughout this process include the importance of a) allocating additional research time, to account for potential interruption b) daily coordination with security officers to ensure safe access to localities c) identification of extra sites, in case escalation of conflict d) training of additional enumerators in case conflict escalation e) negotiation with authorities to ensure compliance with requirements.
Modeling of suppression and mitigation interventions in the COVID-19 epidemics
Authors: Han YueXing , Xie ZeYang , Guo YiKe , Wang Bing
Published: January 2021

Background: The global spread of the COVID-19 pandemic has become the most fundamental threat to humanealth. In the absence of vaccines and effective therapeutical solutions, non-pharmaceutic interventions have become a major way for controlling the epidemics. Soft mitigation interventions are able to slow down the epidemic but not to halt it well. While strict suppression interventions are efficient for controlling the epidemics, long-term measures are likely to have negative impacts on economics and people’s daily lives. Hence, dynamically balancing the interventions of suppression and mitigation plays a fundamental role in manipulating the epidemic curves.Methods: We collected data of the number of infections for several countries during the COVID-19 pandemics and found a clear phenomenon of periodic waves of infections. Based on the observation, by connecting the infection level with the medical resources and a tolerance parameter, we propose a mathematical model by combining intervention measures to understand the epidemic dynamics.Results: Depending on the parameters of the medical resources, tolerance level, and the starting time of interventions, the combined intervention measure dynamically changes with the infection level, resulting in a periodic wave of infections con-trolled within an accepted level. The study reveals that, (a) with an immediate, strict suppression, the number of infections and deaths is well controlled with a significant reduction in very short time period; (b) an appropriate, dynamical combination of suppression and mitigation may find a feasible way in reducing the impacts of epidemics on people’s lives and economics.Conclusions: While the assumption of interventions deployed with a cycle of period in the model is limited and unrealistic, the phenomenon of periodic waves of infections in reality is captured by our model. These results provide helpful insights for policy-makers to dynamically deploy an appropriate intervention strategy to effectively battle against the COVID-19.
Nomogram for Prediction of fatal outcome in Patients with Severe COVID-19: A Multicenter Study
Authors: Yang Yun , Zhu Xiaofei , Huang Jian , Chen Cui , Zheng Yang , He Wei , Zhao Linghao , Gao Qian , Huang Xuanxuan , Fu Lijuan , Zhang Yu , Chang Yanqin , Zhang Huojun , Lu Zhijie
Published: January 2021

Background & Aims: To develop an effective model of predicting fatalOutcome in the severe coronavirus disease 2019 (COVID-19) patients.Methods: Between February 20, 2020 and April 4, 2020, consecutive COVID-19 patients from three designated hospitals were enrolled in this study. Independent high- risk factors associated with death were analyzed using Cox proportional hazard model. A prognostic nomogram was constructed to predict the survival of severe COVID-19 patients.Results: There were 124 severe patients in the training cohort, and there were 71 and 76 severe patients in the two independent validation cohorts, respectively. Multivariate Cox analysis indicated that age ≥ 70 years (HR 1.184, 95% CI 1.061-1.321), Panting(breathing rate ≥ 30/min) (HR 3.300, 95% CI 2.509-6.286), lymphocyte count < 1.0 × 109/L (HR 2.283, 95% CI 1.779-3.267), and IL-6 >10pg/mL (HR 3.029, 95% CI 1.567-7.116) were independent high-risk factors associated with fatal outcome. We developed the nomogram for identifying survival of severe COVID-19 patients in the training cohort (AUC 0.900, [95% CI 0.841-0.960], sensitivity 95.5%, specificity 77.5%); in validation cohort 1 (AUC 0.811, [95% CI 0.763-0.961], sensitivity 77.3%, specificity 73.5); in validation cohort 2 (AUC 0.862, [95% CI 0.698-0.924], sensitivity 92.9%, specificity 64.5%). The calibration curve for probability of death indicated a good consistence between prediction by the nomogram and the actual observation. The prognosis of severe COVID-19 patients with high levels of interleukin-6 (IL-6) receiving tocilizumab was better than that of those patients without tocilizumab both in the training and validation cohorts, but without difference (p = 0.105 for training cohort, p = 0.133 for validation cohort 1, and p = 0.210 for validation cohort 2).Conclusions: This nomogram could help clinicians to identify severe patients who have high risk of death, and to develop more appropriate treatment strategies to reduce the mortality of severe patients. Tocilizumab may improve the prognosis of severe COVID-19 patients with high levels of IL-6.
Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study
Authors: Li Jinghua , Xu Jingdong , Zhou Huan , You Hua , Wang Xiaohui , Li Yan , Liang Yuan , Li Shan , Ma Lina , Zeng Jing , Cai Huanle , Xie Jinzhao , Pan Chenghao , Hao Chun , Gilmour Stuart , Lau Joseph Tak-fai , Hao Yuantao , Xu Dong Roman , Gu Jing
Published: January 2021

Background: Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic.Methods: Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results: The prevalence of depression, anxiety, and poor self-rated health was 21.3%, 19.0%, and 9.8%, respectively, among public health workers (27.1%, 20.6%, and 15.0% among CDC workers and 17.5%, 17.9%, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001).Conclusions: Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.
Family function fully mediates the relationship between social support and perinatal depression in rural Southwest China
Authors: Huang Yilin , Liu Yan , Wang Yu , Liu Danping
Published: January 2021

Background: Perinatal depression is the most common complication of gestation and childbearing affecting women and their families, and good social support and family function are considered the protective and modifiable factors. This study aimed to investigate the depression status and explore inter-relationships between social support and perinatal depression considering the influence of family function in rural areas of Southwest China.Methods: This is a cross-sectional study. The following instruments were used: the Edinburgh Postpartum Depression Scale, the APGAR Family Care Index Scale, and the Social Support Rate Scale. A structural equation modelling was used to test the hypothesis relationships among the variables. Results: A total of 490 rural antenatal (N=249) and postpartum(N=241) women (age: 28.17± 5.12) participated. We found that the prevalence of depression symptoms was 10.4%. Path analysis showed that family function had a direct negative correlation with depression (β =-0.251, 95%CI: -0.382 to -0.118). Social support had a direct positive correlation with family function (β =0.293, 95%CI: 0.147 to 0.434) and had an indirect negative correlation with depression (β =-0.074, 95%CI: -0.139 to -0.032), family function fully mediated the relationship between social support and depression. Conclusions: Findings of this study highlight that family function should be considered as the key target for interventions aiming to lower the prevalence of perinatal depression. Family members interventions are critical to reduce depression among antenatal and postpartum women.
Assessing Fidelity to Family-Based Treatment: An Exploratory Examination of Expert, Therapist, Parent, and Peer Ratings
Authors: Couturier Jennifer , Kimber Melissa , Barwick Melanie , McVey Gail , Findlay Sheri , Webb Cheryl , Niccols Alison , Lock James
Published: January 2021

Introduction: Fidelity is an essential component for evaluating the clinical and implementation outcomes related to delivery of evidence-based practices (EBPs). Effective measurement of fidelity requires clinical buy-in, and as such, requires a process that is not burdensome for clinicians and managers. As part of a larger implementation study, we examined fidelity to Family-Based Treatment (FBT) measured by several different raters including an expert, a peer, therapists themselves, and parents, with a goal of determining a pragmatic, reliable and efficient method to capture treatment fidelity to FBT. Methods: Each therapist audio-recorded at least one FBT case and submitted recordings from session 1, 2, and 3 from phase 1, plus one additional session from phase 1, two sessions from phase 2, and one session from phase 3. These submitted files were rated by an expert and a peer rater using a validated FBT fidelity measure. As well, therapists and parents rated fidelity immediately following each session and submitted ratings to the research team. Inter-observer reliability was calculated for each item using the intraclass correlation coefficient (ICC), comparing the expert ratings to ratings from each of the other raters (parents, therapists, and peer). Mean scale scores were compared using repeated measures ANOVA.Results: Intraclass correlation coefficients revealed that agreement was the best between expert and peer, with excellent, good, or fair agreement in 7 of 13 items from session 1, 2 and 3. There were only four such values when comparing expert to parent agreement, and two such values comparing expert to therapist ratings. The rest of the ICC values indicated poor agreement. Scale level analysis indicated that expert fidelity ratings for phase 1 treatment sessions scores were significantly higher than the peer ratings and, that parent fidelity ratings tended to be significantly higher than the other raters across all three treatment phases. There were no significant differences between expert and therapist mean scores.Conclusions: There may be challenges inherent in parents rating fidelity accurately. Peer rating or therapist self-rating may be considered pragmatic, efficient, and reliable approaches to fidelity assessment for real-world clinical settings.
Epidemiologic characteristics and double-buffered strategy for patients in orthopedic surgery during the novel coronavirus outbreak: Wuhan's experience
Authors: Zhou Yan , Ming Jianghua , Liu Shiqing
Published: January 2021

Background: The purpose of this article is to summarize the epidemiologic characteristics and double-buffered strategy for patients in orthopedic surgery during the COVID-19 outbreak in Wuhan, China, based on our own experience in our hospital. Methods: A retrospective and comparative study was performed to identify all inpatients at our clinic from February 17, 2020 to April 20, 2020 (epidemic group), and from February 17, 2019 to April 20, 2019 (control group). Epidemiologic characteristics, screening effect, perioperative complications, and nosocomial infection were analyzed. Results: In the epidemic group, 82 patients were identified, a decrease by 76.0% than the 342 patients in the same period in the 2019. Patients in the epidemic group (54.6 ± 20.2 years) were older than those in the control group (49.6 ± 22.5 years). For the epidemic group, the proportion rates of traumatic factures (69.5%) and low-energy injuries (86.0%) were higher than that in the control group, respectively (35.4% and 37.2%). The preoperative waiting time (7.0 ± 2.6 days) in the epidemic group was longer than that in the control group (4.5 ± 2.1 days). The postoperative complication rate (12.2%) in the epidemic group was higher than that in the control group (3.5%). No nosocomial infection of orthopedic staff and patients with COVID-19 was noted in the epidemic group.Conclusion: During the COVID-19 outbreak in Wuhan, China, orthopedic inpatients showed unique epidemiological characteristics. The double-buffered strategy could effectively avoid nosocomial infections among medical staff and patients. Doctors should fully evaluate the perioperative risks and complications.
Comparison of carbon footprint and net ecosystem carbon budget under organic materials retention combined with reduced mineral fertilizer
Authors: Liu Ying , Tang Haiying , Smith Pete , Zhong Chuan , Huang Guoqin
Published: January 2021

Background: Excessive application of chemical fertilizer has resulted in lower nitrogen uptake and utilization efficiency of crops, decreasing soil fertility, increasing greenhouse gas emissions, and worse environment pollution. Organic material retention is regard as the key to solve these problems. he objective of this study is to conduct an assessment of carbon budget under Astragalus sinicus L. and rice straw retention combined with reduced mineral fertilizer based on the two-year field experiment in a paddy field in the south of China. The experiment was randomized complete block design including four treatments with triplicates: control CK (winter follow, 120 kg ha-1 N fertilizer for each rice season) and three treatments with Astragalus sinicus L. and rice straw retention named RA, RB, and RC (reduced N fertilizer by 15%, 27.5%, and 40% in each rice season). Results: Treatments RA, RB, and RC increased greenhouse gases emissions by 9.30%~101.25%, among which CH4 accounted for more than 60%; Carbon input of crops from treatments RA, RB, and RC increased by 2.25%~12.10% compared with control CK over the two years. Though treatments RA, RB, and RC enhanced CO2 emissions, however, treatment RB decreased carbon footprint and became carbon sink.Conclusions: The results of this study reveal that treatment RB (Astragalus sinicus L. and rice straw retention with reduced N fertilizer by 27.5%) is better in reducing chemical fertilizer amount, increasing crop yield and carbon input, which is more conductive to sustainable development of agriculture.
Differential response of digesta- and mucosa-associated intestinal microbiota to dietary insect meal during the seawater phase of Atlantic salmon
Authors: Li Yanxian , Bruni Leonardo , Jaramillo-Torres Alexander , Gajardo Karina , Kortner Trond M. , Krogdahl Åshild
Published: January 2021

Background: Intestinal digesta is commonly used for studying responses of microbiota to dietary shifts, yet evidence is accumulating that it represents an incomplete view of the intestinal microbiota. The present work aims to investigate the differences between digesta- and mucosa-associated intestinal microbiota in Atlantic salmon (Salmo salar) and how they may respond differently to dietary perturbations. In a 16-week seawater feeding trial, Atlantic salmon were fed either a commercially-relevant reference diet or an insect meal diet containing ~15% black soldier fly (Hermetia illucens) larvae meal. The digesta- and mucosa-associated distal intestinal microbiota were profiled by 16S rRNA gene sequencing. Results: Regardless of diet, we observed substantial differences between digesta- and mucosa-associated intestinal microbiota. Microbial richness and diversity were much higher in the digesta than the mucosa. The insect meal diet altered the distal intestinal microbiota resulting in higher microbial richness and diversity. The diet effect, however, depended on the sample origin. Digesta-associated intestinal microbiota showed more pronounced changes than the mucosa-associated microbiota. Multivariate association analyses identified two mucosa-enriched taxa, Brevinema andersonii and Spirochaetaceae, associated with the expression of genes related to immune responses and barrier function in the distal intestine, respectively. Conclusions: Our data show that salmon intestinal digesta and mucosa harbor microbial communities with clear differences. While feeding insects increased microbial richness and diversity in both digesta- and mucosa-associated intestinal microbiota, mucosa-associated intestinal microbiota seems more resilient to variations in the diet composition. To fully unveil the response of intestinal microbiota to dietary changes, concurrent profiling of digesta- and mucosa-associated intestinal microbiota is recommended whenever feasible. Specific taxa enriched in the intestinal mucosa are associated to gene expression related to immune responses and barrier function. Detailed studies are needed on the ecological and functional significance of taxa associated to intestinal microbiota dwelling on the mucosa.
Association between social capital and loneliness among older adults: A cross-sectional study in Anhui Province, China
Authors: Bai Zhongliang , Wang Zijing , Shao Tiantai , Qin Xia , Hu Zhi
Published: January 2021

Background: We aimed to examine the association between social capital and loneliness in Anhui Province, China. Methods: Data were collected from a cross-sectional study using a multi-stage stratified cluster sampling strategy. Data on demographic characteristics, socioeconomic factors, social capital, and loneliness in 1810 older adults (aged 60 years and older) were used for analysis. Binary logistic regression models and a classification and regression tree model were performed to assess the association of social capital and loneliness. Results: Our results indicated that social capital in terms of lower level of social participation (AOR = 1.38; 95% CI: 1.10-1.74), social connection (AOR = 1.51; 95% CI: 1.18-1.93), and reciprocity (AOR = 1.47; 95% CI: 1.13-1.90) were associated with higher odds of developing loneliness. We noted the interactive effect of different social capital dimensions on loneliness, suggesting that the risk for suffering loneliness was greatest in older people limited in functional ability, with less trust, less social connection, and less social participation. Conclusions: Our findings show that social capital is associated with loneliness in older adults. This implies that social capital, especially in terms of trust, social connection, and social participation may be significant for alleviating loneliness in later life.