bluuebunny/crossref_metadata_2025 huggingface dataset:
Huaier Extract Inhibits Proliferation and Promotes Apoptosis via the MAPK Pathway in Human Osteosarcoma Cells
Authors: Guan Xin , Zhai Yaxi , Tang Rong , Yang Panpan , Li Dongfang , Kou Yuying , Yue Ziqi , Zhang Yi , Sun Lin , Zhang Sen , Liu Hongrui , Guo Jie , Hasegawa Tomoka , Li Minqi
Published: January 2021

Background: Osteosarcoma is a common pediatric bone malignancy. Huaier, a traditional Chinese medicine, attracts increasing attention for its antitumor effect. The aim of this study is to investigate the inhibitory effect and molecular mechanisms of Huaier in osteosarcoma cells. Methods: Bioinformatics was performed to determine the biological processes and pathways connected to Huaier. The CCK-8 method and flow cytometry were used to detect the cell viability, cell cycle distribution and apoptosis of osteosarcoma cells (MG-63 and MNNG/HOS). Western blot was applied to assess the expression of proteins involved in apoptosis, cell cycle and the MAPK pathway. Results: Huaier could inhibit osteosarcoma cells proliferation by arresting cells in the G0/G1 phase. The extract also suppressed invasion and migration, while promoting the apoptosis of osteosarcoma cells in a time- and dose-dependent manner. Under Huaier stimulation, the expression of p-ERK/ERK, Cyclin D1 and Bcl-2 decreased, while the expression of p-JNK/JNK, p-P38/P38, P21, P27, Bax and Caspase3 increased in osteosarcoma cells. Conclusions: Our findings demonstrated for the first time that Huaier extract could inhibit proliferation and promote apoptosis in osteosarcoma cells via the MAPK pathway in vitro, suggesting that Huaier may be developed as a chemopreventive medicine for the treatment of osteosarcoma.
A biomechanical analysis of four anterior cervical techniques to treating multilevel cervical spondylotic myelopathy: a finite element study
Authors: Li Zhonghai , Liu Hui , Yang Ming , Zhang Wentao
Published: January 2021

Background: The decision to treat multilevel cervical spondylotic myelopathy (MCSM) remains controversial. The purpose of this study is to compare the biomechanical characteristics of the intervertebral discs at the adjacent segments and internal fixation, and to provide scientific experimental evidence for surgical treatment of MCSM. Methods: An intact C2-C7 cervical spine model was developed and validated. Four additional models were developed from the fusion model, including multilevel anterior cervical discectomy and fusion (mACDF), anterior cervical corpectomy and fusion (ACCF), hybrid decompression and fusion (HDF), and mACDF with cage alone (mACDF-CA). Biomechanical characteristics on the plate and the disc of adjacent levels (C2/3, C6/7) were comparatively analyzed. Results: Of the four models, stress on the upper (C2/3) adjacent intervertebral disc was the lowest in the mACDF-CA group and highest in the ACCF group. Stress on the intervertebral discs at adjacent segments was higher for the upper C2/3 than the lower C6/7 intervertebral disc. In all models, the mACDF-CA group had the lowest stress on the intervertebral disc, while the ACCF group had the highest stress. In the three surgical models with titanium plate fixation (mACDF, ACCF, and HDF), the ACCF group had the highest stress at the titanium plate-screw interface, while the mACDF group had the lowest stress Conclusion: Among the four anterior cervical reconstructive techniques for MCSM, mACDF-CA makes little effect on the adjacent disc stress, which might reduce the incidence of adjacent segment degeneration (ASD) after fusion. However, the accompanying risk of the increased incidence of cage subsidence should never be neglected.
Image Alignment in Pose Variations of Human Faces by using Corner Detection Method and its Application for PIFR System
Authors: Dubey Deepika , Tomar Geetam Singh
Published: January 2021

The Major challenge in the recent face recognition techniques is to deal with pose variations during matching as facial image differences occurs due to motion/rotation in image, which is very large. The Pose Invariant Face Recognition is still an open area for developers to find solution. In this paper focus is on PIFR techniques and combined it with other algorithms for enhancing the results. Here we are using the Harris Corner Detection model along with Image alignment and Image tagging to get front face images. By generalization different tricks to handle the pose on face images has minimized the pose variation. On evaluating performance of the system, we have also calculate the Euler angle and their position change and according to it correct the pose variation. The results are in accordance with the expected lines.
The Evolution of Plant Harvesting at The Dawn of Agriculture: Perspectives from Sickle Gloss Texture Analyses
Authors: Ibáñez Juan , Anderson Patricia , Arranz-Otaegui Amaia , González-Urquijo Jesús , Jörgensen-Lindahl Anne , Mazzucco Niccolò , Pichon Fiona , Richter Tobias
Published: January 2021

Archaeobotanical and genetic analysis of modern plant materials are drawing a complex scenario for the origins of cereal agriculture in the Levant. This paper presents an improved method for the study of early farming harvesting systems based on the texture analysis of gloss observed on sickle blades. We identify different harvesting activities (unripe/semi-ripe/ripe cereal reaping and reed and grass cutting) and evaluate their evolution during the time when plant cultivation activities started and domesticated crops appeared in the Levant (12,800 to 7000 cal BC). The state of maturity of cereals when harvested shifted through time from unripe, to semi-ripe and finally to ripe. Most of these changes in harvesting techniques are explained by the modification of crops during the transition to agriculture. The shift of plant harvesting strategies was neither chronologically linear nor geographically homogeneous. Fully mature cereal harvesting starts to be dominant around 8500 cal BC in Southern Levant and one millennium later in Northern Levant, which fits with the appearance of domestic varieties in the archaeobotanical record. The evolution of plant harvesting better fits with the gradualist model of explanation of cereal agriculture than with the punctuated one.
Technical and Economic Feasibility of the First Wind Farm on Egypt's Mediterranean Sea Coast
Authors: Ahmed Ahmed Shata
Published: January 2021

Recently, the utilization of wind turbines in the production of clean energy has been increased to achieve sustainable electricity supply, as planned by the government of Egypt through the use of renewable resources like wind power. This paper purposed to assess the wind power potential for the coastal area in Sidi Barrani province, a meteorological station with mast of 10 m was constructed near the Mediterranean Sea shore in Egypt. The density of wind power was assessed at the level of 100 m monthly and seasonally after taking into account the correction of air density. On the annual basis, the station is rated with high potential 441 kW/m2. This is an ideal location for large-scale wind turbine to generate sustainable electricity. A performance assessment was executed using three commercialized wind generators having capacity of 2000 kW from different manufacturers and were also equal in height and rotor diameter, for choosing the best unit suitable for the target area. The economic analysis of a 200 MW coastal wind farm in the studied area was done using the advanced method of present value costs. The findings prove that the proposed project could produce approximately 988 GWh per year of electrical energy with an economic price of 1.7 US cents per kWh. Consequently, this huge sustainable electrical energy produced from this project can be transferred to Southern European countries along the Mediterranean, because it is relatively more than the Egypt's needs. It also limits the burning of local petroleum products, as well as stopping the emission of thousands of tons of carbon annually.
Knowledge and Determinants of Women’s Knowledge on Vertical Transmission of HIV and AIDS in South Africa
Authors: Darteh Eugene Kofuor Maafo , Abraham Susanna Aba , Seidu Abdul-Aziz , Chattu Vijay , Yaya Sanni
Published: January 2021

Background HIV/AIDS is still one of the major public health concerns globally. It is one of the major contributory causes of deaths among women in the reproductive age (15-49 years) and has resulted in about 14 million orphaned children globally. Knowledge of Mother-to Child transmission is one of the strategies to fight against HIV. This study, therefore, sought to assess the knowledge and determinants of women’s knowledge on vertical transmission of HIV and AIDS in their reproductive age in South Africa. MethodsData were obtained from the South Africa Demographic and Health Survey (SADHS) 2016. Both descriptive (frequencies and percentages) and inferential analysis (binary logistic regression) were conducted and the statistical significance was set at p<0.05. ResultsThe prevalence of knowledge of mother to child transmission of HIV and AIDS during pregnancy, delivery, breastfeeding and at least knowledge of one source are 87.0%, 81.1%, 80.3% and 91.4% respectively. Women with secondary [AOR=1.271,CI=1.04,1.55] and higher [AOR=1.495, CI=1.18,1.89], those in urban areas [AOR=1.153,CI=[1.07,1.25], Limpopo [AOR=1.341,CI=1.16,1.55], Gauteng [AOR=1.337,CI=[1.15,1.55] and North west [AOR=1.410,CI=[1.22,1.63], those who read newspaper at least once a week [AOR=1.136,CI=1.05,1.23], and those who listen to radio less than once a week [AOR=1.163,CI=[1.02,1.33] had higher odds of knowledge on mother to child transmission of HIV and AIDs. However, those with parity 0 [AOR=0.783, CI= [0.68,0.90], poorest [AOR=0.837, CI=0.73,0.96] had lower odds of knowledge of mother to child transmission of HIV and AIDS.Conclusion The study has demonstrated that there is relatively high knowledge of mother to child transmission of HIV and AIDS in South Africa. The factors associated with the knowledge are educational level, wealth status, place of residence, the region of residence, exposure to mass media and parity. To further increase the knowledge, it is imperative to adopt various messages and target respondents in different part of SSA through the mass media channels. This should be done taking cognizant of the rural-urban variations and socio-economic status.
Cartilage-targeting Poly(Ethyleneglycol) (PEG)-formononetin (FMN) Nanodrug for Treating Osteoarthritis
Authors: Xiong Wei , Lan Qiumei , Liang Xiaonan , Zhao Jinmin , Huang Hanji , Zhan Yanting , Qin Zainen , Jiang Xianfang , Zheng Li
Published: January 2021

Intra-articular (IA) injection is an efficient treatment for osteoarthritis. Such a treatment will minimize systemic side effects and avoid the inconvenience of frequent injections. However, the joint has poor bioavailability for systemically administered drugs and experiences rapid clearance of therapeutics after intra-articular injection. Delivering system modified through active targeting strategies to facilitate localization within specific joint tissues such as cartilage is hopeful to increase the therapeutic effects. In this study, we designed a nanoscaled amphiphilic and cartilage-targeting polymer-drug delivery system by using formononetin (FMN)-poly(ethylene glycol) (PEG) (denoted as PCFMN), which was prepared by PEGylation of FMN followed by coupling with cartilage-targeting peptide (CollBP). Our results showed that PCFMN was approximately regular spherical with the average diameter about 218 nm. The in vitro test using IL-1β stimulated chondrocytes indicated that PCFMN were biocompatible and upregulated anabolic genes while simultaneously downregulated catabolic genes of the articular cartilage. The therapeutic effects in vivo indicated that PCFMN could effectively attenuate the progression of OA as evidenced by immunohistochemical staining and histological analysis. In addition, PCFMN showed higher intention time in joints and better anti-inflammatory effects than FMN, indicating the efficacy of cartilage targeting nanodrug on OA. This study may provide reference for clinical OA therapy.
Association of Blood Biomarkers and Autoimmunity with Immune Related Adverse Events in Patients with Cancer treated with Immune Checkpoint Inhibitors
Authors: Michailidou Despina , Khaki Ali , Morelli Maria , Diamantopoulos Leonidas , Singh Namrata , Grivas Petros
Published: January 2021

Background: Patients with cancer treated with immune checkpoint inhibitors (ICIs) develop immune related adverse events (irAEs), however biomarkers are lacking. We hypothesized that clinicopathologic and laboratory factors would be associated with irAE risk and overall survival (OS) in this population.Methods: In a retrospective study of patients treated with ICIs we collected clinicopathologic, laboratory, irAEs and outcomes data. The association between baseline blood biomarkers, clinicopathologic features and irAEs was assessed by logistic regression adjusting for age, sex, smoking, cancer type, performance status, concomitant other systemic therapy, history of autoimmune disease (AD) and chronic infection. Optimal cutoff values of biomarkers were identified by recursive partitioning analysis.Results: 470 patients were identified; 156 (33%) developed irAEs, which were associated with baseline absolute lymphocyte count >2.6k/ul (adjusted [a]OR:4.12), neutrophil to lymphocyte ratio (NLR) ≤5.3 (aOR:2.08) and monocyte to lymphocyte ratio (MLR)≤0.73 (aOR:3.11). Patients with pre-existing AD (aOR:2.81), family history of AD (aOR:5.86), and ICI combination (aOR:2.26) had higher odds of irAEs. Baseline NLR≤5.3 (aHR:0.68) and MLR≤0.73 (aHR:0.43) were associated with longer OS.Conclusion: irAE were associated with autoimmune history, ICI combination and baseline laboratory measurements. Lower NLR and MLR may have favorable prognostic value. Our hypothesis-generating findings require validation in larger prospective studies.
The Impact of Organic Extracts of Seasonal PM2.5 on Primary Human Lung Epithelial Cells and Their Chemical Characterization
Authors: Park Jieun , Lee Kyoung-Hee , Kim Hyewon , Woo Jisu , Heo Jongbae , Lee Chang-Hoon , Yi Seung-Muk , Yoo Chul-Gyu
Published: January 2021

Background: Lung epithelial cells serve as first line of defense against various inhaled pollutant particles. This study focused on assessing the impact of organic extracts of PM2.5 collected in Seoul, South Korea on primary human lung epithelial cells and identifying the relevant components and sources which induced lung epithelial cell injury.Results: We used primary lung epithelial cells isolated directly from healthy donors and evaluated the effects of organic compounds of twelve selected, seasonal PM2.5 on inflammation, cellular aging, and macroautophagy in primary lung epithelial cells. Organic extracts of PM2.5 specifically induced neutrophilic chemokine, interleukin-8, via extracellular signal regulated kinase activation. Moreover, PM2.5 significantly increased the expression of aging markers (p16, p21, and p27) and activated macroautophagy. Average mass concentrations, OC and EC, had no significant correlations with PM2.5 effects. However, regression analysis showed that polycyclic aromatic hydrocarbons and n-alkanes were the most relevant components of PM2.5 correlated with neutrophilic inflammation. Vegetative detritus and residential bituminous coal combustion sources were strongly correlated with neutrophilic inflammation, aging and macroautophagy activation.Conclusions: These data suggest that the chemical composition of PM2.5 is crucially important to determine the adverse health effects of PM2.5. Our study provides encouraging evidence to regulate the harmful components of PM2.5 in Seoul.
Epidemiological analysis of 3,219 COVID-19 outbreaks in the state of Baden-Wuerttemberg, Germany.
Authors: Dressler Aparna , Finci Iris , Wagner-Wiening Christiane , Eichner Martin , Brockmann Stefan
Published: January 2021

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has emerged as an unprecedented global crisis challenging health systems. The dynamic nature of the pandemic warrants ongoing characterisation and assessment of outbreak settings to identify groups at greatest risk, to establish early measures to curb transmission. The current analysis aims to assess and characterise SARS-CoV-2 outbreaks in the state of Baden-Wuerttemberg. Methods: We analysed all mandatory notified (i.e. laboratory-confirmed) coronavirus disease (COVID-19) outbreaks from the state of Baden-Wuerttemberg in calendar weeks 18 to 49 (from April 27 to December 06, 2020). We used the following classification for settings: asylum and refugee accommodation, care homes, care facilities, day care child centers, hobby related, hospitality, hospitals, households, other, residence halls, schools, supported housing, training schools, transportation, treatment facilities, and workplace (occupational). We used R program version 3.6.3 for analysis. Results: In the current analysis, 3,219 outbreaks with 22,238 individuals were included. Around 48% of all outbreaks in this period were in household settings and hobby related activities. We observed an exponential increase in the number of notified outbreaks starting around the 41th week with N = 291 outbreaks reported in week 49. We observed an increase in hospitalisations, and mortality associated with COVID-19 outbreaks in care homes after the 40th week. Overall, 70% (500/715) of all deceased persons in outbreaks in the study period were in care homes compared to 4.2% in household settings (30/715). Conclusions: The increase in the number of outbreaks and in the number of cases per outbreak in high-risk settings, specifically in care homes after the 40th week highlights the imperative of controlling transmission in vulnerable populations.
To Explore the Mechanism of Tibetan Medicine Gaoyuan' an Capsule Improving Plateau Hypoxia Tolerance
Authors: He Chunjuan , Xing Shishi , Peng Linna , Li Dandan , Wang Li , Yuan Dongya , Jin Tianbo
Published: January 2021

Background: Tibetan medicine Gaoyuan 'an capsule (GYAC) is widely used to prevent pulmonary edema at high altitude, but the specific mechanism of its action has not been explored. Therefore, based on bioinformatics and network pharmacology, this study analyzed the mechanism of improving hypoxia tolerance of GYAC, and provided new ideas for the prevention of altitude disease.Methods: The effective components and corresponding targets of GYAC were screened by using the Chinese herbal medicine network database, and the key targets of diseases were retrieved by using Genecards, OMIM and PubMed database with the key word "hypoxia". The drug targets and disease targets were mapped into common targets to obtain the final target. Cytoscape 3.7.2 was used to analyze the topological network and construct the Herbs-Components-Targets network and Core Targets-Signal Pathways network. GO function and KEGG enrichment analysis were performed to predict the mechanism of action, and molecular docking techniques were used to verify the binding force of target compounds and targets.Results: The results showed that GYAC enhanced hypoxia tolerance by simultaneously regulating the functions of various signaling proteins, including IL6、TNF、NOS3、VEGFA etc. The main regulatory pathways were HIF-1 signaling pathway, Chagas disease, and pathway in cancer. The main biological processes involved are the positive regulation of RNA polymerase II promoter transcription, the extracellular space as the cell component, and the cytokine activity as the molecular function. Molecular docking shows that hydrogen bonding is the main form of binding between drug molecules and proteins.Conclusions: GYAC is mainly directed at the interaction of HIF-1 signaling pathway with targets such as IL6 and TNF to improve the body's hypoxia tolerance, that is, they are multi-pathway, multi-pathway and multi-target interaction.
Healthcare Utilization of Below Poverty Line Population under Government-Funded Health Protection Scheme in one sub-district in Bangladesh: A Cross-Sectional Study
Authors: Hasan Md. Zahid , Ahmed Mohammad Wahid , Mehdi Gazi Golam , Khan Jahangir AM , Islam Ziaul , Chowdhury Mahbub Elahi , Ahmed Sayem
Published: January 2021

BackgroundThe below poverty line (BPL) population in rural Bangladesh have low access to hospital inpatient-care (IPC) services. The Government of Bangladesh (GoB) launched pilot Shasthyo Suroksha Karmasuchi (SSK) at Kalihati Upazila of Tangail district in 2016 aiming to improve IPC access of the BPL population and financial protection for healthcare. The GoB funded scheme provides IPC for 78 diseases and outpatient consultation through an existing health facility. In this study, we aimed to assess the level of healthcare utilization among the scheme beneficiaries and identify the associated factors with utilization.MethodsThis was an exploratory study with a cross-sectional household survey conducted from July to September 2018 among 806 sampled households using a structured questionnaire. Data on illness and healthcare utilization was collected from the selected households for the last 90 days of the interview date. A logistic regression model was applied to determine the factors associated with healthcare utilization from SSK facility.ResultsOverall, 8% of the ill patients in the last 90 days prior to survey sought healthcare from SSK facilities (n=639; total patients who sought care), 28% from medically trained providers (MTPs), and 64% from non-MTPs. Of the 23 (3.6%) patients who sought inpatient care (IPC), less than half (10 patients) of them utilized IPC under SSK. Individuals with accident/injury, unemployed, having knowledge about SSK, non-BPL status, were more likely to utilize healthcare from SSK facility. Individuals reside more than 15 km away from facility, had 4-5 family members, and above secondary level education were less likely to utilize care from SSK facility.Conclusions It is evident that healthcare utilization of beneficiaries from the SSK scheme was very low. Effective strategies for enhancing knowledge on SSK benefits and precise BPL households targeting can be instrumental in increasing utilization of the scheme. The scheme also has a potential to bring the individuals under its coverage who utilize healthcare from other MTP and non-MTP.
Acting between guidelines and reality. Managers’ balancing between standardisation and adaptive behaviour in patient safety work- an interview study
Authors: Hedsköld Mats , Sachs Magna Andreen , Rosander Thorleif , von Knorring Mia , Harenstam Karin Pukk
Published: January 2021

Abstract

Background:
Safety culture can be described and understood through its manifestations in the organisation as artefacts, espoused values and basic underlying assumptions and is strongly related to leadership-yet it remains elusive as a concept. Even if the literature points to leadership as an important factor for creating and sustaining a mature safety culture, little is known about how the safety work of first line managers’ actually is done and how they balance the different and often conflicting organizational goals in everyday practice. The purpose of this study was to explore how health care first line managers perceive their role and how they promote patient safety and patient safety culture in their units.
Methods:
Interview study with first line managers in intensive care units in eight different hospitals located in the middle of Sweden. An inductive qualitative content analysis approach was used, this was then followed by a deductive analysis of the strategies informed by constructs from High reliability organizations.
Results:
We present how first line managers view their role in patient safety and exemplify concrete strategies by which managers promote patient safety in everyday work.
Conclusions:
Our study shows the central role of front-line managers in organizing for safe care and creating a culture for patient safety. Although promoted widely in Swedish healthcare at the time for the interviews, the HSOPSC was not mentioned by the managers as a central source of information on the unit’s safety culture.
Age at First Marriage and Fertility Decline in Dabat Health and Demographic Surveillance System Site, northwest Ethiopia: Decomposition analysis
Authors: Alazbih Nega Mihret , Kaya Assefa Hailemariam , Mengistu Mezgebu Yitayal , Gelaye Kassahun Alemu
Published: January 2021

Background: Fertility declines in Ethiopia have been documented since 1990s. Amhara National Regional State has recorded the most noticeable fertility decline. However, specific factors that explain the incipient course of fertility decline in the study area and their relative contributions were not well investigated. Hence, the purpose of this study was to determine the factors that contributed for fertility decline, and to assess the variations in fertility that can be attributed to both changes in characteristics and reproductive behaviors of women aged 15–49 years between 2008 and 2014 in Dabat Demographic and Health Surveillance System Site, Northwest Ethiopia.Methods: Cross sectional censuses were carried out in Dabat Health and Demographic Surveillance System site in 2008 and 2014. Data for 4,775 and 10,807 women with reproductive age in 2008 and 2014 were used for the analysis. Poisson regression model was employed to assess the trends of determinants of fertility, and Multivariate Decomposition technique was applied to evaluate observed changes in fertility using data from two consecutive cross-sectional censuses of Dabat HDSS conducted in 2008 and 2014.Results: The findings indicated that there was a reduction of an average 640.69 births per 1,000 women of the reproductive age during the year 2014 compared to the year 2008 in the surveillance site (P-value <0.001; 95% CI: -669.5 to -582.4). This overall change in fertility during the study period was attributed to both changing characteristics of women (the distribution effect) (76%) (P-value < 0.001; 95%CI: -524.74, -453.13, and their reproductive behavior (the effect shown by regression coefficients of the variables on the outcome) (24%) (P-value <0.001; 95% CI: -224.36 to -79.14). The drivers of the recent fertility decline during the study period were the shift observed in the age at first marriage, the change in the proportion of currently married women, the shift in women’s birth to later age and the change in women's educational status.Conclusion: This study indicated that the overall reduction in fertility was attributed to both changing characteristics of women and their reproductive behavior. The major contributors to the changes in fertility were the postponing of women’s first marriage to later age and the change in the proportion of currently married women over the study period. Encouraging women to complete at least secondary education are important to increase the age at first marriage and birth which intern accelerate the current fertility transition.
Association Between Supportive Interventions and Healthcare Utilization and Outcomes in Patients on Long-Term Prescribed Opioid Therapy Presenting to Acute Healthcare Settings: a systematic review and meta-analysis
Authors: Deschamps Jean , Gilbertson James , Straube Sebastian , Dong Kathryn , MacMaster Frank P. , Korownyk Christina , Montgomery Lori , Mahaffey Ryan , Downar James , Clarke Hance , Muscedere John , Rittenbach Katherine , Featherstone Robin , Sebastianski Meghan , Vandermeer Ben , Lynam Deborah , Magnussen Ryan , Bagshaw Sean M , Rewa Oleksa G
Published: January 2021

Background Long-term prescription of opioids by healthcare professionals has been linked to poor individual patient outcomes and high resource utilization. Supportive strategies in this population regarding acute healthcare settings may have substantial impact. Methods We performed a systematic review and meta-analysis of primary studies. The studies were included according to the following criteria: 1) age 18 and older; 2) long-term prescribed opioid therapy; 3) acute healthcare setting presentation from a complication of opioid therapy; 4) evaluating a supportive strategy; 5) comparing the effectiveness of different interventions; 6) addressing patient or healthcare related outcomes. We performed a qualitative analysis of supportive strategies identified. We pooled patient and system related outcome data for each supportive strategy.Results A total of 5664 studies were screened and 19 studies were included. A total of 9 broad categories of supportive strategies were identified. Meta-analysis was performed for the “supports for patients in pain” supportive strategy on two system-related outcomes using a ratio of means. The number of emergency department (ED) visits were significantly reduced for cohort studies (n = 6, 0.36, 95% CI [0.20-0.62], I2 = 87%) and randomized controlled trials (RCTs) (n = 3, 0.71, 95% CI [0.61-0.82], I2 = 0%). The number of opioid prescriptions at ED discharge was significantly reduced for RCTs (n = 3, 0.34, 95% CI [0.14-0.82], I2 = 78%).Conclusion For patients presenting to acute healthcare settings with complications related to long-term opioid therapy, the intervention with the most robust data is “supports for patients in pain”.
Comparative Evaluation of Six Molecular Assays based on RT-PCR and Cross Primer Isothermal Amplification for SARS-CoV-2 RNA Detection
Authors: Wu Shuang , Shi Xiaolu , Chen Qiongcheng , Jiang Yixiang , Zuo Le , Wang Lei , Jiang Min , Lin Yiman , Fang Shisong , Peng Bo , Wu Weihua , Liu Hui , Zhang Renli , Kwan Patrick S.L. , Hu Qinghua
Published: January 2021

Background: SARS-CoV-2 is a newly emerged coronavirus, causing the coronavirus disease 2019 (COVID-19) outbreak in December, 2019. As drugs and vaccines of COVID-19 remain in development, accurate virus detection plays a crucial role in the current public health crisis. Quantitative real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) kits have been reliably used for detection of SARS-CoV-2 RNA since the beginning of the COVID-19 outbreak, whereas isothermal nucleic acid amplification-based point-of-care automated kits have also been considered as a simpler and rapid alternative. However, as these kits have only been developed and applied clinically within a short timeframe, their clinical performance has not been adequately evaluated to date. We describe a comparative study between a newly developed cross-priming isothermal amplification (CPA) kit (Kit A) and five RT-qPCR kits (Kits B–F) to evaluate their sensitivity, specificity, predictive values and accuracy.

Methods: Fifty-two clinical samples were used including throat swabs (n=30), nasal swabs (n=7), nasopharyngeal swabs (n=7) and sputum specimens (n=8), comprising confirmed (n=26) and negative cases (n=26). SARS-CoV-2 detection was simultaneously performed on each sample using six nucleic acid amplification kits. The sensitivity, specificity, positive/negative predictive values (PPV/NPV) and the accuracy for each kit were assessed using clinical manifestation and molecular diagnoses as the reference standard. Reproducibility for RT-qPCR kits was evaluated in triplicate by three different operators using a SARS-CoV-2 RNA-positive sample. On the basis of the six kits’ evaluation results, CPA kit (Kit A) and two RT-qPCR Kits (Kit B and F) were applied to the SARS-CoV-2 detection in close-contacts of COVID-19 patients.

Results: For Kit A, the sensitivity, specificity, PPV/NPV and accuracy were 100%. Among the five RT-qPCR kits, Kits B, C and F had good agreement with the clinical diagnostic reports (Kappa≥0.75); Kits D and E were less congruent (0.4≤Kappa<0.75). Differences between all kits were statistically significant (P<0.001). The reproducibility of RT-qPCR kits was determined using a coefficients of variation (CV) between 0.95% and 2.57%, indicating good reproducibility.

Conclusions: This is the first comparative study to evaluate CPA and RT-qPCR kits’ specificity and sensitivity for SARS-CoV-2 detection, and could serve as a reference for clinical laboratories, thus informing testing protocols amid the rapidly progressing COVID-19 pandemic.

Keywords: SARS-CoV-2; COVID-19; nucleic acid detection; real-time reverse transcriptase PCR (RT-qPCR); cross-priming isothermal amplification (CPA)
Analysis of clinical characteristics of severe pertussis in infants and children: a retrospective study
Authors: Wang Caiying , Zhang Huimin , Zhang Yanlan , Xu Lin , Miao Min , Yang Hongling , Liu Yuhuan , He Shuxin , Pang Lin
Published: January 2021

Background: The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants. Methods: A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed. Results: Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% of the total patients were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with mild cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with severe pneumonia (100% vs. 0%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05). Conclusions: 1. Infants aged <3 months not vaccinated for pertussis appear more likely to become infected and have more severe disease. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis.
A method for estimating neighborhood characterization in the association with availability of sit-down restaurants and supermarkets
Authors: Peng Ke , Rodriguez Daniel A. , Hirsch Jana A. , Gordon-Larsen Penny
Published: January 2021

Background : Although neighborhood-level access to food differs by sociodemographic factors, almost all research on neighborhoods and food access has used a single construct of neighborhood context, such as income or race. Neighborhoods possess many interrelated built environment and sociodemographic characteristics, a condition that obscures relationships between neighborhood factors and food access. Methods : The objective of this study is to examine the association between neighborhood characterization and neighborhood food availability while accounting for the effects of many interrelated aspects of neighborhoods associated with food access. We used cluster analyses method that used multiple measures (e.g., population density, mix of land use, and sociodemographic factors) that are easy to obtain to define six neighborhood types in 1993 in the Twin Cities Region, Minnesota. We then used mixed effects regression models to estimate the differences in the relative availability of sit-down restaurants and supermarkets in 1993, 2001, and 2011 across the six neighborhood types. Results : Between 1993 and 2011, inner city neighborhoods experienced a greater increase in the percent of sit-down restaurants compared with urban core, urban, and aging suburb. The differences in the percent of sit-down restaurants between inner city and aging suburb, high-income suburb and suburban edge neighborhoods increased between 1993 and 2011. Using classification of neighborhood type based on sociodemographic and built environment characteristics, we found a complex and increasingly varied distribution of restaurants and food stores. Conclusions : The temporal increase in the relative availability of sit-down restaurants in inner cities after accounting for all restaurants might be associated with a higher proportion of residents who eat-away-from-home, which is associated with higher calorie and fat intake. Keywords: built environment, sociodemographic, food stores, urbanization
Clients and professionals elicit long-term care preferences by using ‘What matters to me’: A process evaluation
Authors: Leersum Catharina Margaretha van , Moser Albine , Steenkiste Ben van , Wolf Judith R.L.M. , Weijden Trudy van der
Published: January 2021

Background: ‘What matters to me’ is a five-category preference elicitation tool to assist clients and professionals in choosing long-term care. This study aimed to evaluate the use of and experiences with this tool.Methods: A mixed-method process evaluation was applied. Participants were clients, relatives, and professionals. They were all involved in decision-making on long-term care. Data collection comprised online user activity logs (N=71), questionnaires (N=38), and interviews (N=20). Descriptive statistics was used for quantitative data, and a thematic analysis for qualitative data.Results: Sixty-nine percent of participants completed one or more categories in an average time of 6.9 (±0.03) minutes. The tool was rated 6.63 (±0.88) out of seven in the Post-Study System Usability Questionnaire (PSSUQ). Ninety-five percent experienced the tool as useful in practice. Suggestions for improvement included a separate version for relatives and a non-digital version. Although professionals thought the potentially extended consultation time could be problematic, all participants would recommend the tool to others.Conclusion: ‘What matters to me’ seems useful to assist clients and professionals with preference elicitation for long-term care. Evaluation of the impact on consultations between clients and professionals by using ‘What matters to me’ is needed.
Comparative chloroplast genome s: insights into the evolution of the chloroplast genome of Camellia sinensis and the phylogeny of Camellia
Authors: li LI , Hu Yunfei , He Min , Zhang Bo , Wu Wei , Cai Pumo , Huo Da , Hong Yongcong
Published: January 2021

Background: Chloroplast genome resources can provide useful information for the evolution of plant species. Tea plant (Camellia sinensis) is among the most economically valuable member of Camellia. Here, we determined the chloroplast genome of the first natural triploid Chinary type tea (‘Wuyi narcissus’ cultivar of Camellia sinensis var. sinensis, CWN) and conducted the genome comparison with the diploid Chinary type tea (Camellia sinensis var. sinensis, CSS) and two types of diploid Assamica type teas (Camellia sinensis var. assamica: Chinese Assamica type tea, CSA and Indian Assamica type tea, CIA). Further, the evolutionary mechanism of the chloroplast genome of Camellia sinensis and the relationships of Camellia species based on chloroplast genome were discussed.Results: Comparative analysis showed the evolutionary dynamics of chloroplast genome of Camellia sinensis were the repeats and insertion-deletions (indels), and distribution of the repeats, indels and substitutions were significantly correlated. Chinese tea and Indian tea had significant differences in the structural characteristic and the codon usage of the chloroplast genome. Analysis of sequence characterized amplified region (SCAR) using sequences of the intergenic spacers (trnE/trnT) showed none of 292 different Camellia sinensis cultivars had similar sequence characteristic to triploid CWN, but the other four Camellia species did. Estimations of the divergence time showed that CIA diverged from the common ancestor of two Assamica type teas about 6.2 Mya (CI: 4.4-8.1 Mya). CSS and CSA diverged to each other about 0.8 Mya (CI: 0.4-1.5 Mya). Moreover, phylogenetic clustering was not exactly consistent with the current taxonomy of Camellia. Conclusions: The repeat-induced and indel-induced mutations were two important dynamics contributed to the diversification of the chloroplast genome in Camellia sinensis, which were not mutually exclusive. Chinese tea and Indian tea might have undergone different selection pressures. Chloroplast transfer occurred during the polyploid evolution in Camellia sinensis. In addition, our results supported the three different domestication origins of Chinary type tea, Chinese Assamica type tea and Indian Assamica type tea. And, the current classification of some Camellia species might need to be further discussed.
Myostatin and Markers of Bone Metabolism in Dermatomyositis
Authors: Kerschan-Schindl Katharina , Gruther Wolfgang , Föger-Samwald Ursula , Bangert Christine , Kudlacek Stefan , Pietschmann Peter
Published: January 2021

Background: In dermatomyostis (DM) patients, inflammation, reduced activity, and medication have a negative impact on the musculoskeletal system. Several endocrine factors are involved in muscle growth and bone turnover.Objective: We aimed to investigate factors regulating myogenesis and bone metabolism and to evaluate possible associations between these endocrine factors, muscle strength, and functional tests in DM patients.Methods: We conducted a cross-sectional study in 20 dermatomyositis patients. Serum levels of myostatin (MSTN), follistatin (FSTN), dickkopf 1 (Dkk1), sclerostin (SOST), periostin (PSTN), the receptor activator nuclear factor kB ligand (RANKL):osteoprotegerin (OPG) ratio and fibroblast growth factor 23 (FGF23) were determined. Physical function was evaluated by hand-held strength measurement, chair rising test, timed up and go test and the 3-minute walking test. Results: Serum MSTN and FGF23 levels (2.5 [1.9; 3.2] vs. 1.9 [1.6; 2.3] and 2.17 [1.45; 3.26] vs. 1.28 [0.79; 1.96], respectively; p<0.05) were significantly higher in DM patients than in controls. Dkk1 was significantly lower (11.4 [6.9; 20.0] vs. 31.8 [14.3; 50.6], p<0.01). Muscle strength and physical function tests correlated with each other (e.g. hip flexion – timed up and go test: r=-0.748, p<0.01).Conclusion: In DM patients, biochemical musculo-skeletal markers are altered and physical function shows deficits. All these tests reflect independent of each other different deficits in long-term DM patients which is important for the assessment of DM patients as well as planning of therapeutic interventions in clinical routine.
Prevalence of postural musculoskeletal symptoms among dental students in United Arab Emirates.
Authors: Hashim Raghad , Salah Afraa , Mayahi Fatemeh , Haidary Saeedeh
Published: January 2021

Background The purpose of the present study was to determine the prevalence of neck, shoulder, and low-back pain and to examine factors associated with musculoskeletal pain (MSP) among dental students at Ajman University and Ras Al Khaimah College of Dental Sciences in United Arab Emirates (UAE). Method A cross-sectional study was conducted among dental students using an online questionnaire, which was a modified version of the Standardized Nordic questionnaire, focused on neck, shoulder and low-back pain in the past week and the past year. Results A total of two hundred and two dental students (out of 368) responded to the questionnaire. The majority were female 75.2%. The prevalence of MSP in at least one body site in the past week, and in the past year was 48.5% and 68.3% respectively. The factors significantly associated with MSP in at least one body site at any time were having history of trauma (P = 0.009), lack of exercise (P = 0.001), longer clinical sessions (P = 0.000), and higher BMI (P = 0.010). Conclusion The present study indicates that the prevalence of MSP among dental students in the UAE is high. Careful attention from dental colleges is needed to increase students’ awareness of this problem. This study contributed to better understanding of MSP among dental professionals.
The Objective Structured Clinical Examination as an assessment strategy for clinical competence in Novice Nursing Practitioners in Taiwan
Authors: Chen Sue-Hsien , Chen Shu-Ching , Lai Yo-Ping , Chen Pin-Hsuan , Yeh Kun-Yun
Published: January 2021

Background: The conventional written tests and professional assessment have limitation in fair judgement of clinical competence. Because the examiners may not have total objectivity and may lack standardization throughout the assessment process. We sought to design a valid method of competence assessment in medical and nursing specialties. This work was aimed to develop an Objective Structured Clinical Exam (OSCE) to evaluate novice nursing practitioners’ clinical competency, work stress, professional confidence, and career satisfaction. Methods: A Quasi-experimental study (pre-post). Fifty-five novice nursing practitioners received the OSCE three-months following their graduation, which consisted of four stations: history taking, physical examination, problem-directed management, interpersonal communication, and the required techniques of related procedures. The examiners had to complete an assessment checklist, and the participants had to complete a pre-post questionnaire (modified from a Nursing Competency Questionnaire, a Stress scale, and Satisfaction with Learning scale). Results: Among the novice nursing practitioners, 41 of them (74.5%) passed the exam with a mean score of 61.38 ± 8.34. There was a significantly higher passing rate among nurses who were working in medical-surgical wards (85.7%) and the intensive care unit-emergency department (77.8%) compared to novice nursing practitioners working in other units. All the novice nursing practitioners at Station A had poor performance in assessing patients with a fever. OSCE performance was more associated with educational attainment and work unit, rather than the gender. Finally, the participants showed statistically significant increases in their clinical competency, confidence in their professional competence, satisfaction with the clinical practice, and decreased work stress after the OSCE. Conclusions: We found that the OSCE process had a positive educational effect, in providing a meaningful and accurate assessment of the competence of novice nursing practitioners. Although the implementation of an OSCE remains costly, the consequent benefits for novice nursing practitioners, educators, and administrators can outweigh its costs, demonstrated by the increased competence and workforce stability following OSCE training.
To do or not to do – A survey study on factors associated with participating in the Danish screening program for colorectal cancer
Authors: Nielsen Jesper Bo , Berg-Beckhoff Gabriela , Leppin Anja
Published: January 2021

Background Screening programs for colorectal cancer (CRC) exist in many countries, and with varying participation rates. The present study aimed at identifying socio-demographic factors for accepting a cost-free screening offer for CRC in Denmark, and to study if more people would accept the screening offer if the present fecal test was replaced by a blood test. Methods We used a cross-sectional survey design based on a representative group of 6,807 Danish citizens aged 50-80 years returning a fully answered web-based questionnaire with socio-demographic data added from national registries. Data were analyzed in STATA and based on bivariate analyses followed by regression models. Results Danes in general have a high level of lifetime participation (+80%) in the national CRC screening program. The results of the stepwise logistic regression model to predict CRC screening participation demonstrated that female gender, higher age, higher income, and moderate alcohol intake were positively associated with screening participation, whereas a negative association was observed for higher educational attainment, obesity, being a smoker, and higher willingness to take health risks. Of the 1026 respondents not accepting the screening offer, 61% were willing to reconsider their initial negative response if the fecal sampling procedure were replaced by blood sampling.Conclusion The CRC screening program intends to include the entire population within a certain at-risk age group. However, individual factors (e.g. sex, age obesity, smoking, risk aversity) appear to significantly affect willingness to participate in the screening program. From a preventive perspective, our findings indicate the need for a more targeted approach trying to reach these groups.