bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Efficient Method to Detect Genetic Interactions for Lung Cancer GWAS
Authors: Luyapan Jennifer , Ji Xuemei , Li Siting , Xiao Xiangjun , Zhu Dakai , Duell Eric J. , Christiani David C. , Schabath Matthew B. , Arnold Susanne M. , Zienolddiny Shanbeh , Brunnström Hans , Melander Olle , Thornquist Mark D. , MacKenzie Todd A. , Amos Christopher I. , Gui Jiang
Published: August 2020

Background: Genome-wide association studies (GWAS) have proven successful in predicting genetic risk of disease using single-locus models; however, identifying single nucleotide polymorphism (SNP) interactions at the genome-wide scale is limited due to computational and statistical challenges. We addressed the computational burden encountered when detecting SNP interactions for survival analysis, such as age of disease-onset. To confront this problem, we developed a novel algorithm, called the Efficient Survival Multifactor Dimensionality Reduction (ES-MDR) method, which used Martingale Residuals as the outcome parameter to estimate survival outcomes, and implemented the Quantitative Multifactor Dimensionality Reduction method to identify significant interactions associated with age of disease-onset. Methods: To demonstrate efficacy, we evaluated this method on two simulation data sets to estimate the type I error rate and power. Simulations showed that ES-MDR identified interactions using less computational workload and allowed for adjustment of covariates. We applied ES-MDR on the OncoArray-TRICL Consortium data with 14,935 cases and 12,787 controls for lung cancer (SNPs = 108,254) to search over all two-way interactions to identify genetic interactions associated with lung cancer age-of-onset. We tested the best model in an independent data set from the OncoArray-TRICL data. Results: Our experiment on the OncoArray-TRICL data identified many one-way and two-way models with a single-base deletion in the noncoding region of BRCA1 (HR = 1.24, P = 3.15 x 10 -15 ), as the top marker to predict age of lung cancer onset. Conclusions: From the results of our extensive simulations and analysis of a large GWAS study, we demonstrated that our method is an efficient algorithm that identified genetic interactions to include in our models to predict survival outcomes.
Cytokine profile in the sputum of subjects with post-tuberculosis airflow obstruction and in those with tobacco related chronic obstructive pulmonary disease
Authors: Guiedem Elise , Pefura-Yone Eric Walter , Ikomey George Mondinde , Nkenfou Céline Nguefeu , Mesembe Martha , Mbanyamsig Yivala Mispa , Bih Chendi Hycenta , Graeme Jacobs Brendon , Chegou Novel Njweipi , Okomo Marie Claire Assoumou
Published: August 2020

Background: Previous studies have shown that tuberculosis (TB) is a risk factor for chronic airflow limitation. Chronic obstructive pulmonary disease (COPD) is recognized as the result of chronic inflammation, usually related to noxious particles. Post-TB airflow obstruction and tobacco-related COPD have the same functional pathway characterized by persistent airflow limitation. We sought to compare the profile of 29 cytokines in the sputum of subjects with post-TB airflow obstruction and those with COPD related to tobacco.Results: The forced expiratory volume in the first second (FEV1) and forced expiratory volume/forced vital capacity (FEV/FVC) ratio were lower in the COPD patients with the history of smoking compared to the post-TB airflow obstruction subgroup. The stages of the disease were more advanced in COPD / tobacco patients. Among the cytokines, IL-1α, IL-1β, MIP-1β, sCD40L and VEGF levels were higher in COPD patients, compared to the controls with p values ​​of 0.003, 0.0001, 0.03, 0.0001 and 0.02 respectively. When the two COPD subgroups were compared, IL-1α, IL-6, TNF-α and IL-8 levels were higher in the COPD patients with the history of tobacco compared to the COPD patients with the history of TB with p-values ​​of 0.031, 0.05, 0.021 and 0.016, respectively.Conclusion: COPD related to tobacco is more severe than post-TB airflow obstruction. The pathogenesis of post-TB airflow obstruction appears to involve the cytokines IL-1RA, IL-1α, IL-1β, IL-17, GRO and sCD40L, while COPD related to tobacco involves more cytokines.
Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia
Authors: Martini Ross P , Yanez N David , Treggiari Miriam , Tekkali Praveen , Soelberg Cobin , Aziz Michael F
Published: August 2020

Background: Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff. We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation.Methods: We used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia.Results: 15,388 subjects were included; 6,351 in the intervention cohort and 9,037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p=0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p=0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p=0.010).Conclusions: The broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery. ClinicalTrials.gov ID NCT02450929
Are antenatal interventions effective in improving multiple health behaviours among pregnant women? A systematic review protocol.
Authors: Hollis Jenna , Doherty Emma , Dray Julia , Tremain Danika , Hunter Mandy , Takats Karen , Williams Christopher M , Murray Henry , Pennell Craig , Tully Belinda , Wiggers John , Daly Justine , Kingsland Melanie
Published: August 2020

Background: Maternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. Due to the high prevalence, co-occurrence, and possible interactive health effects of such health behaviours in pregnancy, antenatal interventions that support pregnant women to improve multiple SNAP behaviours have a greater potential impact on the health outcomes of women and their children than interventions addressing single behaviours. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women.Methods: Seven electronic databases will be searched for potentially eligible studies. Eligible studies will include those where pregnant women are attending antenatal care. Studies that examine the effect of an intervention that addresses multiple SNAP behaviours (≥ two behaviours) during pregnancy and are delivered or instigated through antenatal care in a healthcare service will be included. Systematic reviews of randomised controlled trials (RCTs), RCTs, cluster RCTs, stepped wedge RCTs, and non-randomised control trials will be eligible. Studies that include a no intervention control, wait-list control group, standard/usual care, or another active single behavioural intervention (e.g. addressing one behaviour only) will be considered. Two independent reviewers will conduct study screening, data extraction and risk of bias assessment. Discrepancies will be resolved by consensus or a third reviewer if required. A random effects model will be used to synthesise the results. Alternative synthesis methods will be investigated in instances where a meta-analysis is not appropriate, such as summarising effect estimates, combining P values, vote counting based on direction of effect, or synthesis in narrative form.Discussion: The review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care, and will help researchers, policy makers, and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short and long term health outcomes for women and their children.Systematic review registration: PROSPERO 2018 CRD42018095315
Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices
Authors: Senanayake Sameera , Graves Nicholas , Healy Helen , Baboolal Keshwar , Barnett Adrian , Sypek Matthew P. , Kularatna Sanjeewa
Published: August 2020

Background

Matching survival of a donor kidney with that of the recipient (longevity matching), is use in some kidney allocation systems to maximize graft-life years. It is not part of the allocation algorithm for Australia. Given the growing evidence of survival benefit due to longevity matching based allocation algorithms, development of a similar kidney allocation system for Australia is currently underway. The aim of this research is to estimate the impact that changes to costs and health outcomes arising from ‘longevity matching’ on the Australian healthcare system.

Methods

A decision analytic model to estimate cost-effectiveness was developed using a Markov process. Four plausible competing allocation options were compared to the current kidney allocation practice. Models were simulated in one-year cycles for a 20-year time horizon, with transitions through distinct health states relevant to the kidney recipient. Willingness to pay was considered as AUD 28000.

Results

Base case analysis indicated that allocating the worst 20% of Kidney Donor Risk Index (KDRI) donor kidneys to the worst 20% of estimated post-transplant survival (EPTS) recipients (option 2) and allocating the oldest 25% of donor kidneys to the oldest 25% of recipients are both cost saving and more effective compared to the current Australian allocation practice.

Option 2, returned the lowest costs, greatest health benefits and largest gain to net monetary benefits (NMB). Allocating the best 20% of KDRI donor kidneys to the best 20% of EPTS recipients had the lowest expected incremental NMB.

Conclusion

Of the four longevity-based kidney allocation practices considered, transplanting the lowest quality kidneys to the worst kidney recipients (option 2), was estimated to return the best value for money for the Australian health system.
Transcriptomic and proteomic analysis of putative digestive proteases in the salivary gland and gut of Empoasca (Matsumurasca) onukii Matsuda
Authors: Shao Ensi , Song Yujuan , Wang Yaomin , Liao Yichen , Luo Yufei , Liu Sijun , Guan Xiong , Huang Zhipeng
Published: August 2020

Background: Infestation by tea green leafhoppers, Empoasca (Matsumurasca) onukii , could cause a series of biochemical changes in tea leaves. As a typical cell-rupture feeder, E. onukii secretes proteases while probing with its stylet into the tender shoots of tea plants ( Camellia sinensis ). This study identified and analyzed proteases specifically expressed in the salivary gland (SG) and gut of E. onukii through enzymatic activity assays, complemented with an integrated analysis of transcriptome and proteome data.Results: In total, 129 contigs representing seven types of putative proteases were identified. Transcript abundance of digestive proteases and enzymatic activity assays showed that cathepsin B-like protease, cathepsin L-like protease, and serine proteases (trypsin- and chymotrypsin-like protease) were highly abundant in the gut while moderately abundant in the SG. The abundance pattern of digestive proteases in the SG and gut of E. onukii differed from that of other hemipterans including Nilaparvata lugens , Laodelphax striatellus , Acyrthosiphum pisum , Halyomorpha halys and Nephotettix cincticeps . Phylogenetic analysis showed that aminopeptidase N-like proteins and serine proteases abundant in the SG or gut of hemipterans were distributed to two distinct clusters.Conclusions: Altogether, this study provide insightful information on the digestive system of E. onukii and observed different patterns of proteases abundant in the SG and gut of E. onukii , in comparison with other five hemipteran species. These results will be beneficial in understanding the interaction between tea plants and E. onukii .
hUMSCs regulate the differentiation of ovarian stromal cells via TGF-β1 /Smad3 signaling pathway to inhibit ovarian fibrosis to repair ovarian function in POI rats
Authors: Cui Linlu , Bao Hongchu , Liu Zhongfeng , Man Xuejing , Liu Hongyuan , Hou Yun , Luo Qianqian , Wang Siyuan , Fu Qiang , Zhang Hongqin
Published: August 2020

Objective: The basic pathological changes of primary ovarian insufficiency (POI) include ovarian tissue fibrosis and follicular development disorders. The human umbilical cord mesenchymal stem cells (hUMSCs) transplantation has been shown an effective method to improve the ovarian function in POI rat model; however, the exact mechanisms are still unclear. The purpose of this study is to investigate whether the recovery of ovarian function in POI rats is related to the inhibition of tissue fibrosis following hUMSCs transplantation. Furthermore, the transforming growth factor-β1 (TGF-β1 ) signaling pathway is explored to determine the mechanisms of ovarian function recovery through its inhibition of tissue fibrosis. Methods: The primary ovarian insufficiency (POI) rat model was established by intraperitoneal injection of chemotherapy drug cisplatin (CDDP) for 7 days, The levels of serum sex hormones were measured using enzyme-linked immunosorbent assay (ELISA). The tissue fibrosis in ovary was examined using masson staining and Sirus red staining. The collagen fibers in the ovarian tissues were detected by Western blot analysis. To investigate the mechanisms of ovarian function recovery following hUMSCs transplantation, ovarian stromal cells were isolated from the ovarian cortex of immature rats. The expression of Cytochrome P450 17A1 (Cyp17a1) and fibrosis marker of alpha smooth muscle Actin (α-SMA) in ovarian stromal cells were examined using immunofluorescence analysis. Also, the protein levels of Cyp17a1 and α-SMA in ovarian stromal cells were examined by western blot analysis. The expression of TGF-β1 and Smade3 signals were measured by Western blot and quantitative reverse-transcription polymerase chain reaction (qRT-PCR) analysis. Results: The results show that the function of ovary in POI rats were significantly improved after hUMSCs transplantation. The expression of fibrosis markers (α-SMA) and production of Collagen Type I (Collagen Ⅰ) and Collagen Type Ⅲ (Collagen Ⅲ) in POI rats were significantly inhibited in POI rats following hUMSCs transplantation. In the cultured ovarian stromal cells, the decrease of TGF-β1 and p-Smade3 protein expression was observed in hUMSCs treated POI rats. The treatment with TGF-β1 inhibitor of SB431542 further confirmed this signal pathway was involved in the process. Conclusion : Our study demonstrated that the TGF-β1 /Smad3 signaling pathway was involved in the inhibition of ovarian tissue fibrosis, which contributed to the restoration of ovarian function in POI rats following hUMSCs transplantation.
Treatment of Defects on the Volar Surface of the Finger using the Dorsal Digital–metacarpal Flap Versus the Free Medial Plantar Artery Flap: A Comparative Study
Authors: Liu Quanzhe , Guo Wenlai , Qu Wenrui , Ou Xiaolan , Li Rui , Tian Heng
Published: August 2020

Background
Few cases are reported on the treatment of defects on the volar surface of the finger, and its utility for digital resurfacing remains unclear. This study compared the outcomes of the free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction.
Methods
This cohort study was conducted on 24 patients who had soft-tissue defects on the volar side of the finger from March 2014 to March 2017. The patients were divided into the following 2 groups: the MPAF group and the DDMF group. The operative time as well as complications, including flap necrosis, graft loss, infection, paresthesia, donor-site morbidity, and two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire (MHQ) was applied to conduct follow-up assessment.
Results
After more than 12 months of follow-up, the results were significant. In terms of overall function, MPAF was superior to DDMF (p < 0.005).
Conclusion
The MPAF and the DDMF are available and reliable for reconstruction of the volar surface of the finger; however, the MPAF offers better functional outcomes with a lower frequency of postoperative complications.
Knowledge about the COVID-19 pandemic among undergraduate medical and dental students in Lalitpur, Nepal
Authors: Jha Nisha , Singh Neeti , Bajracharya Omi , Manandhar Tejendra , Devkota Pragya , Kafle Sajala , Shankar Pathiyil Ravi
Published: August 2020

Background The number of cases of coronavirus disease-19 (COVID-19) is still increasing especially in South Asia. There is an urgent need to measure the knowledge of the disease among health science students who may be required to play an active role in pandemic control. The research was conducted to answer how does Nepalese medical students' knowledge about coronavirus compare to medical students in other countries and what are the educational needs of medical students who may be called in to support the treatment of COVID-19 in Nepal. Methods A cross sectional study was performed during the third week of June among first to final year medical and dental students. As the country was in lockdown, a structured online questionnaire was used to obtain data. The responses obtained were cleaned, coded, entered in IBM SPSS Statistics for Windows and the normality of the data checked using one-sample Kolmogorov Smirnov test (p<0.05). The demographic parameters were tabulated and total score compared among different subgroups of participants. The frequency of different measures mentioned by respondents to control the pandemic were also noted. Results Out of the 565 participants, 336 (59.6%) were females followed by 229 (40.4%) males. Nearly half of the participants, 282 (49.8%) were belonging to age group 21-23 years. Majority 415 (73.5%) were undergraduate medical and 150 (26.5%) were undergraduate dental students. The largest number of respondents, 140 (24.9%) were from second year of study and 344 (60.9%) were from urban areas. The median total score was 21 and the interquartile range 4. The maximum possible score was 30. The scores among students belonging to different years of study were significantly different (p=0.033). Total scores were not significantly different among other subgroups of respondents. Conclusions The knowledge of the participants was good. Deficiencies in knowledge were noted in certain areas and these should be addressed through an educational intervention. In countries where epidemic is on the rise, strategies to keep health science students updated with proper information related to COVID-19 is important. Similar studies can be undertaken in other medical colleges in the country and in nursing and pharmacy colleges also.
Addition of Routine Blood Biomarkers to TIMI Risk Score Improves Predictive Performance of 1-year Mortality in Patients with ST-segment Elevation Myocardial Infarction
Authors: Oh Pyung Chun , Eom Young Sil , Moon Jeonggeun , Jang Ho-Jun , Kim Tae-Hoon , Suh Jon , Kong Min Gyu , Park Sang-Don , Kwon Sung Woo , Suh Soon Yong , Lee Kyounghoon , Han Seung Hwan , Ahn Taehoon , Kang Woong Chol
Published: August 2020

Background: Several biomarkers have been proposed as independent predictors of poor outcomes in ST-segment elevation myocardial infarction (STEMI). We investigated whether adding information obtained from routine blood tests including hypoxic liver injury (HLI), dysglycemia, anemia, and high neutrophil to lymphocyte ratio (NLR) could improve the prognostic performance of the TIMI risk score for the prediction of 1-year mortality. Methods: A total of 1057 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) between 2007 and 2014 were retrospectively enrolled from 4-regional hospitals. HLI and dysglycemia were defined as serum transaminase >twice the normal upper limit and glucose <90 or >250 mg/dL, respectively. The effect of adding biomarkers to the TIMI risk score on its discriminative ability was assessed using c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: The 1-year mortality rate was 7.1%. The best cutoff value of NLR for the prediction of 1-year mortality was 4.3 (sensitivity, 67%; specificity, 65%). HLI (HR, 2.019; 95% CI, 1.104-3.695), dysglycemia (HR, 2.535; 95% CI, 1.324-3.923), anemia (HR, 2.071; 95% CI, 1.093-3.923), and high NLR (HR, 3.651; 95% CI, 1.927-6.918) were independent predictors of 1-year mortality. When these 4 parameters were added to the TIMI risk score, the c-statistic significantly improved from 0.841 to 0.876 (p<0.001), and the NRI and IDI were estimated at 0.203 (95% CI, 0.130-0.275; p<0.001) and 0.089 (95% CI, 0.060-0.119; p<0.001), respectively. Conclusions: The addition of HLI, dysglycemia, anemia, and high NLR to the TIMI risk score may be useful for very early risk stratification in patients with STEMI receiving primary PCI.
The burden of the current curative expenditure of injury in Dalian, China-A study based on “System of Health Accounts 2011”
Authors: Sun Shu , Yang Liuna , Hu Xinzhu , Zhu Yalan , Liu Boxi , Yang Yunbin , Wang Xin
Published: August 2020

Background
Injury is one of the major public health problems, which causes more than 5 million deaths in the world every year. Cases of specific types of injury put a tremendous threat to human health and also add a heavy medical burden on individuals and societies. This study was to calculate and analyze the current curative expenditure (CCE) of injury in Dalian and consequently to provide control strategies for decision-makers.
Main text:
A total of 565 medical institutions were selected with multistage stratified cluster random sampling, containing 4,375,351 valid samples. Subsequently, the distribution of injury CCE in different dimensions (including age and site of injury) was analyzed under the framework of System of Health Accounts 2011(SHA 2011) using the established database. There were increases from 32.36/100,000 in 2006 to 37.34/100,000 in 2017 and from 46.12/100,000 in 2006 to 54.48/100,000 in 2017 in urban and rural residents respectively. The study found that the CCE of injury in Dalian had reached 1572.73 million RMB, accounting for 7.45% of the total curative care expenditure. In the 15–25 age group, the cost of injury accounts for a larger proportion of CCE than other age groups. Among the injuries in different regions of the body, injuries to the spine, lower limb, head and foreign body entering cost the most.
Conclusions
Dalian has a relatively serious burden of injury costs. The essential and primary goal is to reduce the cost and increase the benefit of attending to patients with injuries. Specific control strategies should be tilted toward the age group 15–25. Injuries to the spine, lower limb, head and foreign body entering also should be priorities of interventions.
The impact of malocclusions and orthodontic treatments on a patient's quality of life.
Authors: BOURZGUI Farid , Diouny Samir , KAMAL Dounia , Serhier Zineb , Othmani Mohamed Bennani
Published: August 2020

Aim: This study aimed to compare the variations in patients’ perception of oral health related quality of life (OHRQoL), using the Moroccan version of PIDAQ, before and after orthodontic treatment among patients with the same initial PAR Index score, age and gender. Methods: In this study, 67 participants were divided into 2 groups. Group A (normal, control group) consisted of 30 patients who received orthodontic treatment; group B comprised of 37 patients who were either at the initiation stage of treatment or potential candidates. The matching of group A and group B was achieved by reaching a compromise between PAR index score, age and gender. The assessment of the psychosocial impact of malocclusion was carried out using the Moroccan version of PIDAQ. The Chi-square test was used to establish associations between qualitative variables. Levene and Mann Whitney's tests were employed to determine the associations between quantitative variables. Results: The age of the patients ranges from 7 to 58 years, with an mean age of 23 years +/_10. 22. While 41 subjects (61.2%) consulted for aesthetic reasons, 26 subjects (38.8%) consulted for a functional reason. The distribution of scores of the two groups before and after orthodontic intervention showed no significant difference between the mean scores of the four PIDAQ domains. Conclusion: The results of our study showed a significant improvement in the psychosocial impact of malocclusion when comparing the two case-control groups, with a reduction in the perceived needs of patients who completed orthodontic treatment.
Implementing Social Distancing Policy Measures in the Battle Against the Coronavirus: Protocol of a Comparative Study of Denmark and Sweden
Authors: Nilsen Per , Seing Ida , Ericsson Carin , Andersen Ove , Stefánsdóttir Nina Thórný , Tjørnhøj-Thomsen Tine , Kallemose Thomas , Kirk Jeanette Wassar
Published: August 2020

Background: Social distancing policies to ensure physical distance between people have become a crucial strategy in the battle against the spread of the Coronavirus. The aim of this project is to analyze and compare social distancing policies implemented in Denmark and Sweden in 2020. Despite many similarities between the two countries, their response to the Coronavirus pandemic differed markedly. Whereas authorities in Denmark initiated mandatory regulations and many severe restrictions, Swedish authorities predominantly promoted voluntary recommendations.Methods: The project is an interdisciplinary collaboration between researchers in Denmark and Sweden with different disciplinary backgrounds. The project is based on a comparative analysis, an approach that attempts to reach conclusions beyond single cases and to explain differences and similarities between objects of analysis and relations between objects against the backdrop of their contextual conditions. Data will be gathered by means of document analysis, qualitative interviews, and a questionnaire survey to address three research questions: (1) What social distancing policies regarding the Coronavirus have been formulated and implemented, who are the policymakers behind the policy measures, which implementers are expected to implement the measures, and who are the targets that the measures ultimately seek to influence? (2) How have the social distancing policies and policy measures been justified, and what types of knowledge form the basis for the measures? and (3) What are the differences and similarities in citizens’ perceptions of acceptability and compliance with social distancing policy measures in relation to the Coronavirus?Discussion: To create a structure for addressing the three research questions, the project applies a theoretical framework informed by the policy and implementation science literatures. The framework consists of five interdependent domains that have an impact on policy implementation: (1) policymakers; (2) policy characteristics; (3) implementers; (4) targets; and (5) policy environment. Details of the framework are provided in the article.
Changes in Patient Visits and Diagnoses seen in an Academic Ophthalmology Department during the COVID-19 pandemic
Authors: Berkenstock Meghan K , Liberman Paulina , McDonnell Peter J , Chaon Benjamin C
Published: August 2020

BACKGROUND: To minimize the risk of viral transmission, ophthalmology practices limited face to face encounters to only patients with urgent and emergent ophthalmic conditions, in the weeks after the start of the COVID-19 epidemic in the United States. The impact of this is unknown. METHODS: We did a retrospective analysis of the change in the frequency of ICD-10 code use and patient volumes in the six weeks before and after the changes in clinical practice associated with COVID-19.RESULTS: The total number of encounters decreased four-fold after the implementation of clinic changes associated with COVID-19. The low vision, pediatric ophthalmology, general ophthalmology, and cornea divisions had the largest decrease of in-person visits. Conversely, telemedicine visits increased sixty-fold. The number of diagnostic codes associated with ocular malignancies, most ocular inflammatory disorders, and retinal conditions requiring intravitreal injections increased. ICD-10 codes associated with ocular screening exams for systemic disorders decreased during the weeks post COVID-19. CONCLUSION: Ophthalmology practices need to be prepared to experience changes in practice patterns, implementation of telemedicine, and decreased patient volumes during a pandemic. Knowing the changes specific to each subspecialty clinic is vital to redistribute available resources correctly.
Health-Promoting Leadership during an Infectious Disease Outbreak: A Cross-sectional Study of US Soldiers Deployed to Liberia
Authors: Booth Laurel C , Schwalb Molly , Kim Paul Y , Adler Amy B
Published: August 2020

Background
Infectious disease outbreaks are uniquely stressful for non-medical essential employees. Promoting the health of these workers is vital to minimize their distress and to ensure they are able to continue in their professional capacity. One way to support worker health is for supervisors to engage in behaviors that promote their employees’ behavioral health, wellbeing, and attitudes towards preventive medicine practices.
Methods
The present study examined if health-promoting leadership contributes to these outcomes in employees operating in an epidemic. Active-duty soldiers (N = 173) deployed to provide non-medical support in Liberia during the 2014 Ebola crisis completed surveys assessing posttraumatic stress disorder (PTSD), depression, anxiety, sleep problems, burnout, morale and attitudes, and rating their leaders on health-promoting behaviors. An exploratory factor analysis identified two leadership factors, one focused on psychological health and one on preventive medicine behaviors.
Results
Using mixed effects logistic regression, after adjusting for general leadership and soldier rank, health-promoting leadership focused on psychological health was associated with decreased odds of PTSD, depression, anxiety, and burnout, and increased odds of high morale and avoiding unnecessary risk. Health-promoting leadership behaviors focused on preventive medicine were associated with decreased odds of depression and anxiety, and increased odds of high morale, understanding the level of risk from disease, positive attitudes towards the deployment and preventive practices, and avoiding unnecessary risk.
Conclusions
Findings suggest health-promoting leadership behaviors could be valuable for employees responding to infectious disease outbreaks. Future research should examine whether training leaders in these skills can improve outcomes for non-medical employees in both military and civilian settings.
Effect of seawater immersion on pathophysiological changes in rats combined burns with open abdominal injury
Authors: ying lin , liangming liu , jifu qu
Published: August 2020

Objective: To observe the effects of seawater immersion on the pathophysiological changes in rats combined burns with open abdominal injury.Method: Eighty-eight male Sprague-Dawley(SD) rats combined burns with open abdominal injuries were randomly divided into the seawater immersion group (SI) and the control group (Ctl).Rats in SI group were immersed in seawater at 15℃ for 1 hour. The changes of respiration, blood pressure, rectal temperature, blood gases, blood electrolyte, liver and kidney function, coagulation function, heart damage and animal survival at different time points in the early stage (within 9 hours after injury) were observed.Result: After immersed in seawater, the body temperature of rats in SI group were significantly decreased, the respiration were remarkably inhibited and the blood pressure were obviously declined as compared to those in Ctl group. The blood pH of rats in SI group were significantly lower than those in Ctl group, showing severe acidosis(P<0.05). The changes of HCO3-, PCO2 and BE also presented the similiar trends(P<0.05). PO2 and PCO2 in SI group were significantly higher than those in Ctl group (P<0.05). However, the SaO2 in SI group were lower than those in Ctl group (P<0.05). Blood sodium and chlorine in SI group were higher than those in Ctl group, showing severe hypernatremia and hyperchloremia(P<0.05). The concentration of potassium and calcium were not obviously changed. The liver and kidney function parameters(AST,ALT,Urea,Crea) in SI group were lower than those in Ctl group 4 hours after injury(P<0.05), while myocardial damage markers (TNT) in SI group were higher than those in Ctl group. There were no significant differences in coagulation function between the two groups. The survival time of the SI group rats were shorter than those in Ctl group and the mortality was higher than those in Ctl group (66.7% vs 41.7%).Conclusion: Low-temperature seawater immersion might aggravate injury, accelerate animal death, induce hypothermia, respiratory depression, acidosis, hypernatremia and hyperchloremia. Immersing in low temperature seawater for 1 hour can cause myocardial damage, but it has protective effects on the liver and kidney. Therefore, more attentions should be paid to the secondary injury caused by seawater immersion in the emergency treatment of the wounded, such as rapidly rewarming, rectifying the acidosis and maintaining the stability of homeostasis of the wounded, so as to lay the foundation for the further definitive treatments.
Network Structure Impacts the Synchronization of Collective Beliefs
Authors: Vlasceanu Madalina , Coman Alin
Published: August 2020

People’s beliefs are influenced by interactions within their communities. The propagation of this influence through conversational social networks should impact the degree to which community members synchronize their beliefs. To investigate, we recruited a sample of 140 participants and constructed fourteen 10-member communities. Participants first rated the accuracy of a set of statements (pre-test) and were then provided with relevant evidence about them. Then, participants discussed the statements in a series of conversational interactions, following pre-determined network structures (clustered/non-clustered). Finally, they rated the accuracy of the statements again (post-test). The results show that belief synchronization, measuring the increase in belief similarity among individuals within a community from pre-test to post-test, is influenced by the community’s conversational network structure. This synchronization is circumscribed by a degree of separation effect and is equivalent in the clustered and non-clustered networks. We also find that conversational content predicts belief change from pre-test to post-test.
Numerical Simulation of Coal Wall Cutting and Lump Coal Formation in a Fully Mechanized Mining Face
Authors: Yuan Yong , Wang Shengzhi , Wang Wenmiao , Zhu Cheng
Published: August 2020

It is difficult to accurately calculate the lump coal rate in a fully mechanized mining face. Therefore, a numerical simulation of the coal wall cutting process, which revealed the crack expansion, development, evolution in the coal body and the corresponding lump coal formation mechanism, was performed in PFC. Moreover, a correlation was established between the cutting force and lump coal formation, and a statistical analysis method was proposed to determine the lump coal rate. The following conclusions were drawn from the results. (1) Based on a soft ball model, a coal wall cutting model was established. By setting the roller parameters based on linear bonding and simulating the roller cutting process of the coal body, the coal wall cutting process was effectively simulated, and accurate lump coal rate statistics were provided. (2) Under the cutting stress, the coal body in the working face underwent three stages—microfracture generation, fracture expansion, and fracture penetration—to form lump coal, in which the fracture direction was orthogonal to the cutting pressure chain. Within a certain range from the roller, as the cutting depth of the roller increased, the number of new fractures in the coal body first increased and then stabilized. (3) Under the cutting stress, the fractured coal body was locally compressed, thereby forming a compact core. The formation and destruction of the compact core caused fluctuations in the cutting force. The fluctuation amplitude was positively related to the coal mass. (4) Because the simulation did not consider secondary damage in the coal, the simulated lump coal rate was larger than the actual lump coal rate in the working face; this deviation was mainly concentrated in large lump coal with a diameter greater than 300 mm.
Extravascular risk factors in the prognostic evaluation for spinal cord injury during thoraco-abdominal aortic aneurysm exclusion: a case report.
Authors: Villani Flavio , Fargion Aaron Thomas , Melani Alberto , Esposito Davide , Domenico Rossella Di , Dorigo Walter , Pratesi Carlo
Published: August 2020

Background: The etiology of delayed-onset spinal cord injury (SCI) following endovascular repair of thoraco-abdominal aortic aneurysms (TAAA) is still unclear and may be related to multiple factors. Extravascular factors, such as lumbar spinal stenosis (LSS), may play a significant role in the selection of patient at risk of SCI. In this report we describe a case of paraplegia following thoracic endovascular aortic repair (TEVAR) in a patient suffering from severe and symptomatic LSS and undergoing staged endovascular repair of a TAAA.Case presentation: A 70-year-old man was admitted to our department with an asymptomatic type III TAAA in previous open repair for abdominal aortic aneurysm. The patient complained of buttock and thigh claudication in the absence of defects in the pelvic perfusion; a spinal magnetic resonance angiography (MRA) showed a severe narrowing of the lumbar canal. The first-step procedure was estimated at intermediate risk of SCI and considering a recent cardiac procedure requiring double antiplatelet therapy, in agreement with anesthesiologists, a preoperative cerebrospinal fluid (CSF) drainage was not performed during the first-step. After 24 hours from TEVAR paraplegia was detected. The drainage was then placed with incomplete recovery. The second stage was performed in urgency three weeks after, without complications and changes in neurological status.Conclusions: Stenotic damage to the spinal cord is thought to be the result of direct compression of the neural elements and ischemic disruption of arterial and venous structures surrounding the spinal cord. This comorbidity may constitute an additional anatomic risk factor in those patients currently recognized as prognostically associated to the development of SCI.
Separation of Magnetotelluric Signals Based on Refined Composite Multiscale Dispersion Entropy and Orthogonal Matching Pursuit
Authors: Zhang Xian , Li Jin , Li Diquan , Li Yong , Liu Bei , Hu Yanfang
Published: August 2020

Magnetotelluric (MT) signal processing can increase the reliability of data. Traditional MT de-noising methods are usually filtered in entire MT time-series sequence, which result in losing of useful MT signals and the degradation of electromagnetic inversion imaging accuracy. However, targeted MT noise separation will retain the part of data that is not affected by strong noise, and enhance the quality of MT data. Thus, we proposed a novel method which using refined composite multiscale dispersion entropy (RCMDE) and orthogonal matching pursuit (OMP) for MT noise separation. Firstly, we extracted the RCMDE characteristic parameters from each segment of the MT time-series. Then, the characteristic parameters are input to the fuzzy c-mean (FCM) clustering for automatic signal-noise identification. Next, the identified noise segments were independently denoised by using OMP method. Finally, the reconstructed signal consists of the denoised data segments and the identified useful signal segments. We conducted the simulation experiments and algorithm evaluation on the EMTF data, simulated data and measured sites. The results indicate that a variety of entropy without scale factor is not stable enough, and the RCMDE can improve the stability of multiscale dispersion entropy (MDE) and multiscale entropy (MSE) by analyzing the characteristics of the signal samples library, and thus effectively dividing MT signals and noise. In this paper, the existing techniques of the entire time domain de-noising and signal-noise identification method are compared. Only for RCMDE and OMP as characteristic parameter and noise separation method, the proposed method simplified the multi-features fusion method, and improved the accuracy of signal-noise identification, accelerated de-noising efficiency, and improved the MT data quality of low-frequency band.
Risk Factors Affecting Survival Time to First Recurrence of Breast Cancer Patients: The Case of South West Ethiopia
Authors: Bacha Reta Habtamu , Jabir Yasin Negash , Tesfay Yohannes Yebabe , Dame Kenenisa Tadesse
Published: August 2020

Background: Among the cancers, next to cervical cancer, in Ethiopia, breast cancer is the second common cancer health problem for women. This article aimed to identify the potential risk factors affecting of time-to-first-recurrence of breast cancer patients in southwest Ethiopia: Jimma Medical Center, Bedelle hospital, Mizan-Aman hospital, and Mettu hospital and Karl hospital. Methods: The data were taken from the patient’s medical record that registered from January 2012 to January 2019. The study considered a sample size of 642 breast cancer patients. Different non-parametric and parametric shared frailty survival models employed. Results: Out of 642 breast cancer patients, about 447 (69.6 %) recovered/cured of the disease. The median cure time from breast cancer found 13 months. The lognormal parametric shared frailty survival model predicted that treatment, stage of breast cancer, smoking habit, and marital status significantly affects the time to the first recurrence of breast cancer. Conclusion: Treatment, stages of breast cancer, and marital status were improved while smoking habits worsen the time to first cure of breast cancer. To mitigate breast cancer diseases awareness should be given for the community on identified factors
Psychosocial Rehabilitation Experiences of Women Victims of Armed Conflict in Colombia.
Authors: Sarmiento-Marulanda Laura Camila , Aguilera-Char Amira Ayleen , Gonzalez-Gil Catalina , López-López Wilson
Published: August 2020

Background: After nine years of the ground-breaking social policy Law 1448 of 2011 -Victims Law- and its extension until 2030, the Colombian State and other stakeholders have made several efforts towards granting the right of integral reparation for more than nine million victims that are recognized in the Colombian transitional context. Psychosocial rehabilitation is a reparation measure of the Victims Law’s whose objective is to re-establish the psychosocial, physical and mental health welfare in the individual, familiar and community levels. This study aims to understand the experiences of psychosocial rehabilitation of women victims of armed conflict in Montes de Maria and the underlying social intervention paradigms that guide the Law’s implementation. Methods: Based on a qualitative design with a phenomenological approach, narrative tools and thematic network analysis permitted to give voice to the women participants. Individual narrative interviews and a focus group were conducted with twelve and eight women victims, respectively. Results: Although the Victims Law is oriented by a sociopolitical intervention paradigm, the stories of the women’s victims of Montes de María mainly evidenced non-sociopolitical interventions with humanitarian assistance towards revictimization and State abandonment. As a coping mechanism towards the State negligence encountered, women strive to overcome psychosocial trauma by developing agency and community resources for the resignification of the traumatic experiences and peacebuilding. Conclusions: For the Victims Law to achieve its integrality aim, the psychosocial approach should be implemented through all its measures but remains absent. Women and their communities are urgently demanding mental health interventions with adequate psychosocial rehabilitation to overcome trauma. Therefore, it is an urgent matter for the different stakeholders to collaborate towards transformative and participatory psychosocial interventions based on the community’s necessities and resources and non-repetition guarantees to avoid revictimization, as conflict and an Unconstitutional state of affairs persists.