bluuebunny/crossref_metadata_2025 huggingface dataset:
The economic impact and health-related quality of life of Spinal Muscular Atrophy: An analysis across Europe.
Authors: Longobardo Luz María Peña , Aranda-Reneo Isaac , Oliva-Moreno Juan , Litzkendorf Svenja , Durand-Zaleski Isabelle , Tizzano Eduardo F. , López-Bastida Julio
Published: May 2020

Background this study aimed to estimate the economic impact and health related quality of life (HRQOL) of patients with spinal muscular atrophy (SMA) in three European countries. For this purpose, it was a cross-sectional study carried out in France, Germany and the United Kingdom. Data were collected from July 2015 to November 2015. Healthcare costs (hospitalizations, emergencies, medical tests, drugs consumption, visits to GPs and specialists, health material and healthcare transport) and non-healthcare costs (social services and informal care) were identified and valued. EuroQol instruments, the Zarit interview and the Barthel Index were also used to reflect the burden and the social impact of the disease beyond the healthcare cost.Results we included 86 children with SMA, 26.7% of them Type I and 73.3% Type II or III. The annually average cost associated with SMA reaches at 54,295 € in the UK, 32,042 € in France and 51,983 € in Germany. The direct non-healthcare costs ranged between 79%-86% of the total cost and the informal care costs were the main determinant of these costs. Additionally, people suffering from this disease have a very low health related quality of life, showing large differences between countries.Conclusions SMA represents a considerably high socioeconomic impact both in terms of healthcare and social costs. It was also observed exceptional reduced HRQOL of children affected. The figures shown in this study may help to design more efficient and equitable policies, with special emphasis on the support provided to the families or non-healthcare aids.
Malaria Prevalence and Knowledge, Attitude and Practice about Malaria among Febrile Patients Attending Chagni Health Center, Northwest Ethiopia: A Cross-Sectional Study
Authors: Belay Bogale , Gelana Tegenu , Gebresilassie Araya
Published: May 2020

Background: Ethiopia has achieved remarkable progresses in the prevention and control of malaria in the past decades, yet it is a formidable health concern and socio-economic impediment. This study aimed at assessing the magnitude and knowledge, attitudes and practices towards malaria among febrile patients attending Chagni health center, northwest Ethiopia. Methods: In the health facility based cross-sectional study, patients attending health center with suspicion of malaria symptoms and signs, were enlisted. To determine the magnitude of malaria, finger prick blood samples were collected from malaria suspected patients visiting health center between September 2017 and February 2018. A pre-tested semi-structured questionnaire was also applied to assess KAP of suspected malaria patients attending the health center. Data were analyzed using SPSS version 20.0. Results: Prevalence of malaria among febrile patients attending at the sampled health facility was 7.3%. Of these, Plasmodium falciparum, P. vivax, and mixed infection accounted for 55, 44.3 and 0.7% of the cases, respectively. This study also revealed that 97% of the respondents had ever heard about malaria and recognized it as a serious health problem. Mosquito bite was identified as the main malaria transmission. Taking drug (86.3%), use of mosquito nets (73.3%), drain stagnated water (68%), and house spay with insecticides (66%) were mentioned as the main malaria prevention methods. Mosquito net coverage and its utilization in the previous night were 98% and 75%, respectively. Indoor residual spraying (IRS) coverage was 99%, of which 77.5% of houses of participants were get sprayed in the last six months. Conclusions: The current study revealed that prevalence of malaria among febrile illnesses in the study area was relatively low (7.3%) with a high proportion of P. falciparum. Besides, participants had adequate knowledge, encouraging attitudes, and good practices about prevention and control of malaria. However, some misconceptions on malaria disease, its transmission, and prevention have been noted that actually require due attention by the concerned stakeholders. We believe that findings of this study would make inroads into the implementation effective malaria interventions in the area and beyond focusing on enhancing community awareness and scaling up coverage of evidence-based interventions.
Trifocal diffractive intraocular lens implantation in patients after previous corneal refractive laser surgery for myopia
Authors: Li Qiu-Mei , Wang Feng , Li Shao-Wei , Stieger Knut , Wu Zhe-Ming , Liu Zhen , Zhan Chuan , Chen Bing-Heng , Sima Jing
Published: May 2020

Background: With the difficulties in IOL power calculation and the potential side effects occurring postoperatively, multifocal IOL implantation after previous corneal refractive surgery are rarely reported especially for the trifocal IOL. Herein we report the clinical observation of trifocal IOL implantation in patients with previous myopia excimer laser correction. In this study, a multi-formula average method was performed for the IOLs power calculation to improve the accuracy. Visual and refractive outcomes were analyzed, and the subjective quality of patients’ life was evaluated by questionnaires survey.Methods: This retrospective case series included patients with previous myopia excimer laser correction who underwent femtosecond laser assisted phacoemulsification and trifocal IOL (AT LISA tri 839 MP) implantation. Follow-up was done at 1-day, 1-month and 3-month to assess the visual outcomes. Outcome measures were uncorrected distance, intermediate and near visual acuity (UDVA, UIVA, UNVA), manifest refraction, defocus curve, and subjective quality of vision.Results: 16 patients (14 eyes with previous laser in situ keratomileusis and 7 eyes with previous photorefractive keratectomy) were included. Mean postoperative spherical equivalent (SE) at 3-month was −0.56 D ± 0.49 SD, wherein, 48% of eyes were within ±0.50 D of emmetropia, and 91% were within ±1.0 D. Mean monocular UDVA, UIVA and UNVA (logMAR) at last visit were 0.02 ± 0.07, 0.10 ± 0.10, and 0.15 ± 0.11 respectively. Three patients (19%) reported halos and glare in postoperative 3 months, two of them needed to use spectacles to improve the intermediate visual acuity. Fifteen patients (94%) reported a satisfaction score of ≥3.5 out of 4.0, and thirteen patients (81%) did not need spectacles at all distances. Mean composite score of the VF-14 questionnaire was 95.00 ± 7.29 out of 100.Conclusions: Trifocal IOL implantation after myopia excimer laser correction could safely achieve a full range of adequate vision and accurate refractive outcomes.
Political Economy Analysis of the Performance-Based Financing Programme in Afghanistan
Authors: Salehi Ahmad Shah , Blanchut Karl , Vassal Anna , Borghi Josephine
Published: May 2020

Background Performance-based financing (PBF) has attracted considerable attention in recent years in low and middle-income countries. Afghanistan’s Ministry of Public Health (MoPH) implemented a PBF programme between 2010 and 2015 to strengthen the utilisation of maternal and child health services in primary health facilities. Methods We used a political economy analysis framework which aims to understand the main dynamics that influence the adoption and design of a policy and facilitates the exploration of policy processes and the roles played by key actors at various stages of implementation. Retrospective qualitative research methods were employed. The data comprised transcripts of key informant interviews and a review of PBF related documents. Results This study discovered a range of contextual factors contributing to the introduction of PBF in Afghanistan. In addition, the study identified the role, power, interest, and ideas of actors in relation to PBF and the extent to which they were involved in and affected the design, adoption, and implementation of PBF programme in the country. Besides, the study described the process of PBF programme design and how it was implemented in practice, including nonconformities to the initial design and reasons for these. Discussion Political economy factors played a critical role in the introduction, design and implementation of PBF programme in Afghanistan. This study highlighted a number of contextual factors including global and local forces supporting the introduction of PBF in Afghanistan. The process underlying the design and implementation of the PBF programme was a result of power and resource dynamics between PBF programme actors. This study makes an important contribution to the global literature through its focus on a low-income setting and a fragile and conflict-affected state where numerous forces have combined to bring a programme into existence and have influenced its implementation and outcome. Conclusion PBF programmes are inherently political as they enforce distinct arrangements for the sharing of resources and represents a risk or opportunity to actors as a result of changes to their roles and responsibilities and the modification of organisational processes. Future studies are required to focus on conducting empirical research to understand the main political economy dynamics that influence the policy cycle of such programmes. We recommend further use of political economy analysis in such studies.
Treatment of Complex Regional Pain Syndrome in Children and Adolescents: A Systematic Review
Authors: Vescio Andrea , Testa Gianluca , Culmone Annalisa , Sapienza Marco , Valenti Fabiana , Maria Fabrizio Di , Pavone Vito
Published: May 2020

Background: Complex Regional Pain Syndrome (CRPS), as known as Reflex Sympathetic Dystrophy, is characterized by chronic, spontaneous and provoked pain of the distal extremities, whose severity is disproportionate to the triggering event. In growing age, CRPS affects most commonly women aged 5 to 17 years, with a maximum incidence peak around the 13th year of age. Among the orthopedics, diagnosis remains challenging, as well as, the treatment is still debated and multidisciplinary. The purpose of this systematic review is to analyze the available literature to provide an update on the latest evidence related to the treatment of CRPS in growing age. Methods: Three reviewers searched Pubmed and Web of Science databases from their date of inception to the 20th September 2019 in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses guidelines.Data extraction was performed independently by 3 reviewers based on predefined criteria and the methodologic quality of included studies was quantified by the the Newcastle-Ottawa Quality Assessment Scale Cohort Studies. Results:A total of n = 264 articles were found. At the end of the first screening, following the previously described selection criteria, we selected n = 103 articles eligible for full-text reading. Ultimately, after full-text reading and a reference list check, we selected n = 6. The articles focused on physical (PT), cognitive-behavioral (CBT) and pharmacological (PhT) treatments. The combination of PT+CBT is the most efficacy and suggested, but a commonly accepted protocol has been not developed. Despite the good patients outcome, several are the adverse events recorded in PT. Conclusions: Physical therapy in association with occupational, and cognitive behavioral treatment is the recommended option in the management of pediatric CPRS. Pharmacological therapy should be reserved for refractory and selected patients. The design and development of a standard protocol are strongly suggested.
GABARAP Suppresses EMT and Breast Cancer Progression Via the AKT/mTOR Signaling Pathway
Authors: Liu Ying , Wang Dandan , Lei Mengxia , Gao Jiayi , Cui Yuqing , Jin Xiaoying , Yu Qiujie , Jiang Ying , Guo Yan , Liu Yali , Cai Li , Chen Xuesong
Published: May 2020

Background: Recent studies document that γ-aminobutyric acid type A (GABAA) receptor-associated protein (GABARAP) plays an important role in cancer autophagy. However, little is known about its role in tumor invasion, migration and metastasis. Here, the authors investigated the expression and significance of GABARAP in breast cancer. Method: A large group of clinical samples was assessed to detect GABARAP expression and its associations with clinicopathological features and prognosis. Gain- and loss-of-function experiments in cell lines and mouse xenograft models were performed to elucidate the function and underlying mechanisms of GABARAP-regulated tumor progression. Results: We analyzed GABARAP levels in clinical breast cancer samples and cell lines and confirmed that GABARAP was negatively correlated with advanced clinicopathologic features, such as tumor size (P=0.025) and TNM stage (P=0.001). Importantly, patients with low GABARAP levels had a poor prognosis (p = 0.0047). Functionally, our data revealed that GABARAP can inhibit proliferation, migration and invasion in vitro and in vivo. Importantly, low levels of GABARAP induced epithelial-mesenchymal transition (EMT), one of the most important mechanisms for the promotion of tumor metastasis, in breast cancer cells. Mechanistically, low levels of GABARAP increased the levels of p-AKT (S473) and p-mTOR (S2448), and a specific AKT pathway inhibitor reversed the downregulation of GABARAP-induced tumor progression. In clinical breast cancer specimens, immunohistochemistry (IHC) revealed that the distribution and intensity of GABARAP expression were negatively correlated with those of matrix metalloproteinase (MMP) 2 (P=0.0013) and MMP14 (P=0.019). Conclusions: Collectively, these data indicated that GABARAP suppressed the malignant behaviors of breast cancer cells, illuminating that the possible mechanism acts via the AkT/mTOR pathway. Targeting GABARAP may provide a potential diagnosis and treatment strategy for breast cancer.
CGA: A New Feature Selection Model for Visual Human Action Recognition
Authors: Guha Ritam , Kha Ali Hussain , Singh Pawan Kumar , Sarkar Ram
Published: May 2020

Recognition of human actions from visual contents is a budding field of computer vision and image understanding. The problem with such recognition system is the huge dimensions of the feature vectors. Many of these features are irrelevant to the classification mechanism. For this reason, in this paper, we propose a novel Feature Selection (FS) model called Co-operative Genetic Algorithm (CGA) to select some of the most important and discriminating features from the entire feature set to improve the classification accuracy as well as the time requirement of the activity recognition mechanism. In CGA, we have made an effort to embed the concepts of co-operative game theory in GA to create a both-way reinforcement mechanism to improve the solution of the FS model. The proposed FS model is tested on four benchmark video datasets such as Weizmann, KTH, UCF11, HMDB51 and two sensor-based UCI HAR datasets. The experiments are conducted using four state-of-the-art feature descriptors, namely HOG, GLCM, SURF, and GIST. It is found that there is a significant improvement in the overall classification accuracy while considering nearly 50 to 60% of the original feature vector.
Short-term changes in behaviors resulting from COVID-19-related social isolation and their influences on mental health
Authors: Asiamah Nestor , Opuni Frank Frimpong , Mends-Brew Edwin , Mensah Samuel Worlanyo , Mensah Henry Kofi , Quansah Fidelis
Published: May 2020

Withdrawing from social activities abruptly can be associated with anxiety and mental health struggles, but this behavior is unavoidable when an infectious disease such as Coronavirus 2019 (COVID-19) is spreading. With many governments taking to social distancing protocols, short-term changes in behaviors and their influences on health are expected. This study adopted a correlational research approach to assess the behavioral outcomes of the social distancing protocols and its influences on mental health. An online survey hosted by Survey Monkey was utilized to collect data from residents of three cities under a COVID-19 mandatory lockdown. A total of 621 surveys were analyzed using descriptive statistics and multiple linear regression analysis, with a sensitivity analysis utilized to select potential covariates for the final regression model. Findings indicate that reduced physical activity time, increased sedentary behavior time, and a change in sexual activity and smoking frequency are some short-term changes in behavior resulting from social isolation during the lockdown. An increase in sedentary behavior made a negative influence on mental health (β = -0.85; t = -46.76, p = 0.000). The only change in behavior that has a positive influence on mental health is substance use. For the most part, changes in behaviors in the short-term attributable to COVID-19 social isolation were associated with lower mental health scores. Our findings imply that COVID-19 social distancing measures should be rolled out alongside public education programs for discouraging unhealthy changes in behaviors.
Significant reduction in abundance of peridomestic mosquitoes (Culicidae) and Culicoides midges (Ceratopogonidae): an additional benefit of a novel attract-and-kill intervention applied against Leishmania infantum transmission, in São Paulo Brazil
Authors: González Mikel A. , Dilger Erin , Ronderos María M. , Spinelli Gustavo R. , Courtenay Orin , Hamilton James Gordon Campbell
Published: May 2020

Background
Following the long-term (42-month) evaluation of residual insecticide (co-located with sand fly pheromone) and insecticide-impregnated dog-collars in a randomised control trial (RCT) against leishmaniasis, we assessed the impact of these interventions on the peridomestic abundance and distribution of mosquitoes (Culicidae) and midges (Ceratopogonidae) in Western São Paulo, Brazil. Both of these Dipteran groups are vectors of diseases of medical and veterinary relevance to humans and domestic animals in Brazil.
Methods
The interventions in the 3-arm RCT: pheromone + insecticide (PI) (chicken roosts sprayed with microencapsulated lambda-cyhalothrin), dog-collars (DC) (dogs fitted with deltamethrin-impregnated collars), and control (C) (unexposed to pyrethroids) were extended by 12 months. During that time adult mosquitoes and midges were sampled at three household locations (inside human dwellings, dog sleeping sites, chicken roosts).
Results
We collected 3,145 culicids (9 genera mostly Culex spp.) distributed relatively uniformly across all 3 arms; 43.5% inside houses, 36.2% at chicken roosts and 20.3% at dog sleeping sites. We collected 11,464 Culicoides (at least 15 species) found mostly at chicken roosting sites (84.7%) compared with dog sleeping sites (12.2%) or houses (3.1%). Mosquitoes and Culicoides were predominant during the hot and rainy reason. Increased daytime temperature was significantly associated with increased mosquito abundance (z = 1.97; P = 0.049) but marginally associated with Culicoides abundance (z = 1.71; P = 0.087). There was no significant association with average rainfall for either group. Household-level mosquito and midge numbers were both significantly reduced by the PI intervention 56% (Incidence Rate Ratio, IRR = 0.54 [95% C.I. 0.30, 0.97], P ≤ 0.05] and 53% (IRR = 0.47 [0.26, 0.85], P ≤ 0.05), respectively. The abundance of both Dipteran groups at dog sleeping sites was largely unaffected by the PI and DC interventions. The PI intervention significantly reduced abundance of mosquitoes inside houses (41%) and at chicken roosting sites (48%) and reduced midge abundance by 51% in chicken roosting sites.
Conclusions
Sprayed insecticide at chicken roosting sites reduced the abundance of mosquitoes and midges at the peridomestic level while dog collars had no effect on numbers for any group.
Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Patients Living with Human Immunodeficiency Virus: Case Reports and Review of the Literature
Authors: Chen Liping , Xiao Fang , Cao Li , Xie Meng , Wen Yue , Zhang Zhicheng , Ding Qiang , Yan Wei , Tian Dean , Wang Ge
Published: May 2020

Background: Novel coronavirus pneumonia (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread over the globe. The knowledge about SARS-CoV-2 infection in immunocompromised patients was limited. Case presentation: We presented here two human immunodeficiency virus (HIV)-infected cases with laboratory confirmed COVID-19 and clinically confirmed COVID-19, respectively. The patients both presented with fever at illness onset and patchy shadows in radiological images of lungs. Laboratory findings revealed leukopenia, lymphopenia and positive anti-HIV antibody. The younger case had a moderate course and was discharged after a 28-day hospitalization. However, the elder case with multiple comorbidities developed dyspnea and died on the fourth day after admission. Conclusions: Combining our data with two case reports, we summarize that disease course varies in HIV-infected patients with COVID-19. More attention should be paid to the management of these patients. Whether there is any difference about clinical characteristics and prognosis of COVID-19 between HIV-infected and non-HIV infected patients, remains to be further investigated.
An Analysis of the ‘Failed States Index’ by Partial Order Methodology
Authors: Carlsen Lars , Brüggemann Rainer
Published: May 2020

Often objects are to be ranked. However, there is no measurable quantity available to express the ranking aim and to quantify it. The consequence is that indicators are selected, serving as proxies for the ranking aim. Although this set of indicators is of great importance for its own right, the most commonly used practice to obtain a ranking is an aggregation method. Any aggregation, however suffers from the effect of compensation, because the aggregation technique is in the broadest sense an averaging method. Here an alternative is suggested which avoids this averaging and which is derived from simple elements of the theory of partially ordered sets (posets). The central concept in partial order is the ‘concept of comparison’ and the most general outcome is a web of relations between objects according to their indicator values, respecting the ranking aim.

As an example the ‘Failed State Index’ (FSI), annually prepared by the Fund of Peace is selected. The FSI is based on twelve individual contextual different indicators, subsequently transformed into a single composite indicator, by simple addition of the single indicator values. Such an operation leaves space for compensation effects, where one or more indicators level out the effect of others. Hence, a comparison between the single states (in total 177) based on their mutual FSI ranking has its limitations as the comparisons are made based on the composite indicator. We show that brain drain is one of the indicators in the FSI-study that plays a crucial role in the ranking, whereby the ranking aim is the stabilization of nations.
Sensör ve Akıllı Telefon Kayıtları Yardımı ile Yapının Dinamik Karakteristiklerin Belirlenmesi
Authors: UYAR Hidayet , AĞCAKOCA Elif
Published: May 2020

Çalışma kapsamında, sarsma tablasındaki çelik model yapıya yerleştirilen sensör ve akıllı telefondan elde edilen titreşim değerleri ile MATLAB matematiksel tahmin modeli kullanılarak oluşturulan titreşim değerleri arasındaki uyum oranları karşılaştırılmıştır. Deneysel çalışmada kullanılan çelik model yapı; tek açıklıklı, dört katlı çelik malzemesinden üretilmiştir. Çelik model yapıda bulunan kolon-kiriş bağlantıları rijit, model binanın dört tarafında bulunan temel bağlantıları sarsma tablasına ankastre olacak şekilde montelenmiştir. Deneysel çalışmadan elde edilen titreşim değerleri, sarsma tablasının tabanına ve çelik model yapının tepe noktasına yerleştirilen sensör ve akıllı telefondan elde edilmiştir. Sarsma tablası El-Centro, Loma-Prieta, Kobe ve Sakarya depremlerinin titreşim değerleriyle zorlanmış ve oluşan zorlanmanın yapıda meydana getirdiği titreşimler sensör ve akıllı telefon yardımıyla kaydedilmiştir. Sarsma tablasının tabanında bulunan sensör ve akıllı telefon titreşim değerleri girdi, çelik model yapının tepe noktasında bulunan sensör ve akıllı telefonlar titreşim değerleri sisteme çıktı olarak tanımlanmıştır. Çalışmaların sonucunda deneysel olarak elde edilen girdi-çıktı verileri arasındaki uyumluluk oranları, Matlab programındaki otoregresif ARX ve otoregresif hareketli ortalamalar ARMAX modelinde bulunan tahmin-öngörü ile üretilen girdi-çıktı arasındaki uyumluluk oranları karşılaştırılmıştır.
Akıllı Şebekelerde İletişim Altyapısı ve Siber Güvenlik
Authors: GÜNDÜZ Muhammed Zekeriya , DAŞ Resul
Published: May 2020

Akıllı şebekeler, mevcut elektrik şebekelerinin bilgi iletişim teknolojileri ile donatılmış yeni nesil güç sistemlerine dönüştürülmesidir. Gelişmiş bilgi iletişim teknolojilerinin ve yenilenebilir enerji kaynaklarının etkin bir şekilde mevcut elektrik şebekelerine entegre edilmesi geleceğin güç sistemlerinin verimlilik ve etkinliğini artıracaktır. Siber-fiziksel bir sistem olan akıllı şebekeler sağladıkları olanakların yanı sıra siber güvenlik ile ilgili ciddi sorunları da beraberinde getirmektedirler. Bu sorunları engellemek, tespit etmek ve sistemi bunlara karşı korumak için iletişim altyapısının verimli, güvenilir, güvenli ve etkin bir şekilde tasarlanması gerekmektedir. Bu çalışmada akıllı şebeke iletişim altyapısındaki siber güvenlik gereklilikleri, ağ zafiyetleri, güvenli iletişim mimarileri ve protokolleri ile siber saldırıların engellenmesi konuları ele alınmıştır. Ayrıca, akıllı şebekelerde öne çıkan siber güvenlik zafiyetlerinin ve çözümlerinin derinlemesine anlaşılması sağlanarak, konu ile alakalı gelecekte yapılacak çalışmalara yol gösterilmesi amaçlanmıştır.
Socio-Cultural and Axiological Aspects of Economic Behavior and Satisfaction of Human Needs
Authors: Zolotukhin Vladimir , Semina Dariya , Semina Marina
Published: May 2020

The present article considers the correlation of two key categories of human economic behavior: needs and values. As the socio-cultural attitudes of modern society change, values become the main reference point of the individual, and the ways the person chooses to realize his or her needs characterize the formation of value orientations and stereotypes of human behavior. From the point of view of development of various consumption models, the axiological attitude to goods and services is undergoing a transformation. The vector of transformation depends on how this process is reflected by human consciousness. The way one chooses to satisfy his or her needs depends on the prevailing value stereotypes in one’s economic behavior. The formation of needs and their assessment are determined by the economic reality and the socio-cultural environment. A person has the right to determine the trajectory of their economic behavior, as long as it is legal and conscious, both in the technological and economic sense. From the point of view of the subject of activity and consumption, a person is a reflection of social identity, due to the socio-cultural environment, limited by a certain awareness and understanding of the quality of life. The author focuses on the fact that certain negative socio-cultural practices caused by inefficient and problematic activities of state institutions result increase irresponsible behavior, legal nihilism, unjustified tolerance and / or zero tolerance, as well as the transformation of value stereotypes.
In Silico Structural and Functional Analysis of Bacillus Uricases
Authors: Nelapati Anand Kumar , Meena Shubham , Singh Aditya Kumar , Bhakta Narsimha , PonnanEttiyappan JagadeeshBabu
Published: May 2020

Background:

Excluding humans, the peroxisomal uricase is responsible for the
catabolism of uric acid into allantoin in many species like microorganisms, plants, and invertebrates.
Particularly in humans, the synthesis and excretion of uric acid are naturally balanced.
When the uric acid concentration crosses 7 mg/dl, it results in conditions such as hyperuricemia
and gout. Uricase is one of the potential sources for the reduction of uric acid in humans. Uricase is
also widely used as a commercial diagnostic reagent in medical and clinical biochemistry to estimate
the uric acid concentration in blood and other biological fluids. Computational approaches
can be used for screening and investigation of uricase enzyme with desirable characteristics that
can be employed in diverse industrial applications.

Objectives:

The present study deals with computational-based structural, functional, and phylogenetic
analyses of uricase enzymes from various Bacillus species.

Methods:

Seventy uricase protein sequences from Bacillus species were selected for multiple sequence
alignment, phylogenetic analysis, motif assessment, domain architecture examination, understanding
of basic physicochemical properties and in silico identification of the composition of
amino acids in uricase. Further, structural (secondary and tertiary structure prediction), and functional
(CYS_REC, MOTIF scan, CD-search, STRING, SOSUI, and PeptideCutter) analyses of uricase
were performed.

Results:

Bacillus simplex (WP_063232385.1) was chosen as the representative species of the Bacillus
genera. The three-dimensional (3D) structure of B. simplex uricase was predicted and validated
using QMEAN, RAMPAGE, ERRAT, Verify 3D and PROQ servers. The analysis revealed that
the tertiary structure of the selected uricase has good quality and acceptability.

Conclusion:

Computational analysis of uricase from various Bacillus sources revealed that all the
selected Bacillus uricases are active within acidic to a neutral environment, and thermally stable
with a molecular weight ranging from 35.59-59.85kDa. The secondary structure analysis showed
that all uricases are rich in alpha-helices and sheets. The CDD tool identified two conserved domains,
one of which belongs to OHCU decarboxylase and another belongs to Uricase superfamily.
The quality estimation of 3D modeled protein gave a high overall quality factor score of 94.64. Also,
all Bacillus species of uricase enzyme and their corresponding genes showed a strong correlation
from the phylogenetic comparison of the selected taxa. The present detailed computational investigation
on the uricase protein could help in screening a suitable uricase producing microbe with
desirable characteristics for industrial application.
Metabolic Regulation and Related Molecular Mechanisms in Various Stem Cell Functions
Authors: Lee Hwa-Yong , Hong In-Sun
Published: May 2020

Recent studies on the mechanisms that link metabolic changes with stem cell fate have deepened our understanding of how specific metabolic pathways can regulate various stem cell functions during the development of an organism. Although it was originally thought to be merely a consequence of the specific cell state, metabolism is currently known to play a critical role in regulating the self-renewal capacity, differentiation potential, and quiescence of stem cells. Many studies in recent years have revealed that metabolic pathways regulate various stem cell behaviors (e.g., selfrenewal, migration, and differentiation) by modulating energy production through glycolysis or oxidative phosphorylation and by regulating the generation of metabolites, which can modulate multiple signaling pathways. Therefore, a more comprehensive understanding of stem cell metabolism could allow us to establish optimal culture conditions and differentiation methods that would increase stem cell expansion and function for cell-based therapies. However, little is known about how metabolic pathways regulate various stem cell functions. In this context, we review the current advances in metabolic research that have revealed functional roles for mitochondrial oxidative phosphorylation, anaerobic glycolysis, and oxidative stress during the self-renewal, differentiation and aging of various adult stem cell types. These approaches could provide novel strategies for the development of metabolic or pharmacological therapies to promote the regenerative potential of stem cells and subsequently promote their therapeutic utility.
Azacitidine, as a DNMT Inhibitor Decreases hTERT Gene Expression and Telomerase Activity More Effective Compared with HDAC Inhibitor in Human Head and Neck Squamous Cell Carcinoma Cell Lines
Authors: Atri Sepideh , Nasoohi Nikoo , Hodjat Mahshid
Published: May 2020

Background:

Head and neck squamous cell carcinoma (HNSCC) is one of the most fatal malignancies worldwide and
despite using various therapeutic strategies for the treatment of HNSCC, the surveillance rate is low. Telomerase has been remarked
as the primary targets in cancer therapy. Considering the key regulatory role of epigenetic mechanisms in controlling genome
expression, the present study aimed to investigate the effects of two epigenetic modulators, a DNA methylation inhibitor and a
histone deacetylase inhibitor on cell migration, proliferation, hTERT gene expression, and telomerase activity in HNSCC cell lines.

Methods:

Human HNSCC cell lines were treated with Azacitidine and Trichostatin A to investigate their effects on telomerase
gene expression and activity. Cell viability, migration, hTERT gene expression, and telomerase activity were studied using MTT
colorimetric assay, scratch wound assay, qRT-PCR, and TRAP assay, respectively.

Results:

Azacitidine at concentrations of ≤1μM and Trichostatin A at 0.1 to 0.3nM concentrations significantly decreased FaDu
and Cal-27 cells migration. The results showed that Azacitidine significantly decreased hTERT gene expression and telomerase
activity in FaDu and Cal-27 cell lines. However, there were no significant changes in hTERT gene expression at different
concentrations of Trichostatin A in both cell lines. Trichostatin A treatment affected telomerase activity at the high dose of 0.3 nM
Trichostatin A.

Conclusion:

The findings revealed that unlike histone deacetylase inhibitor, Azacitidine as an inhibitor of DNA methylation
decreases telomerase expression in HNSCC cells. This might suggest the potential role of DNA methyltransferase inhibitors in
telomerase-based therapeutic approaches in squamous cell carcinoma.
Evaluating the Effectiveness of an Intervention Integrating Technology and In-Person Sexual Health Education for Adolescents (In the Know): Protocol for a Cluster Randomized Controlled Trial
Authors: Decker Martha J. , Gutmann-Gonzalez Abigail , Price Melisa , Romero Julio , Sheoran Bhupendra , Yarger Jennifer
Published: May 2020

Background

Access to a smartphone is nearly universal among American adolescents, and most of them have used the internet to seek health information. Integrating digital technologies into health program delivery may expand opportunities for youth to receive important health information, yet there are few rigorous studies assessing the effectiveness of this type of intervention.

Objective

The purpose of this study is to assess the effectiveness of In the Know (ITK), a program integrating in-person and technology-based sexual health education for underserved adolescents.

Methods

Youth were engaged in the development of the intervention, including the design of the digital technology and the curriculum content. The intervention focuses on 3 main areas: sexual health and contraceptive use, healthy relationships, and educational and career success. It includes an in-person, classroom component, along with a web-based component to complement and reinforce key content. A cluster randomized controlled trial is in progress among adolescents aged 13-19 years living in Fresno County, California. It is designed to examine the differences in self-reported health and behavioral outcomes among youth in the intervention and control groups at 3 and 9 months. Primary outcomes are condom and contraceptive use or no sex in the past 3 months and use of any clinical health services in the past 3 months. Secondary outcomes include the number of sexual partners in the past 3 months and knowledge of local clinical sexual health services. We will use mixed-effects linear and logistic regression models to assess differences between the intervention and control groups.

Results

Trial enrollment began in October 2017 and ended in March 2020 with a total of 1260 participants. The mean age of the participants is 15.73 (SD 1.83) years, and 69.98% (867/1239) of the participants report being Hispanic or Latino. Study results will be available in 2021.

Conclusions

ITK has the potential to improve contraceptive and clinic use among underserved youth. This trial will inform future youth-focused health interventions that are considering incorporating technology.

International Registered Report Identifier (IRRID)

DERR1-10.2196/18060
Emergency Response to COVID-19 in Canada: Platform Development and Implementation for eHealth in Crisis Management
Authors: Krausz Michael , Westenberg Jean Nicolas , Vigo Daniel , Spence Richard Trafford , Ramsey Damon
Published: May 2020

Background

Public health emergencies like epidemics put enormous pressure on health care systems while revealing deep structural and functional problems in the organization of care. The current coronavirus disease (COVID-19) pandemic illustrates this at a global level. The sudden increased demand on delivery systems puts unique pressures on pre-established care pathways. These extraordinary times require efficient tools for smart governance and resource allocation.

Objective

The aim of this study is to develop an innovative web-based solution addressing the seemingly insurmountable challenges of triaging, monitoring, and delivering nonhospital services unleashed by the COVID-19 pandemic.

Methods

An adaptable crisis management digital platform was envisioned and designed with the goal of improving the system’s response on the basis of the literature; an existing shared health record platform; and discussions between health care providers, decision makers, academia, and the private sector in response to the COVID 19 epidemic.

Results

The Crisis Management Platform was developed and offered to health authorities in Ontario on a nonprofit basis. It has the capability to dramatically streamline patient intake, triage, monitoring, referral, and delivery of nonhospital services. It decentralizes the provision of services (by moving them online) and centralizes data gathering and analysis, maximizing the use of existing human resources, facilitating evidence-based decision making, and minimizing the risk to both users and providers. It has unlimited scale-up possibilities (only constrained by human health risk resource availability) with minimal marginal cost. Similar web-based solutions have the potential to fill an urgent gap in resource allocation, becoming a unique asset for health systems governance and management during critical times. They highlight the potential effectiveness of web-based solutions if built on an outcome-driven architecture.

Conclusions

Data and web-based approaches in response to a public health crisis are key to evidence-driven oversight and management of public health emergencies.
Measuring the Outreach Efforts of Public Health Authorities and the Public Response on Facebook During the COVID-19 Pandemic in Early 2020: Cross-Country Comparison
Authors: Sesagiri Raamkumar Aravind , Tan Soon Guan , Wee Hwee Lin
Published: May 2020

Background

The coronavirus disease (COVID-19) pandemic presents one of the most challenging global crises at the dawn of a new decade. Public health authorities (PHAs) are increasingly adopting the use of social media such as Facebook to rapidly communicate and disseminate pandemic response measures to the public. Understanding of communication strategies across different PHAs and examining the public response on the social media landscapes can help improve practices for disseminating information to the public.

Objective

This study aims to examine COVID-19-related outreach efforts of PHAs in Singapore, the United States, and England, and the corresponding public response to these outreach efforts on Facebook.

Methods

Posts and comments from the Facebook pages of the Ministry of Health (MOH) in Singapore, the Centers for Disease Control and Prevention (CDC) in the United States, and Public Health England (PHE) in England were extracted from January 1, 2019, to March 18, 2020. Posts published before January 1, 2020, were categorized as pre-COVID-19, while the remaining posts were categorized as peri-COVID-19 posts. COVID-19-related posts were identified and classified into themes. Metrics used for measuring outreach and engagement were frequency, mean posts per day (PPD), mean reactions per post, mean shares per post, and mean comments per post. Responses to the COVID-19 posts were measured using frequency, mean sentiment polarity, positive to negative sentiments ratio (PNSR), and positive to negative emotions ratio (PNER). Toxicity in comments were identified and analyzed using frequency, mean likes per toxic comment, and mean replies per toxic comment. Trend analysis was performed to examine how the metrics varied with key events such as when COVID-19 was declared a pandemic.

Results

The MOH published more COVID-19 posts (n=271; mean PPD 5.0) compared to the CDC (n=94; mean PPD 2.2) and PHE (n=45; mean PPD 1.4). The mean number of comments per COVID-19 post was highest for the CDC (mean CPP 255.3) compared to the MOH (mean CPP 15.6) and PHE (mean CPP 12.5). Six major themes were identified, with posts about prevention and safety measures and situation updates being prevalent across the three PHAs. The themes of the MOH’s posts were diverse, while the CDC and PHE posts focused on a few themes. Overall, response sentiments for the MOH posts (PNSR 0.94) were more favorable compared to response sentiments for the CDC (PNSR 0.57) and PHE (PNSR 0.55) posts. Toxic comments were rare (0.01%) across all PHAs.

Conclusions

PHAs’ extent of Facebook use for outreach purposes during the COVID-19 pandemic varied among the three PHAs, highlighting the strategies and approaches that other PHAs can potentially adopt. Our study showed that social media analysis was capable of providing insights about the communication strategies of PHAs during disease outbreaks.
Can Social Communication Skills for Children Diagnosed With Autism Spectrum Disorder Rehearsed Inside the Video Game Environment of Minecraft Generalize to the Real World? (Preprint)
Authors: Cadieux Lee , Keenan Mickey
Published: May 2020

UNSTRUCTURED

In this paper, we outline opportunities within the video game environment for building skills applicable to real-world issues faced by some children. The game Minecraft is extremely popular and of particular interest to children diagnosed with autism spectrum disorder. Although the game has been used by support communities to facilitate the social interaction of children and peer support for their parents, little has been done to examine how social skills developed within the game environment generalize to the real world. Social Craft aims to establish a framework in which key social communication skills would be rehearsed in-game with a view to facilitating their replication in a similarly contained real-world environment. Central to this approach is an understanding of the basic principles of behavior and the engagement of a sound methodology for the collection of data inside and outside the respective environments.
Mental Health, Risk Factors, and Social Media Use During the COVID-19 Epidemic and Cordon Sanitaire Among the Community and Health Professionals in Wuhan, China: Cross-Sectional Survey (Preprint)
Authors: Ni Michael Y , Yang Lin , Leung Candi M C , Li Na , Yao Xiaoxin I , Wang Yishan , Leung Gabriel M , Cowling Benjamin J , Liao Qiuyan
Published: May 2020

BACKGROUND

The mental health consequences of the coronavirus disease (COVID-19) pandemic, community-wide interventions, and social media use during a pandemic are unclear. The first and most draconian interventions have been implemented in Wuhan, China, and these countermeasures have been increasingly deployed by countries around the world.

OBJECTIVE

The aim of this study was to examine risk factors, including the use of social media, for probable anxiety and depression in the community and among health professionals in the epicenter, Wuhan, China.

METHODS

We conducted an online survey via WeChat, the most widely used social media platform in China, which was administered to 1577 community-based adults and 214 health professionals in Wuhan. Probable anxiety and probable depression were assessed by the validated Generalized Anxiety Disorder-2 (cutoff ≥3) and Patient Health Questionnaire-2 (cutoff ≥3), respectively. A multivariable logistic regression analysis was used to examine factors associated with probable anxiety and probable depression.

RESULTS

Of the 1577 community-based adults, about one-fifth of respondents reported probable anxiety (n=376, 23.84%, 95% CI 21.8-26.0) and probable depression (n=303, 19.21%, 95% CI 17.3-21.2). Similarly, of the 214 health professionals, about one-fifth of surveyed health professionals reported probable anxiety (n=47, 22.0%, 95% CI 16.6-28.1) or probable depression (n=41, 19.2%, 95% CI 14.1-25.1). Around one-third of community-based adults and health professionals spent ≥2 hours daily on COVID-19 news via social media. Close contact with individuals with COVID-19 and spending ≥2 hours daily on COVID-19 news via social media were associated with probable anxiety and depression in community-based adults. Social support was associated with less probable anxiety and depression in both health professionals and community-based adults.

CONCLUSIONS

The internet could be harnessed for telemedicine and restoring daily routines, yet caution is warranted toward spending excessive time searching for COVID-19 news on social media given the infodemic and emotional contagion through online social networks. Online platforms may be used to monitor the toll of the pandemic on mental health.
Information Technology–Based Management of Clinically Healthy COVID-19 Patients: Lessons From a Living and Treatment Support Center Operated by Seoul National University Hospital (Preprint)
Authors: Bae Ye Seul , Kim Kyung Hwan , Choi Sae Won , Ko Taehoon , Jeong Chang Wook , Cho BeLong , Kim Min Sun , Kang EunKyo
Published: May 2020

BACKGROUND

South Korea took preemptive action against coronavirus disease (COVID-19) by implementing extensive testing, thorough epidemiological investigation, strict social distancing, and rapid treatment of patients according to disease severity. The Korean government entrusted large-scale hospitals with the operation of living and treatment support centers (LTSCs) for the management for clinically healthy COVID-19 patients.

OBJECTIVE

The aim of this paper is to introduce our experience implementing information and communications technology (ICT)-based remote patient management systems at a COVID-19 LTSC.

METHODS

We adopted new electronic health record templates, hospital information system (HIS) dashboards, cloud-based medical image sharing, a mobile app, and smart vital sign monitoring devices.

RESULTS

Enhancements were made to the HIS to assist in the workflow and care of patients in the LTSC. A dashboard was created for the medical staff to view the vital signs and symptoms of all patients. Patients used a mobile app to consult with their physician or nurse, answer questionnaires, and input self-measured vital signs; the results were uploaded to the hospital information system in real time. Cloud-based image sharing enabled interoperability between medical institutions. Korea’s strategy of aggressive mitigation has “flattened the curve” of the rate of infection. A multidisciplinary approach was integral to develop systems supporting patient care and management at the living and treatment support center as quickly as possible.

CONCLUSIONS

Faced with a novel infectious disease, we describe the implementation and experience of applying an ICT-based patient management system in the LTSC affiliated with Seoul National University Hospital. ICT-based tools and applications are increasingly important in health care, and we hope that our experience will provide insight into future technology-based infectious disease responses.