bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Symptoms and Treatment of Common Respiratory Tract Infections in Relation to Microbiological Profiles in Rural Health Facilities in China: Implications for Antibiotic Stewardship
Authors: Shen Xingrong , Shen Jilu , Pan Yaping , Cheng Jing , Chai Jing , Bowker Karen , MacGowan Alasdair , Oliver Isabel , Lambert Helen , Wang Debin
Published: August 2020

Background This study aims to identify the extent to which current clinical practice in the treatment of common respiratory tract infections (RTIs) is consistent with presenting symptoms and microbiological characteristics at health care settings in rural China and implications for future antibiotic stewardship.Methods The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. Observations, structured and semi-structured interviews were conducted to investigate antibiotic use. Sputum and throat swabs were collected for bacterial culture and susceptibility testing.Results A total of 1068 completed the study. Antibiotics were prescribed for 87.8% of RTI patients. Of all the specimens tested, 329 (30.8%) specimens were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24.15% in all specimens), H. influenza (16.19%), H. parainfluenzae (14.77%), S.aureus (5.11%), M. catarrhalis (3.41%) and S. pneumoniae (2.27%). The bacteria detection was associated with age (OR=1.91), season (OR=0.41 to 0.60), days since infection onset (OR=1.54 to 1.81), and runny or blocked nose (OR=1.39 to 1.61), cough with green or white sputum (OR=1.47 to 1.59). Antibiotic use was only linked with limited non-specific clinical manifestations e.g., days since infection onset (OR=0.53) and sore throat (OR=1.64).Conclusions The study reveals that antibiotics prescription is still very common in rural China which is driven mainly by non-pathological factors rather than treatment of bacterial infections. The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China.
Midwifery Core Competency Assessment Tool: A Systematic Review Protocol
Authors: Li Shenmei , Dai Yunyun , Chen Yangguang , Gao Yan , Pan Chuang
Published: August 2020

Background: In recent years, the capacity building of midwives has attracted the attention of all countries in the world, especially in countries with a lack of midwifery human resources. Improving the capacity of midwives is an important strategy to ensure the health of mothers and infants.Professional associations in many countries have issued standards for midwife competency, which are basically similar to the core competency module proposed by ICM, but some countries have made localization adjustments according to their own characteristics. In August 2019 a further update was made to correct an error in competency of the English version,the French and Spanish versions by ICM.In order to further standardize the evaluation tools of midwives' core competence, it is urgent to evaluate them.Methods/Design: We will conduct a systematic review and utility critique of instruments used to measure effectiveness of core competence assessment tools for midwives at different levels. The databases Medical Literature Analysis and Retrieval System Online(MEDLINE), Cumulative Index to midwife competency and Web of Knowledge will be searched from inception until end November 2020. Search strategies will include the key words; midwife, core competency ,questionnaires, instruments, delphi technique, index system, reliability, validity. We will contact experts in the field of measuring core competency and scrutinise all secondary references. A reviewer will apply an inclusion criteria scale to all titles and abstracts. A second reviewer will apply the inclusion criteria scale to a random 10% selection. Two reviewers will independently evaluate the methodological rigour of the testing of the instruments using the Consensus-based Standards for the selection of core competency checklist. We will present a narrative synthesis on the utility of all instruments and make recommendations for instrument selection in practice.Discussion: This systematic review of the utility of instruments to measure the core competence assessment tools for midwives at different levels. It will aid managers ,educator and policy makers to select an instrument fit for purpose. Importantly, appropriate instrument selection will provide a mechanism for effective training of midwives' core competency ability in different levels.
Usefulness of Positron Emission Tomography-Guided Surgery with 64Cu-Labeled Cetuximab for Resection of Intrapancreatic Primary and Residual Tumors in a Xenograft Mouse Model of Resectable Pancreatic Cancer
Authors: Igarashi Chika , Yoshii Yukie , Tashima Hideaki , Iwao Yuma , Sakurai Kohei , Hihara Fukiko , Tachibana Tomoko , Yoshida Eiji , Wakizaka Hidekatsu , Akamatsu Go , Yamaya Taiga , Yoshimoto Mitsuyoshi , Matsumoto Hiroki , Zhang Ming-Rong , Nagatsu Kotaro , Sugyo Aya , Tsuji Atsushi B , Higashi Tatsuya
Published: August 2020

Background: Pancreatic cancer (PC) has a very poor prognosis. Surgery is the standard treatment for resectable PC but the accurate intraoperative identification and resection of intrapancreatic tumors remain challenging and tumor residuals frequently cause local recurrence. We have developed a novel open-type positron emission tomography (PET) system (called “OpenPET”) that enables high-resolution PET-guided surgery in real-time. Furthermore, we have demonstrated that OpenPET-guided surgery with ip-administered 64Cu-labeled anti-epidermal growth factor receptor antibody cetuximab can image and remove primary small (< 1 cm) resectable PC tumors in an orthotopic xenograft mouse model. Here, we further investigated the usefulness of OpenPET-guided surgery for the intraoperative identification and resection of not only primary but also unexpected residual intrapancreatic tumors using an orthotopic xenograft mouse model with large (> 1 cm) resectable PC and examined its survival benefit over conventional surgery.Methods: To establish the model, human PC xPA-1-DC cells expressing red fluorescent protein (RFP) were slowly inoculated into the mouse pancreas. To investigate its usefulness, OpenPET-guided surgery was conducted 24 h after intraperitoneal administration of 64Cu-labeled cetuximab (7.4 MBq/mouse). For comparison, similar surgical procedures were conducted, and conventional tumor resection was attempted using only the naked eye (control). The survival rate after OpenPET-guided surgery was compared to that after control operations. Results: The intraoperative OpenPET guidance enabled the detection and resection of both primary and small residual tumors. In this study, 10 residual tumor specimens were intraoperatively isolated with OpenPET guidance (n=7 mice); three and seven tumors were 5–10 mm and 3–5 mm in diameter, respectively. In all isolated specimens, tumor RFP signals were detected. By contrast, no tumor tissue was resected in control group because in this model, the locations and boundaries of primary tumors within the pancreas were not clearly detectable by the naked eye alone. Mice after OpenPET-guided surgery showed significantly longer survival rates than those in control group.Conclusions: OpenPET-guided surgery with 64Cu-labeled-cetuximab enabled the intraoperative identification and resection of intrapancreatic primary and residual tumors in vivo. This technology could be useful to prevent tumor residuals during surgery and improve PC survival.
Differences in 18F-Fluorodeoxyglucose uptake in BAT of UCP1 -/- and UCP1+/+ during Adrenergic Stimulation of Non-Shivering Thermogenesis
Authors: McHugh Christian T , Garside John , Barkes Jared , Frank Jonathan , Dragicevich Constance , Yuan Hong , Branca Rosa T
Published: August 2020

BackgroundBrown adipose tissue (BAT) is a fat tissue found in most mammals that helps regulate energy balance and core body temperature through a sympathetic process known as non-shivering thermogenesis. BAT activity is commonly detected and quantified in 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans, and radiotracer uptake in BAT during adrenergic stimulation is often used as a surrogate measure for identifying thermogenic activity in the tissue. BAT thermogenesis is believed to be contingent upon the expression of the protein UCP1, but conflicting results have been reported in the literature concerning 18F-FDG uptake within BAT of mice with and without UCP1. Differences in animal handling techniques such as feeding status, type of anesthetic, type of BAT stimulation, and estrogen levels were identified as possible confounding variables for 18F-FDG uptake. In this study, we aimed to assess differences in BAT 18F-FDG uptake between wildtype and UCP1-knockout mice using a protocol that minimizes possible variations in BAT stimulation caused by different stress responses to mouse handling.Results18F-FDG PET/CT scans were ran on mice that were anesthetized with pentobarbital after stimulation of non-shivering thermogenesis by norepinephrine. While in wild type mice 18F-FDG uptake in BAT increased significantly with norepinephrine stimulation of BAT, there was no consistent change in 18F-FDG uptake in BAT of mice lacking UCP1. Conclusions18F-FDG uptake within adrenergically stimulated BAT of wildtype and UCP1-knockout mice can significantly vary such that an 18F-FDG uptake threshold cannot be used to differentiate wildtype from UCP1-knockout mice. However, while an increase in BAT 18F-FDG uptake during adrenergic stimulation is consistently observed in wild type mice, in UCP1-knockout mice 18F-FDG uptake in BAT seems to be is independent of β3 adrenergic stimulation of non-shivering thermogenesis.
Decreased Eosinophil Counts and Elevated Lactate Dehydrogenase Predict Severe COVID-19 Patients with Underlying Chronic Airway Diseases
Authors: Yi Lingling , Chen Dian , Zhang Shuchen , Feng Yuchen , Wu Wenliang , Chang Chenli , Chen Shengchong , Zhen Guohua
Published: August 2020

Background: Several predictors for the severity of coronavirus disease 2019 (COVID-19) have been reported, including decreased circulating lymphocytes and eosinophil counts. However, chronic airway inflammation characterized by accumulated lymphocytes or eosinophils may affect the pathogenesis of COVID-19. We aimed to investigate the predictors for the severity of COVID-19 in patients with chronic airway diseases.Methods: In this retrospective cohort study, we reviewed medical records of all laboratory-confirmed COVID-19 patients with chronic bronchitis, chronic obstructive pulmonary disease (COPD) and asthma admitted in Sino-French New City Branch of Tongji Hospital, a large regional hospital in Wuhan, China, from January 26th to April 3rd. The Tongji Hospital ethics committee approved this study.Results: There were 59 patients with underlying chronic airway inflammation including chronic bronchitis, COPD, and asthma. When compared with non-severe patients, severe patients were more likely to have decreased lymphocyte counts (0.6 vs. 1.1× 10⁹/L, p < 0.001), eosinopenia (< 0.02 × 10⁹/L, 73% vs. 24%, p < 0.001), increased lactate dehydrogenase (LDH) (471.0 vs. 230.0 U/L, p < 0.001) and elevated IL-6 level (47.4 vs. 5.7 pg/ml, p = 0.002) on admission. Eosinopenia and elevated LDH were significantly associated with disease severity in both univariate and multivariate regression models included the above variables. Eosinopenia was also an independent risk factor for mortality of this cohort in a multivariate model included the above variables. Moreover, eosinophil counts and LDH levels tended to return to normal range over time in both groups after treatment and severe patients recovered slower than non-severe patients, especially eosinophil counts.Conclusions: Eosinopenia and elevated LDH are potential predictors of disease severity in COVID-19 patients with underlying chronic airway diseases. Theses predictors may help clinicians identify the severe COVID-19 patients with chronic bronchitis, COPD, and asthma.
Hydrothermal Sulfonation of Palm Empty Fruit Bunch Carbon as Solid Acid Catalyst and Its Hydrolysis Catalytic Activity
Authors: Nata Iryanti F. , Irawan Chairul , Putra Meilana D. , Lee Cheng-Kang
Published: August 2020

The sulfonated carbon solid acid catalyst (C-SO3H) was successfully generated from palm empty fruit bunch (PEFB) carbon via hydrothermal sulfonation by addition of hydroxyethylsulfonic acid and citric acid. The C-SO3H was identified contain of 1.75 mmol/g of acidity and 40.2% of sulphur. The surface morphology of C-SO3H showed pores with diameters of 3-6 µm and crystalline index (CrI) of material was decreased to 63.8% due to changed structure become carbon. The surface area of carbon was increased significantly from 11.5 to 239.65 m2g-1 after hydrothermal treatment. The identification of functional groups of -SO3H, COOH and -OH were detected by Fourier Transform Infra-Red (FT-IR). The optimum catalytic activity of C-SO3H was achieved via hydrolysis reaction with 60.4% of total reducing sugar (TRS) yield. The both concentrations of C-SO3H and cassava peel starch is 5% at 100 oC for 1 h. Stability of C-SO3H showed good performance for 4th repeated used; it showed insignificant of activity that decreased only of 6%. Thus, the C-SO3H is a candidate for green and potential sulfonated solid acid catalyst for wide range applications.
Delirium is Associated with High Mortality in Elderly patients with Acute Decompensated Heart Failure
Authors: Pak Misun , Hara Masahiko , Miura Shoko , Furuya Motohide , Tamaki Masatake , Okada Taiji , Watanabe Nobuhide , Endo Akihiro , Tanabe Kazuaki
Published: August 2020

Background: Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF.Methods: This single-center prospective observational study enrolled 132 consecutive patients with ADHF. We utilized the Diagnostic and Statistical Manual of Mental Disorders, fifth edition and classified the patients into two groups according to the presence or absence of delirium. The primary endpoint was 90-day all-cause mortality. The prognostic impact and risk factors of delirium were evaluated using multivariable Cox and logistic regression analyses, respectively. Results: The median patient age was 83 (interquartile range, 75–87) years. Approximately 51.5% were men. Delirium occurred in 36 (27.3%) patients, and hyperactive delirium was the most frequent type (86.1%). The 90-day all-cause mortality was higher in the patients with delirium than in those without (21.6% versus 3.9%, log-rank p=0.002). Delirium was associated with higher mortality with an adjusted hazard ratio of 6.8 (95% confidence interval, 1.1–42.6, p=0.042). The risk factors associated with delirium included advanced age, male sex, higher clinical frailty scale score, and dementia.Conclusions: Delirium was associated with a higher 90-day all-cause mortality in the elderly patients with ADHF. Hyperactive delirium was the most common subtype.
Adding Team-Based Financial Incentives to the Carrot Rewards App Increases Daily Step Count on a Population Scale: A 24-Week Matched Pairs Study
Authors: Pearson Emma , Prapavessis Harry , Higgins Christopher , Petrella Robert , White Lauren , Mitchell Marc
Published: August 2020

Background
Mobile health applications (mHealth apps) targeting physical inactivity have increased in popularity yet are usually limited by low engagement. This study examined the impact of adding team-based incentives (Step Together Challenges, STCs) to an existing mHealth app (Carrot Rewards) that rewarded individual physical activity achievements.
Methods
A 24-week quasi-experimental study (retrospective matched pairs design) was conducted in three Canadian provinces (pre-intervention: weeks 1–12; intervention: weeks 13–24). Participants who used Carrot Rewards and STCs (experimental group) were matched with those who used Carrot Rewards only (controls) on age, gender, province and baseline mean daily step count (± 500 steps/d). Carrot Rewards users earned individual-level incentives (worth $0.04 CAD) each day they reached a personalized daily step goal. With a single partner, STC users could earn team incentives ($0.40 CAD) for collaboratively reaching individual daily step goals 10 times in seven days (e.g., Partner A completes four goals and Partner B completes six goals in a week).
Results
The main analysis included 61,170 users (mean age = 32yrs; % female = 64). Controlling for pre-intervention mean daily step count, a significant difference in intervention mean daily step count favoured the experimental group (p < 0.0001; ηp2 = 0.024). The estimated marginal mean group difference was 537 steps per day, or 3759 steps per week (about 40 walking min/wk). Linear regression suggested a dose-response relationship between the number of STCs completed (app engagement) and intervention mean daily step count (adjusted R2 = 0.699) with each new STC corresponding to approximately 200 more steps per day.
Conclusion
Despite an explosion of physical activity app interest (100,000 + published apps), low engagement leading to small or no effects remains an industry hallmark. In this paper, we found that adding modest team-based incentives to the Carrot Rewards app increased mean daily step count, and importantly, app engagement moderated this effect. Others should consider novel small-teams based approaches to boost engagement and effects.
The Herbal Formula CBD Improves Sleep Quality Dependent on Oral Microbial Type and Tongue Diagnostic Features in Insomnia
Authors: Kim Min-Jee , Bose Shambhunath , Shin Na Rae , Yang Meng , Kwon Ojin , Song Eun-Ji , Nam Young-Do , Nam Dong-Hyun , Lee Jun-Hwan , Kim Hojun
Published: August 2020

Background Cheonwangbosim-dan (CBD) is a traditional Korean herb formula that has been widely prescribed for insomnia patients with a heart-yin deficiency (HYD) pattern. Several studies have recently reported that heart function and insomnia are interrelated, and others have explored associations between insomnia, oral microbiota, and tongue diagnosis. This study aimed to evaluate the effects of CBD on primary insomnia, tongue diagnosis, and oral microbiota. We conducted a prospective, open-label clinical trial on primary insomnia. At baseline, 56 patients with primary insomnia were assigned to two groups, a HYD group and a non-HYD (NHYD) group. Members of these groups took CBD for 6 weeks. Primary and secondary outcomes including Pittsburgh Sleep Quality Indices (PSQIs), Insomnia Severity Indices (ISIs), actigraphy results, cardiac function, autonomic nerve function, clinical laboratory results, tongue features, and oral microbiota were collected from all subjects at after 0, 3, or 6 weeks of treatment. Additionally, PSQI and ISI were determined by telephone follow-up 10 weeks after study commencement.Results During the study, PSQIs and ISIs decreased significantly in both groups. However, the PSQI reduction observed in the HYD group was greater than in the NHYD group and sleep times as determined by actigraphy, that is, total bedtimes (TBTs) and total sleep times (TST), increased only in the HYD group. As sleep quality improved, the amount of tongue coating increased at the posterior tongue, where heart function appears. At baseline, the HYD and NHYD group had a specific oral microbiota (Veillonella at genus level), but no significant change was observed after taking CBD. Additionally, subjects were divided into two oral microbiota types (‘orotype’). The genera Prevotella, Veillonella or Neisseria were abundant in each orotype. The reduction in PSQI in the orotype 1 during the 6-week treatment period was greater than in orotype 2.Conclusions Taking together, CBD was effective in primary insomnia patients with a HYD pattern and CBD increased the amount of tongue coating. In addition, oral microbiota distributions were different in patients with a HYD or a NHYD pattern. The study shows CBD could be used to treat primary insomnia in patients with a HYD pattern as determined using tongue diagnosis and oral microbiota distributional patterns.
Development of an ALBI and ascites based model to predict survival for BCLC Stage B hepatocellular carcinoma
Authors: Lin Huapeng , Jin Zheng , Yang Jing , Hu Wei , Zhu Ying
Published: August 2020

Background: The outcome of the patients with BCLC stage B hepatocellular carcinoma (HCC) varied. Albumin-Bilirubin (ALBI) grade, as a surrogate of the Child-Pugh (CP) grade, was evaluated to be a simple tool for the assessing of the liver function and prognosis. However, it appears to be arbitrary and crude to eliminate the ascites variable from the ALBI grade. We aimed to develop a predictive model constituted with the ALBI grade, the ascites and tumor burden related parameters in patients with BCLC stage B HCC. Methods: Patients diagnosed as the BCLC stage B HCC were collected from a retrospective database. Construction and validation of the predictive model were performed based on multivariate Cox regression analysis. Predictive accuracy, discrimination and fitness performance of the model were compared with the other eight models. The decision curve analysis (DCA) was used to evaluate the clinical utility.Results: A total of 1773 patients diagnosed as BCLC stage B HCC between 2007 to 2016 were included in the present study. As the methods for the assessing of the liver function, the ALBI grade and ascites showed their independent prognostic value, and then the two parameters were combined into one, the ALBI-AS grade. Subsequently, the ALBI-AS grade (hazard ratio (HR)=1.26, p=0.008) along with two tumor burden related parameters (the AFP level and the 8-and-14 grade, p＜0.001) were used for the development of a prognostic prediction model after multivariate analysis. The area under the receiver operator characteristic curve (AUROC) for overall survival at 1, 2 and 3 years predicted by the present model were 0.73, 0.69 and 0.67 in the training cohort. The concordance index (c-index) and the Aiken information criterion (AIC) were 0.68 and 6216.3, respectively. In the internal and external validation cohorts, the present model still revealed excellent predictive accuracy, discrimination and fitness performance. Then the ALBI-AS based model was evaluated to be superior to other prognostic models with highest AUROC, c-index and lowest AIC values. Moreover, DCA also demonstrated that the present model was clinical beneficial. Additionally, participants could be classified into three distinct risk groups by the model.Conclusion: The ALBI-AS grade, as a pragmatic alternative of the ALBI grade, is a novel predictor of survival for patients with BCLC stage B HCC. The ALBI-AS based model was evaluated to be an accurate prognostic tool for individual prognostication, and performed well in terms of discrimination and fitness against other prognostic models. And it is appropriate to validate our findings on a larger prospective cohort.
Longer Hospital Length of Stay After Admission Before Rapid Response System Activation is Associated with Worse Clinical Outcome: A Retrospective Multicenter Cohort Study
Authors: Park Jimyung , Lee Yeon Joo , Hong Sang-Bum , Jeon Kyeongman , Moon Jae Young , Kim Jung Soo , Kang Byung Ju , Ahn Jong-Joon , Lee Dong-Hyun , Park Jisoo , Cho Jae Hwa , Lee Sang-Min
Published: August 2020

Background: Rapid response system (RRS) has been increasingly adopted to improve patient safety in hospitals worldwide. However, predictors of survival outcome after RRS activation because of unexpected clinical deterioration are not well defined. We investigated whether hospital length of stay (LOS) before RRS activation can predict the clinical outcomes.Methods: Using a nationwide multicenter RRS database, we identified patients for whom RRS was activated during hospitalization at 9 tertiary referral hospitals in South Korea between January 1, 2016, and December 31, 2017. All information on patient characteristics, RRS activation, and clinical outcomes were retrospectively collected by reviewing patient medical records at each center. Patients were categorized into two groups according to their hospital LOS before RRS activation: early deterioration (LOS <5 days) and late deterioration (LOS ≥5 days). The primary outcome was 28-day mortality and multivariable logistic regression was used to compare the two groups. In addition, propensity score-matched analysis was used to minimize the effects of confounding factors.Results: Among 11,612 patients, 5,779 and 5,883 patients belonged to the early and late deterioration groups, respectively. Patients in the late deterioration group were more likely to have malignant disease and to be more severely ill at the time of RRS activation. After adjusting for confounding factors, the late deterioration group had higher 28-day mortality (aOR 1.60, 95% CI 1.44–1.77). Other clinical outcomes (in-hospital mortality and hospital LOS after RRS activation) were worse in the late deterioration group as well, and similar results were found in the propensity score-matched analysis (aOR for 28-day mortality 1.66, 95% CI 1.45–1.91).Conclusions: Patients who stayed longer in the hospital before RRS activation had worse clinical outcomes. During the RRS team review of patients, hospital LOS before RRS activation should be considered as a predictor of future outcome.
Does It Pay to Offend? Short- and Long-term Responses to Offensive Ads
Authors: Friedmann Enav , Solodoha Eliran , Treister Dorit Efrat
Published: August 2020

How does the use of offensive ads, especially those which insult low-power social groups, affect consumer response? Existing literature stresses the immediate negative consumer response to offensive ads, while practice shows continuing use of offensive ads by firms, creating a discrepancy between the literature and practice. In four studies (two in the field and two in the lab) we demonstrate a negative short-term response but positive long-term response to offensive ads in purchase intentions and brand choice, a phenomenon that we term the “time–offense paradox” (TOP). The effect is driven mainly by a larger positive increase in consumer response in the long term among members of low-power groups (compared to high-power groups). We call this the ‘Trigger TOP effect’. In line with power-approach theory, we suggest and show that offensiveness influences brand choice via brand power and brand attraction (a two-path mediation). Our framework integrates the dimension of time into power-approach theory in the context of offensive ads.
Job Satisfaction, Engagement and Associated Factors among Employees Working at Adama Hospital Medical College, Adama, Oromia Regional State, Ethiopia: Institution Based Cross Sectional Study
Authors: Mohammed Ebrahim , Daybaso Haji Aman , Habtewold Ephrem Mannekulih
Published: August 2020

Introduction: High level of professional satisfaction among health workers earns high dividends such as higher worker force retention and patients satisfactionObjective: To assess level of employees` satisfaction and associated factors among employees` working in Adama hospital medical college town from January to March 2019.Methods: institution based cross-sectional study design was employed. About 389 employees were interviewed.Multi variable logistic regression analysis was used to identify the relationship among predictors and outcome variable. P-value <0.25 will be used as cutoff point for variable to be candidate for multi variable logistic regression. P-value <0.05 and Adjusted odds ratio at 95% level of significance will be used to declare predictors of employees satisfaction.Results: A total of 389 study participant responded to the questionnaires with response rate of 92.20%. More than half 212(54.5%) were male and the mean age of study participants were 32.24 years (SD± 7.87). The overall level of job satisfaction was 185(47.6%) (95%CI: 1.43, 1.53). Factors like shisha smoking (AOR, 0.4; 95% CI: 0.01, 0.44), Co-workers relationship (AOR, 2.85; 95% CI: 1.21, 6.72), working environment (AOR, 4.08; 95% CI: 1.98, 8.41), autonomy at their working (AOR, 4.40; 95% CI: 1.89, 11.19), commitment for their organization (AOR, 2.48; 95% CI: 1.20, 5.10), performance evaluation (AOR, 5.69; 95% CI: 2.53, 12.80), promotion or growth opportunity (AOR, 9.58; 95% CI: 4.11, 22.32) and relationship with immediate supervisor (AOR,4.59; 95% CI: 1.89, 11.19) shows significant association with employees` job satisfaction.Conclusion and recommendation: The overall level of employees` satisfaction is low. The organization should work on factors associated with employees` job satisfaction in order to increase satisfaction levels of employees.
Defining muscle-invasive bladder cancer immunotypes by introducing tumor mutation burden, CD8+ T cells, and molecular subtypes
Authors: Chen Zihao , Liu Guojun , Liu Guoqing , Bolkov Mikhail A. , Tuzankina Irina A. , Chereshnev Valery A. , Wang Zhifeng
Published: August 2020

Immunotherapy, especially anti-PD-1, is becoming a pillar of modern muscle-invasive bladder cancer (MIBC) treatment. However, the objective response rates (ORR) are relatively low due to the lack of precise biomarkers to select patients. Herein, the molecular subtype, tumor mutation burden (TMB), and CD8 + T cells were calculated by the gene expression and mutation profiles of MIBC patients. MIBC immunotypes were constructed using clustering analysis based on tumor mutation burden, CD8 + T cells, and molecular subtypes. Mutated genes, KEGG pathways, GO terms, and co-expressed network-specific hub genes have been identified. We demonstrated that ORR of immunotype A patients identified by molecular subtype, CD8 + T cells, and TMB is about 36% predictable. PIK3CA, RB1, FGFR3, KMT2C, MACF1, RYR2, and EP300 are differentially mutated among three immunotypes. Pathways such as ECM-receptor interaction, PI3K-Akt signaling pathway, and TGF-beta signaling pathway are top-ranked in enrichment analysis. Low expression of ACTA2 was associated with the MIBC survival benefit. This study identified which MIBC patients are suitable for immunotherapy, and it is an important step forward to the personalized treatment of bladder cancers.
The impact of a Community Based Rehabilitation Program in Afghanistan: A longitudinal analysis using propensity score matching and difference in difference analysis
Authors: Trani Jean-Francois , Vasquez-Escallon Juanita , Bakhshi Parul
Published: August 2020

Background. The 2006 United Nations Convention on the Rights of Persons with Disabilities states that the achievement of equal rights, empowerment and social inclusion of people with disabilities requires comprehensive rehabilitation services encompassing all components of the World Health Organization Community based rehabilitation (CBR) matrix: health, education, livelihood, social and empowerment. CBR programs specifically aim to deliver such comprehensive interventions. In the present study, we investigate the impact of a CBR program in Afghanistan on all these components. Methods. We enrolled 1861 newly recruited CBR participants with disabilities in the study, from 169 villages between July 2012 and December 2013 as well as 1132 controls with disabilities randomly selected through a two-stage process within 6000 households from 100 villages in the same provinces but outside the catchment area of the CBR program. We interviewed them again after one (midline) and two (end-line) years in the study. Using propensity score matching and difference in difference analysis, we estimated the impact of the CBR on outcomes of interest, namely mobility, activities of daily living, communication, participation in social and community life, emotional well-being and employment.Results. There were statistically significant differences between participants and controls on all outcomes between baseline and end-line, with impacts ranging from the highest on emotional wellbeing (1.02, 95%CI 0.04-2.00) and the lowest on activities of daily living (0.08, CI 0.03-0.13).Conclusion. Our study indicates that a CBR program may provide positive rehabilitation outcomes for persons with disabilities even in a conflict context, and improve overall well-being of all participants with disabilities, whatever their impairment, individual characteristics and the CBR matrix components considered. Trial registration. ISRCTN, ISRCTN50214054. Registered August 5th 2020 - retrospectively registered, http://www.isrctn.com/ISRCTN50214054
Morbidity Associated with Patent Ductus Arteriosus in Preterm Newborns: A Retrospective Case-Control Study
Authors: Terrin Gianluca , Chiara Maria Di , Boscarino Giovanni , Metrangolo Valentina , Faccioli Francesca , Onestà Elisa , Giancotti Antonella , Donato Violante Di , Cardilli Viviana , De Curtis Mario
Published: August 2020

Introduction: Association between persistency of a patent ductus arteriosus (PDA) and morbidity in preterm newborns is still controversial. We aimed to investigate the relation between PDA and morbidity in a large retrospective study.Methods: A case-control study including neonates consecutively admitted to the Neonatal Intensive Care Unit (NICU), with gestational age (GA) ≤ 32 weeks or body birth weight (BW) ≤ 1500 g, over a 5-year period. Newborns were divided into Cases and Controls, according with the presence or absence of a hemodynamically significant PDA (hs-PDA).Results: We enrolled 85 Cases and 193 Controls. Subjects with hs-PDA had significantly (p<0.001) lower GA (26.7 w, 95%CI 27.1-28.0 vs. 30.1 w, 95%CI 29.7-30.4), BW (1024 g, 95% CI 952-1097 vs. 1310 g 95%CI 1263-1358) and an increased morbidity (60.0% vs. 18.7%). In a sub-group of extremely preterm newborns (GA < 29 weeks and BW < 1000 g), the rate of BPD was significantly increased in Cases (31.7%) compared with Controls (5.9%, p=0.033). Multivariate analysis showed that morbidity significantly depended on hs-PDA, GA and BW, and that, in extremely preterms, the hs-PDA represented an independent risk factor for BPD.Conclusions: The presence of hs-PDA seemed to increase the risk of morbidity in very low birth weight (VLBW) infants. In extremely preterm newborns, the risk of bronchopulmonary dysplasia (BPD) depended on the occurrence of hs-PDA.
Copy Number Variation in Triple Negative Breast Cancer Samples Associated with Lymph Node Metastasis
Authors: Pariyar Mamta , Johns Andrea , Thorne Rick Francis , Scott Rodney J. , Avery-Kiejda Kelly A.
Published: August 2020

BackgroundTriple negative breast cancer (TNBC) is a highly metastatic and aggressive subtype of breast cancer and cases presenting with lymph node involvement have worse outcomes. This study aimed to determine the regions of copy number variation (CNV) associated with lymph node metastasis in TNBC patients. MethodsCNV analyses were performed in a study cohort of 23 invasive ductal carcinomas (IDC), 12 lymph node metastases (LNmets) and 7 normal adjacent tissues (NAT); as well as in a second cohort containing 70 TNBC IDC samples and the same 7 NATs. CNVs associated genes were analysed using GO-enrichment and Pathway analysis and also integrated with gene expression analysis. The prognostic role for genes showing CNV based change in mRNA expression was determined using Kaplan-Meier (KM) plotter database. ResultsFor the IDCs, frequent amplification was evident in chromosomal regions 8q, 1q, 2(p and q), 3q24, 10p and 12p and deletion in 3p, 4 (p and q), 5q, 14q and 17p in contrast to LNmets showing frequent amplification of 4q, 2p, 3q24, 1q, 10p, 12p, 8q, 20p, 21q and 6p and deletion in 1p, 4q (4q21.1, 4q26) and 5q. A total of 686 (441 amplified and 245 deleted) genes were associated with lymph node metastasis. The LNmet-associated genes were highly enriched for “regulation of complement activation”, “regulation of protein activation cascade”, “regulation of humoral immune response”, “oxytocin signalling pathway” and “trail binding” pathways. Moreover, 6/686 LNmet-associated genes showed CNV-based changes in their mRNA expression of which, high expression of ASPM and KIF14 was significantly associated with worse relapse free survival.ConclusionThis study has identified several CNV regions in TNBC that could play a major role in metastasis to the lymph node.
Intestinal Explant Cultures from Gilthead Seabream (Sparus Aurata, L.) Allowed Determining the Mucosal Sensitivity to Bacterial Pathogens and the Impact of a Plant Protein Diet
Authors: Peñaranda David Sanchez , Bäuerl Christine , Tomás-Vidal Ana , Miguel Jover-Cerdá , Estruch Guillem , Martínez Gaspar Pérez , Martínez-Llorens Silvia
Published: August 2020

BackgroundAlthough high levels of fish meal replacement by alternative protein sources have been achieved without relevant alterations in terms of growth performance, negative effects on immune status were detected. The diet and fish immunity interactions at gut level have been widely discussed, although in vivo approaches have reported several limitations. In this sense, intestine explant culture system can be a valuable complementary tool to study the interactions between pathogenic bacteria and fish gut response, and the possible influence of environmental, breeding, rearing conditions or dietary components on the responsiveness of the innate immune system in fish.The object of this study was to test the impact of total substitution of fish meal by plant protein on the intestinal health of seabream (12g) in two growth stages: phase I (90 days), up to 68 g, and phase II (305 days), up to 250g. In phase II, the effects of the long term and short exposure (15 days) to plant protein diet were determined. In order to determine the effect of plant protein feeding on the innate immune response to bacterial pathogens, and an ex vivo procedure of intestine explants culture was implemented.ResultsFish showed less tolerance to dietary plant protein in phase I than in phase II, while the ex vivo assays indicated that the intestine from fish fed at short-term plant diets showed a higher immune response than at long term feeding.In relation to the immune response to bacterial challenge, a significant expression in pro-inflammatory cytokines IL-1β and IL-6 after 6 hours of exposure to V. algynoliticus, while COX-2 expression was significantly induced by P. damselae subsp. pisicida, showing positive high correlation between them.ConclusionsA differential health status was observed depending of growth stage, being stricter to the plant protein inclusion the younger fish. The new experimental system based on fish intestinal explants culture has been successfully implemented, becoming an effective methodology for ex vivo studies. Under ex vivo conditions, the bacterial challenge induced inflammatory and immune intestinal response, responding stronger those intestine of fish fed during a short-term with a total substitution of fish meal.
Upregulation of TIPE2 attenuates macrophage activation and neuroinflammation after intracerebral hemorrhage in mice
Authors: Liu Shudong , Wang Jie , Li Wenyan , Shi Hui , Zhou Changlong , Tang Ge , Zhang Jiangwei , yang zhao
Published: August 2020

Background: Intracerebral hemorrhage (ICH) is a serious disease with high mortality and morbidity, and effective treatment is limited. A large amount of evidence suggests that the inflammatory response contributes to secondary brain damage following ICH. TIPE2 is an essential negative regulator of both innate and adaptive immunity, and depletion of TIPE2 causes inflammatory disease. However, the possible role of TIPE2 following ICH has not been reported. Methods: In this study, we investigated TIPE2 levels and inflammation in macrophages treated with erythrocyte lysate in vitro, and we observed proinflammatory cytokine production, BBB disruption, cerebral water content and neurological damage in ICH mice in vivo. Results: We found that TIPE2 levels were significantly decreased in erythrocyte lysate-treated macrophages compared to control macrophages. Upregulation of TIPE2 decreased macrophage activation and cytokine production and accelerated brain damage in ICH mice. In addition, upregulation of TIPE2 attenuated proinflammatory cytokine production, BBB disruption, and severe brain inflammation after ICH. Conclusion: The results demonstrated that TIPE2 was negatively correlated with the pathogenesis of ICH, which prevented brain injury and attenuated deleterious inflammatory responses following ICH. TIPE2 might serve as a novel target for ICH therapy.
Renal tumors: Age spectrum and histological distribution across childhood
Authors: Liu Tingting , Al-Kzayer Lika’a Fasih Y. , Nakazawa Yozo , chen lei
Published: August 2020

Background: The objective of this study was to identify the relationship between the histopathological distribution of renal tumors and the age parameter across childhood period and to compare that with the available literature. Methods: A total of 193 pediatric patients with renal tumors were classified into 5 groups as embryo, infant, early childhood, childhood, and adolescent. Age distribution, pathological types and clinical characteristics were summarized. Results: Among the 193 patients, 95.8% presented with malignant tumors, and 4.2% showed benign tumors. The prevalence of Wilms’ tumor (WT( and non-WT, were 63.7% and 36.3%, respectively. Non-WT patients included clear cell sarcoma of the kidney (CCSK), followed by rhabdoid tumor of the kidney (RTK), congenital mesoblastic nephroma (CMN), cystic partially differentiated nephroblastoma (CPDN), and renal cell carcinoma (RCC). Early childhood (89/193, 46.2%) was the most common period of onset, followed by infant (73/193, 37.9%), childhood (19/193, 9.8%), embryo (8/193, 4.1%) and adolescent (4/193, 2.0%). WT predominantly occurred in infant and early childhood and decreased among older age group. Non-WT occurred various period of onset and rather common during embryo. 10.9% of patients were asymptomatic at the time of diagnosis and that was significantly observed in non-WT (P=0.04). Conclusions: Age of onset is a highly significant factor for pediatric renal tumors. Relationship between age spectrum and pathological characteristics influences distinguishing the histopathological distribution of WT and non-WT.
Correlation based analysis of COVID-19 virus genome versus other	fatal virus genomes
Authors: Purohit Sidharth , Satapathy Suresh Chandra , S Sibi Chakkaravarthy , Zhang Yu-Dong
Published: August 2020

Virus attacks have had devastating effects on mankind. The prominent viruses such as Ebola virus (2012), SARS-CoV or Severe acute respiratory syndrome, Middle East respiratory syndrome-related coronavirus called as the MERS (EMC/2012), Spanish flu (H1N1 virus-1918) and the most recent COVID-19(SARS-CoV-2) are the ones that have created a difficult situation for the survival of the human race.Background: Currently, throughout the world, a global pandemic situation has put economy, livelihood, and human existence in a very pathetic situation. Most of the above-mentioned viruses exhibit some similar characteristics and genetic pattern. Analyzing such characteristics and genetic pattern can help the researchers to get a deeper insight into the viruses and helps in finding appropriate medicine or cure.Methods: To address these issues, this paper proposes an experimental analysis of the above-mentioned viruses data using correlation methods. The virus data considered for the experimental analysis includes the distribution of various amino acids, protein sequences, 3D modelling of viruses, pairwise alignment of proteins that comprise the DNA genome of the viruses. Furthermore, this comparative analysis can be used by the researchers and organizations like WHO(World Health Organization), computational biologists, genetic engineers to frame a layout for studying the DNA sequence distribution, percentage of GC (Guanine-Cytosine) protein which determines the heat stability of viruses. We have used the BioPython to illustrate the gene study of prominent viruses and have derived results and insights in the form of 3D modelling.Results: The experimental results are more promising with an accuracy rate of 96% in overall virus relationship calculation.
mTOR Inhibitor INK128 Promotes Wound Healing by Regulating MDSCs
Authors: Li Yi , Xu Yujun , Liu Xinghan , Yan Xin , Lin Yue , Tan Qian , Hou Yayi
Published: August 2020

Background: Skin wounds in diabetic patients are hardly to recover. Accumulating evidence has shown that mammalian target of rapamycin (mTOR) pathway and myeloid-derived suppressor cells (MDSCs) are involved in inflammatory-related response. INK128 is a novel mTOR kinase inhibitor in clinical development. However, the exact roles of MDSCs and INK128 in healing wound of diabetic patients are unclear. Methods: Mice models of normal, diabetic, and diabetic+INK128 were constructed. Bone marrow (BM)-derived macrophages and RAW264.7 cell line co-cultured with MDSCs, which were induced at different conditions. Flow cytometry, western blot, quantitative real-time PCR, and immunohistochemical analysis were performed. Results: Diabetic mice (DM) had a slower recovery rate, thinner epidermal and dermal, and less blood vessels than those of normal mice. MDSCs were abnormally accumulated in DM and mTOR was activated in MDSCs of DM and the cells treat with high glucose. Moreover, mTOR signaling inhibitor INK128 could promote wound healing through reducing the MDSCs. MDSCs function was disordered in DM and high glucose environments, while INK128 could help retrieve their function. Furthermore, high glucose and other factors in DM could promote M-MDSCs differentiation to M1 pro-inflammatory macrophage cells, thus inhibiting wound healing. The differentiation, which was dependent on mTOR signaling, could be reversed by INK128. Conclusion: INK128 is potential to be developed as a clinical strategy to promote wound healing of diabetic patients.
Analysis and Prediction of COVID-19 Pandemic in Bangladesh by using Long short-term memory network (LSTM) and Adaptive neuro fuzzy inference system(ANFIS)
Authors: Chowdhury Anjir Ahmed , Hasan Khandaker Tabin , Hoque Khadija Kubra Shahjalal
Published: August 2020

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