bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility and Outcome of Metacognitive Therapy for Major Depressive Disorder: A pilot study
Authors: Winter Lotta , Schweiger Ulrich , Kahl Kai G.
Published: August 2020

Background Several studies have shown the effectiveness of Metacognitive Therapy (MCT) in treating different mental disorders. Most of these studies were performed in English speaking countries using the original English version of the manual. Our study aimed to examine the feasibility of the translated MCT manual in a sample of German patients with major depressive disorder.Methods 20 outpatients (6 male, 14 female, mean age 42.1y) with major depressive disorder were included. The main outcome was drop-out rate and satisfaction with the treatment; secondary outcomes were changes in metacognitive beliefs assessed with the metacognitive questionnaire 30 (MCQ-30), and symptom reduction measured with the Beck Depression Inventory-2 sum score (BDI-2).Results No drop-outs during the treatment and the follow-up phase were observed. Patients and therapists were highly satisfied with MCT treatment. The MCQ-30 significantly declined over the treatment course, paralleled by a significant reduction of the BDI-2 sum scores (from 29 ± 8.6 at T0 to 8.4 ± 9.6 at the end of treatment).The average treatment duration was 10 ± 4 sessions.Conclusions Applying the German version of the manual for Metacognitive Therapy proved to be feasible in the treatment of depressed patients in an outpatient setting. The treatment was well tolerated by German patients. Outcome in terms of reduction of depressive symptoms was good. Remarkable is the comparably short treatment duration which should be investigated further in future studies.
Incidence of Airway Complications Associated with Deep Extubation in Adults
Authors: Juang Jeremy , Cordoba Martha , Ciaramella Alex , Xiao Mark , Goldfarb Jeremy , Bayter Jorge Enrique , Macias Alvaro Andres
Published: August 2020

Background: Endotracheal extubation is the most crucial step during emergence from general anesthesia. In the vast majority of cases, this is carried out when patients are awake with return of airway reflexes. Alternatively, extubations can also be accomplished while patients are deeply anesthetized, a technique known as “deep extubation”, in order to provide a “smooth” emergence from anesthesia. This smooth emergence is particularly important for procedures that require maintenance of stable levels of intraocular and intracranial pressures, such as in neurologic, ophthalmic, and head-and-neck surgery [1]. Reluctance to performing deep extubation in adults, even in appropriate circumstances, is common and likely derives both from concerns for potential respiratory complications [2] and limited research supporting its safety. It is in this context that we designed our prospective study to understand the factors that contribute to the success or failure of deep extubation in adults. Methods: In this prospective observational study, 300 patients, age ≥ 18, American Society of Anesthesiologists Physical Status (ASA PS) Classification I - III, who underwent head-and-neck and ocular surgeries. Patients’ demographic, comorbidity, airway assessment, O2 saturation, end tidal CO2 levels, time to exit OR, time to eye opening, and respiratory complications after deep extubation in the OR were analyzed. Results: Forty (13%) out of 300 patients had at least one complication in the OR, as defined by persistent coughing, desaturation SpO2 < 90% for longer than 10s, laryngospasm, stridor, bronchospasm and reintubation. When comparing the complication group to the no complication group, the patients in the complication group had significantly higher BMI (30 vs 26), lower O2 saturation pre and post extubation, and longer time from end of surgery to out of OR (p<0.05). Conclusions: The complication rate during deep extubation in adults was low and all easily reversible. And patient factors and extubation conditions may influence probability of success in deep extubation.
The Impact of a Training Programme Incorporating The Conceptual Framework Of The International Classification of Functioning (ICF) on Knowledge And Attitudes Regarding Interprofessional Practice in Rwandan Health Professionals: A Cluster Randomized Control Trial
Authors: Sagahutu Jean Baptiste , Kagwiza Jeanne , Cilliers Francois , Jelsma Jennifer
Published: August 2020

Background: The first step in improving interprofessional teamwork entails training health professionals (HP) to acknowledge the role and value the contribution of each member of the team.ICF has been developed by WHO to provide a common language to facilitate communication between HPs.Objective: To determine whether ICF training programme would result in improved knowledge and attitudes regarding interprofessional practice within Rwandan district hospitals.Design, setting and participants: A cluster randomised, single blinded, control trial design was used to select four district hospitals. Participants included physicians, social workers, Physiotherapists, nutritionists, clinical psychologists/mental health nurses. Intervention: Health professionals either received one day’s training in interprofessional practice (IPP) based on the ICF framework (experimental group) or a short talk on the topic (control group).Outcome measures: Validated questionnaires were used to explore changes in knowledge and attitudes. Ethical approval was obtained from the relevant authorities.Results: There were 103 participants in the experimental and 100 in the control group. There was no significant difference between Knowledge and Attitude scales at baseline. Post-intervention the experimental group (mean=41.3, SD=9.5) scored significantly higher on the knowledge scale than the control group (mean=17.7, SD=4.7 (t=22.5; p<.001)). The median scores on the Attitude Scale improved in the Experimental group from 77.8 to 91.1%, whereas the median scores of the control remained approximately 80% (Adjusted Z =10.72p<.001).Conclusion: The ICF proved to be a useful framework for structuring the training of all HPs in IPP and the training resulted in a significant improvement in knowledge and attitudes regarding IPP. As suggested by the HPs, more training and refresher courses were needed for sustainability and the training should be extended to other hospitals in Rwanda. It is thus recommended that the framework can be used in interprofessional education and practice in Rwanda and possibly in other similar countries.Name of the registry: Pan African Clinical Trial Registry Trial registration number: PACTR201604001185358 Date of registration: 22/04/2016URL of trial registry record: www.pactr.orgFunding: Republic of Rwanda through Rwanda Education Board
Association of Chorioamnionitis With Failed Conversion of Epidural Labor Analgesia to Cesarean Delivery Anesthesia: a Retrospective Cohort Study
Authors: Katakura Yumi , Nagamine Yusuke , Goto Takahisa , Sumikura Hiroyuki
Published: August 2020

Background: This study examined the association between clinically diagnosed chorioamnionitis and failed conversion of epidural labor analgesia to cesarean delivery anesthesia.Methods: This retrospective cohort study, conducted in a single-center university hospital, enrolled term parturients undergoing emergency cesarean section after induction of epidural labor analgesia between September 2015 and May 2019. For the purpose of the study, all cases were re-examined to ensure that they fulfilled the criteria of chorioamnionitis, regardless of the actual indication for cesarean section proposed by obstetricians at the time of application. The primary outcome was failure of conversion of epidural labor analgesia to cesarean delivery anesthesia. Multivariable logistic regression analysis was performed to investigate the association between chorioamnionitis and failure of anesthesia for cesarean section.Results: Among the 180 parturients, it was found that 58 parturients (43.9%) fulfilled the criteria of chorioamnionitis. Failure of epidural conversion in the chorioamnionitis (+) group was significantly higher than that in the chorioamnionitis (-) group (46.6 % [27/58] vs. 18.9% [14/74], crude odds ratio = 3.7, 95% confidence interval 1.7-8.3). After adjustment for potential confounders (age, body mass index, multiparity, and duration for epidural labor analgesia), chorioamnionitis was found to be associated with failure of anesthesia for cesarean sections (adjusted odds ratio = 3.6, 95% confidence interval 1.6-8.4). Conclusions: Chorioamnionitis is associated with the failed conversion of epidural labor analgesia to cesarean delivery anesthesia.
Blood Lead alters the anemia status of malaria infected children in Katanga Kampala Uganda.
Authors: Mukisa Ambrose K , Kasozi Denis M , Aguttu Claire , Vuzi Peter C. , Kyambadde Joseph
Published: August 2020

Background Uganda, like other malaria endemic countries, childhood anemia due to malaria infection, malnutrition and social disadvantages remains a health challenge. Other contributing factors towards the pathogenesis of this disease like blood lead have not been fully explored. Persistent lead exposure accounts for one’s blood lead levels and other many health outcomes. Recent studies report elevated environmental lead levels in urban Uganda with anthropogenic activities including leaded paints, leaded fuels spillages, lead-contaminated air, water and soils listed as major sources. Blood lead (BL) alters iron bioavailability by competitively blocking iron absorption hence anemia. BL inhibits key enzymes ferrochelatase and aminolevulinic acid dehydratase (ALAD) involved in hemoglobin (Hb) biosynthesis resulting into elevated free erythrocyte protoporphyrin (FEP). Children in this area are generally anemic due chronic exposure to malaria parasites that thrive on their red blood cells for survival. Concomitant exposure to both malaria infection and lead pollution, exerbates the anemia status of these children. This study therefore aimed at expounding the anemia status of these Ugandan children simultaneously living exposed to both malaria infection and environmental lead pollution. Methods Briefly venous blood samples from 198 children were microscopically assayed for malaria parasite density, hemoglobin (Hb) concentrations by the cyanmethemoglobin method, BL levels by the standard atomic absorption spectrophotometric method and FEP levels by the standard fluorimetric method. Results A total of 151/198 (76.3%) children were analyzed with moderate anemia (Hb <10>5 g/dL) while 8/198 (4%) had severe anemia (<5 g/dL). They had means of BL levels (9.3 µg/dL), Hb (7.5 g/dL), FEP/Hb (8.3 µg/g) and parasite density (PD) (3.21×103 parasites / µL). There was weak negative correlation between PD and Hb (r = -0.231, R2= 0.15 P-value < 0.001), as compared to that between FEP/Hb and Hb (r = -0.6, R2=0.572 P-value=0.001). Conclusion Basing on this study’s findings, we conclude that BL is a significant contributor to anemia pathogenesis and therefore its co-existence with plasmodium malaria infection in the host exerbates the anemia status.Trial registration Not applicable
SARS-CoV-2 analysis on environmental surfaces collected in an intensive care unit. Keeping Ernest Shackleton´s spirit.
Authors: Escudero Dolores , Boga Jose Antonio , Fernández Javier , Forcelledo Lorena , Balboa Salvador , Albillos Rodrigo , Astola Iván , García-Prieto Emilio , Álvarez-Argüelles Marta Elena , Martín Gabriel , Jiménez Josu , Vázquez Fernando
Published: August 2020

Background Intensive care unit workers are at high risk of acquiring COVID-19 infection, specially when performing invasive techniques and certain procedures that generate aerosols (<5 µm). Therefore, one of the objectives of the health systems should be to implement safety practices to minimize the risk of contagion among these health professionals. Monitoring environmental contamination of SARS-CoV-2 may help to determine the potential of the environment as a transmission medium in an area highly exposed to SARS-CoV-2, such as an intensive care unit. The objective of the study was to analyze the environmental contamination by SARS-CoV-2 on surfaces collected in an intensive care unit, which is dedicated exclusively to the care of patients with COVID-19 and equipped with negative pressure of -10 pascals and an air change rate of 20 cycles per hour. Results A total of 102 samples (72 collected with pre-moistened swabs used for collection of nasopharyngeal exudates and 30 with moistened wipes used in the environmental microbiological control of the food industry) were obtained from ventilators, monitors, perfusion pumps, bed rails, lab benches, containers of personal protective equipment, computer keyboards and mice, telephones, workers' shoes, floor and other areas of close contact with COVID-19 patients and healthcare professionals who cared for them. The analysis by quantitative RT-PCR showed no detection of SARS-CoV-2 genome in environmental samples collected by any of the two methods described.Conclusions Presence of SARS-CoV-2 on the ICU surfaces could not be determined supporting that personal protection, decontamination procedures and negative pressure settings are effective in preventing environmental contamination and protecting the staff and patients inside intensive care units.
Localized spin-orbit polaron in magnetic Weyl semimetal Co3Sn2S2
Authors: Xing Yuqing , Shen Jianlei , Chen Hui , Huang Li , Gao Yuxiang , Zheng Qi , Zhang Yu-Yang , Li Geng , Hu Bin , Qian Guojian , Cao Lu , Zhang Xianli , Fan Peng , Ma Ruisong , Wang Qi , Yin Qiangwei , Lei Hechang , Ji Wei , Du Shixuan , Yang Haitao , Shen Chengmin , Lin X. , Liu Enke , Shen Baogen , Wang Ziqiang , Gao Hong-Jun
Published: August 2020

The kagome lattice Co3Sn2S2 exhibits the quintessential topological phenomena of a magnetic Weyl semimetal such as the chiral anomaly and Fermi-arc surface states. Probing its magnetic properties is crucial for understanding this correlated topological state. Here, using spin-polarized scanning tunneling microscopy/spectroscopy (STM/S) and non-contact atomic force microscopy (nc-AFM) combined with first-principle calculations, we report the discovery of localized spin-orbit polarons (SOPs) with three-fold rotation symmetry nucleated around single S-vacancies in Co3Sn2S2. The SOPs carry a magnetic moment and a large diamagnetic orbital magnetization of a possible topological origin associated relating to the diamagnetic circulating current around the S-vacancy. Appreciable magneto-elastic coupling of the SOP is detected by nc-AFM and STM. Our findings suggest that the SOPs can enhance magnetism and stability of the magnetic Weyl nodes for more robust time-reversal-symmetry-breaking topological phenomena. Controlled engineering of the SOPs may pave the way toward practical applications in functional quantum devices.
Comparison of prognostic impact of anatomic location of the pancreas on postoperative pancreatic fistula in laparoscopic and open gastrectomy
Authors: Kinoshita Jun , Yamaguchi Takahisa , Saito Hiroto , Moriyama Hideki , Shimada Mari , Terai Shiro , Okamoto Koichi , Nakanuma Shinichi , Makino Isamu , Nakamura Keishi , Tajima Hidehiro , Ninomiya Itasu , Fushida Sachio
Published: August 2020

Background
Postoperative pancreatic fistula (POPF) is a serious complication after gastric cancer surgery. The current study aimed to investigate the significance of the anatomic location of the pancreas as a predictor for POPF in both laparoscopic gastrectomy (LG) and open gastrectomy (OG).
Methods
In total, 233 patients with gastric cancer were assessed retrospectively. We measured the maximum vertical (P-L height; PLH) and horizontal length (P-L depth; PLD) between the upper border of pancreas and the root of left gastric artery on a preoperative CT in the sagittal direction. The maximum length of the vertical line between the surface of the pancreas and the aorta (P-A length), previously reported as prognostic factor of POPF, was also measured. We investigated the correlations between these parameters and the incidence of POPF in LG and OG groups.
Results
Among the patients in this study, 118 underwent OG and 115 underwent LG. In LG, the median PLH and P-A length in patients with POPF were significantly longer compared with those without POPF (p = 0.026, 0.034, respectively), but not in OG. There was no significant difference in the median PLD between the patients with or without POPF in both LG and OG. The multivariate analysis demonstrated that PLH (odds ratio [OR] 4.19, 95% confidence interval [CI] 1.57–11.3, P = 0.004) and P-A length (OR 4.06, 95%CI 1.05–15.7, P = 0.042] were independent factors for predicting POPF in LG. However, intraoperative blood loss (OR 2.55, 95%CI 1.05–6.18, P = 0.038) was extracted as an independent factor in OG. The median amylase level in the drained fluid (D-Amy) were significantly higher in patients with high PLH(≥ 12.4 mm) or high P-A length (≥ 45 mm) compared with those with low PLH or low P-A length in LG. However, there were no differences in the D-Amy levels by PLH or P-A length in OG patients.
Conclusions
The anatomic location of the pancreas is a specific and independent predictor of POPF in LG but not in OG. PLH is a simple parameter that can evaluate the anatomic position of the pancreas, and it may be useful for preventing POPF after LG.
Resilience and sense of coherence in first year medical students - a cross-sectional study
Authors: Luibl Lena , Traversari Julia , Paulsen Friedrich , Scholz Michael , Burger Pascal
Published: August 2020

Background: A broad range of high-quality studies show that medical students often have a significantly deteriorated mental health status. Although starting medical school with values comparable to the population average, only a few semesters later, medical undergraduates show increased rates of psychological risk states and some manifest mental illnesses, such as burnout and depression. In our survey we intentionally assessed mental health parameters from a salutogenetic, i.e. resource-oriented point of view. Methods: We examined first-year medical students in a cross-sectional study and assessed sense of coherence (SOC) and resilience as parameters from the salutogenesis model by Antonovsky in a structured way using validated, self-administered questionnaires. In total, we examined 236 students of human medicine, dentistry and molecular medicine at the Friedrich-Alexander-University Erlangen-Nürnberg (FAU).Results: Our analyses showed significantly higher values of resilience among male students compared to female students. In contrast, even though a significant correlation between resilience and SOC was observed, only a non-significantly lower value of SOC was found in female students. Compared to the population average our medical students in their first year of study showed significantly lower values for resilience and SOC. Conclusion: Resilience and SOC are known to correlate with psychological stress (burnout parameters) and depression. In order to keep protective factors like SOC and resilience in medical students at a good and healthy level we see the necessity to address that problem proactively and also from the teaching side. Integrating training focused on the preservation of the students´ own mental health into the medical curriculum from the beginning of university courses, and throughout the whole medical study course, is essential and should be an obligatory training goal. Based on our study results, we also deem it necessary to think about ways to adapt the measures for the gender-specific needs of our students, e.g. dependent on their biological gender.
Voltage hysteresis during lithiation/delithiation of graphite associated with meta-stable carbon stackings
Authors: Mercer Michael , Peng Chao , Soares Cindy , Hoster Harry , Kramer Denis
Published: August 2020

Cell voltage is a fundamental quantity used to monitor and control Li-ion batteries. The open circuit voltage (OCV) is of particular interest as it is believed to be a thermodynamic quantity, free of kinetic effects and history and, therefore, "simple" to interpret. Here we show that the OCV characteristics of graphite show hysteresis between charge and discharge that does not solely originate from Li dynamics and that the OCV is in fact history dependent. Combining First Principles calculations with temperature-controlled electrochemical measurements, we identify a residual hysteresis that persists even at elevated temperatures of greater than 50°C due to differences in the phase succession between charge and discharge. Experimental entropy profiling, as well as energies and volume changes determined from First Principles calculations, suggest that the residual hysteresis is associated with different host lattice stackings of carbon and is related to Li disorder across planes in stage II configurations.
Temporomandibular Joint Ankylosis Among Patients at Saint Paul’s Hospital Millennium Medical College, Ethiopia: a 9 Year Retrospective Study
Authors: Mekonnen Dereje , Gizaw Andamlak , Kebede Bruktawit
Published: August 2020

Background: Temporomandibular joint ankylosis (TMJA) is a gradually developing pathological condition manifested by a limited mouth opening. It can result in an extremely disabling situation that may affect mastication, swallowing, speech, oral hygiene, and facial cosmetic appearance. The present study was aimed to determine the pattern of TMJA at St. Paul’s Hospital millennium medical college (SPHMMC), Addis Ababa, Ethiopia.Methods: A retrospective descriptive study design was conducted at SPHMMC. All medical records of patients with the diagnosis of TMJA that visited the Maxillofacial Surgery unit from September 2010 through August 2019 were reviewed. Clinical data including age, sex, place of residency, duration of the case, etiology, clinical presentations, imaging results, the type of operation and complications after surgery were collected, and analyzed by using SPSS version 20.0 windows software computer program. Results: A total of 130 patients’ medical records were reviewed. Out of this, 95 were included in the study. 42(44.2%) of the TMJA case were males, while the remaining 53(55.8%) were females with a female to male ratio of 1.26:1. The most affected age group was 20 to 39 years 36(37.9%), followed by the age group of 30 to 39 years 33(34.7%). Trauma was identified as the most common cause of TMJA. Notably, bilateral ankylosis was more common than unilateral, and mandibular deformity (micrognathia) was the most common deformity observed. The majority 52(54.7%) of TMJA patients were treated with Gap arthroplasty.Conclusions: Trauma was identified as the main cause of TMJA. The majority of TMJA cases were surgically treated with Gap arthroplasty with almost no postoperative complications. Thus early detection and intervention to release the ankylosed joint is needed to improve patient’s quality of life.
The Immediate Effect of COVID-19 Pandemic on Children and Adolescents with Obsessive Compulsive Disorder
Authors: Nissen Judith Becker , Højgaard David , Thomsen Per Hove
Published: August 2020

BackgroundObsessive compulsive disorder (OCD) is a distressing psychiatric disorder. Traumas may trigger or aggravate OCD symptoms. COVID-19 pandemic has coursed a global crisis and has been associated with onset of psychiatric disorders in adults. Little is known about children/adolescents with OCD. The present study aimed to examine how children/adolescents with OCD react towards COVID-19 crisis. MethodsA questionnaire was distributed to two separate groups of children/adolescents. One group was a clinical group newly diagnosed at a specialized OCD clinic. All the children/adolescents had a current close contact to a therapist or doctor. The other group was a survey group identified through the Danish OCD Association. Most of these children/adolescents were diagnosed years ago, and their primary treatment was completed. For the clinical group, data from patient files was available. ResultsIn both groups, but most pronounced in the survey group, participants experienced a worsening of their OCD, anxiety, and depressive symptoms. The aggravation of OCD correlated with the worsening of anxiety, depressive symptoms, and the extent of avoidance behavior. For both groups, OCD aggressive symptoms predicted a significant worsening. Poor baseline insight showed a trend to predict a symptom worsening. The worsening was most pronounced in children with early age of onset and a family history of attention deficit hyperactivity disorder.ConclusionsTo our knowledge, this is the first study examining the effect of COVID-19 in children/adolescents with OCD. The effect was examined in two separate populations strengthening the findings. The study points towards an influence of the OCD phenotype differentiating the early-onset group from the adult group, baseline insight suggesting a continued vulnerability, and a family history of psychiatric disorders. Trial registrationThe study is approved by the Danish Data Protection Agency (1-16-02-147-20) registered 1st of April 2020. Oral and written information was given to parents and patients and written consent from patients over 15 years and parents were received.
Expression profile analysis of Differentially Expressed Genes in Human Coronary Artery Endothelial Cells Induced by Serum from Kawasaki Disease: A preliminary study
Authors: Fan Xue , Li Meng , Xiao Min , Liu Cong , Xu Mingguo
Published: August 2020

Background: Kawasaki disease (KD) leads to coronary artery damage and the etiology of KD is unknown. The present study was designed to explore the differentially expressed genes (DEGs) in KD serum-induced human coronary artery endothelial cells (HCAECs) by RNA-sequence (RNA-seq). Methods: HCAECs were stimulated with serum (15% (v/v)), which were collected from 20 healthy children and 20 KD patients, for 24 hours. DEGs were then detected and analyzed by RNA-seq and bioinformatics analysis. Results: The expression of SMAD1, SMAD6, CD34, CXCL1, PITX2, and APLN was validated by qPCR. 102 genes, 59 up-regulated and 43 down-regulated genes, were significantly differentially expressed in KD groups. GO enrichment analysis showed that DEGs were enriched in cellular response to cytokines, cytokine-mediated signaling pathway, and regulation of immune cells migration and chemotaxis. KEGG signaling pathway analysis showed that DEGs were mainly involved in cytokine−cytokine receptor interaction, chemokine signaling pathway, and TGF−β signaling pathway. Besides, the mRNA expression levels of SMAD1, SMAD6, CD34, CXCL1, and APLN in the KD group were signiﬁcantly up-regulated compared with the normal group, whilePITX2 was significantly down-regulated. Conclusion: 102 DEGs in KD serum-induced HCAECs were identified, and six new targets were proposed as potential indicators of KD.
Microscopic research on the olfactory organ of the Far Eastern brook lamprey Lethenteron reissneri (Pisces, Petromyzontidae)
Authors: Kim Hyun-Tae , Park Jong-Young
Published: August 2020

The olfactory anatomy and histology of Lethenteron reissneri were researched using a stereo microscope, a light microscope, and a scanning electron microscope. As in other lampreys, it shows same characters as follows: i) a single olfactory organ, ii) a single tubular nostril, iii) a single olfactory chamber with gourd-like form, iv) a nasal valve, v) a nasopharyngeal pouch, vi) a sensory epithelium (SE) of continuous distribution, vii) a supporting cells with numerous long cilia, viii) an accessory olfactory organ. However, the description of a pseudostratified columnar layer in the SE and NSE is a first record, not reported in sea lamprey Petromyzon marinus. In particular, both 19 to 20 lamellae in number and olfactory receptor neuron’s quarter ciliary length of the knob diameter differ from those of P. marinus. From these results, it might be considered that the olfactory organ of L. reissneri shows well adaptive structure of a primitive fish to slow flowing water with gravel, pebbles, and sand and a hiding habit into sand bottom at daytime. The lamellar number and neuron’s ciliary length may be a meaningful taxonomic character for the class Petromyzonida.
Achieving SDG 3.8.2: Financial Protection Against Catastrophic Health Expenditure in Malaysia
Authors: Sukeri Surianti , Sayuti Muaz
Published: August 2020

Background: The Sustainable Development Goal (SDG) 3.8.2 is one of the two indicators to monitor a country's progress towards universal health coverage. It concerns the financial protection against catastrophic spending on health based on the budget share approach. The purpose of this study is twofold: 1) to measure SDG 3.8.2 on the proportion of households with catastrophic health expenditure (CHE), and 2) to determine households at risk of CHEMethods: A cross-sectional study was conducted using secondary data from the 2015/2016 Household Expenditure Survey. The inclusion criterion was Malaysian households with some health spending in the past 12 months before the date of the survey. The World Health Organization method of calculating CHE was applied in the calculation, and a threshold of 10% out-of-pocket health spending from total household expenditures was used to determine CHE. Data were analysed descriptively, and multiple logistic regression was used to determine factors associated with CHE.Results: A total of 13015 households were involved in the study. The proportion of CHE was 2.8%. Four associated factors that were statistically significant were female-headed household (Adjusted OR 1.6; CI 1.25, 2.03; p-value <0.001), household that lived in rural area (Adjusted OR 1.29; 95% CI 1.04, 1.61; p-value =0.022), small household size (Adjusted OR 2.4; 95% CI 1.81, 3.18; p-value <0.001) and head of household aged below 60 years old (Adjusted OR2.34; 95% CI 1.81, 3.18; p-value <0.001).Conclusions: The low proportion of CHE revealed that Malaysia is on the right track towards achieving SDG 3.8 on universal health coverage status by 2030. However there is an increasing trend in the proportion of CHE. Households at risk of CHE require financial protection to afford healthcare and safety net measures to prevent from spiralling further into the vicious cycle of illness and poverty.
Respiratory syncytial virus prophylaxis for prevention of recurrent childhood wheeze and asthma: a systematic review
Authors: Quinn Lauren , Shields Michael D , Sinha Ian , Groves Helen E
Published: August 2020

Background Acute bronchiolitis caused by Respiratory Syncytial Virus (RSV) has been associated with greater risk of recurrent wheezing and asthma. However, it is unclear whether this association is causal. RSV-specific monoclonal antibodies have been shown to reduce RSV-related hospitalisations in high-risk infants, but the longer term follow-up has given conflicting evidence for prevention of recurrent wheeze or asthma.Objective We performed a systematic review and meta-analysis to determine whether monoclonal antibody prophylaxis against RSV-bronchiolitis reduces the risk of subsequent recurrent wheeze or asthma. If so, this may support the hypothesis of causality.Methods Studies were identified via an online database search. Manufacturers of monoclonal antibodies were contacted directly for unpublished data. The intervention of interest was RSV monoclonal antibody prophylaxis and the primary outcome measure was recurrent wheeze and/or asthma. Studies were screened according to inclusion/exclusion criteria. Included studies were evaluated for quality and assessed for bias independently by 3 reviewers using the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE) approach. Results were extracted into 2 × 2 outcome tables and a meta-analysis carried out producing forest plots based on relative risk. Heterogeneity was assessed using the I2 statistic.Results 11,195 infants were included in the meta-analysis, consisting of eight studies (2 randomised controlled trials). The overall result demonstrated a non-statistically significant reduction in relative risk of developing recurrent wheeze or asthma (RR 0.60; 95% CI 0.31 to 1.16). Study quality was generally low with evidence of publication bias and statistical heterogeneity. Sub-group analysis excluding studies deemed to be ‘very low’ quality showed a relative risk of 0.42 (95% CI: 0.22 to 0.80, p = 0.008). A further sub-group analysis for infants aged 32 to < 36 weeks showed a statistically significant relative risk of 0.35 (95% CI: 0.14 to 0.86, p = 0.02).Discussion We did not identify an overall statistically significant benefit. However, our two subgroup analyses did find statistically significant benefits of monoclonal antibody therapy on the risk of recurrent wheeze and asthma. The main limitation of this study is the lack of high quality randomised controlled trials, highlighting the need for more research in this field.
CD83 Expression Regulates Antibody Production in Response to Influenza A Virus Infection
Authors: Akauliya Madhav , Gautam Avishekh , Maharjan Sony , Park Byoung Kwon , Kim Jinsoo , Kwon Hyung-Joo
Published: August 2020

Background: CD83 is known to regulate lymphocyte maturation, activation, homeostasis, and antibody response to immunization and infection. While CD83 has a major part in B cell function, its role in influenza A virus infection has not yet been investigated. Methods: We investigated the role of CD83 using C57BL/6J wild type mice and CD83 knockout (KO) mice after intraperitoneal administration of the influenza A/WSN/1933 virus. We analyzed cells of the peritoneal cavity, splenocytes, and cells of the bone marrow with FACS to investigate CD83 expression and cell population change in response to the virus infection. ELISA was performed with sera and peritoneal cavity fluids to detect A/WSN/1933 virus-specific IgG and the subclasses of IgG. Results: FACS analysis data showed a transient but distinct induction of CD83 expression in the peritoneal B cells of wild type mice. CD83 KO mice exhibited a delayed recovery of B cells in the bone marrow after influenza virus infection and overall, a smaller T cell population compared to wild type mice. The peritoneal cavity and serum of the wild type mice contained a high titer of IgG within 14 days after infection, whereas the CD83 KO mice had a very low titer of IgG. Conclusions: These results show the importance of CD83 in lymphocytes homeostasis and antibody production during influenza A virus infection.
Anti-Platelet Aggregation of Panax Notoginseng Triol Saponins by regulating GP1BA for Ischemic Stroke Therapy
Authors: Xu Zhiyi , Xu Yang , Xie Xiaofang , Tian Yin , Sui Junhui , Sun Yong , Lin Dasheng , Gao Xing , Peng Cheng , Fan Yujiang
Published: August 2020

Background: Panax notoginseng triol saponins (PTS) has been used clinically for ischemic stroke therapy (IST) by potential anti-platelet aggregation and neuro-protective in China for more than sixteen years, but its mechanisms are still unclear. In this study, anti-platelet aggregation related protein analysis and computer simulations of drug-protein binding interactions were performed for exploring mechanism of PTS against ischemic stroke by ischemia reperfusion model. Methods: Three doses of PTS were administered orally in middle cerebral artery occlusion (MCAO) model rats; Panax notoginseng total saponins (PNS) and the combination of PTS and aspirin were chosen as comparison. The cerebral infarct size and water content in brain tissue, histomorphological observation, related factors and platelet receptor expression in serum, as well as binding affinity of PTS and platelet adhesion receptor were detected to evaluate therapeutic effect and explore possible mechanisms of anti-platelet aggregation. Results: Compared with PNS, PTS showed stronger and more extensive anti-platelet aggregation effect on MCAO model rats. The combination of PTS and aspirin might reduce the gastrointestinal adverse reactions by regulating TXA2/PGI2 ratio. However, PTS could reduce the chance of VWF-mediated platelet adhesion to damaged vascular endothelium, and thus enhance the probability of anti-platelet aggregation and anti-thrombosis under pathological conditions.Conclusion: Our results showed that GP1BA was closely related with anti-platelet aggregation action of PTS, which provided new scientific evidences for its clinical application.
Establishing percentiles for blood pressure based on absolute height for children and adolescents
Authors: Cossio-Bolaños Marco , Vidal-Espinoza Ruben , de Campos Felipe Castelli Correia , Sulla-Torres Jose , Cossio-Bolaños Wilbert , Andruske Cynthia , Urra-Albornoz Camilo , Gomez-Campos Rossana
Published: August 2020

Background: Evaluating blood pressure (BP) is one element for diagnosing and preventing disease in student populations. The objectives of this research were to a) verify the range of height for measuring BP adjusted for student populations and b) propose percentiles for evaluating BP based on height.Methods: A cross-sectional study was carried out with 3,013 students. Weight, height, and diastolic (DBP) and systolic (SBP) blood pressure were evaluated. Body Mass Index (BMI) was calculated. Height ranges of 5 and 10 cm were generated.Results: R2 values for height ranges of 5 cm consisted of [normotensive: DBP (R2=10 to 13%) and SBP (R2=14 to 20%) and for hypertensive: DBP (R2=0.07 to 15%) and SBP (R2=29 to 32%)]. For height ranges of 10cm, values included: [normotensive: DBP (R2=10 to 15%) and SBP (R2=15 to 21%) and for hypertensive: DBP (R2= 0.07 to 16%) and SBP (R2=29 to 35%)]. For 5 cm height ranges, diferences occurred between both sexes for DBP (in 5 height ranges from 123 to 148 cm and 158 to 168 cm) and for the SBP ( in 6 height ranges from 128 to 148 cm and from 158 to 168 cm). In the 10 cm categories, diferences appeared in DBP (from 138 to 148 cm) and in the SBP (from 158 to 168 cm).Conclusion: Height is a determinant for evaluating blood pressure, and height ranges of 10 cm are more suitable for children and adolescents. The proposed percentiles based on height ranges allowed assessment of the DBP and SBP suggest their use in epidemiological and educational contexts.
Fine structure of the intercalated disc and cardiac junctions in the black widow spider Latrodectus mactans
Authors: SUN Yan , LEE Seung-Min , KU Bon-Jin , Moon Myung-Jin
Published: August 2020

Arthropods have an open circulatory system with a simple tubular heart, so it has been estimated that the contractile pumping structure of the cardiac muscle will be less efficient than that of vertebrates. Nevertheless, certain arthropods are known to have far superior properties and characteristics than vertebrates, so we investigated the fine structural features of intercalated discs and cardiac junctions of cardiac muscle cells in the black widow spider Latrodectus mactans. Characteristically, the spider cardiac muscle has typical striated features and represents a functional syncytium that supports multiple connections to adjacent cells by intercalated discs. Histologically, the boundary lamina of each sarcolemma connects to the basement membrane to form an elastic sheath, and the extracellular matrix allows the cells to be anchored to other tissues. Since the intercalated disc is also part of sarcolemma, it contains gap junctions for depolarization and desmosomes that keep the fibers together during cardiac muscle contraction. Furthermore, fascia adherens and macula adherens (desmosomes) were also identified as cell junctions in both sarcolemma and intercalated discs. To enable the coordinated heartbeat of the cardiac muscle, the muscle fibers have neuronal innervations by multiple axons from the motor ganglion.
Possible mechanisms of the hypoglycaemic effect of artesunate: Gender implication
Authors: Alagbonsi Abdullateef Isiaka , Salman Toyin Mohammad , Sulaiman Sheu Oluwadare , Kafayat Adedini , Kebu Susan
Published: August 2020

Background
Artesunate is an antimalarial drug that affects glucose homeostasis but the mechanism of its glucose-modulating effect is not fully understood especially with gender implication, which is the information this study sought to provide.
Methods
Twenty-five (25) male and 25 female rats were separately and blindly allocated into five identical groups (n = 5/group). Group I (control) received 0.2 ml/kg distilled water. Groups II and III both received 2.90 mg/kg artesunate on day one, but 1.45 mg/kg from day two till day five and day fifteen respectively. Groups IV and V both received 8.70 mg/kg artesunate on day one, but 4.35 mg/kg artesunate from day two till day five and day fifteen respectively.
Results
In male rats, the blood glucose was reduced by low and high doses of artesunate at 5 days but increased by high dose at 15 days. Glucose was reduced in female rats but unchanged in male rats by low dose artesunate at 15 days. Artesunate increased glycogen concentration at short duration which normalised at long duration in both genders. Artesunate increased G6P concentration only in male rats at 15 days but reduced G6Pase activity in male and female rats (except in those that received low and high doses of artesunate for 15 days). Artesunate increased insulin only in male rats treated with low dose artesunate for 5 days. Artesunate increased cortisol concentration in male but reduced it in female rats. Artesunate decreased glucagon concentration except in female rats treated with high dose for 5 days. Artesunate increased oestrogen concentration in male rats that received low dose artesunate for 5 days but reduced it in female rats that received high dose for 15 days. Except in male rats that received high dose of artesunate for 15 days where testosterone was increased, artesunate did not affect testosterone concentration in all other male and female groups
Conclusions
The present study suggests that artesunate causes reduction in plasma glucose by reducing plasma glucagon concentrations and inhibiting liver glycogenolysis via inhibition of G6Pase activity in both sexes. In addition, increase in plasma insulin concentration contributed to the reduction in blood glucose caused by artesunate in male but not female rats; and artesunate-induced increase in G6P, a substrate for G6PD, could enhance NADPH generation and antioxidant enzyme activation in male rats.
Wearable Monitoring and Predicting System for Knee Joint Fatigue Based on Curvature and Pressure Sensing
Authors: Xin Jiawei , Chen Jialun , Huang Xuanyu , Pan Xiaodong , Zou Tengyue
Published: August 2020

Background

Knee injury is always a trouble for people in daily life. It not only threatens the career of an athlete but also affects a normal engineer through morning running. The injury of the knee joint is found to be directly related to the fatigue caused by excessive exercise.
Methods

An economical embedded system with a designed acceleration-weighted curve fitting method was developed to estimate and predict the knee fatigue state. Then the warning message and recommended lasting time were sent to users to avoid excessive exercise. 24 healthy volunteers were involved in the experiments to verify the effectiveness of the system compared to human perception.
Results

Only using human perception to prevent knee joint fatigue had a risk of failure while the designed wearable system could protect knee successfully. It was also found that the knee of female was more likely to be injured than the one of male in intense exercises and a high BMI value could influence the risk of knee injuries during sports. However, a short break in sports could significantly extend the healthy time for knee.
Conclusions

Early warning from the specially designed embedded system can successfully help people avoid knee joint fatigue and injuries during exercises, such as running, badminton, table tennis and basketball.
Allele-specific expression reveals the phenotypic differences between thin- and fat-tailed sheep
Authors: Shao Junjie , He Sangang , Pan Xiangyu , Yang Zhirui , Nanaei Hojjat Asadollahpour , Chen Lei , Li Ran , Wang Yu , Gao Shan , Xu Han , Liu Mingjun , Jiang Yu
Published: August 2020

Background: The thin-tailed sheep breeds from Europe and the fat-tailed sheep breeds from China exhibit distinct phenotypic differences in fat deposition and meat production traits. However, the molecular mechanisms underlying gene expression related to these phenotypic differences are not well understood. Allele-specific expression (ASE) refers to the significant imbalance of expression levels of two parental alleles. Characterization of such events in F1 hybrid offspring generated from these two groups of sheep breeds can minimize the external factors influencing gene expression and reveal the variants with a cis -regulatory effect on gene expression. The aim of the present study was to investigate the genetic factors that influence different fat-deposition and meat production traits between thin- and fat-tailed sheep.Results: Fifteen F1 hybrids were generated from crosses between Texel and Kazakh sheep as the representative phenotypes of thin- and fat-tailed breeds, respectively. Totally, 33 whole genomes from F1 individuals and their parents were sequenced with an average depth of ~17.21× coverage per sample. ASE analysis results from 70 RNA-seq samples of adipose and skeleton muscle tissues showed 128 ASE candidate genes were related to the function of fat deposition and meat production traits. A genome-wide scan of selective sweeps was also conducted between these two groups of sheep breeds in an effort to identify genomic regions related to fat deposition and meat production, respectively. We detected signatures of selection in ASE genes associated with fat deposition (e.g., PDGFD ) and meat production traits (e.g., LRCC2 ). Further analysis suggested that PDGFD and LRCC2 genes were speculated to be causative genes for fat deposition and meat production traits in sheep, respectively. Furthermore, AMPK signaling pathway was significantly enriched in ASE genes related to fatty acid biosynthesis in both adipose and skeleton muscle tissues, while PPAR signaling pathway was significantly enriched in ASE genes related to lipid metabolism in adipose tissue. Conclusions: Our finding illustrates that the expression of identified ASE genes could potentially lead to the differences in traits of fat deposition and meat production between thin- and fat-tailed sheep. Keywords: allele-specific expression, phenotypic difference, thin- and fat-tailed sheep, whole-genome sequencing, transcriptome
Postprandial Effects of Macronutrient Composition Meals on Metabolic Responses and Arterial Stiffness Indexes in Lean and Obese Men Adults; A Protocol Study
Authors: Firouzi Safieh , Rezvani Reza , Pahlavani Naseh , Jarahi Lida , Navashenaq Jamshid Gholizadeh , Ranjbar Golnaz , Malekahmadi Mahsa , Taherzadeh Zhila , Safarian Mohammad
Published: August 2020

Background: Prior studies have shown that meal composition is capable of effect on metabolic response and arterial stiffness indexes. Objective: A three-phase parallel study will be designed to investigate the effects of meal composition on metabolic parameters and arterial stiffness indexes among lean and obese adult. The planned study protocol will be presented.Methods/design: This is a pilot parallel clinical trial targeting adults (aged 18–35 years, free from any diseases) will be selected by inclusion and exclusion criteria at Mashhad University Medical Sciences. Each subject will complete three interventions with a washout period of one week: high carbohydrate, high protein and high fat meal. The postprandial effect will be assessed during 360 minutes from each meal including energy expenditure component (such as resting energy expenditure, thermic effect of feeding, respiratory quotient and substrate oxidation) and arterial stiffness indexes (such as augmentation index and pulse wave velocity) and blood sampling.Results: The study will be conducted from September 2020 to January 2021 (individual N=20). Assessment of intervention outcomes will be done in 6 hours after intervention.Conclusions: The differences in postprandial responses due to different meal composition could affect the metabolic and vascular parameters. This could provide necessary information for the establishment of new strategies in terms of nutritional education and metabolic and vascular improvement.Trial Registration: Iranian Registry of Clinical Trials: IRCT20190818044552N1. Registered on August 26, 2019