bluuebunny/crossref_metadata_2025 huggingface dataset:
The Gardening Activities to Reduce Postpartum Stress in Japanese Postpartum Women: Preliminary Evidence from Pilot Single-Arm Trial Study
Authors: Kotozaki Yuka
Published: May 2020

Objective

There is a need for safer and more effective programs to address postpartum women's mental health dysfunction. The objective of this study was to clarify the effects on mental health, including postpartum depression, by implementing Japanese postpartum women with gardening activities by a pilot single-arm trial.
Results

15 women about a year after giving birth, recruited through newspaper advertisements, took part in this pilot study. I used the Japanese version of Edinburgh Postpartum Depression Scale (EPDS) score as the primary outcome measure. Secondary outcome measures were parenting stress, anxiety, and quality of life (QOL). Data collected at pre and post-test were analyzed using a paired t test. The EPDS, stress regarding parents, State-Trait Anxiety Inventory (STAI)-state, and STAI-trait of post-test were significant decreased than pre-test (p < 0.05). Also, physical health and psychological health of the World Health Organization Quality of life 26 (WHOQOL-26) of post-test were significantly increased than pre-test (p < 0.05). The gardening activity might be promising for mitigating depressive mood in postpartum women.
Effectiveness of Low-Frequency Stimulation in Proprioceptive Neuromuscular Facilitation Techniques for Post-Ankle-Sprain Balance and Proprioception in Adults- a Randomized controlled trial
Authors: ALAHMARI KHALID A , Samuel Paul Silvian , Ahmad Irshad , Reddy Ravi Shankar , Tedla Jaya Shanker , Kakaraparthi Venkata Nagaraj , Rengaramanujam Kanagaraj
Published: May 2020

BackgroundStretching is an important part of post-ankle-sprain rehabilitation, as well as an effective exercise for improving general ankle-joint performance. But the combination of stretching alongside muscle stimulation has not yet been extensively studied. Therefore the purpose of the present research is to compare the baseline, post- and follow-up effects of the proprioceptive neuromuscular facilitation (PNF) stretching technique combined with transcutaneous electrical nerve stimulation (TENS), as compared against the effects of the PNF stretching technique alone.MethodsSixty subjects with lateral ankle sprains were selected and randomly allocated to three groups: Experimental Group One (EG 1), Experimental Group Two (EG 2), and the Control Group (CG). Subjects in EG 1 received the PNF stretching technique combined with TENS. Subjects in EG2 received the PNF stretching technique alone. Both experimental groups received these treatments for 4 weeks (4 days/week); follow-up assessments were administered in the third and fifth weeks. CG received no treatment; outcome measures alone were assessed. Outcome measures comprised pain, flexibility, proprioception, range of motion, muscle strength, physical activity, and balance. A mixed-model ANOVA was used to analyze the effects of time factors and groups on these outcome measures.ResultsThere was significant interaction (time and group), and the time effect for all the outcome measures (p < 0.05). Physical activity, dorsiflexion, and balance in the medial, lateral, anterolateral, and anteromedial directions did not show a significant difference between the groups. EG 1 showed significant improvement for all the outcome variables between pre- and post-treatment and follow-up when compared to the other groups.ConclusionsThe present study showed that a 12-session treatment program of 3 weeks’ duration that combines PNF stretching with low-frequency TENS for post-ankle sprain subjects, compared against PNF stretching alone, produced significant improvements in balance, proprioception, strength, and range of motion. The study also showed that the treatment effect was sustained even after treatment was ceased after the follow-up assessment in the fifth week.Trial Registration:Human Research Ethics Committee approval for the trial (approval no.: (ECM#2019-26)Clinical trial was also registered in the Clinical Trials Registry – ISRCTN 18013941﻿
A Synergistic Bactericidal Effect of Low-Frequency and Low-Intensity Ultrasound Combined with Levofloxacin-Loaded PLGA Nanoparticles on M. Smegmatis in Macrophages
Authors: Xie Shuang , Li Gangjing , Hou Yuru , Yang Min , Li Fahui , Li Jianhu , Li Dairong , Du Yonghong
Published: May 2020

Purpose: Tuberculosis (TB) is a highly infectious disease caused by Mycobacterium tuberculosis (Mtb), which often parasites in macrophages. This study is performed to investigate the bactericidal effect and underlying mechanisms of low-frequency and low-intensity ultrasound (LFLIU) combined with levofloxacin-loaded PLGA nanoparticles (LEV-NPs) on M. smegmatis (a surrogate of Mtb) in macrophages.Methods and results: The LEV-NPs were prepared using a double emulsification method. The average diameter, zeta potential, polydispersity index, morphology, and drug release efficiency in vitro of the LEV-NPs were investigated. M. smegmatis in macrophages was treated using the LEV-NPs combined with 42 kHz ultrasound irradiation at an intensity of 0.13 W/cm2 for 10 min. The results showed that ultrasound significantly promoted the phagocytosis of nanoparticles by macrophages (p < 0.05). In addition, further ultrasound combined with the LEV-NPs promoted the production of reactive oxygen species (ROS) in macrophage , and the apoptosis rate of the macrophages was significantly higher than that of the control (p < 0.05). The transmission electronic microscope showed that the cell wall of M. smegmatis was ruptured, the cell structure was incomplete, and the bacteria received severe damage in the ultrasound combined with the LEV-NPs group. Activity assays showed that ultrasound combined with the LEV-NPs exhibited a 10-fold higher antibacterial activity against M. smegmatis residing inside macrophages compared with the free drug.Conclusion: These data demonstrated that ultrasound combined with LEV-NPs has great potential as a therapeutic agent for TB.
Health-related quality of life after pelvic organ prolapse surgery in Ethiopia: A 6 month follow-up study
Authors: Belayneh Tadesse , Gebeyehu Abebaw , Adefris Mulat , Rortveit Guri , Gjerde Janne Lillelid , Awoke Tadesse
Published: May 2020

Background
Pelvic organ prolapse (POP) affects health-related quality of life (HRQoL). Patient-reported outcomes (PRO) measures the quality of care from the patient’s perspective. PROs are an important measure of surgical outcome and used to calculate health gains after surgical treatment. We assessed HRQoL in women undergoing surgical repair of POP.
Methods
Two hundred fifteen women with stage III or IV prolapse underwent surgical POP repair between February 2018 and May 2019. Pelvic Organ Prolapse Quality of Life (P-QoL-20) was administered at baseline, 3 and 6 months postoperatively to assess HRQoL. Depressive symptoms and body image also evaluated. Linear mixed-effect models were used to compare pre and postoperative HRQoL scores and investigate potential predictors.
Results
Participant’s mean age was 49.3 ± 9.4 years. Most (81.9%) had stage III prolapse and underwent a vaginal hysterectomy, although 40% preferred uterine preservation. No differences were seen between women follow-up and those lost to follow-up in HRQoL (p > 0.05). The P-QoL, depressive symptoms, and body image were improved 6 months post-operatively. The change in P-QoL significantly associated with body image scores. The type of surgery did not show a significant difference. Being married showed an improvement in the personal relationship subscale score (β = 5.8, p < 0.01).
Conclusions
Our results indicated a potential improvement of HRQoL after surgical treatment. The result could be useful for patient counseling on the expected HRQoL outcomes of surgical treatment. Surgical service should be accessible for women suffering from POP to improve HRQoL.
Characterizing sensitivity and coverage of clinical WGS as a diagnostic test for genetic disorders
Authors: Sun Yan , Liu Fengxia , Fan Chunna , Wang Yaoshen , Song Lijie , Fang Zhonghai , Han Rui , Wang Zhonghua , Wang Xiaodan , Yang Ziying , Xu Zhenpeng , Peng Jiguang , Shi Chaonan , Zhang Hongyun , Dong Wei , Huang Hui , Li Yun , Le Yanqun , Sun Jun , Peng Zhiyu
Published: May 2020

Background
With the reduce of cost and incomparable advantages, WGS is likely to change the way of clinical diagnosis of rare and undiagnosed diseases. However, the sensitivity and breadth of coverage of clinical WGS as a diagnostic test for genetic disorders has not been fully evaluated, especially for CNV detection. All the samples underwent WGS using MGISEQ-2000. The performance of NA12878, YH cell line, and the Chinese trios were measured for sensitivity, PPV, depth and breadth of coverage. We also compared the performance of WES and WGS using NA12878. The sensitivity and PPV were tested using family-based trio design in the Chinese trios. We also developed a systematic WGS pipeline for the analysis of 8 clinical cases with known disease-causing variants.
Results
In general, the sensitivity and PPV for SNV/indel detection increased with mean depth, and reached a plateau at a ~ 40X mean depth using down-sampling samples of NA12878. With a mean depth of 40X, the sensitivity of homozyous and heterozygous SNPs of NA12878 was > 99.25% and > 99.50% respectively, and PPVs were 99.97% and 98.96%. Homozygous and heterozygous indels showed lower sensitivity and PPV. The sensitivity and PPV is still not 100% even with a mean depth of ~ 150X. We also observed a substantial variation in the sensitivity of CNV detection across different tools, especially in CNVs with a size of less than 1 kb. In general, the breadth of coverage for disease-associated genes and CNVs increased with mean depth. The sensitivity and coverage of WGS (~ 40X) is better than WES (~ 120X). Among the Chinese trios with ~ 40X mean depth, the sensitivity in the offspring was > 99.48% and > 96.36% for SNP and indel detection, and PPVs were 99.86% and 97.93%. All the 12 previously validated variants in the 8 clinical cases were successfully detected by our WGS pipeline.
Conclusions
The current standard of a mean depth of 40X may be sufficient for SNV/indel detection and identification of most CNVs. Clinical scientists should know the range of sensitivity and PPV for different classes of variants for a particular WGS pipeline, which would be useful when interpreting and delivering clinical reports.
Visit-to-Visit Glycemic Variability is Associated with In-Stent Restenosis in Patients with Type 2 Diabetes after Percutaneous Coronary Intervention
Authors: Yang Chen Die , Shen Ying , Lu Lin , Ding Feng Hua , Yang Zhen Kun , Hu Jian , Zhang Rui Yan , Shen Wei Feng , Wang Xiao Qun
Published: May 2020

Background:Patients with type 2 diabetes are under substantially higher risk of in-stent restenosis (ISR) after coronary stent implantation. We sought to investigate whether visit-to-visit glycemic variability is a potential predictor of ISR in diabetic patients after stent implantation.Methods:Type 2 diabetic patients underwent elective percutaneous coronary intervention were consecutively enrolled and 1-year follow-up coronary angiography was performed. The incidence of ISR and its relationship with visit-to-visit HbA1c variability, expressed as coefficient of variation (CV), standard deviation (SD) and variability independent of the mean (VIM), were studied. Multivariable Cox proportional hazards models were constructed to analyze the predictive value of glycemic variability for ISR.Results:From September 2014 to July 2018 in Ruijin Hospital, a total of 420 diabetic patients (688 lesions) after stent implantation were included in the final analysis. During a mean follow-up of 12.8 ± 1.3 months, the incidence of ISR was 8.6%, which was significantly increased in patients with higher CV of HbA1c (P = 0.001). The mean diameter stenosis (DS), net luminal loss and net luminal gain were 22.9 ± 16.8%, 0.42 ± 0.88 mm and 1.66 ± 0.83 mm, respectively. Greater DS was observed in subjects with higher tertiles of CV of HbA1c (P < 0.001), and this trend was more prominent in patients with optimal glycemic control (HbA1c ≤ 7%). In multivariate analysis, HbA1c variability was independently associated with incidence of ISR after adjustment for traditional risk factors and mean HbA1c (HR: 3.00 [95% CI:1.14 ~ 7.92] for highest vs. lowest tertile). Inclusion of CV of HbA1c led to a better risk stratification accuracy. Assessing glycemic variability by SD or VIM yielded similar findings.Conclusions:This study suggests that visit-to-visit HbA1c variability is an independent predictor of incidence of ISR in patients with type 2 diabetes after stent implantation.
Risk Evaluation and Molecular Biomarkers Identification of Firefighter Suffering Lung Cancer Via the TCGA Database
Authors: Bai Bin , Meng Qinghao
Published: May 2020

To evaluate the risk of firefighters suffering lung cancer after a long-term career and identify novel molecule biomarkers for evaluation, we tested the composition of flame-resistance door combustion byproducts. The results showed that the main component of combustion byproducts was PAHs and VOCs. The ceRNAs network showed that 26 mRNAs, 18 miRNAs, and 141 lncRNAs were involved in the lung cancer process. Most of the ceRNAs in our study could be affected by PAHs and VOCs. The Kaplan-Meier plots of differentially expressed RNAs in the ceRNA network showed that 3 mRNAs, 4 miRNAs, and 13lncRNAs have a relationship with the survival time of lung cancer patients. We recommended that mRNA COL1A1, CCBN1, and PFKP; miRNA hsa-miR-143, hsa-miR-183, hsa-miR-144, hsa-miR-372 and hsa-miR-373; lncRNA UCA1, TTTY16, LSAMP-AS1, LINC00337 and LNX1-AS1 as a biomarker to evaluate the risk of a firefighter suffering lung cancer and other cancers.
Increased concentration of 7-ketocholesterol and 7β-hydroxycholesterol in HDL from young anabolic androgenic steroid users
Authors: Souza Francis , Santos Marcelo , Fonseca Guilherme , Ferreira Guilherme , Negrão Carlos , Passarelli Marisa , Alves Maria Janieire
Published: May 2020

Background:Oxysterols are cholesterol oxidative derivatives that play an important role in cell cholesterol homeostasis. However, HDL particles enriched with oxysterols, especially the 7-ketocholesterol, have lower ability to mediate cell cholesterol removal by the reverse cholesterol transport. Anabolic androgenic steroids (AAS) misuse is associated with diminished cholesterol efflux and increased atherogenesis in young men. Unknown is whether the concentration of oxysterols is altered in AAS users.Methods:In this subanalysis, we evaluated six AAS users (AASU) and 6 AAS nonusers (AASNU) involved in strength training, and 6 sedentary men (SC). Oxysterols were evaluated by gas chromatography-mass spectrometry in HDL particles isolated by ultra centrifugation.Results:AASU presented higher levels of 7-ketocholesterol (104.1 ± 64.0 vs.43.7 ± 8.3 and 43.2 ± 9.1 ng/mg C; p < 0.05) and 7β-hydroxycholesterol (15.5 ± 5.6 vs. 10.1 ± 2.0 and 8.1 ± 1.0 ng/mg C; p < 0.05) in HDL compared to AASNU and SC, respectively. 7α-hydroxycholesterol (10.7 ± 4.2 vs. 8.0 ± 1.5 and 6.8 ± 2.2 ng/mg C; p = 0.089) and 27 hydroxycholesterol (25.6 ± 7.2 vs. 28.0 ± 7.0 and 21.8 ± 3.2 ng/mg C; p = 0.235) were similar among groups.Conclusion:This pilot study suggests that AAS abuse increases 7-ketocholesterol and 7β-hydroxycholesterol in HDL that may be related to HDL impaired function and increased atherosclerotic coronary disease in young AAS users. The clinical implication of this finding should be considered in future, larger, long-term studies.Trial registration:This is a cross-sectional pilot observational study from a retrospectively registered study NCT03450837.
Paclitaxel-Loaded and Folic Acid Modified PLGA Nanomedicine with Glutathione-Response for the Treatment of Lung Cancer
Authors: Zhang Zhanxia , Yao Wang , Yao Jialiang , Qian Fangfang , Que Zujun , Yu Pan , Luo Tianle , Zheng Dan , Tian Jianhui
Published: May 2020

Targeted delivery and smart response of nanomedicine hold great promise to improve the therapeutic efficacy and alleviate the side effects of chemotherapy agents in cancer treatment. While a few research systems about organic nanomedicines with these properties have limited the development prospect of nanomedicines. In the present study, folic acid (FA) targeted delivery and GSH (glutathione) smart responsive nanomedicine was rationally designed for paclitaxel (PTX) delivery in the treatment of lung cancer. Compared with other stimuli responsive nanomedicines, this nano-carrier was not only sensitive to biologically relevant GSH for on demand drug release but also biodegradable into biocompatible by products after fulfilling its delivering task. The nanomedicine can firstly enter into tumor cells via FA and its receptor mediated endocytosis. After lysosomes escape, the PLGA (poly(lactic-co-glycolic acid) nanomedicine was triggered by the higher level of GSH and released its cargo in tumor microenvironment. In vitro and in vivo results revealed that the PLGA nanomedicine not only can inhibit the proliferation and promote the apoptosis of lung cancer cells greatly, but also possesses less toxic side effects when compared with free PTX. Therefore, the proposed drug delivery system demonstrates the encouraging potential for multifunctional nano-platform applicable to enhance the bioavailability and reduce the side effects of chemotherapy agents.
Effects of Nutrition Education Supported by Mobile Application on Weight Loss and Quality of Life: A Randomized Controlled Trial
Authors: Peksever Doga , Seckiner Selda , Meseri Reci
Published: May 2020

Background Obesity is a growing health problem which affects people from all age groups all over the world. Obese people do not feel motivated enough to change their lifestyle behaviors. Mobile applications can be used to motivate people.Objective To evaluate effect of nutrition education supported by MOtiVE mobile application on weight loss and quality of life (QoL).Methods In this randomized-controlled study, 79 overweight/obese adult patients who presented to University Hospital Outpatient Clinic between March-September 2018 to consult a dietitian were included. All the participants were provided a weight-loss diet program by the dietitian. Then, participants were randomized to experimental and control groups. During the first interview, all participants completed the questionnaire and anthropometric measurements were done. BMI, the scores obtained from different Quality of Life scales and Healthy Eating Index (HEI) were the dependent variables. The participants in the experimental group were provided with daily messages for 3 months via MOtiVE mobile application designed solely for this study. All the participants were asked to present three months later for a follow-up appointment. Using SPSS 25.0, change in BMI, QoL scores and other variables within both groups was assessed via Wilcoxon signed-rank test and McNemar chi-square test. p < 0.05 was considered statistically significant.Results Although 39 cases and 40 controls took the first test, 20 cases and 18 controls participants completed the study. The mean BMI decreased significantly in both groups being more predominant in cases as from 33.8 ± 6.0 kg/m2 to 32.8 ± 5.8 kg/m2(p = 0.001) in cases and from 33.3 ± 5.0 kg/m2 to 32.2 ± 4.7 kg/m2 (p = 0.006) in controls. Moreover, waist circumference decreased (p = 0.029), self-esteem (p = 0.035) and healthy eating scores (p = 0.007) increased only in cases significantly.Conclusions Nutrition education supported by MOtiVE mobile application improved anthropometric measurements, self-esteem, quality of life and healthy eating habits of the overweight/obese participants. Free mobile applications can be used in increasing motivation to adopt new behaviors in order to tackle obesity.Trial Registration: ClinicalTrials.gov NCT04026971
Measuring Hygiene Competence: A Vignette-Based Situational Judgement Test
Authors: Heininger Susanne Katharina , Baumgartner Maria , Zehner Fabian , Burgkart Rainer , Söllner Nina , Berberat Pascal O. , Gartmeier Martin
Published: May 2020

Background: Since the onset of the Corona pandemic at the beginning of 2020, the extreme importance of hygiene has once again become very clear. In the medical context, it is not easy to find suitable test formats to assess the competencies involved in “working hygienically”. Pre-existing test formats usually use self-report questionnaires, which are suboptimal for this purpose. Methods: We designed a Situational Judgement Test (SJT) to assess hygiene competence. The SJT incorporates reliable measures and is a good predictor of job performance. The test consists of twenty pictures (items) presenting only one unambiguous hygiene lapse. Test respondents were asked (1) to note down whether they recognized a problem in the picture in respect of hygiene guidelines and (2), if yes, to describe the problem in a short verbal response. The sample comprised n = 149 health care professionals (79.1% female; age: M = 26.7 years, SD = 7.3 years) working as clinicians or nurses. The written responses were rated by two independent raters with high agreement (α > .80), indicating high reliability of the measurement. We then used Item Response Theory (IRT) for data analysis. Results: The reported IRT analyses show that the test is suitable to assess hygiene competence and that it is possible to distinguish between persons demonstrating different levels of ability for seventeen of the twenty items/pictures), expecially for the range of low to medium person abilities.Conclusions: The test in its present form can be used to assess the hygiene competence of medical students, medical doctors, nurses and trainee nurses in cross-sectional measurements. In order to broaden the difficulty spectrum of the current test, additional test items with higher difficulty should be developed. The Situational Judgement Test designed to assess hygiene competence can be helpful in testing and teaching the ability of working hygienically.
An Assessment of Serial Co-cultivation Approach for Generating Novel Zymomonas Mobilis Strains
Authors: Fuchino Katsuya , Bruheim Per
Published: May 2020

ObjectiveThe alphaproteobacterium Zymomonas mobilis is an efficient ethanol producer.Utilizing its distinctive physiological features, Z. mobilis-based biorefinery shows a great potential for an industrial biofuel production at large scale.Serial co-cultivation based adaptation that promotes species-interaction has been an emerging approach to improve or rewire metabolic features in industrially useful microorganisms by inducing frequent mutations. We applied this method to assess if adaptation to long term co-culture improves or rewire the desirable physiological features of Z. mobilis.ResultsWe have performed serial co-culture of Z. mobilis mixed with the baker yeast Saccharomyces cerevisiae. We observed filamentation of Z. mobilis cell in the co-culture, indicating that Z. mobilis cells were stressed due to the presence of competitor and that there appeared to be a selective pressure. After 50 times of serial transfers, we characterized the generated Z. mobilis strains. The analysis showed that long term co-culture did not drive significant changes in growth or excreted metabolites profile of generated strains. In line with this, whole genome sequencing of the generated Z. mobilis strains revealed only minor genetic variations from parental strain. The result indicates that co-culture method should be carefully optimized for Z. mobilis strain improvement.
Study of radiation damage with the radiation workers by low dose irradiation
Authors: Liu Gang , Li Ye
Published: May 2020

Objective To explore the sensitivity index of radiation injury of radiation workers was analyzed and investigate whether the body changes and radiation doses of workers exposed to low-dose radiation have a dose-effect relationship. Methods The occupational health monitoring data of radiology staff were analyzed by retrospectively. Results Individual dose monitoring data, interventional radiology workers had the highest average cumulative annual dose, 0.86mSv. Lens opacity has a high detection rate, Compared with the control group, the lymphocyte count was increased. Annual cumulative dose reached 2.04 mSv, and single cycle average dose reached 1.62 mSv, dicentric chromosome was detected. Conclusions Radiation workers have certain radiation damage, and the focus is on those engaged in interventional radiology. The chromosome aberration rate was highest in people with more than 20 years of working life. Annual cumulative dose reached 2.04 mSv, and single cycle average dose reached 1.62 mSv, dicentric chromosome was detected, it suggests that the chromosome aberration analysis is an important index in occupational health monitoring of radiological workers.
Combat Process Simulation and Attrition Forecasting Based on System Dynamics and Multi-Agent Modeling
Authors: PENG BO , Liu Shuo , Xu Lei , He Zhen
Published: May 2020

Purpose: To predict and analyze the spatial and temporal distribution of combat attrition.Methods: Construct a combat process simulation and combat attrition forecasting model using system dynamics methods and introduce macroscopic attrition data to the attrition forecast model by using agents to decompose the attrition data, assigning battle wound information according to specific ratios.Results: Using the attrition forecast model, based on system dynamics, the causal loop and stock-flow relationship of the combat operation process may be constructed by combining the specific combat mission with an analysis of the factors that influence the operation, such as the lethality of the weapons and the defensive capability of the two sides. The damage levels of the various targets on the two sides in combat are converted into attrition data. Based on these data, an agent modeling method is used to extract the macroscopic attrition data derived from the battle attrition forecast model. By constructing a correspondence between the combat target damage level and the various types of battle injuries, the injury to each casualty may be modeled and assigned a value in order to complete the mapping from attrition to injury.Conclusions: This work establishes an attrition forecasting model based on system dynamics and an agent-based simulation model for the occurrence of casualties. It can estimate the temporal and spatial distribution of attrition in combat.
Interleukin 17-Producing γδ T Cell Induced Demyelination of the Brain in Angiostrongylus Cantonensis Infection
Authors: Feng Ying , Zhou Zongpu , Zheng Cunjing , Feng Feng , Xie Fukang , Wu Zhongdao
Published: May 2020

Background Angiostrongylus cantonensis infection is a typical cause of eosinophilic encephalitis (EM), which has been reported to induce serious damage in the central nervous system. Both parasite and host factors contribute to the onset of EM, but the related immune-inflammation pathogenesis remains poorly characterised.Methods An A. cantonensis infection model was generated through infection of mice by gavage. Transmission electron microscopy and immunohistochemistry were used to assess the pathologic changes in the brain. The mRNA expression of inflammatory factors was tested using qRT-PCR. A combination of flow cytometry and western blotting was used to evaluate the alteration of leukocytes and related cytokines. A critical role of IL-17 was found by injecting IL-17A monoclonal antibody into naïve and A. cantonensis-infected mice.Results A. cantonensis larvae altered the immune homeostasis in the brain, leading to the destruction of myelin sheaths and activation of microglia. During this process, IL-17A accumulation was observed, and IL-17RA was expressed in oligodendrocytes and microglia during the infection. Notably, γδ T cells were the origin of IL-17A production induced by the parasite. After an IL-17A-neutralising antibody was applied, alterations in myelination and the state of the microglia were discovered; the neurobehavioral scores of the mice also improved.Conclusion Our study reveals a previously unrecognised impact of the IL-17+ γδ T cells in parasitic encephalopathy and emphasizes that blocking IL-17A signalling can attenuate microglial activation, thus reducing CNS demyelination and ameliorating the behavioural deficit in A. cantonensis-infected mice.
Assessing the play and learning environments of children under two years in peri-urban Lima, Peru: A formative research study
Authors: Rothstein Jessica D , Buckland Audrey J , Gagnier Kristin , Ochoa Mayra , Allen-Valley Aliya , Jivapong Belinda , Cabrera Lilia Z , Leontsini Elli , Fisher Kelly R
Published: May 2020

Background During the first two years of life, children’s access to learning materials and opportunities for play, as mediated by the caregiver, are critical components of a developmentally supportive environment. While home-based interventions have potential for improving early child development (ECD) in low-resource settings, the design of locally acceptable strategies requires an understanding of the household context. In this exploratory study, we aimed to characterize the home learning environments of children 6–23 months of age in peri-urban Lima, Peru, with an emphasis on play and communication.Methods Drawing on the developmental niche framework, we used quantitative and qualitative methods to understand children’s physical and social settings, childcare practices, and caregiver perspectives. We conducted interviews, unstructured observations, and spot-checks with 30 randomly selected caregiver-child dyads, as well as key informant interviews with 12 daycare instructors. We analyzed data for key trends and themes using Stata and Atlas.ti, and employed an adapted version of the Indicator of Parent-Child Interaction to evaluate the video-recorded observations.Results Children’s social settings were characterized by multi-generational homes and the presence of siblings and cousins as play partners. Access to books and complex hand-eye coordination toys (e.g. puzzles, building blocks) in the home was limited. Caregivers generally demonstrated low or inconsistent levels of interaction with their children; they rarely communicated using descriptive language or introduced novel, stimulating activities while playing. While it was not common for caregiver to read or tell stories to children, singing to children was widely practiced and enjoyed. On average, caregivers ascribed a high learning value to electronic toys and “educational” TV programs, and perceived playing with everyday objects in the home as less beneficial.Conclusions The features of the home learning environment highlighted here indicate several opportunities for intervention development to improve ECD in peri-urban Peru. These include encouraging caregivers to communicate with children using full sentences in the context of their daily commitments and activities and enhancing the use of everyday objects as toys. In addition, there is great potential for a home-based intervention to leverage song and music to encourage positive caregiver-child interactions in this setting.
Deep Cardiovascular Disease Prediction with Risk Factors Powered Bi-Attention
Authors: Qiu Yanlong , Zhang Zhichang , Qin Xiaohui , Tao Shengxin
Published: May 2020

Background Cardiovascular disease (CVD), as a chronic disease, has been perplexing human beings and is one of the serious diseases endangering life and health. Therefore, using the electronic medical record information of patients to automatically predict CVD has important application value in intelligent auxiliary diagnosis and treatment, and is a hot issue in intelligent medical research. In recent years, attention mechanism has been successfully extended to various tasks of natural language processing. Typically, these methods use attention to focus on a small part of the context and summarize it with a fixed-size vector, coupling attention in time, and/or often forming a uni-directional attention. Methods In this paper, we propose a CVD risk factors powered bi-directional attention (RFPBiA) network, which is a multi-stage hierarchical process, representing information fusion at different granularity levels, and uses the bi-directional attention to obtain the text representation of risk factors without early aggregation. Results The experimental results show that the proposed method can obviously improve the performance of CVD prediction, and the F-score reaches 0.9424, which is better than the existing related methods. Conclusions We propose to extract the risk factors leading to CVD by using the existing mature entity recognition technology, which provides a new idea for disease prediction tasks. Moreover, the memory- less attention mechanism in both directions in our proposed prediction model of RFPBiA can fuse the character sequence and the risk factors contained in the electronic medical record text to predict CVD.
The clinical spectrum of COVID-19 in neonates and infants: A systematic review protocol
Authors: Allana Ahreen , Ali Sumera Aziz , Saleem Ali Faisal
Published: May 2020

Background Preliminary data on COVID-19 in the pediatric population has revealed that children account for a milder clinical course and better prognosis compared with adults. However, infants are at the greatest risk within this subset, with studies demonstrating the highest proportion of critical cases in this age group. The clinical spectrum of the disease in these children remains largely unexplored. Similarly, there is a dearth of research on the potential vertical/perinatal transmission of SARS-nCoV and the clinical outcomes of infants born to mothers who have been tested positive for the virus. In this review, we aim to summarize available literature on the clinical spectrum of COVID-19 in neonates and infants. Methodology This review will explore the clinical characteristics of COVID-19 in infants tested positive for SARS-nCoV using RT-PCR assays as well as neonates born to mothers who were detected with the virus during pregnancy. We will conduct a comprehensive search of two large databases, i.e. PubMed and Google Scholar and shortlist published and unpublished (pre-proof and pre-proof accepted) articles in English between 1 st November 2019 and 15 th May 2020 that meet the eligibility criteria. Keeping in view the paucity of data on the study topic, we plan to include all relevant articles irrespective of study design. The findings will be synthesized narratively following an analytical interpretation to capture emerging themes. Discussion Through this systematic review, we hope to provide an evidence-based framework for pediatricians to incorporate into their practice while managing neonates and infants tested positive for COVID-19 or those born to mothers who tested positive for the disease. This will set the stage for prospective clinical research to address the questions that remain unanswered. More importantly, exploring disease pathogenesis and transmission in pediatric patients could provide practical insights to guide future therapeutic and preventative measures and, perhaps, vaccine development. Systematic review registration: This review has been submitted for registration with PROSPERO (acknowledgement of receipt -185333).
Addressing the Problems and Challenges of Medical Research During the Syrian Crisis
Authors: Alhaffar MHD Bahaa Aldin , Albarshah Marwah , alhaffar MHD ALAA ALDIN
Published: May 2020

Introduction : The Syrian crisis started 9 years ago causing substantial damage to the country’s infrastructure, and the consequences of this tragedy have further stunted the underdeveloped research environment in Syria. This paper aims to address the challenges of conducting medical research among Syrian academics during the Syrian crisis. Methods: The data were collected from (471) Syrian researchers (MsC or PhD students, university professors) from 13 universities and hospitals, covering 10 governates. A questionnaire was developed to collect the data and 52 factors were identified as research challenges. Results: The main institutional challenges are: (94%) insufficient funding, (80.3%) difficulties in acquiring supplies and equipment, (79.6%) lack of neutrality in approving research proposals. In regards to the personal challenges, (70.1%) expressed a high level of motivation to carry out research but only (33.4%) are confident that they have enough knowledge, (53.1%) do not have academic writing skills, (73.5%) do not have the basic information about medical statistics. For the crisis related factors, (83.5%) cite collecting data and reaching the sources of data as the main challenge, (80.4%) for losing contact with the patients because of the war situation, (76.3%) for lack of governmental support for the research during the crisis. Conclusion: Syrian medical researchers continue to face a number of challenges and the Syrian crisis has brought more problems and obstacles to the surface. However, despite those numerous challenges, researchers from Syrian institutes are still working on research projects.
Longitudinal Imaging-Based Clusters in Former Smokers of the COPD Cohort Associate with Clinical Characteristics: the SubPopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS)
Authors: Zou Chunrui , Li Frank , Choi Jiwoong , Haghighi Babak , Choi Sanghun , Rajaraman Prathish K. , Comellas Alejandro P. , Newell John D. , Lee Chang Hyun , Barr R. Graham , Bleecker Eugene , Cooper Christopher B. , Couper David , Han MeiLan , Hansel Nadia N. , Kanner Richard E. , Kazerooni Ella A. , Kleerup Eric C. , Martinez Fernando J. , O’Neal Wanda , Paine Robert , Rennard Stephen I , Smith Benjamin M. , Woodruff Prescott G , Hoffman Eric A. , Lin Ching-Long
Published: May 2020

Background: Quantitative CT (qCT) imaging-based cluster analysis identified clinically meaningful COPD former-smoker subgroups (clusters) based on cross-sectional data. We aimed to identify progression clusters for former smokers using longitudinal data.Patients and Methods: We selected 472 former smokers from SPIROMICS with a baseline visit and a one-year follow-up visit. A total of 150 qCT imaging-based variables, comprising 75 variables at baseline and their corresponding progression rates, were derived from the respective inspiration and expiration scans of the two visits. The COPD progression clusters identified were then associated with subject demography, clinical variables and biomarkers.Results: COPD severities at baseline increased with increasing cluster number. Cluster 1 patients were an obese subgroup with rapid progression of functional small airway disease percentage (fSAD%) and emphysema percentage (Emph%), and preserved FEV1%predicted but impairment of FEV1/FVC ratio over one year. Cluster 2 exhibited a decrease of fSAD% and Emph%, an increase of tissue fraction at total lung capacity, airway narrowing, and a reduced post-bronchodilator FEV1%predicted but preserved FEV1/FVC ratio over one year. Cluster 3 showed rapid expansion of Emph% and an attenuation of fSAD%. Cluster 4 demonstrated severe emphysema and fSAD and significant structural alterations at baseline with rapid progression of fSAD% over one year. Subjects with different progression patterns in the same cross-sectional cluster were identified by longitudinal clustering.Conclusions: qCT imaging-based metrics at two visits for former smokers allow for the derivation of four statistically stable clusters associated with unique progression patterns and clinical characteristics. Use of baseline variables and their progression rates enables identification of longitudinal clusters, resulting in a refinement of cross-sectional clusters.
Acute Respiratory Infection of under-five children associated with place of food cooking in Ethiopia: Multilevel Analysis of 2005-2016 Ethiopian Demographic Health Survey data
Authors: Geremew Abraham , Gebremedhin Selamawit , Mulugeta Yohannes , Assebe Tesfaye
Published: May 2020

Background: Acute respiratory infection is the leading causes of under-five child mortality globally especially in least income countries. Exposure to toxic pollutants from solid biomass fuel in the indoor environment is the main risk factor. In Ethiopia, where more than 90% of population use this energy source and the disease is one of the top health problems, there is a paucity of evidence on the association of cooking places with the disease based on nationally representative data. Therefore, the current study is intended to at assess the association of food cooking places with acute respiratory infection based on a large-scale and time varying data.Methods: The data of Ethiopian Demographic and health surveys collected in 2005, 2011 and 2016 were used for this study. The data were obtained via online registration and analyzed using a multilevel analysis. The “svy” command in Stata was used to weight the data to adjust for cluster sampling design. Result: The total number of children included in the analysis was 30895, with 9,517 from 2005, 11,176 from 2011 and 10, 291 from 2016 survey. In total, 11.9% of children had an acute lower respiratory infection with 12.7%, 11.9% and 11.1% respectively in 2005, 2011 and 2016. In 2005, 71% of mothers cooked food inside the house and it declined to 43% in 2016. The risk of the infection to children whose mother cooked food outside the house compared to inside the house was 68% less likely (AOR = 0.32, 95% CI= 0.10, 0.98). Watching television at least once in a week had also reduced the risk of infection (AOR=0.60, 95% CI =0.38, 0.94). There was a statistically a significant difference among the children of within survey to have an infection and no difference among the children of between surveys.Conclusion: The mothers’ cooking of food outside the house lessen the risk of children to have acute respiratory infection. No difference among different surveys on the infection suggests the rareness of progress in the practices that could minimize the risk therefore measures like encouraging to cook in indoor environment of well-ventilated needs to be taken.
Comparison of the metabolic profiles of rice cultivars with different eating qualities during grain development and the post-harvesting process
Authors: Chen Yi-Bo , wang zhidong , wang chongrong , Li Hong , Huang Daoqiang , Zhou Degui , Wu Yukun , Zhao Lei , Gong Rong , Pan Yangyang , Zhou Shaochuan
Published: May 2020

Background: Rice eating quality and nutritional quality is affected by both grain development and the post-harvesting process, but the dynamic metabolite changes among rice cultivars during these processes are unclear.Results: We successfully identified 623 metabolites in four indica cultivars with different eating qualities using a widely-targeted metabolomics approach, and found that the metabolic variation became increasingly smaller and differed according to the stage and cultivar during grain development and post-harvesting. Our results suggested that the levels of sugars, amino acids, lipids, and flavones demonstrated cultivar-specific changes during grain development, and sufficient carbon supply during grain development may contribute to the formation of excellent eating quality. We further found that most of the metabolites, especially the nutritional metabolites, decreased significantly or even lost, whereas only few increased during post-harvesting, further indicating that the post-harvesting process reduced the metabolic molecular differences between rice cultivars with different eating qualities, and had an even greater influence on metabolites than genetic factors.Conclusions: We found that a large number of metabolites changed significantly in the rice cultivars during grain development and the post-harvesting process, which facilitates further study of rice quality formation and has potential application in eating quality and nutritional quality improvement.
Yield and Yield-reduction Predictors in Drought: A Review of Recent Drought Years in a Highland and Lowland in Southern Tigray, Northern Ethiopia
Authors: Eze Emmanuel
Published: May 2020

The consequences of prolonged precipitation-deficient periods are primarily substantial water deficit, with the spatial characteristics of a place being (semi)arid, and various socioeconomic factors worsening its impacts and deepening poverty among agrarian communities.This study utilizes a combination of climate, remote sensing and field survey data from farmers to obtain a first-hand information on the impacts of recent (2015 and 2017) droughts on crop yield in Raya Azebo and Endamehoni woredas in Ethiopia. Annual rainfall, kiremt rainfall, annual NDVI and Dev-NDVI, kiremt season Dev-NDVI, monthly Dev-NDVI (for June to October), and monthly SPI-1, SPI-3 and SPI-12 (for June to October) were considered as likely factors that could relate with yield and yield loss in the area. Correlation and multiple linear stepwise regression statistical techniques were used to determine drought-yield relationships, and identify more accurate predictors of yield and yield losses in each of the drought years.Results obtained show droughts as having spatiotemporal variations and impacts, with its primary and common reflection being reduced vegetation amount, translating to crop failures, food shortages and reduced income of smallholders.Spate irrigation should be further popularized in the low-lying areas of Raya Azebo to augment for future deficiencies in the kiremt rainfall.
COVID-19 Exposure Risk of Healthcare Personnel in Digestive Endoscopy: A Prospective Study
Authors: Dioscoridi Lorenzo , Carrisi Chiara
Published: May 2020

Background: Of many descriptive papers about healthcare workers’ (HW) COVID-19 infection, asymptomatic cases have not yet considered. Aims: The present study calculated the numbers of COVID-19 patients afferent to GI endoscopy and the number of positive HW using nasopharyngeal swabs (NS), serological rapid IgM/IgG tests (SRT) and serological quantitative IgG test (SQT).Methods: The study was conducted from 2ndto 30thApril 2020. All the recommended national and international indications on infection control measures were followed. Out of 1227 patients accepted, 1009 were included in the study. 38 HW were tested by NS, SRT and SQT. Descriptive statistical analyses were used to summarize the data.Results: 17 patients were diagnosed COVID-19 positive at NS. 9 patients were known positive at the time of the endoscopy and 8 were diagnosed COVID-19 positive after the procedure. Of the 38 HW, 2 were positive both to NS and SRT with IgM/IgG lines; 7 showed IgG line only at SRT, confirmed by SQT with negative NS. Other 7 HW showed not well-defined line of IgG at SRT, confirmed negative by SQT. The two cases positive to NS and IgM/IgG SRT were asymptomatic. The crude contagion’s rate (R0)was 0.41 and 1.7% of COVID-19 patients caused 19% of positive cases in HW.Conclusions: Not previously diagnosed COVID-19 patients expose HW to additional and incalculable risk of contamination. Association between different tests reduced the variability related to possible confounding factors and increases the accuracy. Since most cases in HW seem to go asymptomatic, large-scale tests using both NS and SRT for both HW and patients should be recommended to minimize the risk of in-hospital infection’s relapses.