bluuebunny/crossref_metadata_2025 huggingface dataset:
Perineal Fistula With High Dilated Colon: One of a Special Type of Anorectal Malformations
Authors: Li Sen , Wang Jun
Published: December 2020

Background The perineal fistula with high dilated colon is a rare anomalous in the spectrum of anorectal malformations. The aim of this study is to explore the diagnosis and treatment of this special type of perineal fistula (SPF), and to avoid the severe consequence due to misdiagnosis.Methods From March 2012 to January 2019, 7 patients who suffered from perineal fistula with high dilated colon were retrospectively reviewed. Three were operated on primarily by our department, and 4 cases were re-operated after a perineal anoplasty repair performed elsewhere. Four were operated by laparoscopic anorectoplasty (LARP), and 3 cases were repaired by posterior sagittal anorectoplasty (PSARP). The follow-up outcomes were compared with 71 cases of normal perineal fistula (NPF) in the same period.Results 7 cases have been followed up for 0.5-4 years (M=2.57±1.26) after definitive surgery. Their bowel function score (BFS) was lower than normal perineal fistula (SPF=12, rang:5-18; NPF=18.5, rang:18-20). Four cases underwent anorectomanometry. The incidence of rectoanal inhibitory reflex (RAIR) was lower in the special type group. (p=0.14). Three cases of barium enema angiography: 2 cases of colorectal dilatation and thickening changes, 1 case showed no obvious abnormalities.Conclusions Anorectal perineal fistula should be examined by distal colostogram at preoperation. Select appropriate surgical approach is essential for children’s defecation function, and blind surgery can seriously affect long-term defecation function.
Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany
Authors: Reisenauer Christl , Amend Bastian , Falch Claudius , Abele Harald , Brucker Sara Yvonne , Andress Jürgen
Published: December 2020

BackgroundObstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre.MethodsWomen who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively.ResultsEleven out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort, genitourinary fistulas were more common in multiparous women (9/11), and rectovaginal fistulas were more common in primiparous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina, and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65% of cases. For women with rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended fistula repair in the context of a subsequent delivery. For the first time, pregnancy-related changes in the vaginal wall were used to optimize the success rate of fistula closure.ConclusionsIn developed countries, birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon’s experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Although vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient, and a vesicovaginal fistula should be ruled out.Trial registrationretrospectively registered, DRKS 00022543, 28.07.2020
Protective Effects of Swertiamarin against Methylglyoxal induced Damage and its Role in Preventing Diabetic Nephropathy by Improving Oxidative Stress in Rat Kidney Epithelial (NRK-52E) Cells
Authors: Parwani Kirti , Patel Farhin , Patel Dhara , Mandal Palash
Published: December 2020

Increased blood glucose in diabetic individuals results in the formation of advanced glycation end products (AGEs), which result in various adverse effects on kidney cells, leading to diabetic nephropathy (DN). In this study, the antiglycative potential of Swertiamarin (SM) isolated from the methanolic extract of E. littorale was explored. The effect of SM on protein glycation was studied by incubating bovine serum albumin with fructose at 60 °C in the presence and absence of different concentrations of swertiamarin for 24 h. For comparative analysis, metformin was also used at similar concentrations as SM. Further, to understand the role of SM in preventing DN, in vitro studies using NRK-52E cells were done by treating cells with methylglyoxal (MG) in the presence and absence of SM. SM showed better antiglycative potential as compared to metformin. Also, SM could prevent the MG mediated pathogenesis in DN by reducing levels of argpyrimidine, oxidative stress and apoptosis in kidney cells. SM also downregulated the expression of interleukin-6, tumor necrosis factor-α and interleukin-1β. This study, for the first time, reports the antiglycative potential of SM and also provides a novel insight into the molecular mechanisms by which SM prevents toxicity of MG on rat kidney cells.
Influence of Angptl1 on Osteoclast Formation and Osteoblastic Phenotype in Mouse Cells.
Authors: Ishida Masayoshi , Kawao Naoyuki , Mizukami Yuya , Takafuji Yoshimasa , Kaji Hiroshi
Published: December 2020

Background: Osteoblasts and osteoclasts play important roles during the bone remodeling in the physiological and pathophysiological states. Although angiopoietin family Angiopoietin like proteins (Angptls), including Angptl1, have been reported to be involved in inflammation, lipid metabolism and angiogenesis, the roles of Angptl1 in bone have not been reported so far. Methods: We examined the effects of Angptl1 overexpression on the osteoblast and osteoclast phenotypes using mouse cell lines.Results: Angptl1 overexpression significantly inhibited the osteoclast formation and mRNA levels of tartrate-resistant acid phosphatase and cathepsin K enhanced by receptor activator of nuclear factor κB ligand in RAW 264.7 cells. Moreover, Angptl1 overexpression significantly enhanced Osterix mRNA levels, alkaline phosphatase activity and mineralization induced by bone morphogenetic protein-2 in ST2 cells, although it did not affect the expression of osteogenic genes in MC3T3-E1 cells. On the other hand, Angptl1 overexpression significantly reduced the mRNA levels of peroxisome proliferator-activated receptor γ and adipocyte protein-2 induced by adipogenic medium in 3T3-L1 cells.Conclusions: The present study first indicated that Angptl1 suppresses and enhances osteoclast formation and osteoblastic differentiation in mouse cell line, respectively, although it inhibits adipogenic differentiation of 3T3-L1 cells. These data suggest the possibility that Angptl1 might be physiologically related to bone remodeling.
Dynamic Anti-plane Behavior of Rare Earth Giant Magnetostrictive Medium With a Circular Cavity Defect in Semi-space
Authors: Liu Zhi , Qi Hui
Published: December 2020

An analytical solution to the anti-plane dynamics problem of semi-space rare earth giant magnetostrictive media with circular cavity defects near the horizontal boundary under the action of SH wave is studied. Based on the Helmholtz theorem and the theory of complex function, the elastic-magnetic dynamic equation of magnetostrictive medium is established, and the semi-space incident wave field is written. In addition, the scattered displacement field and the corresponding magnetic potential of the scattered wave under the condition of no stress and magnetic insulation of the horizontal boundary are obtained by image method. Then, based on the conditions of free boundary stress, continuous magnetic induction intensity and continuous magnetic potential around the circular cavity, the infinite linear algebraic equations are established. Finally, the analytical expressions of dynamic stress concentration factor and magnetic field intensity concentration factor around circular cavity in semi-space rare earth giant magnetostrictive medium are obtained. Numerical examples show that the analysis results depend on the following parameters: permeability, dimensional-piezomagnetic coefficient, frequency of the incident wave, incident angle, distance between the circular cavity and horizontal boundary. These results have certain reference value for the study of non-destructive testing and failure analysis of rare earth giant magnetostrictive materials.
Index of Complexity, Outcome and Need (Icon) for Determining Treatment Need in The Northern Border Region of Saudi Arabia: An Epidemiological Study
Authors: kundi Ibadullah
Published: December 2020

Background: Assessment of orthodontic treatment need is a complicated issue. As integral part of oral health care programs, Orthodontic treatment needs to be based on information of treatment needs. The evaluation of malocclusion is the essential component in establishing the diagnosis and treatment need of the orthodontic patient.Taking decision of whether or not one should undergo orthodontic treatment, both the desire of the patient (and/ or parents) and the opinion of the orthodontist must be taken into account. One of the major problems in studying malocclusion is the availability of a suitable objective method for recording the occurrence and severity of orthodontic problem. Thus, orthodontic indices are used in clinical and epidemiological studies of malocclusion. The aim of this study is to determine the necessity and complexity of orthodontic anomalies by applying Index of Complexity, Outcome and Need (ICON) in Saudi population.Methods: A descriptive cross-sectional study was conducted on dental casts of 150 patients (mean age 15.66±1.07) adolescents randomly selected from the northern border region of Saudi Arabia (KSA). Index of Complexity Outcome and Need (ICON) was applied to find out the orthodontic treatment need and initial stage complexity grades. The data was performed using the statistical software package IBM SPSS Statistics 24.0. Results: 80% of the patients needed some sort of orthodontic therapy. More than 65% of the cases were classified as being difficult and very difficult to treat. Conclusion: It was concluded that a high number of cases were in need of the orthodontic therapy and majority of the patients undergoing orthodontic treatment were in difficult grades.
An Extended Approach to Value Chain Analysis
Authors: Knez Klemen , Jaklič Andreja , Stare Metka
Published: December 2020

In the article, we propose a comprehensive methodology of value chain analysis in the international input-output framework, introducing a new measure of value chain participation and an extended typology of value chains, including a new measure of fragmentation of domestic value chain production. This allows for the simultaneous analysis of both global and domestic production fragmentation, complex patterns of their evolution and their impact on economic development. The main contribution of the proposed methodology is conceptual: it allows the measurement of all value chain paths that pass through each country-sector from production to final consumption, whether the path includes downstream linkages, upstream linkages or a combination of both at the same time. The empirical application of this methodology shows the importance of including domestic fragmentation in value chain analyses: Both global and domestic fragmentation levels of production show a significant positive correlation with economic growth. This implies that the effects of global production fragmentation need to be analysed together with the changing structure of domestic production fragmentation to obtain a complete picture, which could provide important information for policy-making and industrial policy.
Developing a Non-destructive Metabarcoding Protocol for Detection of Pest Insects in Bulk Trap Catches
Authors: Batovska Jana , Piper Alexander , Valenzuela Isabel , Cunningham John , Blacket Mark
Published: December 2020

Metabarcoding has the potential to revolutionise insect surveillance by providing high-throughput and cost-effective species identification of all specimens within mixed trap catches. Nevertheless, incorporation of metabarcoding into insect diagnostic laboratories will first require the development and evaluation of protocols that adhere to the specialised regulatory requirements of invasive species surveillance. In this study, we develop a multi-locus non-destructive metabarcoding protocol that allows sensitive detection of agricultural pests, and subsequent confirmation using traditional diagnostic techniques. We validate this protocol for the detection of tomato potato psyllid (Bactericera cockerelli) and Russian wheat aphid (Diuraphis noxia) within mock communities and field survey traps. We find that metabarcoding can reliably detect target insects within mixed community samples, including specimens that morphological identification did not initially detect, but sensitivity appears inversely related to community size and is impacted by primer biases, target loci, and sample indexing strategy. While our multi-locus approach allowed independent validation of target detection, lack of reference sequences for 18S and 12S restricted its usefulness for estimating diversity in field samples. The non-destructive DNA extraction proved invaluable for resolving inconsistencies between morphological and metabarcoding identification results, and post-extraction specimens were suitable for both morphological re-examination and DNA re-extraction for confirmatory barcoding.
Absence of EpCAM in Cervical Cancer Cells Is Involved in Slug-induced Epithelial-mesenchymal Transition
Authors: Liu Xian , Qian Feng , Zhang Yanru , Zheng Pengsheng , Cui Nan
Published: December 2020

Background: Slug (Snai2) is a pivotal player in initiating epithelial-mesenchymal transition (EMT) through its trans-suppression effect on E-cadherin in various normal and malignant cells. In this study. The positive effect of Slug on promoting cell motility and metastasis in cervical cancer was further confirmed in this study.Methods: RNA-Seq was performed to explore the potential molecules that participate in Slug-mediated EMT in cervical cancer cells. The negative correlation between Slug and EpCAM expression in cervical cancer cells was detected in this study, and linked them with in vitro migration and invasion assay, in vivo metastasis experiments, luciferase reporter assay and Chromatin immunoprecipitation.Results: Transcriptome sequencing analysis revealed that epithelial cell adhesion molecule (EpCAM) was significantly decreased in Slug-overexpressing SiHa cells. Simultaneously, an absence of EpCAM expression was observed in Slug-overexpressing cells. Further studies revealed the trans-suppression effect of Slug on EpCAM through its binding to the E-boxes in the proximal promoter region of EpCAM in cervical cancer cells. Restoring EpCAM in Slug-overexpressing cells by transiently transfecting an EpCAM recombinant plasmid attenuated cell motility and promoted cell growth. Moreover, the negative correlation between Slug and EpCAM expression in human squamous cervical carcinoma (SCC) samples was verified by using Pearson correlation analysis.Conclusions: These results demonstrated that the absence of EpCAM under Slug expression in cervical cancer cells probably participated in Slug-regulated EMT and further promoted tumor metastasis. Additionally, this study supports a potential way for Slug to initiate EMT progression in cervical cancer cells in addition to inhibiting E-cadherin.
Functional Status of Mechanically Ventilated COVID-19 Survivors at ICU and Hospital Discharge
Authors: Musheyev Benjamin , Borg Lara , Janowicz Rebeca , Matarlo Michael , Boyle Hayle , Singh Gurinder , Ende Victoria , Babatsikos Ioannis , Hou Wei , Duong Tim
Published: December 2020

Background A significant number of COVID-19 patients have been treated using invasive mechanical ventilation (IMV). The ability to evaluate functional status of COVID-19 survivors early on at ICU and hospital discharge can help minimize ICU-acquired weakness, promote rapid functional recovery, and improve quality of lifeMethods The modified “Mental Status”, ICU Mobility, and Barthel Index scores at ICU and hospital discharge were tabulated for 118 COVID-19 survivors treated with invasive mechanical ventilation (IMV). These functional scores were compared with pre-admission functional status, discharge durable medical equipment, discharge medical follow-up recommendation, duration on IMV, duration post IMV, demographics, comorbidities, laboratory tests, and vital signs at ICU and hospital discharge. Results The majority of COVID-19 IMV patients were not functionally independent at hospital discharge (22% discharged with cane or rolling walker, 49% discharged with durable medical equipment, and 14% admitted to a rehabilitation facility), although they were prior to COVID-19 illness. Half of the patients were discharged with supplemental oxygen equipment. The most prevalent medical follow-up recommendations were cardiology, vascular medicine, pulmonology, endocrinology, and neurology with many patients receiving multiple medical follow-up recommendations. Functional status improved from ICU discharge to hospital discharge (p<0.001). Worse functional status at hospital discharge was associated with longer IMV duration, older age, male sex, higher number of comorbidities, and the presence of pre-existing comorbidities including hypertension, diabetes, chronic obstructive pulmonary disease, and immunosuppression (p<0.05, ANOVA). Conclusions The majority of IMV COVID-19 survivors were not functionally independent at discharge and required significant follow-up medical care. The COVID-19 circumstance has placed constraints on access to in-hospital rehabilitation. These findings underscore the need for prospective studies to ascertain the short- and long-term sequela in COVID-19 survivors.
Incidence of New-Onset Pain, Characteristics and Influence on Health-Related Quality of life in COVID-19 Survivors After Critical Illness. Analysis of the PAIN COVID Clinical Trial cohort.
Authors: Ojeda Antonio , Calvo Andrea , Cuñat Tomas , Artigas Ricard Mellado , Comino-Trinidad Oscar , Aliaga Jorge , Arias Marilyn , Ferrando Carlos , Martínez Graciela , Dürsteler Christian
Published: December 2020

Background: To explore the incidence and characteristics of new-onset pain, its impact on quality of life (HRQoL), and to quantify the presence of mood disorders in critically ill COVID-19 survivors. Methods: This is a preliminary report of PAIN-COVID clinical trial (NCT04394169) presenting a descriptive analysis in critical ill COVID 19 survivors one month after hospital discharge. Pain was assed using the Brief Pain Inventory short form, Douleur Neuropathique 4 Questions test and Pain Catastrophizing Scale. Health related quality of life (HRQoL) was evaluated with EQoL-5D/5L and mood disorders with Hospital Anxiety and Depression test (HAD).Results: From May 27th to July 19th 2020, 203 patients were consecutively screened for eligibility and 65 were finally included in this analysis. In 33 (50.8%) patients a new-onset pain was reported: 18 (54.5%) reported clinically significant intense pain, 11 (33.3%) a positive screening for neuropathic pain, 3 (9.1%) clinically relevant pain catastrophizing thoughts, 29 (87.9%) pain in ≥2 body sites and 5 (15.2%) widespread pain. Median EQoL-5D/5L index value and visual analogue scale was 0.8 (IQR 0.57-0.87) and 70 (IQR 60-80) respectively. Pain intensity was negatively correlated both to the former (Spearman Rho: -0.546, p<0.001) and to the latter (Spearman Rho: -0.387, p=0.001). A HAD anxiety and depression value over 8 were obtained in 7 (10,8 %) and 5 (7,7%) of patients, respectively.Conclusion: The incidence of new-onset pain in critically ill COVID-19 survivors is high and it was associated with a lower HRQoL. Trial registration: NCT04394169. Registered 19 May 2020. https://clinicaltrials.gov/ct2/show/NCT04394169
Development and Validation of a Model to Predict Acute Kidney Injury Following Wasp Stings: A Multicenter Cohort Study
Authors: Tang Xin , Lin Li , Yang ying Ying , Huang shuang Rong , Wang bei Bei , Zhang Ling , Fu Ping , Wen Yu , Xu xian Ji , Xiao Jian , Chen zheng De , Zhu zhi Zai , Xue Hen , Liao bin Chang , Bi hong Wei , Ma Ying , Tan Hua , Tang gang Zhi , Zhang chao Wan , Xie qiong De , Zhang Lin , Liu feng Lin , Chen ming Fang , Wang long Yin
Published: December 2020

BackgroundAcute kidney injury (AKI) following wasp stings is a serious and common health hazard, however the early prediction remains challenging. The study aimed to establish a model to predict AKI following wasp stings and validate it.MethodsIn the multicenter prospective cohort study, 508 patients with wasp stings from Jul 2015 to Dec 2019 were randomly divided into the training set (n = 381) and validation set (n = 127) for internal and external validation. A model that based on the multivariable logistic regression analysis was utilized to predict the probability of AKI following wasp stings by a predictive formula and a nomogram. The performances of the model were assessed by using the area under the curve (AUC) and accuracy (ACC) of the receiver operating characteristic curve. The calibration curves were utilized for estimating the consistency between the actual observed outcome and the nomogram predicted AKI probability. Decision curve analysis (DCA) demonstrated the net benefit associated with the use of the nomogram-derived probability for the prediction of AKI following wasp stings.Results Number of stings, hemoglobin (HB) < 110 g/dl, total bilirubin (TBI) > 34 mg/dl, alanine transaminase (ALT) > 40 U/L and activated partial thromboplastin time (APTT) > 47 s were demonstrated as the independent risk factors for AKI following wasp stings (all P value < 0.05) and were incorporated into the model. The performances of the model were validated (AUC = 0.912, ACC = 0.869 and AUC = 0.936, ACC = 0.898 in the training set and validation set respectively). The predictive formula and nomogram of the model could be utilized to predict the AKI following wasp stings, which having sufficient accuracies, good predictive capabilities and good net benefits.ConclusionIn conclusion, we proved that number of stings, HB < 110 g/dl, TBI > 34 mg/dl, ALT > 40 U/L and APTT > 47 s were independence risk factors for AKI following wasp stings. The predictive formula and the individual nomogram of the model might serve as promising predictive tools to assess the probability of the AKI following wasp stings.
Performance, Intestinal Microbial Population, Immune and Physiological Responses of Broiler Chickens to Diet With Different Levels of Silver Nanoparticles Coated on Zeolite
Authors: Bolandi Niloofar , Hashemi Seyed Reza , Davoodi Daryoush , Dastar Behrouz , Hassani Saeed , Ashayerizadeh Amin
Published: December 2020

Background: The aim of this study was to evaluate the effects of different levels of silver nanoparticles coated on zeolite on performance, gastrointestinal microflora, heterophile to lymphocyte ratio and humoral immune system responses of broiler chickens. Three hundred seventy five Cobb 500 in a completely randomized design were distributed to 5 experimental diets: control diet, 1% zeolite, 0.25%, 0.50% and 0.75% of silver nanoparticles coated on 1% zeolite. Performance traits were recorded and Blood samples were taken to determine antibody response against Newcastle on d 14, infectious bursal disease (Gumboro) on d 21 and Serum immunoglobulins (IgY, IgM, and IgA) were determined on d 42. Heterophile to lymphocyte ratio was evaluated on days 28, 35 and 42. At the end of d 21 and d 42. Results: The result showed that feed conversion ratio was significantly improved in silver nanoparticle treatments compare with the control group (p < 0.05). Total anaerobic bacteria and the population of E.coli in ileum and cecum were decreased (p < 0.05). The highest number of lactobacillus was observed in NS50 (p < 0.05). Antibody response against Gumboro was decreased as well as the amount of IgY antibody in silver nanoparticles treatments. Significant differences were observed in heterophile to lymphocyte ratio on d 28 and 35 and the highest amount was observed in NS50 group (p < 0.05). Conclusions: In conclusion, using silver nanoparticle dietary coated on zeolite could improve gut microflora, but silver nanoparticles could also have harmful side effects on the immune mechanism of broiler chickens.
Three-Phase Distribution Transformer Connections Modeling Based on Matrix Operation Method by Phase-coordinates
Authors: Zhang Zhigang , Mo Mingrui , Wu Caizhu
Published: December 2020

This paper proposes a matrix operation method for modeling the three-phase transformer by phase-coordinates. Based on decoupling theory, the 12x12 dimension primitive admittance matrix is obtained at first employing the coupling configuration of the windings. Under the condition of asymmetric magnetic circuits, according to the boundary conditions for transformer connections, the transformers in different connections enable to be modeling by the matrix operation method from the primitive admittance matrix. Another purpose of this paper is to explain the differences of the phase-coordinates and the positive sequence parameters in the impedances of the transformers. The numerical testing results in IEEE-4 system show that the proposed method is valid and efficient.
Sickle Cell Disease (SCD) and COVID-19 – A Case Series
Authors: Al-Naami Awaji Q. , Khan Liaqat A. , Zaidan Faisal I. , Halawi Hussam M. , Asiri Laila E. , Sumaili Taher A. , Qaisi Amal A. , Darweesh Turki M. , Al-Neami Ibrahim A.
Published: December 2020

The ongoing pandemic of COVID-19 that started in the Hubei province of China in late December 2019, caused by severe acute respiratory syndrome corona virus-2 (SARS CoV-2). Globally millions affected by the disease so far. The risk of COVID-19 severity and its complications increases with age and other comorbidities. The course of SARS-CoV-2 infection or its related complications has yet to be established in patients with sickle cell disease (SCD), once more evidence is available. It is clear from the available data that the course of COVID-19 in patients with SCD is mild to moderate, seldom severe, and rarely fatal. Herein we report three known cases of SCD with confirmed COVID-19, in whom the course of the disease was mild to moderate and uncomplicated with uneventful recoveries.
The effect of socioeconomic status on informal caregiving for parents among adult married females: Evidence from China
Authors: Wang Yi , Li Jiajia , Ding Lulu , Feng Yuejing , Tang Xue , Sun Long , Zhou Chengchao
Published: December 2020

Background: Married female caregivers face a higher risk of an informal care burden than other caregivers. No study has explored the effect of socioeconomic status (SES) on the intensity of informal care provided by married female caregivers in China. The purpose of this study is to empirically examine how the SES of married female caregivers affects the intensity of the informal care they provide for their parents/parents-in-law in China.Methods: The data for this study were drawn from 8 waves of the China Health and Nutrition Survey (CHNS). The respondents were married women whose parents/parents-in-law needed care and lived in the same city as them. SES was defined based on four indicators: education, economic status, employment status, and hukou (China’s household registration system). Informal caregivers were divided into three categories: non-caregivers (0 hrs/week), low-intensity caregivers (less than 10 hrs/week), and high-intensity caregivers (10 hrs/week and above). Multinomial logistic regression analysis was used to examine the relation between SES and the likelihood of a low- and high-intensity caregiving among married female caregivers, adjusting for age, family characteristics and survey wave.Results: Of the 2661 respondents, high-intensity and low-intensity caregivers accounted for 16.35% and 21.27%, respectively. The multinomial logistic regression results showed that the likelihood of being a high-intensity caregiver versus (vs. a non-caregiver) increased as the caregiver’s educational attainment increased (p < 0.05), and that high economic status was related to the likelihood of being a high-intensity caregiver, but this relationship was only significant at the 10% level. Urban females were 1.34 times more likely than their rural counterparts to provide low-intensity care vs. no care (p < 0.05) and were 1.33 times more likely to provide high-intensity care vs. no care (p < 0.05). Employed females were 1.25 times more likely than those unemployed females to provide low-intensity care vs. no care (p < 0.05).Conclusions: Differences in SES were found between high-intensity caregivers and low-intensity caregivers. Women with high educational attainment and urban hukou were more likely to provide high-intensity informal care, and women who were employed and had urban hukou were more likely to provide low-intensity care.
The positive RNASEH1-AS1/has-miR-218-5p/NET1 feedback loop mediated by POU2F1 contributes to the development and progression of human lung squamous carcinoma
Authors: Jia Jing-hao , Wang Jing , Yu Jia-rui , Gao Peng , Liu Yan-kun , Li Yu-feng , Sun Guo-gui , Shi Gao-feng
Published: December 2020

Background At the molecular level, competing endogenous RNAs (ceRNAs) regulate other RNA transcripts by competing for shared microRNAs (miRNA). Notably, miRNAs negatively regulate gene expression at the levels of mRNA stability and translation suppression.MethodsWe measured theexpression of miR-218-5p and RNASEH1-AS1 in clinical lung squamous cell carcinoma tissues using qRT-PCR. In an attempt to explore the roles of miR-218-5p and RNASEH1-AS1 in determining the malignant phenotype of NCI-H520 cells, colony formation and MTT assays were performed to measure cell viability and proliferation, and transwell invasion and wound healing assays were performed to examine cell migration and invasion. A ChIP assay was conducted to confirm the direct binding of POU2F1 to the RNASEH1-AS1 promoter.ResultsIn this investigation, the expression of the lncRNA RNASEH1-AS1 is upregulated in human lung cancer tissues, and it functions as a miRNA sponge for hsa-miR-218-5p in human lung squamous carcinoma cells. The lncRNA RNASEH1-AS1 facilitates the growth and motility of lung squamous carcinoma cells, while miR-218-5p exerts the opposite effects. NET1 and POU2F1 are validated as direct and functional targets of miR-218-5p. The downregulation of miR-218-5p releases the suppression of NET1 and POU2F1. POU2F1 binds directly to the lncRNA-RNASEH1-AS1 promoter and functions as transcription factor to enhance the promoter activity of RNASEH1-AS1.ConclusionsOverall, the positive RNASEH1-AS1/hsa-miR-218-5p/NET1/POU2F1 feedback loop can help us understand the regulatory mechanism underlying the genesis and progression of human lung squamouscarcinoma, possibly providing new biomarkers for its diagnosis and treatment.
Differential microRNAs expression profiles in liver from three different lifestyle modification mice models
Authors: Gong Huan , Zhang Ming , Han Yiwen , Zhang Ying , Pang Jing , Zhao Yanyang , Chen Beidong , Wu Wei , Qi Ruomei , Zhang Tiemei
Published: December 2020

Background MicroRNAs play an important role in many fundamental biological and pathological processes. Defining the microRNAs profile underlying the processes by beneficial and detrimental lifestyles, including caloric restriction(CR), exercise and high-fat diet(HF), is necessary for understanding both normal physiology and the pathogenesis of metabolic disease. We used the microarray to detect microRNAs expression in livers from CR, EX and HF mice models. After predicted potential target genes of differentially expressed microRNAs with four algorithms, we applied GO and KEGG to analyze the function of predicted microRNA targets. Results We describe the overall microRNAs expression pattern, and identified 84 differentially expressed microRNAs changed by one or two or even all the three lifestyle modifications. The common and different enriched categories of gene function and main biochemical and signal transduction pathways were presented. Conclusions We provided for the first time a comprehensive and thorough comparison of microRNAs expression profiles in liver among these lifestyle modifications. With this knowledge, our findings provide us with an overall vision of microRNAs in the molecular impact of lifestyle on health as well as useful clues for future and thorough research of the role of microRNAs.
Model to assess workload of village doctors in the National Essential Public Health Services Program in six provinces of China
Authors: Yin Delu , Yin Tao , Yang Huiming , Wang Lihong , Chen Bowen
Published: December 2020

Background: No studies, particularly quantitative analyses, have been conducted regarding the workload of village doctors in the National Essential Public Health Services (NEPHS) program and differences in service delivery by village doctors, according to region and services. In this study, we developed a quantitative analysis approach to measure the workload of NEPHS provided by village doctors in six provinces of China in 2016. We aimed to identify areas and services of the NEPHS needing improvement, so as to implement targeted measures to ensure adequate delivery of NEPHSs in rural remote underserved areas.Methods: Based on survey data from 300 town hospital centers (THCs) located in 60 counties in the six selected provinces, we calculated village doctors’ share of workload under the NEPHS using the equivalent value (EV) model. To define the workload and corresponding EV of each NEPHS, a series of five meetings was held with THC managers, public health workers, family physicians, nurses and village doctors. Field observations were conducted to verify the workload and EV of each service.Results: Village doctors’ share of the workload under the NEPHS program was 43.71% across the 300 sampled THCs in six provinces. The village doctors’ workload shares for different NEPHS ranged from 17.14% to 57.00%. The percentage workload undertaken by village doctors under the NEPHS program varied across different provinces, with the highest proportion 63.4% and the lowest 28.5%.Conclusions: The total NEPHS workload assigned to village doctors by THCs in the six sampled provinces exceeded the Chinese government’s requirement of 40%, but the workload proportion in some provinces was less than 40%. In addition, the percentage workload for some NEPHS undertaken by village doctors was lower than others. We suggest conducting district-level analysis of the workload among village doctors under the NEPHS program using the EV method, to identify areas and services needing improvement, to implement targeted measures to expand and promote health service provision in China’s rural underserved areas.
Implementation fidelity of nutritional counselling, Iron and Folic Acid supplementation guidelines and associated challenges in rural Uasin Gishu County Kenya
Authors: Riang'a Roselyter Monchari , Nangulu Anne Kisaka , Broerse Jacqueline E.W.
Published: December 2020

BackgroundImplementation fidelity which is defined as the degree to which programmes are implemented as intended is one of the factors that affect programme outcome, thus requiring careful examination. This study aims to acquire insight into the degree to which nutritional counselling and Iron and Folic Acid supplementation (IFAs) policy guidelines during pregnancy have been implemented as intended and the challenges to implementation fidelity.MethodsData were collected in rural Uasin Gishu County in the western part of Kenya through document analysis, questionnaires among intervention recipients (n=188) and semi-structured interviews with programme implementers (n=6). Data collection and analysis were guided by an implementation fidelity framework. We specifically evaluated adherence to intervention design (content, frequency, duration and coverage), exposure or dosage, quality of delivery and participant responsiveness.ResultsCoverage of nutritional counselling and IFAs policy is widespread. However, partial provision was reported in all the intervention components. Only 10% accessed intervention within the first trimester as recommended by policy guidelines, only 28% reported receiving nutritional counselling, only 18% and 15% of the respondents received 90 or more iron and folic acid pills respectively during their entire pregnancy period, and 66% completed taking the IFAs pills that were issued to them. Late initial bookings to antenatal care, drug stock shortage, staff shortage and long queues, confusing dosage instructions, side effects of the pills and issuing of many pills at one go, were established to be the main challenges to effective implementation fidelity. Anticipated health consequences and emphasis by the health officer to comply with instructions were established to be motivations for adherence to nutritional counselling and IFAs guidelines.ConclusionsImplementation fidelity of nutritional counselling and IFAs policy in Kenya is generally weak. There is need for approaches to enhance early access to interventions, enhance stock availability, provide mitigation measures for the side effects, as well as intensify nutritional counselling to promote the consumption of micronutrient-rich food sources available in the local environment to substitute for the shortage of nutritional supplements and low compliance to IFAs.
Self-reported interpersonal and educational/vocational difficulties in young adults with a history of transient psychotic experiences: findings from a population-based study
Authors: Coughlan Helen , Walton-Ball Erin , Carey Eleanor , Healy Colm , O’Regan-Murphy Grace , Uidhir Aoife Nic , Clarke Mary , Cannon Mary
Published: December 2020

Background Psychotic experiences (PEs) are not uncommon in young people and are associated with both psychopathology and compromised global functioning. Although psychotic experiences are transient (short-lived, self-resolving and non-recurring) for most people who report them, few studies have examined the association between early transient PEs and later functioning in population samples. Additionally, studies using self-report measures of interpersonal and educational/ vocational difficulties are lacking. The aim of this study was to examine the relationship between transient psychotic experiences and self-reported interpersonal and educational/vocational difficulties in adolescence and young adulthood. Methods Participants were 103 young people from a longitudinal population-based study cohort of mental health in Ireland. They attended for baseline clinical interviews in childhood (age 11-13) and were followed up in young adulthood (age 19-25). Participants who reported psychotic experiences at baseline but not at follow-up were classified as having transient psychotic experiences. Data from both time-points were used to examine the association between transient psychotic experiences and self-reported interpersonal and educational/ vocational difficulties in young adulthood using poisson regression modelling.Results Young people with a history of transient psychotic experiences reported significantly higher interpersonal (adj IRR: 1.83, 95%ileCI: 1.10- 3.02, p = .02) and educational/vocational (adj IRR: 2.28, 95%ileCI: 1.43- 3.64, p = .001) difficulties during adolescence. However, no significant differences in interpersonal (adj IRR: 0.49, 95%ileCI: 0.10-2.30, p = .37) or educational/vocational (adj IRR: 0.88, 95%ileCI: 0.37-2.08, p = .77) difficulties were found in young adulthood. Self-reported interpersonal and educational/vocational difficulties in young people both with and without a history of transient psychotic experiences decreased between adolescence and young adulthood.Conclusions Young people with transient psychotic experiences have increased interpersonal and educational/vocational difficulties in adolescence but these may not persist into the young adult years. This finding indicates that early psychotic experiences may not confer high risk for long-term interpersonal or educational/vocational deficits among young people who experience these phenomena transiently.
Rural context, single institution prospective outcomes after Enhanced Recovery colorectal surgery protocol implementation
Authors: Smucker Levi , Victory Jennifer , Scribani Melissa , Oceguera Luis , Monzon Raul
Published: December 2020

Background: Rural hospitals face unique challenges to adopting Enhanced Recovery protocols after colorectal surgical procedures. There are few examples of successful implementation in the United States, and fewer yet of prospective, outcomes-based trials. Methods: This study drew data from elective bowel resection prospectively collected, retrospectively analyzed cases 2 years prior (n=214) and 3 years after (n=224) implementing an ERAS protocol at a small, rural health network in upstate New York. Primary outcomes were cost, length-of-stay, readmission rate, and complications.Results: The implementation required changes and buy-in at multiple levels of the institution. There was a statistically significant reduction in mean length of stay (6.9 versus 5.1 days) and per-patient savings to hospital ($3000) after implementation of ERAS protocol. There was no significant change in rate of 30-day readmissions or complications. Conclusions: The authors conclude that for rural-specific barriers to implementation of Enhanced Recovery protocols there are specific organizational strategies that can ultimately yield sustainable endpoints.
Eleven-year alterations in hand deformities in rheumatoid arthritis by comprehensive assessment using cluster analysis and analysis of covariance
Authors: Toyama Shogo , Tokunaga Daisaku , Tsuchida Shinji , Kushida Rie , Oda Ryo , Kawahito Yutaka , Takahashi Kenji
Published: December 2020

BackgroundAlthough drug therapy in rheumatoid arthritis has recently improved, treating established rheumatoid hand, consisting of three major deformities—thumb deformity, finger deformities, and ulnar drift— remains a challenge. Underlying complex pathophysiology makes it difficult to comprehensively understand these deformities, and comprehensive assessment methods require accumulated skill and long learning curves. We aimed to establish an easier composite method of understanding the pathophysiology and to elucidate alterations in deformities.MethodsWe established a rheumatoid hand cohort in 2004 and clinically evaluated 134 hands (67 patients). We repeated the evaluations in 2009 (100 hands in 52 patients) and 2015 (63 hands in 37 patients) after case exclusion. Thumb deformities, finger deformities (swan-neck and boutonnière deformity), and ulnar drift were semi-quantified and entered as parameters into a two-step cluster (cross-sectional) analysis for the data in 2004. The parameters in each cluster were plotted at each evaluation point. Two-way analysis of covariance was performed to examine whether differences existed between evaluation points and clusters for the deformity parameters.ResultsFive clusters were most appropriate to clarify each deformity: cluster 1: minimal deformity; cluster 2: type 1 thumb deformity; cluster 3: thumb deformity and severe boutonnière deformity; cluster 4: type 2 or 3 thumb deformity and severe ulnar drift; cluster 5: thumb deformity and severe swan-neck deformity. Clusters 1 and 2 had higher function than cluster 5, and cluster 3 had moderate function. Clusters 1–4 had similar disease duration, and showed different paths of deformity progression from disease onset. We considered clusters 1 and 2 as a conservative subset and clusters 3, 4, and 5 as a progressive subset. Over time, thumb deformity type altered to other types, and swan-neck deformity worsened significantly.ConclusionsOur comprehensive assessment indicated five deformity patterns and a progressive course in rheumatoid hand. Knowledge of the characteristics of the progressive subset may allow rheumatologists to more easily determine practical interventions and functional prognosis.
Analysis across diverse fish species highlights no conserved transcriptome signature for proactive behaviour.
Authors: Planellas Sonia Rey , Jin Xingkun , Damsgard Borge , Begout Marie-Laure , Mackenzie Simon
Published: December 2020

Background: Consistent individual differences in behaviour, known as animal personalities, have been demonstrated within and across species. In fish, studies applying an animal personality approach have been used to resolve variation in physiological and molecular data suggesting a linkage, genotype-phenotype, between behaviour and transcriptome regulation. In this study, using three fish species (zebrafish; Danio rerio, Atlantic salmon; Salmo salar and European sea bass; Dicentrarchus labrax), we firstly address whether personality-specific mRNA transcript abundances are transferrable across distantly-related fish species and secondly whether a proactive transcriptome signature is conserved across all three species.Results: Previous zebrafish transcriptome data was used as a foundation to produce a curated list of mRNA transcripts related to animal personality across all three species. mRNA transcript copy numbers for selected gene targets show that differential mRNA transcript abundance in the brain appears to be partially conserved across species relative to personality type. Secondly, we performed RNA-Seq using whole brains from S. salar and D. labrax scoring positively for both behavioural and molecular assays for proactive behaviour. We further enriched this dataset by incorporating a zebrafish brain transcriptome dataset specific to the proactive phenotype. Our results indicate that cross-species molecular signatures related to proactive behaviour are functionally conserved where shared functional pathways suggest that evolutionary convergence may be more important than individual mRNAs.Conclusions: Our data supports the proposition that highly polygenic clusters of genes, with small additive effects, likely support the underpinning molecular variation related to the animal personalities in the fish used in this study. The polygenic nature of the proactive brain transcriptome across all three species questions the existence of specific molecular signatures for proactive behaviour, at least at the granularity of specific regulatory gene modules, level of genes, gene networks and molecular functions.