bluuebunny/crossref_metadata_2025 huggingface dataset:
Ischemia considerations for the development of an organ and tissue donor derived bone marrow bank
Authors: Woods Erik John , Sherry Aubrey M. , Woods John R. , Hardin James W. , LaFontaine Michael , Brandacher Gerald , Johnstone Brian H.
Published: June 2020

Background: Deceased organ donors represent an untapped source of therapeutic bone marrow (BM) that can be recovered in 3-5 times the volume of that obtained from living donors, tested for quality, cryopreserved, and banked indefinitely for future on-demand use. A challenge for a future BM banking system will be to manage the prolonged ischemia times that are inevitable when bones procured at geographically-dispersed locations are shipped to distant facilities for processing. Our objectives were to: (a) quantify, under realistic field conditions, the relationship between ischemia time and the quality of hematopoietic stem and progenitor cells (HSPCs) derived from deceased-donor BM; (b) identify ischemia-time boundaries beyond which HSPC quality is adversely affected; (c) investigate whole-body cooling as a strategy for preserving cell quality; and (d) investigate processing experience as a variable affecting quality. Methods: Seventy-five bones from 62 donors were analyzed for CD34+ viability following their exposure to various periods of warm-ischemia time (WIT), cold-ischemia time (CIT), and body-cooling time (BCT). Regression models were developed to quantify the independent associations of WIT, CIT, and BCT, with the viability and function of recovered HSPCs. Results: Results demonstrate that under “real-world” scenarios: (a) combinations of warm- and cold-ischemia times favorable to the recovery of high-quality HSPCs are achievable (e.g., CD34+ cell viabilities in the range of 80-90% were commonly observed); (b) body cooling prior to bone recovery is detrimental to cell viability (e.g., CD34+ viability <73% with, vs. >89% without body cooling); (c) vertebral bodies (VBs) are a superior source of HSPCs compared to ilia (IL) (e.g., %CD34+ viability >80% when VBs were the source, vs. <74% when IL were the source); and (d) processing experience is a critical variable affecting quality. Conclusions: Our models can be used by an emerging BM banking system to formulate ischemia-time tolerance limits and data-driven HSPC quality-acceptance standards.
Immediate Effect of Mental Practice on Performance of a Neurodynamic Skill in Physiotherapy Students: A Randomized Control Trial.
Authors: Chheda Kajal Uday , Akulwar-Tajane Isha
Published: June 2020

Background

Mental Practice (MP), "the cognitive rehearsal of a task in the absence of overt physical movement," has been used successfully in teaching and rehearsing complex psychomotor tasks in several domains, including sports; music; and recently, in surgical skills acquisition. This study investigates the implementation of MP on performance of a neurodynamic skill in third year undergraduate Physiotherapy students.
Method:

It was a randomized control trial (single-blind) conducted in a Physiotherapy institute. A convenient sample of 40 III year undergraduate students who were novice for the topic were recruited. Some important preliminary steps involved development and validation of the tools used in the study viz. an audio script to guide mental imagery practice and an OSPE checklist to assess the outcome. The OSPE checklist was procedural specific for ULNT-1 and included stations for cognitive, psychomotor and affective domains. A neurodynamic skill (ULNT-1 Median nerve) was taught to all the students (n = 38, 2 drop outs) by a teacher as a didactic lecture followed by physical practice which was supervised and guided by the same teacher. After randomization, the intervention group (n = 19) received MP guided by a structured audio script as a single session for 20 minutes delivered to all the participants together in a group. The control group participants (n = 19) intended to serve as a basis of comparison and received no intervention. Pre- and post-intervention assessment was done by a set of examiners who were blinded to the intervention. Comparative analysis was done within the group using Wilcoxon sign rank test and between the groups using unpaired t test.
Results

MP group showed significant improvement in cognitive, psychomotor, affective domain and total score of OSPE post intervention whereas the control group did not show significant difference except for the total score. Between group comparison showed significant differences in all the domains and total score in favor of the MP group. Also, the extent of improvement (effect size calculated using Cohen’s d) was more in the mental practice group than in the control group.
Conclusion

MP as an adjunct to physical practice is a time-and cost-effective strategy to augment traditional training and enhance performance of a neurodynamic skill in Physiotherapy students. This preliminary evidence supported by robust scientific base and ease of integration should facilitate adoption of MP in Physiotherapy education. We recommend future studies to further explore the potential of this promising tool.
The benefits of smoking cessation on survival in cancer patients by integrative analysis of multi-omics data
Authors: Yang Sheng , Liu Tong , Liang Geyu
Published: June 2020

The authors have withdrawn this preprint due to author disagreement.
Influences on participation in a programme addressing loneliness among people with depression and anxiety: findings from the Community Navigator Study
Authors: Frerichs Johanna , Billings Jo , Barber Nick , Chhapia Anjie , Chipp Beverley , Shah Prisha , Shorten Anna , Stefanidou Theodora , Johnson Sonia , Lloyd-Evans Brynmoor , Pinfold Vanessa
Published: June 2020

Background
Loneliness is common among people with mental health problems and is associated with depression, anxiety and poorer recovery. In the absence of an existing evidence-based intervention, the Community Navigator programme was developed to help reduce loneliness among people with severe depression and/or anxiety using secondary mental health services. This paper presents a co-produced qualitative analysis of the factors that appear to influence participation in this programme.
Methods
The programme consisted of up to ten meetings with a Community Navigator and three optional group sessions. It was assessed using a feasibility trial. Semi-structured interviews were carried out with participants (N = 19) shortly after programme completion, by a researcher with experience of depression and anxiety. A two-stage qualitative approach to analysis was undertaken by members of the study’s co-production working group, which included service users, clinicians and researchers, using both a narrative analysis of three interviews to produce case studies as well as a thematic analysis of all nineteen interviews.
Results
From our case study analysis, it was clear how hard it was for participants to work with their feelings of loneliness. Six themes from the thematic analysis were identified to explain both motivation to and barriers towards participation in the programme, which relate to individual and structural factors: desire to connect with others or not; finding meaningful things to do; individual’s social confidence, particularly in group settings; accessibility of resources locally both in terms of practical considerations and financial cost; timing of the programme including in relation to people’s mental health; and, relationship with the Community Navigator.
Conclusions
We found that people with severe depression and/or anxiety supported by secondary mental health services may want to address feelings of loneliness but are aware of the emotional effort this entails. Interventions to address loneliness should be developed that consider the factors that enable and hinder participation and seek to build into their programmes the necessary support structures to address what may be a major personal challenge.
Dynamic manipulation of unknown string by robot arm: Realizing momentary string shapes
Authors: Tabata Kenta , Seki Hiroaki , Tsuji Tokuo , Hiramitsu Tatsuhiro , Hikizu Masatosh
Published: June 2020

In this paper we propose dynamic manipulation for flexible object by using high speed robot arm. We consider dynamic manipulation for unknown string and describe how to manipulete it. Paticulary, we focus on the achived momentary string shapes. For example, momentary string shapes is like a J , C or d. In our strategy for dynamic manipulation of unknown string, manipulation is achieved through repeating 3steps: manipulation of string by robot arm, string parameter estimation. A string is described as the physical-dased 3D model. And ,motion data for robot arm is given as each joint angular velocity data. For simulation of motion, we input the each joint angular velocity data,and initial paramaretars of modeled string.This simulation calculate not only the motion of robot arm but also motion of modeled ropes which occured by robot motion. Parametar estimation is to string parametar by comparing image of the real manipulation with string model and motion generation by estimated model. Repeatly each step, we realize dynamic manipulation of unknown string. Finaly, we show the some experiment of dynamic manipulation ,and we demonstrate effective of parametar estimation and validity.
Clinical Impact of Estradiol/Testosterone Ratio in Patients with Acute Ischemic Stroke
Authors: Choi Jung-Won , Ryoo In Woo , Hong Jun Yeong , Lee Kyung-Yul , Nam Hyo Suk , Kim Won Chan , Oh Seung-Hun , Kang Jaeku , Lee Hoi Young , Na Sang-Jun , Heo Ji Hoe , Lee Kee Ook
Published: June 2020

Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS). Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.
Enhanced photosynthesis and carbohydrate metabolic capability contributes to heterosis of cotton (Gossypium hirsutum) hybrid ‘Huaza Mian H318’ as revealed by genome-wide gene expression analysis
Authors: Ding Yuanhao , Zhang Rui , Zhu Longfu , Wang Maojun , Ma Yizan , Yuan Daojun , Liu Nian , Hu Haiyan , Min Ling , Zhang Xianlong
Published: June 2020

Background
Heterosis has been exploited for decades in different crops for the dramatic increase in yield but less documented molecular evidences reported in cotton.
Results
An elite cotton hybrid variety ‘Huaza Mian H318’ (H318) and its parental lines was used to explore the source of its yield heterosis. A four years’ investigation of yield related traits showed that the boll number of the H318 was stable higher compare with its two parents whether in the climate suitable or unsuitable years. Besides, the hybrid H318 grows faster and showed higher fresh and dry weight than its parental lines at the seedling stage. Transcriptome analysis of seedlings identified 17,308 differential expressed genes (DEGs) between H318 and its parental lines, and 945 extremely changed DEGs were screened out for later analysis. In which, most DEGs (931/945) were gathered between H318 and its paternal line (4–5), but only 78 DEGs were found between H318 and its maternal line (B0011), which implied that H318 display more similar gene action with its maternal parent. GO and KEGG analysis showed that these DEGs highly enriched in photosynthesis and carbohydrate metabolic processes, the expression level of these DEGs was significantly higher in the H318 relative to its parental lines, which implies that sucrose and starch biosynthesis were enhanced in H318.
Conclusion
The enhanced photosynthesis and carbohydrate metabolic capability contributes to the heterosis of H318 at seedling stage, and establish the material foundation for later higher boll setting rates in the complex field environments.
Objectively Measured Association Between Air Pollution and Physical Activity and Sedentary Behavior Among College Students in Beijing
Authors: Yu Miao , Wu Yin , Gordon Shelby Paige , Cheng Jiali , Chen Panpan , Wang Yangyang , Yu Hongjun
Published: June 2020

Background: Air pollution has become a major environmental health risk factor, notably in China. Air pollution potentially has the impact of human populations’ health behavior. Gaps in scientific literature remain regarding more accurately estimates the relationship between air pollution and sedentary behavior in China. The purpose of this study is to examine the association between hourly air pollution AP on hourly physical activity (PA) and sedentary behavior (SB) among college students in Beijing, China. The secondary aim was to examine such associations varied at specific times. Methods: A total of 340 participants were recruited from the Tsinghua University, in Beijing, China. Accelerometers provided PA measures, including moderate-to-vigorous physical activity (MVPA), walking steps, energy expenditure and sedentary time for 7 consecutive days. Corresponding AP data by the Beijing Municipal Ecological Environment Bureau in the closed site (Wan Liu site) at Tsinghua University were collected to include average hourly air quality index (AQI) and PM2.5 (µg/m³). Associations were estimated using linear individual fixed-effect regressions.Results: A one level increase in hourly air quality index (AQI) was associated with a reduction in one-hour MVPA by 0.083 minutes (95% CI =[-0.137, -0.029]), 8.8 walking steps (95% CI = [-15.0, -2.6]), and 0.65 kcals of energy expenditure (95% CI =-[1.03, -0.27]). A 10µg/m³ increase in AP concentration in hourly PM2.5 was associated with a reduction in one-hour MVPA by 0.021 minutes (95% CI = [-0.033, -0.010]), 2.2 walking steps (95% CI = [-3.5, -0.9]), 0.170 kcals of energy expenditure (95% CI = [-0.250, -0.089]), and an increase in one-hour SB by 0.045 (95% CI = [0.005, 0.0845]). At a specific time, there are stronger negative associations of AQI and PM2.5 to PA at 8 am, 4 pm, 5 pm and 7 pm. Similarly, stronger positive associations were found at one hour AQI and PM2.5 with SB at 8 am, 9 am, 11 am, and 7 pm. Conclusions: AP may discourage PA and increases SB among freshman students living in Beijing, China. The impact of AP on PA and sedentary behavior at a specific time may be different.
First Realizations of Spinal Anesthesia in Neonates and Infants - Preterms or Ex prematures - in Antananarivo, Madagascar
Authors: Randriamizao Harifetra Mamy Richard , Rakotondrainibe Aurelia , Razafindrabekoto Lova Dany Ella , Ravoaviarivelo Prisca Funken , Rajaonera Andriambelo Tovohery , Andriamanarivo Mamy Lalatiana
Published: June 2020

Objective: The aim of this study was to describe the first realizations of spinal anesthesia in neonates and infants (preterms or ex prematures) in Antananarivo - Madagascar, because spinal anesthesia – a low cost technique – can limit respiratory complications and postoperative apnea and also general anesthesia can present perioperative risks for pediatric patients.Results: In a retrospective, descriptive, seven-year (2013 to 2019) period study, conducted in the University Hospital Joseph Ravoahangy Andrianavalona, data files of 69 babies planned to have spinal anesthesia were recorded. These pediatric patients were predominantly male (sex ratio = 2.8) and 37 [28 - 52] days old. The smallest anesthetized child weighed 880 g; the youngest was 4 days old. Twenty-seven (27) of them were premature and 20.3% presented respiratory diseases. They were mostly scheduled for hernia repair (97.1%). Spinal anesthesia was performed, with a Gauge 25 Quincke spinal needle, after 2 [1 - 2] attempts with hyperbaric bupivacaine of 4 [3.5 - 4] mg. Failure rate was 5.8% needing general anesthesia conversion. The heart rate was stable throughout perioperative period and no complications were observed.
Label-free quantitative proteomic analysis of alfalfa in response to microRNA156 under high temperature
Authors: Arshad Muhammad , Puri Alpa , Simkovich Aaron J , Renaud Justin , Gruber Margaret Y , Marsolais Frédéric , Hannoufa Abdelali
Published: June 2020

Background Abiotic stress, including heat, is one of the major factors that affect alfalfa growth and forage yield. The small RNA, microRNA156 (miR156), regulates multiple traits in alfalfa during abiotic stress. The aim of this study was to explore the role of miR156 in regulating heat response in alfalfa at the protein level. Results In this study, we compared an empty vector control and miR156 overexpressing (miR156OE) alfalfa plants after exposing them to heat stress (40 ° C) for 24 hours. We measured physiological parameters of control and miR156OE plants under heat stress, and collected leaf samples for protein analysis. A higher proline and antioxidant contents were detected in miR156OE plants than in controls under heat stress. Protein samples were analyzed by label-free quantification proteomics. Across all samples, a total of 1878 protein groups were detected. Under heat stress, 45 protein groups in the empty vector plants were significantly altered (P < 0.05; |log 2 FC| > 2). Conversely, 105 protein groups were significantly altered when miR156OE alfalfa was subjected to heat stress, of which 91 were unique to miR156OE plants. The identified protein groups unique to miR156OE plants were related to diverse functions including metabolism, photosynthesis, stress-response and plant defenses. Furthermore, we identified transcription factors in miR156OE plants, which belonged to squamosa promoter binding-like protein, MYB, ethylene responsive factors, AP2 domain, ABA response element binding factor and bZIP families of transcription factors. Conclusions These results suggest a positive role for miR156 in heat stress response in alfalfa. They reveal a miR156-regulated network of mechanisms at the protein level to modulate heat responses in alfalfa.
Identifying and Supporting Students at Risk of Failing the National Medical Licensure Examination in Japan Using a Predictive Pass Rate
Authors: Tsunekawa Koji , Suzuki Yasuyuki , Shioiri Toshiki
Published: June 2020

Background
Students who fail to pass the National Medical Licensure Examination (NMLE) pose a huge problem from the educational standpoint of healthcare professionals. In the present study, we developed a formula of predictive pass rate (PPR)” which reliably predicts medical students who will fail the NMLE in Japan, and provides an adequate academic support for them.
Methods
Six consecutive cohorts of 531 medical students between 2012 and 2017, Gifu University Graduate School of Medicine, were investigated. Using 7 variables before the admission to medical school and 10 variables after admission, we developed a prediction formula to obtain the PPR for the NMLE using logistic regression analysis. In a new cohort of 106 medical students in 2018, we applied the formula for PPR to them to confirm the capability of the PPR and predicted students who will have a strong likelihood of failing the NMLE.
Results
Medical students who passed the NMLE had the following characteristics: younger age at admission, graduates of high schools located in the surrounding area, high scores in the graduation examination and in the comprehensive computer-based test provided by the Common Achievement Test Organization in Japan. However, total score of examination in pre-clinical medical sciences and Pre-CC OSCE score in the 4th year were not correlated with the PPR. Ninety-one out of 531 students had a strong likelihood of failing the NMLE between 2012 and 2017 and 33 of these 91 students failed NMLE. Using the PPR, we predicted 12 out of 106 students will have a strong likelihood of failing the NMLE. Actually, five of these 12 students failed NMLE.
Conclusions
The PPR can be used to predict medical students who have a higher probability of failing the NMLE. This prediction would enable focused support and guidance by faculty members. Prospective and longitudinal studies for larger and different cohorts would be necessary.
Assessment of Disease Activity by Infrared Thermography in Patients with Rheumatoid Arthritis: A Comparative Cross-Sectional Study of Thermographic, Clinical and Ultrasound Assessments
Authors: VINSON DOROTHEE , paris Caroline , Lafforgue Pierre , Richez Christophe , Pradel Vincent , Pham Thao
Published: June 2020

The authors have withdrawn this preprint due to author disagreement.
A Study of the Association of Serum Zinc and Selenium Levels with the Severity of Asthma in Iranian Children
Authors: Ebraimi Mohsen , Siahpoor Majid , Hamrah Mohammed Hassan , Pahlavanzade Bagher
Published: June 2020

Background: Asthma is the most common respiratory disease among children with a growing prevalence worldwide. In addition to their multiple roles in human body, zinc and selenium have anti-inflammatory properties which is due to their presence in the structure of antioxidant enzymes namely superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). Lack of these elements in the body can cause airway inflammation in asthma patients.Methods: In the present case-control study, 50 asthmatic and 50 non-asthmatic children aged 5-15 years were selected at Taleghani Hospital of Gorgan using convenience sampling. The levels of zinc and selenium were determined in blood samples by an atomic absorption spectrophotometer. T-test, Man-Whitney, ANOVA, Kruskal-Wallis test, and multiple regression were used in this study. Statistical analyses were performed using SPSS statistical software version 16 at a significance level of 0.05.Results: The case and control groups were similar in terms of demographic variables. The mean±sd level of zinc was 46.78±8.93 in the case group, and 50±7.8 in the control group (p= 0.07). The mean±sd level of selenium was 62.78±11.46 in the case group, and 67.86±7.87 in the control group (p= 0.038). The comparison of individuals in the control group and those with different degrees of asthma revealed a significant difference in the mean levels of zinc (p= 0.003) and selenium (p= 0.009). According to the multiple regression analysis, individuals with severe asthma had lower levels of zinc and selenium than the control group.Conclusions: The present study indicated that the levels of zinc and selenium were lower in individuals with asthma than in healthy individuals; and the mean levels of zinc and selenium sharply decreased with increase in the severity of asthma.
Predictors of Mortality among Adult People Living with HIV and Its Implications for Appointment Spacing Model Approach Care in Southwest Ethiopia.
Authors: Teklehaymanot Aderajew Nigusse , Lemma Tefera Belachew , Gudina Esayas Kebede , Getnet Masrie , Amdisa Demuma , Dadi Lelisa Sena
Published: June 2020

Introduction:

Antiretroviral Therapy has markedly improved survival of people living with human Immune virus. Yet, the full potential benefits of the therapy depend on understanding of predictors of mortality among PLWHA. The aim of this study was to assess predictors of mortality among adult PLWHA in Jimma Zone Public Hospitals.
Methods

A retrospective cohort study was conducted among 676 adult PLWHA who enrolled to ART clinic from September 1st, 2012 - August 30, 2016. Multivariable Cox Regression analysis was used to identify predictors of mortality using 95% confidence interval (CI) and at P value ≤ 0.05 cut of point.
Results

The total person-time contributed was 28,209 person-months with an overall mortality incidence rate of 11 per 1000 person-months observation. The cumulative mortality incidence among females over the study period was 16.8% (64/382). The predictors of mortality were found severe Undernourishment (AHR: 3.7; 95% CI: 1.6, 6.7) and moderate malnutrition (AHR: 2.5; 95% CI: 1.7, 7.5) at base line, younger age (AHR:2.1; 95% CI: 1.7, 3.3), female (AHR: 2.8; 95% CI: 2.1,4.6), single (AHR: 2.6; 95% CI: 1.8, 3.8), divorced (AHR: 2.4; 95% CI: 1.3,3.9) Illiterate (AHR: 2.5; 95% CI: 1.9, 4.8), lack of disclosure (AHR: 3.6; 95%: 1.7, 9.5), WHO clinical stage IV (AHR: 3.7; 95% CI: 1.7, 5.3), seeking treatment out of catchment area (AHR:3.6; 95% CI: 1.5,5.4), rural residence (AHR:2.1; 95% CI:1.4, 3.3), and immunological failure (AHR:1.7; 95% CI: 1.3, 2.7).
Conclusions

Poor nutritional status at baseline, advanced HIV disease, occurrence of treatment failure, female sex, substance use disorders, lack of social support, immunological failures, clinical failures, and younger age, low level of education and poor physical access to healthcare facility were found to be important predictors of mortality. Intervening, those factors as routine and part of “appointment spacing model care” can improve survival of PLWHA.
Effect Intravenous Dexamethasone as an Adjuvant to Caudal Block on post operative analgesia: Prospective Cohort study design
Authors: Obsa Mohammed Suleiman , Awol Meron ABrar , Simie Timsel Girma
Published: June 2020

Introduction Caudal block is by far the most commonly employed regional anesthetic techniques to maintain postoperative analgesia in pediatric urogenital surgeries. However, its short duration of action can be prolonged by adding Adjuvants. The aim of this study was to compare the efficacy of dexamethasone administered through intravenous on post-operative analgesia in pediatric patients who underwent infra umbilical surgeries. Method In this prospective study, sixty American Society of Anesthesiologists Physical Status I and II patients aged 1–7 years were randomly allocated into two groups of thirty each. Both groups were compared for the duration of postoperative analgesia and analgesic requirement. Severity of postoperative pain was measured by FLACC score. Mann –Whitney U test was used to compare the pain severity and total analgesic consumption. Independent sample t test was used for analgesia duration as well as Chi-square test was used to analyze independent categorical variables between two groups and a p-value of less than 0.05 was considered as statistically significant. Result Analgesia duration was significantly prolonged in caudal block with IV dexamethasone group than caudal block with bupivacaine alone group ( P < 0.001). Total analgesia consumption was significantly lower ( P < 0.001) in caudal block with IV dexamethasone compared to with bupivacaine alone group. Postoperative severity of pain was significantly lower in caudal block with IV dexamethasone group at 4 th , 6 th and 12 th hours (P<0.001, P<0.001 and P<0.003) respectively. Conclusion Addition of intravenous dexamethasone as an adjuvant to caudal block with 0.25% Bupivacaine significantly reduced the intensity of post-operative pain and prolonged the duration of post-operative analgesia.
Opportunity cost of natural forest management in the Arenal-Huetar Norte Conservation Area, Costa Rica
Authors: Zúñiga-Méndez Christian , Meza-Picado Victor , Ugalde-Alfaro Sebastian , Méndez-Gamboa Jhonny
Published: June 2020

Background: Part of the success of forest conservation programs is due to the economic sustainability they can provide to owners of forest resources, and how these management mechanisms can be used within an increasingly aggressive productive landscape matrix. However, there are currently no precise or up-to-date data on the economic relationships between land uses and their respective productive activities. This study designed a model to evaluate the opportunity cost of natural forest management, taking as a reference the primary productive activities that take place within the Arenal-Huetar Norte Conservation Area, in Costa Rica. Methods: Profitability data from 24 sites in natural forests with a forest management plan approved by the State Forest Administration was used, as well as geographic and productive information on alternative land uses. Results: Based on these data, an opportunity cost map was generated which shows a marked segregation of the forests into two main areas: a) a high-opportunity cost area, located south of the study area; and b) a medium-low opportunity cost area, to the center-north of the study area. Conclusions: It is concluded that ideal areas for timber harvesting are currently restricted to places far from the market, and with low opportunity costs (ranging between ≤ $0 ha -1 year -1 and $500 ha -1 year -1 ).
Vaccine Hesitancy: The Next Challenge in the Fight Against COVID-19
Authors: Dror Amiel A. , Eisenbach Netanel , Taiber Shahar , Morozov Nicole G. , Mizrachi Matti , Zigron Asaf , Sro Samer , Sela Eyal
Published: June 2020

Vaccine hesitancy remains a barrier to full population inoculation against highly infectious diseases. With rapid developments in a potential COVID-19 vaccine by scientists across the globe, public concerns over the safety and side effects of such a vaccine may contribute to vaccine hesitancy. We analyzed anonymous questionnaire answers regarding acceptance of a potential COVID-19 vaccine posed to healthcare workers and the general population throughout Israel with a total respondent count of 1941. Our results demonstrate higher rates of COVID-19 vaccine hesitancy among various groups: parents, nurses, and medical workers not caring for SARS-CoV-2 positive patients. Healthcare staff involved in the care of COVID-19 positive patients and individuals who consider themselves at higher risk of disease were more likely to self-report acquiescence to obtain a COVID-19 vaccine if and when it becomes available. Interventional educational campaigns targeted towards populations at risk of vaccine hesitancy, therefore, are urgently needed to combat misinformation and resultant low inoculation rates.
Ocular surface manifestation of COVID-19 and tear film analysis
Authors: Meduri Alessandro , Oliverio Giovanni William , Mancuso Giuseppe , Giuffrida Angela , Guarneri Claudio , Rullo Emmanuele Venanzi , Nunnari Giuseppe , Aragona Pasquale
Published: June 2020

Purpose: To evaluate the ocular manifestation in patients hospitalized with coronavirus disease 2019 (COVID-19) and to search for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in tears.Methods: This study was conducted in 29 hospitalized patients who were admitted to the COVID center at the Policlinic Hospital of the University of Messina, Italy.All patients underwent an ophthalmologic assessment comprising a Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire, anterior segment, and the ocular surface examination of both eyes using a portable slit lamp.The Schirmer I test was performed, and the filter paper strip was used to search for the presence of SARS-CoV-2 on the ocular surface by real-time quantitative polymerase chain reaction (RT-qPCR).Results: A total of 10 patients reported ocular symptoms; in particular, four reported eye burning, three reported foreign body sensation, and three reported tearing. Moreover, seven patients presented conjunctival hyperemia and/or chemosis, eleven patients presented blepharitis signs such as lid margin hyperemia and/or telangiectasia, crusted eyelashes, and meibomian orifices alterations. Tear analysis did not reveal the presence of SARS-CoV-2.Conclusion: Ocular symptoms are common in patients with COVID-19; although, tear analysis did not reveal the presence of SARS-CoV-2.
Digital Learning Designs in Physiotherapy Education: A Systematic Review and Meta-Analysis.
Authors: Ødegaard Nina Bjerketveit , Myrhaug Hilde Tinderholt , Dahl-Michelsen Tone , Røe Yngve
Published: June 2020

Background: The extent that digital learning designs can improve learning outcomes has been increasingly emphasized in higher education over the last decade, but the research within physiotherapy education is limited. This study identified different types of digital learning designs and their effectiveness in physiotherapy education. Methods: The study was designed as a systematic review and meta-analysis of randomized and non-randomized trials. A search of eight databases on digital teaching and learning technology was conducted. Study selection, methodology and quality assessment were performed independently by three reviewers. The included studies were mapped according to the types of digital interventions and studies. For interventions that were similar, the learning effects were calculated using meta-analysis. Results: Fifteen randomized and five control trials were included in the review; 8 of 20 articles were included in the meta-analysis. The main digital learning designs were blended learning, flipped classrooms, e-learning course designs and Mobil learning designs (apps) using different digital tools, software and learning platforms. The evidence from two meta-analysis showed statistically significant effects: flipped classrooms on knowledge acquisition, SMD of 0.41 (95% CI 0.20, 0.62) and websites (apps) on practical skills, SMD of 1.06 (95% CI 0.70, 1.42). A meta-analysis of website and knowledge acquisition favoured traditional teaching, SMD of -0.59 (95% CI -1.20, 0.03), but this was not statistically significant. Overall, the effects indicated that digital learning designs are more or equally effective than traditional classroom teaching for achieving learning outcomes. Conclusions The findings of this review show various use of digital learning designs in physiotherapy education, ranging from e-learning using digital learning resources to more complex and coherent flipped learning designs. The results indicate that these designs improved or was equal effective compared to traditional classroom teaching. The meta-analysis revealed a significant effect on student learning in favour of flipped classrooms and websites (apps). However, these results must be confirmed in larger controlled trials or randomized controlled trials. Further research should investigate how digital learning designs can be used to facilitate students’ learning of practical skills and behaviour as well as learning retention, learning approaches and preferences for studying in digital learning environments.
The Effect of Corticosteroids on Severe Patients of COVID-19: A retrospective study
Authors: Li Qiang , Cheng Fang , Su Yuyong , Cai Xuefeng , Zeng Fang , Zhang Yu
Published: June 2020

Background

The effect of corticosteroids on COVID-19 remains controversial. This study aims to clarify the potential roles of corticosteroids in severe COVID-19 patients.
Methods

In the current retrospective single-center study, we collected data of 214 severe patients with confirmed COVID-19 in Wuhan Union Hospital from Feb 20th to Mar 1st, 2020. Epidemiological, clinical and treatment were analyzed between patients treated with corticosteroids or not.
Results

Corticosteroids used patients have higher levels of lactate dehydrogenase (LDH), interleukin-6 (IL-6), CD4+/CD8+ cells, C-reactive protein (CRP) and procalcitonin (PCT). Virus clearance time and hospital length of stay in corticosteroids group were also significantly higher. The antiviral treatment and antibiotics treatment in patients given corticosteroids were both significantly higher. Antibiotics treatment duration was significantly longer in corticosteroids group. And the usage of multiple antibiotics in corticosteroid group was also significantly higher. And patients who treated by corticosteroids beyond 5 days showed a significantly longer antibiotics duration. Whereas there were no differences on virus clearance time and multiple antibiotics between the patients treated with corticosteroids beyond 5 days and less than 5 days. Multivariate analysis showed that patients with sputum production and higher IL-6 at admission, or treated with corticosteroid therapy were associated with prolonged virus clearance time and lianhua qingwen capsule may contributed to shorten virus clearance time.
Conclusions

The use of corticosteroids could prolong the virus clearance. The benefits and harms should be carefully weighed in the COVID-19 patients who intend to use corticosteroids. The dosage should be low-to-moderate (≤ 0.5-1 mg/kg per day methylprednisolone or equivalent) and the duration should be short (≤ 5 days) to avoid secondary infections.
Correlations of Gut Microbiome, Serum Metabolome and Immune Factors in Insomnia
Authors: Man Honghao , Chen Bin , Wang Qinghua , Fu Shujie , Xie Guangning , Wang Jingwen , Zhao Changying , Gai Zhongtao , Zhang Chunling , Heng Xueyuan , Huo Shengnan , Wang Jianfeng , Stirling Kyle B. , Yang Junjie , Zhang Lei
Published: June 2020

Insomnia is a common sleep disorder of unclear etiology characterized by individuals experiencing the inability to sleep or the difficulty staying asleep. Gut-brain interaction is being explored with the intent of discerning gut microbiota and its role in many brain-related conditions including insomnia. The number and diversity of gut microbiota that colonize the digestive tract could have a significant association with insomnia, given the microbes that colonize the digestive tract integrate with and impact on the central nervous system, the immune system and multiple metabolic pathways. We aim to examine the diversity and to explore the functional impact of gut microbiota in insomniacs by examining fecal microbiome using 16S rRNA gene sequencing, serum metabolome using ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS), and various immune factors. Our results discover altered and distinct gut microbiota in insomniacs, with enriched Desulfovibrio, Lactobacillus and Streptococcus, and decreased abundance of Bifidobacterium, Gardnerella, Sneathia, Aerococcus and Atopobium. Non-targeted metabolomics identify 31 aberrant metabolites and implicate metabolic pathways in insomniacs. Most importantly, correlations across gut microbiome, serum metabolome and inflammatory factors are unraveled. Our study provides a better understanding of gut microbiota’s role in insomnia and new insights into potential novel etiologies for insomnia.
Genetic Landscapes and Prognostic Implications of Circadian rhythm in Non-small Cell Lung Cancer
Authors: Li Ming , Chen Zhencong , Jiang Tian , Yang Xiaodong , Du Yajing , Liang Jiaqi , Wang Lin , Xi Junjie , Zhan Cheng , Feng Mingxiang
Published: June 2020

Background: Circadian rhythm plays an influential role in the vast majority of behavior and physiology, even of tumorigenesis and development. In this study, we tried to explore the prognostic implication for non-small cell lung cancer (NSCLC) based on the expression profiles of circadian clock-related genes (CCRGs), and describe the changes of immune infiltration and cell functions of related to the circadian rhythm.Methods: Univariate and multivariate Cox proportional hazard regression were performed to determine and construct a CCRGs risk-score significantly correlated with overall survival (OS) of the training set and validation set. GO, KEGG, and GSVA indicated discrepant changes in cellular processes and signaling pathways associated with these CCRGs. Further, immune cell infiltration, mutation rates, and related drugs and pathways analyses were investigated by the online analysis platform and the algorithm provided by works of literature. Results: The risk-score based on ten-gene signatures could independently predict the OS both in TCGA lung adenocarcinoma (p < 0.0001, HR: 2.117, 95% CI: 1.546 to 2.900) and lung squamous cell carcinoma (p < 0.0001, HR: 2.066, 95% CI: 1.552 to 2.751), respectively. The risk-score also had superior accuracy and predictability (LUAD: AUC 0.788; LUSC: AUC 0.738). The prognostic performance of the ten-gene signature was finally validated in validation set based on GEO cohorts. The circadian oscillations driven by CCRGs could disturb the metabolism and cellular functions of cancer cells. We also found that the infiltration level of critical cells in specific anti-tumor immunity process was suppressed apparently. In contrast, the infiltrating of inflammatory cells and immune cells with negative regulatory effects were promoted in the high-risk group. CCRGs were evolutionarily conserved with low mutation rates, which brought difficulties to explore therapeutic targets. Conclusions: We described the landscapes and prognostic implications of CCRGs. The risk-score based on CCRGs was an independent predictor of prognosis and could significantly stratify patient outcomes and immune cell infiltration levels. CCRGs were evolutionarily conserved with low mutation rates, which brought difficulties to explore therapeutic targets. Our study revealed that circadian rhythms might play an influential role in the NSCLC.
Moderating effect of people-oriented public health services on depression among socially isolated people during COVID-19: A cross-sectional study in China
Authors: Cao Bolin , Wang Dongya , Wang Yifan , Hall Brian J. , Wu Nan , Wu Meimei , Ma Qishan , Tucker Joseph D. , Lv Xing
Published: June 2020

Background:Public health measures including social isolationare essential forCOVID-19 control,but also increase the risk of depression. This study examined the influencing and moderating factors on socially isolated people’s depressive symptoms. Methods: Data were collected from people in mandatory home or centralizedsocial isolation in Shenzhen, China from February 28 to March 6 in 2020. We assessed their perceived COVID-19risk, perceived tone of media coverage, perceived quality of people-oriented public health services, and depressive symptoms.Three stepwise multiple regressions were performed to examine the moderating effects controlling age, gender, education, monthly income, socially isolated venue,time spent on COVID-related news, and online social support.Results:We examined data from 340 people. 57.6% men, averaged age at 35.5 years old (SD = 8.37), 55.6% held bachelor’s degree or above.Overall, people in social isolation reported a moderate level ofdepressive symptoms (M =1.24, SD = 0.4). The perceived susceptibility of being infected was relatively low (M = 1.36, SD = 0.54), and the perceived tone of media coverage was mainly positive (M = 1.97, SD = 1.05). In terms of perceived quality of public health services, 3.2% (n = 11) participants reported low-level, 49.1% (n = 167) medium-level, and 47.6 (n =162) high-level quality ofpeople-oriented services. Perceived riskwas significantly associated with depression (β= .12, p< 0.01), and perceived tone of media coverage was negatively associated with depression (β= -.05, p< 0.01).The quality of people-centered public health service moderated the association between perceived riskand depressive symptoms(β= -.15, p< 0.05), and the relationship between perceived tone of media coverage and depressive symptoms(β= .01, p< 0.01).Conclusions:This studyfound thatpeople-oriented public health servicesreduced the effect of risk perception and media tone on depressive symptoms among COVID-19 socially isolated people, suggesting a critical role for frontline public health workers in protecting public mental health.
Hemisensory Syndrome: Hyperacute symptom onset and age differentiates ischemic stroke from other aetiologies
Authors: Koh Pei Xuan , Ti Joanna , Saffari Ehsan , Lim Zhen Yu Isis Claire , Tu Tianming
Published: June 2020

Background: An important cause of hemisensory syndrome is ischemic stroke. However, the diagnostic yield of neuroradiological imaging on hemisensory syndrome is low. Therefore, we aim to describe patients hospitalized with isolated hemisensory syndrome, and to identify clinical features associated with an aetiology of ischemic stroke.Methods: We performed a single centre retrospective observation study, identifying patients who were hospitalised with hemisensory syndrome from October 2015 to March 2016, and whom underwent a magnetic resonance imaging (MRI) brain during the admission. Ischemic stroke was defined as the presence of restricted diffusion-weighted image on the MRI brain. Clinical information was analysed and compared between patients with and without stroke seen on MRI brain.Results: Clinical features associated with ischemic stroke in hospitalised patients with hemisensory syndrome include symptom onset of ≤24 hours at presentation (odds ratio 31.4, 95% CI 3.89-254.4), advanced age (odds ratio 1.14, CI 1.05-1.25) and smoking (odds ratio 7.35, 95% CI 1.20-45). Conclusion: Older patients, with a history of smoking, and who present with an acute onset of symptoms, are more likely to have ischemic stroke as the cause of their hemisensory syndrome.
Effects of effective acute anti-hypertensive therapy on ischemic stroke prognosis: a meta-analysis of randomized controlled trials
Authors: Li Zhaokai , Ma Yingxu , Huang Gan , Zhang Guogang
Published: June 2020

Background: Although multiple randomized controlled trials (RCTs) and meta-analyses have been conducted on the issue of acute phase anti-hypertensive therapies for ischemic stroke (IS) patients, many studies have failed to enhance blood pressure (BP) decrease after these treatments. The effects of effective acute anti-hypertensive therapies on IS prognosis are still unclear.Methods: Published literature was systematically searched in PubMed, Embase and Cochrane Library. Multiple RCTs that included IS patients, in which there was a significant BP decrease in the anti-hypertensive intervention group compared with the control group within 72 h after the onset of stroke, were identified. A meta-analysis was conducted to assess the effects of such therapy on the functional outcome, mortality, and multiple severe adverse events (SAEs) of IS patients.Results: Eight RCTs were included in this study, with a total of 9427 IS patients. According to this meta-analysis, with significant BP differences between the treatment and control groups within 72 h from stroke onset, effective acute anti-hypertensive therapy has a neutral effect on multiple IS prognostic factors, including functional outcome (RR 1.03, 95% CI 0.93-1.13), mortality (RR 1.10, 95% CI 0.89-1.35), and multiple SAEs.Conclusions: Based on current studies, effective acute anti-hypertensive therapy did not improve the prognosis of IS patients, including functional outcome, mortality, and SAEs. There is no evidence that such therapy is beneficial in clinical practice.