bluuebunny/crossref_metadata_2025 huggingface dataset:
Obtención de un modelo de minería de datos aplicado a la deserción universitaria del programa de Ingeniería de Sistemas de la Universidad de Cundinamarca
Authors: Ayala-Yaguara Holmes Yesid , Valenzuela-Sabogal Gina Maribel , Espinosa-García Alexander
Published: October 2020

En el presente artículo se describe la obtención de un modelo de minería de datos aplicado al problema de la deserción universitaria en el programa de Ingeniería de Sistemas de la Universidad de Cundinamarca, extensión Facatativá. El modelo se estructuró mediante la metodología de minería de datos KDD (knowledge discovery in databases) haciendo uso del lenguaje de programación Python, la librería de procesamiento de datos Pandas y de machine learning Sklearn. Para el proceso se tuvieron en cuenta problemas adicionales al proceso de minería, como, por ejemplo, la alta dimensionalidad, por lo cual se aplicaron los métodos de selección de las variables estadístico univariado, feature importance y SelectFromModel (Sklearn). En el proyecto se seleccionaron cinco técnicas de minería de datos para evaluarlas: vecinos más cercanos (K nearest neighbors, KNN), árboles de decisión (decision tree, DT), árboles aleatorios (random forest, RF), regresión logística (logistic regression, LR) y máquinas de vectores soporte (support vector machines, SVM). Respecto a la selección del modelo final se evaluaron los resultados de cada modelo en las métricas de precisión, matriz de confusión y métricas adicionales de la matriz de confusión. Por último, se ajustaron los parámetros del modelo seleccionado y se evaluó la generalización del modelo al graficar su curva de aprendizaje.
Serum miR-27a is a biomarker for prognosis of non-small cell lung cancer patients receiving chemotherapy
Authors: Xie Erfu , Ji Yazhou , Lin Mingxin , Jin Yuexinzi , Zhang Shichang , Huang Lei , Sun Ruihong , Wang Fang , Pan Shiyang
Published: October 2020

Background: Lung cancer has a high incidence and a 5-year survival rate of less than 15%. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancer cases. Chemotherapy and immunotherapy are the most frequently used alternative treatments for patients with advanced-stage NSCLC in whom surgery failed. Previous studies have suggested that miR-27a is involved in cancer development and progression. The purpose of this study was to investigate the clinical value of miR-27a in the prognosis of NSCLC patients after chemotherapy.
Methods: Flow cytometry was used to detect the apoptosis rate of SPC-A1 cells treated with optical cisplatin at different times. Simultaneously, the expression of miR-27a in supernatants and cells was detected. Fifty-two newly diagnosed NSCLC patients were recruited. All patients received gemcitabine and cisplatin as first-line chemotherapy and docetaxel as second-line chemotherapy. At the end of every chemotherapy cycle, a therapeutic evaluation was performed according to the RECIST criteria. The expression of serum miR-27a was detected in each cycle.
Results: After treatment with 2.5 μg/mL cisplatin, the apoptosis rates of SPC-A1 cells were significantly greater than those of the paired untreated control groups at 12, 24, 48 and 72 h. The expression of miR-27a in supernatants and cells was also consistent with the apoptosis rate and changed a time-dependent manner. The chi-square test showed that an increase in miR-27a after chemotherapy was more common in patients who achieved partial response (PR) than in those who achieved no response (NR) (61.5% vs 30.8%, P =0.026). Kaplan–Meier survival analysis indicated that patients with decreased miR-27a levels had poorer outcomes than those with increased miR-27a levels ( P <0.05). Furthermore, dynamic changes in serum miR-27a with a gradual increasing trend during chemotherapy predicted a good prognosis.
Conclusions: Collectively, our results suggest that miR-27a is involved in the apoptosis of lung cancer cells and that serum miR-27a levels are related to the prognosis of NSCLC patients. The expression levels of miR-27a in the serum may be an independent predictor for the prognosis of NSCLC.
Impact of immediate postpartum insertion of TCu380A on the quantity and duration of lochia discharges in Tanzania
Authors: Muganyizi Projestine Selestine , Kimario Grasiana Festus , Rwegoshora France John , Paul Patrick Ponsian , Makins Anita
Published: October 2020

BackgroundThe insertion of Intrauterine Contraceptive Device (PPIUD) for the purpose of contraception immediately after delivery is becoming popular in countries where the use of IUD for contraception has been extremely low. Since 2015, Tanzania implemented the initiative by the International Federation of Gynecology and Obstetrics (FIGO) to institutionalize PPIUD. As a result of capacity building and information delivery under the initiative, there have been increased uptake of the method. Working in this context, the focus of the study was to generate evidence on the effect of TCu380A IUD on amount and duration of lochia and equip service providers with evidence-based knowledge which can help them in counselling their PPIUD clients. ObjectiveEstablish impact of postpartum TCu380A on amount and duration of lochia.Methods A prospective cohort study of delivered women in two teaching hospitals in Tanzania with immediate insertion of TCu380A or without use of postpartum contraception in 2018. TCu380A models; Optima (Injeflex Co. Brazil) and Pregna (Pregna International, Chakan, India) were used. Follow-up was done by weekly calls and examination at 6th week. Lochia was estimated by Likert Scale 0-4 relative to the amount of lochia on the delivery day. An estimated 250 women sample (125 each group) would give 80% power to detect a desired 20% difference in the proportion of women with prolonged lochia discharges among the Exposed and Unexposed groups. Data analysis was by SPSS. Results 260 women were analysed, 127 Exposed and 133 Unexposed. Medical complaints were reported by 41 (28.9%) Exposed and 37 Unexposed (27.8%), p=0.655. Lack of dryness by end of 6th week was to 31 (23.3%) Exposed and 9 (7.1%) Unexposed, p<0.001. Exposed had higher weekly mean lochia scores throughout with the difference most marked in 5th week (3.556 Versus 2.039, p<0.001) and 6th week (1.44 Versus 0.449, p˂0.001) . Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of PPIUD clients’ needs to be informed about the possibility of delayed dryness of lochia at time of counseling are discussed.
Increased E2F2 predicts poor prognosis in patients with HCC based on TCGA data
Authors: Zeng Zhili , Cao Zebiao , Tang Ying
Published: October 2020

Background: The E2F family of transcription factor 2 (E2F2) plays an important role in the development and progression of various tumors, but its association with hepatocellular carcinoma (HCC) remains unknown. Our study aimed to investigate the role and clinical significance of E2F2 in HCC.Methods: HCC raw data were extracted from The Cancer Genome Atlas (TCGA). Wilcoxon signed-rank test, Kruskal-Wallis test and logistic regression were applied to analyze the relationship between the expression of E2F2 and clinicopathologic characteristics. Cox regression and Kaplan-Meier were employed to evaluate the correlation between clinicopathologic features and survival. The biological function of E2F2 was annotated by Gene Set Enrichment Analysis (GSEA).Results: The expression of E2F2 was increased in HCC samples. The expression of elevated E2F2 in HCC samples was prominently correlated with histologic grade (OR =2.62 for G3-4 vs. G1-2, p=1.80E-05), clinical stage (OR =1.74 for III-IV vs. I-II, p=0.03), T (OR =1.64 for T3-4 vs.T1-2, p=0.04), tumor status (OR =1.88 for with tumor vs. tumor free, p= 3.79E-03), plasma alpha fetoprotein (AFP) value (OR =3.18 for AFP≥400 vs AFP＜20, p= 2.16E-04; OR=2.50 for 20≤AFP＜400 vs AFP＜20, p=2.56E-03). Increased E2F2 had an unfavorable OS (p=7.468e−05), PFI (p=3.183e−05), DFI (p=0.001), DSS (p=4.172e−05). Elevated E2F2 was independently bound up with OS (p =0.004, hazard ratio [HR]= 2.4 (95% CI [1.3-4.2])), DFI (P =0.029, hazard ratio [HR] = 2.0 (95% CI [1.1-3.7])) and PFI (P =0.005, hazard ratio [HR] = 2.2 (95% CI [1.3-3.9])). GSEA disclosed that cell circle, RNA degradation, pyrimidine metabolism, base excision repair, aminoacyl tRNA biosynthesis, DNA replication, p53 signaling pathway, nucleotide excision repair, ubiquitin-mediated proteolysis, citrate cycle TCA cycle were notably enriched in E2F2 high expression phenotype.Conclusions: Elevated E2F2 can be a promising independent prognostic biomarker and therapeutic target for HCC. Additionally, cell cycle, pyrimidine metabolism, DNA replication, p53 signaling pathway, ubiquitin-mediated proteolysis, the citrate cycle TCA cycle may be the key pathway by which E2F2 participates in the initial and progression of HCC.
Psychosocial Support Interventions for Improved Adherence and Retention in ART care for Young People Living with HIV (10-24 years): A Scoping Review
Authors: Okonji Emeka Francis , Mukumbang Ferdinand C. , Orth Zaida , Vickerman-Delport Shelley A. , Wyk Brian Van
Published: October 2020

Background: Mental health disorders such as high levels of anxiety, isolation, depression and suicide ideation reported among young people living with HIV (10-24 years; YPLWH) contribute significantly to poor medication adherence and retention in care. While there is evidence supporting the role of psychosocial support interventions in promoting adherence and retention in antiretroviral treatment (ART) among adults living with HIV, there is little evidence on the role of psychosocial support on medication adherence among YPLWH. This scoping review was designed to identify and classify the types and effects of psychosocial support interventions designed to improve adherence and retention in ART among adolescents and young people living with HIV globally.Method: We searched six electronic databases (i.e., Scopus, Pubmed and EBSCOHost (Academic Search Premier, CINAHL, Psycarticles and Medline). Six relevant articles published between 2011 and 2019 met our inclusion criteria. We extracted information relevant to the nature and outcomes of the reported interventions using thematic content analysis informed by the Population, Intervention, comparison, outcome, and time (PICOT) framework.Results: Four distinctive treatment modalities that focused on improving ART adherence and retention in care were identified: individual counselling, support groups, family-centered services, and treatment supporters.Conclusion: There is a dearth of psychosocial support interventions to improve adherence and retention in ART amongst adolescents and young adults living with HIV. Future research and programming should seek to address psychosocial support interventions or approaches specifically designed to address the needs of adolescents and young adults living with HIV.PROSPERO: Registration CRD42018105057
Epidemiology, Clinical Characteristics, and Outcomes of a Large Cohort of COVID-19 Outpatients in Michigan
Authors: Halalau Alexandra , Odish Fadi , Imam Zaid , Sharrak Aryana , Brickner Evan , Lee Paul B. , Foglesong Adam , Michel Adrian , Gill Inayat , Qu Lihua , Abbas Amr E. , Carpenter Christopher
Published: October 2020

Background: Most individuals with COVID-19 do not initially demonstrate severe features requiring hospitalization. Understanding this population’s epidemiological and clinical characteristics to allow outcome anticipation is crucial in healthcare resource allocation. We aim at describing the epidemiology, clinical characteristics and associated outcomes of high-risk patients diagnosed with COVID-19 at the largest healthcare system in Michigan.Methods: Retrospective, multicenter (8 hospitals) study reporting on 821 patients diagnosed with COVID-19 by real-time reverse transcriptase–polymerase chain reaction (RT-PCR) assay of nasopharyngeal swabs and discharged home to self-isolate after evaluation in Emergency Departments (EDs) within Beaumont Health System in March, 2020. Outcomes were collected through April 14, 2020, with a minimum of 12 day follow up and included subsequent ED visit, admission status, and mortality.Results: Of the 821 patients, mean age was 49.3 (SD 15.7), 46.8% were male and 55.1% were African-American. Cough was the most frequent symptom in 78.2% of patients with a median duration of 3 days (IQR 2-7), and other symptoms included fever 62.1%, rhinorrhea or nasal congestion 35.1% and dyspnea 31.2%. ACEI/ARBs usage was reported in 28.7% patients and 34.0% had diabetes mellitus. Return to the ED for re-evaluation was reported in 19.2% of patients from whom 54.4% were admitted. The patients eventually admitted to the hospital were older (mean age 54.4 vs 48.7, p=.002), had higher BMI (35.4 vs 31.9, p=.004), were more likely male (58.1% vs 46.8%, p=.026), and more likely to have hypertension (52.3% vs 29.4%, p<0.001), diabetes mellitus (74.4% vs 29.3%, p<0.001) or prediabetes (25.6% vs 8.4%, p<0.001), COPD (39.5% vs 5.4%, p<0.001), and OSA (36% vs 19%, p<0.001). The overall mortality rate was 1.3%.Conclusions:We found that 80.8% of patients did not return to the ED for re-evaluation. Sending patients with COVID-19 home if they experience mild symptoms is a safe approach for most patients and would likely mitigate some of the financial and staffing pressures on healthcare systems.
Comparative analysis of titanium coating on Cobalt Chrome alloy in vitro & vivo- direct metal fabrication vs. plasma spraying
Authors: Suh Dongwhan , Jo Woo Lam , Kim Seung Chan , Kim Yongsik , Kwon Soon Yong , Lim Youngwook
Published: October 2020

Background Titanium surface coating on Cobalt-Chromium (CoCr) alloy has characteristic desirable for orthopedic implant; strength, osteointegrative capability, biocompatibility. Creating such coated surface takes challenging process and two dissimilar metals are not easily welded. In our study, we utilized additive manufacturing with 3D printing called direct metal fabrication (DMF) and compared it to plasma spraying method (TPS), to coat titanium onto CoCr alloy. We hypothesized that this would yield a coated surface quality as acceptable or better than already established method of plasma spraying. For this, we compared characteristics of titanium coated surfaces created by direct metal fabrication method (DMF) and titanium plasma spraying (TPS), both in-vitro & in-vivo, for (1) cell morphology, (2) confocal microscopy images of immunofluorescent assay of RUNX2 and fibronectin, (3) Quantification of cell proliferation rate, (4) push-out biomechanical test, and (5) bone histomorphometry.Method For in vitro study, human osteoblast cells were seeded onto the coated surfaces. Cellular morphology was observed with scanning electron microscope. Cellular proliferation was validated with ELISA, immunofluorescent assay. For in vivo study, coated rods were inserted into distal femur of rabbit and then harvested. The rods were biomechanically tested with push out test and observed for histomorphometry to evaluate microscopic bone to implant ratio.Result For cell morphology observation, lamellipodia and filopodia, a cytoplasmic projection extending into porous structure, formed on both surfaces created by DMF and TPS. Proliferation of the osteoblasts, the DMF group showed better result at different optic density levels (p = 0.035, 0.005, 0.001). Expression and distribution of fibronectin and Runx-2 genes showed similar degrees of expressions. Biomechanical push-out test yielded similar result (p = 0.714). Histomorphometry analysis also showed similar result (p = 0.657).Conclusion In conclusion, DMF is a method which can reliably create proper titanium surface on CoCr alloy. The resulting product of the surface shows similar quality to that of plasma spraying method, both in vivo and in vitro, in terms of biological and mechanical property.Keywords: Titanium surface coating, Direct metal fabrication, Osteointegration, 3D printing.
Prevalence of postural hypotension in primary, community and institutional care: A systematic review and meta-analysis
Authors: McDonagh Sinead TJ , Mejzner Natasha , Clark Christopher E
Published: October 2020

Background: Postural hypotension (PH), the reduction in blood pressure when rising from sitting or lying to standing, is a risk factor for falls, cognitive decline and mortality. However, it is not often tested for in primary care. PH prevalence varies according to definition, population, care setting and measurement method. The aim of this study was to determine the prevalence of PH across different care settings and disease subgroups.
Methods: Systematic review, meta-analyses and meta-regression. We searched Medline and Embase to October 2019 for studies based in primary, community or institutional care settings reporting PH prevalence. Data and study level demographics were extracted independently by two reviewers. Pooled estimates for mean PH prevalence were compared between care settings and disease subgroups using random effects meta-analyses. Predictors of PH were explored using meta-regression. Quality assessment was undertaken using an adapted Newcastle-Ottawa Scale.
Results: 1816 studies were identified; 61 contributed to analyses. Pooled prevalences for PH using the consensus definition were 17% (95% CI, 14-20%; I2=99%) for community cohorts, 19% (15-25%; I2=98%) for 23 primary care cohorts and 31% (15-50%; I2=0%) for 3 residential care or nursing homes cohorts (P=0.16 between groups). By condition, prevalences were 20% (16-23%; I2=98%) with hypertension (20 cohorts), 21% (16-26%; I2=92%) with diabetes (4 cohorts), 25% (18-33%; I2=88%) with Parkinson’s disease (7 cohorts) and 29% (25-33%; I2=0%) with dementia (3 cohorts), compared to 14% (12-17%; I2=99%) without these conditions (P<0.01 between groups). Multivariable meta-regression modelling identified increasing age and diabetes as predictors of PH (P<0.01, P=0.13, respectively; R2=36%). PH prevalence was not affected by blood pressure measurement device (P=0.65) or sitting or supine resting position (P=0.24), however, when the definition of PH did not fulfil the consensus description, but fell within its parameters, prevalence was underestimated (P=0.01) irrespective of study quality (P=0.04).
Conclusions: PH prevalence in populations relevant to primary care is substantial and the definition of PH used is important. Our findings emphasise the importance of considering checking for PH, particularly in vulnerable populations, to enable interventions to manage it. These data should contribute to future guidelines relevant to the detection and treatment of PH.
PROSPERO:CRD42017075423.
A Real-Time PCR Assay for Rapid Identification of Inducible and Acquired Clarithromycin Resistance in Mycobacterium abscessus
Authors: Sharma Meenu Kaushal , La Yanni , Janella Debra , Soualhine Hafid
Published: October 2020

Background: Mycobacterium abscessus is a rapidly growing mycobacteria involved in severe infections of the lung, skin, or soft tissue. Macrolides such as clarithromycin are the recommended first line drugs for treatment of M. abscessus infections. However, M. abscessus has dual mechanisms of resistance to macrolides, making treatment by macrolides difficult. A functional erm(41) gene confers for inducible resistance while acquired mutations on the 23S rRNA rrl gene confer for constitutive resistance. Methods: We have developed a real-time PCR assay to detect both inducible and acquired resistance to clarithromycin, and compared the results to traditional erm(41) and rrl sequencing and phenotypic susceptibility testing using Sensititre™ plates. Results: Of the total 126 M. abscessus isolates tested, truncated erm(41) was found in 23/126 (18.3%) of the samples, 27/126 (21.4%) had a T28C mutation in erm(41), and 2/126 (1.6%) had an acquired A2058C mutation in rrl. The phenotypic results correlated with the expected sequencing results in 121/126 samples (96%). Phenotypic testing compared to real-time PCR resolved 2 of these discrepancies by showing the existence of both erm(41) alleles in the isolates that sequencing missed. One culture was found to be mixed with two M. abscessus subsp. as per hsp65 sequencing and 2 isolates had discordance between molecular and phenotypic results. It was presumed that 3 isolates showed discrepancy between sequencing and real-time PCR, but one culture was mixed and other 2 detected both alleles by real-time PCR leading to 100% concordance when compared to sequencing. Conclusion: In conclusion, real-time PCR is more accurate for detection of both acquired and induced clarithromycin resistance, specifically when mixed genic profiles are present in a sample.
Who indicates Caesarean section in Romania? A cross-sectional survey in tertiary level maternity on childbirth patients and doctors' profiles 
Authors: Simionescu Anca Angela , Horobet Alexandra , Marin Erika , Belascu Lucian
Published: October 2020

Background. Cesarean section (C-section) rate in Romania is the second-highest in the European Union (44.1% in 2017), and the number of C-sections performed in the country has increased in the past decades. Given how common C-section is now, it is important to gain insight into the practice and perceptions of patients and doctors in countries with high C-section rates. The objectives are 1) to compare the preferred modes of birth among women; 2) to draw a profile of patients and doctors in whose case the actual birth method is different from the preferred method; and 3) to analyze the way Romanian women want to give birth. Methods. We conduct a statistical analysis based on an observational, analytical, and cross-sectional survey on 117 singleton pregnant women more than 36 weeks in spontaneous labor in tertiary level maternity in Romania. Various statistical tests have been used to indicate statistical significance. Results. We calculate an increase of almost 58% in actual childbirth mode against preferred childbirth by C-sections, rather difficult to justify based only on medical emergencies. There are 22 patients with non-concordant C-section indications between preferred and actual mode of birth, 7 of them (31.8%) preferred natural birth and 15 (68.2%) preferred C-section. The profiles of patients with concordant and non-concordant delivery modes are different and indicate a statistically significant difference between the preference for delivery and actual birth method. Patients who preferred vaginal birth, but gave birth by C-section, are mature and more educated women, in the middle to high-income category, mostly attended by consultant doctors and specialists. Doctors’ profiles show that specialists and consultants attend the largest share of non-concordant births, while residents and young senior doctors attend mostly vaginal births. Conclusions. We emphasize health system particularities in Romania as triggers of high C-section rates that favor women’s preferences against C-section medical indication. Improving patients’ confidence in the health care system, built on competence and fitted hierarchical team position may lead to choosing the optimal way of birth for childbirth safety and pain control.
Ethnobotanical study on wild edible plants used by three trans-boundary ethnic groups in Jiangcheng County, Pu' er, Southwest China
Authors: Cao Yilin , li ren , Zhou Shishun , Song Liang , Quan Ruichang , Hu Huabin
Published: October 2020

Background: Dai, Hani, and Yao people, in the trans-boundary region between China, Laos, and Vietnam, have gathered plentiful traditional knowledge about wild edible plants during their long history of understanding and using natural resources. The ecologically rich environment and the multi-ethnic integration provide a valuable foundation and driving force for high biodiversity and cultural diversity in this region. However, little study has uncovered this unique and attractive culture to the world. Methods: We conducted Ethnobotanical survey in 20 villages of Jiangcheng County from 2016 to 2020. Altogether 109 local Dai, Hani, and Yao people were interviewed, and their traditional knowledge about wild edible plants was recorded. Voucher specimens were identified by the authors and deposited in the herbarium of Xishuangbanna Tropical Botanical Garden, Chinese Academy of Sciences (HITBC). The use value was used as a quantitative index to evaluate the consume frequency and relative importance of the wild edible plants. The Jaccard index was calculated to assess the usage similarity of different areas. The relationship of age and recognized wild edible plants by different ethnic people was performed by R. Results: A total of 211 wild edible plants, belonging to 71 families and 151 genera, were recorded. These plants were consumed as wild edible vegetables, seasonal fruits, salads, spices, sour condiments, tonic soups, tea substitutes, liquor brewing, or dyeing materials. The use value (UV), current cultivation, market availability, as well as the quantitative traditional knowledge inheritance situation of these wild edible plants among different generations were analyzed. Based on the data from threatened species list of China’s higher plants and the IUCN Red List, the food plant list for Asia Elephant, the Subject Database of China Plant and the calculated UV score, the top 30 most important wild edible plants were selected for further cultivation in some local villages. Conclusion: Traditional knowledge of wild edible plants, owned by Dai, Hani, and Yao people in Jiangcheng County, is rich but at risk of being lost among the young generation. Diversified cultivation of wild edible plants by the local communities could be a solution for sustainable use of natural resources and to conserve the endangered species in this trans-boundary region.
Digital Consultations in Swedish Primary Health Care: A Qualitative Study of Physicians’ Job control, Demand and Support
Authors: Fernemark Hanna , Skagerstrom Janna , Seing Ida , Ericsson Carin , Nilsen Per
Published: October 2020

Background: Digital consultation with primary care physicians via mobile telephone apps has been spreading rapidly in Sweden since 2014. Digital consultation allows remote working because physicians can work from home, outside their traditional primary care environment. Despite the spread of digital consultation in primary care, there is a lack of knowledge concerning how the new service affects physicians’ psychosocial work environment. Previous research has focused primarily on the patients’ point of view and the cost-effectiveness of digital consultation. Hence, there is a paucity of studies from the perspective of physicians, focusing on their psychosocial work environment. The aim of this study was to investigate primary care physicians’ perceived work demands, control over working processes, and social support when providing digital consultation to primary care patients.Methods: The study has a qualitative design, using semi-structured interviews conducted in Sweden in 2019. We used a purposeful sampling strategy to achieve a heterogeneous sample of physicians who represented a broad spectrum of experiences and perceptions. The interviews were conducted by video meeting, telephone, or a personal meeting, depending on what suited the participant best. The interview questions were informed by the Job Demand-Control-Support (JDCS) model, which was also used as the framework to analyze the data by categorizing the physicians’ perceptions and experiences into the three categories of the model (Demand, Control, Support), in the deductive analysis of the data.Results: Analysis of the data yielded 9 subcategories, which were mapped onto the 3 categories of the JDCS model. Overall, the participants saw numerous benefits with digital consultations, not only with regard to their own job situation but also for patients and the health care system in general even though they identified some shortcomings and risks with digital care.Conclusions: This study has demonstrated that physicians perceive working with digital consultation as flexible with a high grade of autonomy and reasonable to low demands. According to the participants, digital consultation is not something you can work with full time if medical skills and abilities are to be maintained and developed.
Development of a behaviour change workplace-based intervention to improve nurses’ eating and physical activity
Authors: Power Brian , Kiezebrink Kirsty , Allan Julia L , Campbell Marion K
Published: October 2020

Background: There is a critical need for an intervention to improve nurse’s eating and physical activity behaviours. As nurses spend a substantial proportion of their waking hours at work, concerted efforts to deliver such interventions in the workplace is growing. This study formed part of a multiphase programme of research that aimed to systematically develop an evidence-based and theory-informed workplace intervention to promote changes in eating and physical activity among nurses. Methods: The intervention was developed iteratively, in line with Medical Research Council complex intervention guidelines. It involved four activities; (1) identifying the evidence base; (2) understanding the determinants of nurses’ eating and physical activity behaviour change through theory-based qualitative interviews and survey; (3) identifying intervention options using the Behaviour Change Wheel; and (4) specifying intervention content and implementation options using a taxonomy of behaviour change techniques.Results: Data from 13 randomised controlled trials indicated that workplace-based behaviour change interventions targeted to this population are effective in changing behaviour. The evidence base was, however, limited in quantity and quality. Nurses’ beliefs about important factors determining their eating and physical activity behaviour were identified across 16 qualitative interviews and 245 survey responses and key determinants included: environmental context and resources; behavioural regulation; emotion; beliefs about consequences; knowledge and optimism. Based on these findings, 22 behaviour change techniques suitable for targeting the identified determinants were identified and combined into a potential workplace intervention.Conclusions: An evidence-based and theory-informed intervention tailored to the target population and setting has been explicitly conceptualised using a systematic approach. The proposed intervention addresses previous evidence gaps for the user population of nurses. Further to this, such an intervention, if implemented, has the potential to impact nurses’ eating and physical activity behaviours and in turn, the health of nurses and the quality of healthcare delivery.
Socioeconomic inequalities in hypertension in Kenya: A decomposition analysis of 2015 Kenya STEPwise survey on non-communicable diseases risk factors
Authors: Gatimu Samwel Maina , John Thomas Wiswa
Published: October 2020

Background: One in four Kenyans aged 18–69 years have raised blood pressure. Despite this high prevalence of hypertension and known association between socioeconomic status and hypertension, there is limited understanding of factors explaining inequalities in raised blood pressure in Kenya. Hence, we quantified the socioeconomic inequality in hypertension in Kenya and decomposed the determinants contributing to such inequality.Methods: We used data from the 2015 Kenya STEPwise survey for non-communicable diseases risk factors. We included 4,422 respondents aged 18–69 years. We estimated the socioeconomic inequality using the concentration index (C) and decomposed the C using Wagstaff decomposition analysis.Results: The overall concentration index of hypertension in Kenya was −0.08 (95% CI: −0.14, −0.02; p = 0.005), showing socioeconomic inequalities in hypertension disfavouring the poor population. About half (47.1%) of the pro-rich inequalities in hypertension was explained by body mass index while 26.7% by socioeconomic factors (wealth index (10.4%), education (9.3%) and paid employment (7.0%)) and 17.6% by sociodemographic factors (female gender (10.5%), age (4.3%) and marital status (0.6%)). Regional differences explained 7.1% of the estimated inequality with the Central region alone explaining 6.0% of the observed inequality. Our model explained 99.7% of the estimated socioeconomic inequality in hypertension in Kenya with a small non-explained part of the inequality (−0.0002).Conclusion: The present study shows substantial socioeconomic inequalities in hypertension in Kenya, mainly explained by metabolic risk factors (body mass index), individual health behaviours, and socioeconomic factors. Kenya needs gender- and equity-focused interventions to curb the rising burden of hypertension and inequalities in hypertension.
Nutritional Status of HIV-Positive Pregnant Women in Luanda, Angola
Authors: Santana Marli Stela , FILIPE Maura Eunice João
Published: October 2020

During pregnancy, maternal intake of nutrients and their nutritional status affects both mother and baby. Good nutritional status plays an important role for a healthy pregnancy, for this it is necessary that the pregnant woman have a healthy diet to assist in weight gain.Objective: To evaluate the pregestational and gestational nutritional status of HIV-positive women.Methods: This is a cross-sectional and descriptive study, conducted from August to November 2018 in which 171 HIV-positive pregnant women were selected at random, in order of arrival and submitted to nutritional assessment through the Global Subjective Evaluation, whose data collected, were analyzed using EpiInfo software version 7.2.Results: From the main results found it was observed the presence of maternal nutritional eutrophic, considering the pre-gestational Body Mass Index (BMI) of 107 (62.56%), and the gestational BMI of 94 (54.97%). It was found 31(18.12%) of pre-gestational overweight and 54 (28.07%) of overweight during pregnancy, and it was also observed that 12 (7%) of pregnant women were obese before pregnancy and 15 (15.28%) became obese during pregnancy. A significant association was found between pregestational BMI, height (p˂0.0001), gestational BMI, current weight (p˂0.0003), brachial perimeter (p˂0.002), and uterine height (p˂0.005).Conclusion: The results of this study indicate the need to develop nutritional care programs for HIV-positive women, in order to ensure an adequacy of their nutritional status.
Older age and multi-joint external fixator are two risk factors of complications in ulnar lengthening in children with hereditary multiple exostosis
Authors: Zheng Chao , Han Huanli , Cao Yujiang
Published: October 2020

Objectives:
Hereditary multiple exostosis (HME) often involves forearm deformities. The aim of this study was to present the clinical results of 37 children who underwent ulnar lengthening with two different types of unilateral external fixators, and to investigate the risk factors of complications.
Methods:
We evaluated 37 children with forearm deformities caused by HME treated in our hospital from January 2008 to July 2019. The surgical procedures included resection of exostosis, osteotomy of the ulna, and gradual lengthening of the ulna with a single arm external fixator. According to the type of external fixator they received, the children were divided into two groups: group A received monorail fixators, and group B received multi-joint fixators. Radiographic and functional parameters were assessed. Complications were recorded.
Results:
All patients were followed up for an average of 4.6 years (3.0 to 6.5). In both group A and group B, the ulna shortening (US), radial articular angle (RAA), carpal slip (CS), elbow flexion, forearm pronation, supination, and Mayo Elbow Performance Score (MEPS) values improved significantly from preoperatively to postoperatively ( p < 0.05). However, ulnar deviation was observed in 4 cases in group B and no cases in group A. According to logistic regression, the difference was only related to age ( p <0.05) and the type of external fixator ( p <0.05).
Conclusions:
Ulnar lengthening with unilateral external fixation is a safe and effective procedure for the treatment of HME. Regarding complications, deviation of the ulna axis was more likely to occur in older children with multi-joint external fixators.
Effect of a natural plant ingredient — Pulsatilla saponin B4 on clinical mastitis and serum inflammatory indices in dairy cows
Authors: Shen Liuhong , Qian Bolin , You Liuchao , Zhang Yue , Shen Yu , Lv Shangkui , Xiao Jinbang , Su Zhetong , Dong Ke , Zong Xiaolan , Yu Shumin , Cao Suizhong , Yang Shilin , Feng Yulin
Published: October 2020

Background: Bovine mastitis is an inflammatory reaction of the breast caused by pathogenic bacteria infection or breast injury, which affect milk yield and quality and poses severe threat to the health of dairy cows. Pulsatilla chinensis has antibacterial, anti-inflammatory, and immune enhancing effects, etc. However, there was no research about the therapeutic effect of it towards the treatment of cow mastitis. In the study, twelve healthy cows were selected as the control group (group A), and 36 cows with mastitis were equally and randomly divided into group B, C and D. Group A didn’t accept treatment, while group B, C and D were treated with 15, 30 and 60 mL Pulsatilla saponin B4 (a purified extract form Pulsatilla chinensis) injection by brachiocephalicus intramuscular injection once a day for 4-6 day and the optimal dose was selected from them. Then, we investigated the effect of this extract on the clearance rates of pathogenic bacteria, the regulation of somatic cell count (SCC) and inflammatory factors the in appropriate dose group.Results: Pulsatilla saponin B4 was effective in all test groups and showed a dose-effect relationship. The extract had inhibitory effects on Streptococcus agalactiae, Streptococcus dysenteriae, Klebsiella species, Mycoplasma bovis, Escherichia coli and Staphylococcus aureus. Group C cured more cows than group B and D during the 6 days of treatment and was determined as the optimal dose group. The milk SCC, serum haptoglobin (HP), prostaglandin E2 (PGE2), interleukin-1 alpha (IL-1α), interleukin-1 beta (IL-1β), interleukin-2 (IL-2), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumour necrosis factor alpha (TNF-α), interleukin-4 (IL-4) and leukotriene B4 (LTB4) in Group C were significantly higher than those of healthy cows (P < 0.05) on the first day but had no significant difference with group A after treatment. Conclusion: 30 mL Pulsatilla saponin B4 applied through intramuscular injection once a day for 4-6 days leaded to the significant amelioration of bacterial infection, SCC and levels of serum inflammatory factors in cows with clinical mastitis.
Current Perception Threshold Testing in Chronic Ankle Instability
Authors: Zhang Ran , Zhang Xi , Chen Yaping , Song Weiqun
Published: October 2020

Background: Damage to sensory input is one of the pathologies underlying chronic ankle instability (CAI). Therefore, it is necessary to evaluate the sensory function of patients with CAI. This study aims to quantitatively evaluate sensory nerve function in patients with CAI and healthy controls using current perception threshold (CPT) measurements.Methods: Fifty-nine subjects with CAI and 30 healthy control individuals participated in this study. CPT values at the anterior talofibular ligament region were tested on the injured and uninjured sides in CAI patients and on a random side in the healthy control group.Results: There were no significant differences in age, gender, height, weight or BMI between the CAI and healthy control groups. The CPT values did not show significant gender differences. The CPT values were not significantly correlated with age or BMI. Compared to the control group (250 Hz: 24.32±9.28, 5 Hz: 6.87±1.56), the CAI group had significantly higher CPT values on the injured (250 Hz: 42.83±28.49, 5 Hz: 23.43±18.53) and uninjured sides (250 Hz: 38.62±19.98, 5 Hz: 18.84±14.21) under 250 Hz and 5 Hz electrical stimuli (p<0.01). No significant difference was observed under 2000 Hz stimuli. There were correlations among CPT values at different frequencies (p<0.01).Conclusion: This study revealed increased sensory thresholds in injured and uninjured ankles of 250 Hz- and 5 Hz-related sensory nerve fibers among patients with CAI. The bilateral change in sensory threshold may indicate a central sensory modulation process.Level of Evidence: Level III, case-control study.
Epidemiological Survey and Screening Strategy for Dengue Virus in Blood Donors from Yunnan Province
Authors: LI LING , LI YING , Lu Shaofang , Dong Jing , Xu Haixia , Zhang Qian , Weng Rong , Yin Yundi , He Rui , Fang Peng , Shi Hua , Yu Yinghan , Wu Ji , Liu Zhong , Hess John R.
Published: October 2020

BACKGROUNDDengue virus (DENV) can be transmitted through blood transfusion. DENV was not screened regularly in Xishuangbanna blood center. This study was conducted in Xishuangbanna blood center with an attempt to develop DENV screening strategies in one of China’s high-incidence areas.METHODSBlood samples were collected randomly between June 2019 and August 2019. These samples were first screened for anti-DENV IgG and IgM using enzyme-linked immunosorbent assay (ELISA). All reactive samples and some randomly-chosen non-reactive samples were used to detect DENV RNAs using real-time polymerase-chain-reaction (RT-PCR) assay. After RT-PCR assay, these samples were further tested for soluble nonstructural protein 1 (NS1) using the colloidal gold method. The demographic data of donors were collected.RESULTSA total of 2,254 donor samples were collected and tested for anti-DENV IgG and IgM by ELISA between June 2019 and August 2019. ELISA testing revealed that 598 donor samples were anti-DENV IgG and/or IgM reactive, with a serological prevalence of 26.53%. Among all the donor samples, 26 were RT-PCR positive and/or NS1 positive. Moreover, there were significant differences in the prevalence of DENV in terms of occupation (P=0.001), education(P<0.001) and ethnicity (P=0.026).CONCLUSIONThe prevalence of DENV in Xishuangbanna Blood Center was higher than most other blood centers that have implemented DENV donor screening. Our study provides the first-hand data about the prevalence of DENV and allows the development of a screening strategy for clinical use.
Multi-omics examination of Q fever fatigue syndrome identifies similarities with chronic fatigue syndrome
Authors: Raijmakers Ruud , Roerink Megan E. , Jansen Anne F.M. , Keijmel Stephan P. , Gacesa Ranko , Li Yang , Joosten Leo A.B. , Meer Jos W.M. van der , Netea Mihai G. , Bleeker-Rovers Chantal P. , Xu Cheng-Jian
Published: October 2020

Background: Q fever fatigue syndrome (QFS) is characterised by a state of prolonged fatigue that is seen in 20% of acute Q fever infections and has major health-related consequences. The molecular mechanisms underlying QFS are largely unclear. In order to better understand its pathogenesis, we applied a multi-omics approach to study the patterns of the gut microbiome, blood metabolome, and inflammatory proteome of QFS patients, and compared these with those of chronic fatigue syndrome (CFS) patients and healthy controls (HC). Methods: The study population consisted of 31 QFS patients, 50 CFS patients, and 72 HC. All subjects were matched for age, gender, and general geographical region (South-East part of the Netherlands). The gut microbiome composition was assessed by Metagenomic sequencing using the Illumina HiSeq platform. A total of 92 circulating inflammatory markers were measured using Proximity Extension Essay and 1607 metabolic features were assessed with a high-throughput non-targeted metabolomics approach. Results: Inflammatory markers, including 4E-BP1 (P = 9.60-16 and 1.41-7) and MMP-1 (P = 7.09-9 and 3.51-9), are significantly more expressed in both QFS and CFS patients compared to HC. Blood metabolite profiles show significant differences when comparing QFS (319 metabolites) and CFS (441 metabolites) patients to HC, and are significantly enriched in pathways like sphingolipid (P = 0.0256 and 0.0033) metabolism. When comparing QFS to CFS patients, almost no significant differences in metabolome were found. Comparison of microbiome taxonomy of QFS and CFS patients with that of HC, shows both in- and decreases in abundancies in Bacteroidetes (with emphasis on Bacteroides and Alistiples spp.), and Firmicutes and Actinobacteria (with emphasis on Ruminococcus and Bifidobacterium spp.). When we compare QFS patients to CFS patients, there is a striking resemblance and hardly any significant differences in microbiome taxonomy are found.Conclusions: We show that QFS and CFS patients are similar across three different omics layers and 4E-BP1 and MMP-1 have the potential to distinguish QFS and CFS patients from HC.
Analysis and Prediction of COVID-19 Pandemic in Bangladesh by using Long short-term memory network (LSTM) and Adaptive neuro fuzzy inference system(ANFIS)
Authors: Chowdhury Anjir Ahmed , Hasan Khandaker Tabin , Hoque Khadija Kubra Shahjalal
Published: October 2020

Objectives: The dangerously contagious virus named SARS-CoV-2 has hit the world hard that has locked downed billion people in their homes for stopping fur- ther spread. All the researchers and scientists in various fields are working around the clock to come up with a vaccine and prevention methods to save the world from this invisible pathogen. However, reliable prediction of the epidemic may help contain the contagion until cure becomes available. The machine learning techniques is one of the frontier in predicting the future trend and behavior of this outbreak. Our research is focused on finding a suitable machine learning model that can pre- dict on small dataset with higher accuracy.Methods: In this research, we have used the Adap- tive Neuro-Fuzzy Inference System (ANFIS) and the long short-term memory[LSTM] to foresee the newly infected cases in Bangladesh. We have compared both the results of the experiments and it can be forenamed that LSTM has shown more satisfactory results.Results: Upon study and testing on several models, we have showed that LSTM works better on scenario based model for Bangladesh with MAPE 4.51, RMSE 6.55 and Correlation Coefficient 0.75.Conclusion: This study is expected to shade light on Covid-19 prediction models for researchers working with machine learning techniques and help avoid proven failures specially for small imprecise dataset.