bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Health Education Via Mobile Application in Promoting Quality of Life Among Asthmatic Schoolchildren in Urban Malaysia: A Quasi-Experimental Study
Authors: Raimi Abdulaziz Mansoor Al , Chong Mei Chan , Tang Li Yoong , Chua Yan Piaw , Ajeel Latifa Yahya Al
Published: June 2021

BACKGROUND: Bronchial asthma among children is a common chronic disease which may have impact on quality of life. Health education is one of the strategy to improve knowledge and quality of life.OBJECTIVE: The study aims to assess the effect of health education via mobile application (app) in promoting quality of life among schoolchildren with asthma in urban Malaysia.METHODS: A quasi-experimental, pre- and post-intervention design was used in this study during the period September 2016 until April 2017 involving a total of 214 students, randomly assigned into two groups (intervention group and control group). The control group received face-to-face health education while the experimental group received health education via a mobile application.RESULTS: The findings showed that the total score of quality of life (QoL) has improved from a mean total score at pre-intervention (5.31±1.27) to post-intervention (5.66±1.28) for the control group, compared with the experimental group with a mean total score of QoL at pre-intervention (5.01±1.36) and post-intervention (5.85±1.29). A comparison between the experimental and control groups using an independent t-test showed statistically significant differences in their mean QoL scores. The effect of health education via mobile application showed a statistically significant improvement in the mean QoL score from pre- to post-intervention [F (1,288) = 57.46, p = <0.01].CONCLUSION: The use of mobile technology in health education improved QoL as compared to the traditional methods of face-to-face lecture and/or handbooks among schoolchildren with asthma. Thus, educational modules using mobile applications do improve QoL.
Structural Insights Into The Binding of Nanobodies LaM2 and LaM4 to the Red Fluorescent Protein mCherry
Authors: Wang Ziying , Li Long , Hu Rongting , Zhong Peiyu , Zhang Yiran , Cheng Shihao , Liu Rui , Ding Yu
Published: June 2021

Red fluorescent proteins (RFPs) are widely used in molecular biology research, especially in deep tissues and animal models, because of their superior autofluorescence, light scattering, and phototoxicity to GFP. Although RFP can be easily monitored in vivo, improved manipulation of RFP is still desired. Using suitable nanobodies (Nbs) to bind to different epitopes of RFP is the most promising approach; thus, it is crucial to obtain structural information on how the different Nbs interact with RFP. We determined the crystal structures of the LaM2-mCherry and LaM4-mCherry complexes at 1.4 Å and 1.9 Å resolution. Our results showed that LaM2 binds to the side of the mCherry β-barrel, while Lam4 binds to the bottom of the β-barrel and does not interfere with the homo-oligomerization interface. The distinct binding sites of LaM2 and LaM4 were further verified by ITC, F-SEC and DLS assays. Our results also showed that LaM2 and LaM4 can bind simultaneously to mCherry, which is crucial for recruiting multiple operation elements to the RFP. The binding of LaM2 or LaM4 did not significantly change the chromophore environment of mCherry, which is important for fluorescence quantification assays, while several GFP Nbs significantly altered the fluorescence. Mutation of the residues of the LaM2 or LaM4 binding interface to mCherry significantly decreased the binding affinity of the Nb to mCherry. Our results provided atomic resolution interaction information on the binding of Nbs LaM2 and LaM4 binding with mCherry, which is important for developing detection and manipulation methods for RFP-based biotechnology.
ADAM12 as a Clinical Prognostic Indicator Associated with Tumour Immune Infiltration in Lung Adenocarcinoma
Authors: Pan Junfan , Huang Zhidong , Xu Yiquan
Published: June 2021

Background: Lung cancer is the most common cause of cancer-related death worldwide. In humans, 22 functional α-disintegrin and metalloproteinases (ADAMs) have been identified, 12 of which have proteolytic activity. The role of ADAMs in cancer has attracted increasing attention. However, the expression and significance of ADAMs in lung adenocarcinoma (LUAD) remain unclear. The current study aimed to explore the expression and prognostic value of ADAM12in LUAD.Methods: The Cancer Genome Atlas(TCGA) database was used to analyse the expression of ADAMs in LUAD. The cBioPortal database was used to obtain and analyse ADAM12 copy number changes, and the LinkedOmics database was utilised for the analysis of ADAM12-related genes. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was then performed using TIMER. The relationship between ADAM12 and the tumour immune microenvironment(TIM) was assessed via the TISIDB database. ADAM12 and immune-related genes were used to construct a prognostic model. Knockdown of ADAM12 was performed in vitro in order to verify its biological function. The unpaired t-test was used for comparison between the two groups, ANOVA was used for analysing differences between multiple groups, and the Kaplan-Meier test was used to compare survival between groups.Results: Most ADAMs exhibited significant differential expression in LUAD. ADAM12 expression was significantly higher in LUAD tissues than in healthy tissues, and lower ADAM12 expression was associated with better survival. Genetic alterations of ADAM12 mainly included missense mutations, amplifications, and deep deletions. ADAM12 and positively correlated genes were mainly enriched in protein digestion and absorption, ECM-receptor interaction, and adhesion plaques. ADAM12 had a moderate correlation with immune cell markers EBIP1, CCNB1, EXO1, KNTC1, PRC1 and FAM198B. Prognostic model was established based on ADAM12 and immune-related genes. In vitro experiments revealed that knocking down ADAM12 inhibited cell proliferation, migration and invasion.Conclusion: ADAM12 potentially plays an important role in the occurrence of LUAD and may be utilised as an immunotherapy target and a valuable prognostic biomarker for LUAD.
Diagnostic accuracy and prognostic relevance of immunoglobulin heavy chain rearrangement and 18 F-FDG- PET/CT compared with unilateral bone marrow trephination for detecting bone marrow involvement in patients with diffuse large B-cell lymphoma
Authors: Kim Mihee , Ahn Seo-Yeon , Ahn Jae-Sook , Song Ga-Young , Jung Sung-Hoon , Lee Je-Jung , Kim Hyeoung-Joon , Lee Jun Hyung , Shin Myung-Geun , Song Sang Yun , Yang Deok-Hwan
Published: June 2021

Background

In diffuse large B-cell lymphoma (DLBCL), bone marrow involvement (BMI) has an important clinical implication as a component of staging and International Prognostic Index (IPI).
Methods

This study aimed to determine whether molecular analysis of immunoglobulin heavy chain (IgH) genes and PET/CT could overcome the limitation of defining morphologic bone marrow involvement by trephination biopsy and could increase the diagnostic accuracy or prognostic prediction. 94 de novo patients with DLBCL underwent PET/CT, polymerase chain reaction (PCR) test for detection of IgH gene rearrangement, and unilateral BM trephination at diagnosis.
Results

9 patients (9.6%) were confirmed to present morphologic BMI (mBMI) based on trephination biopsy. On the other hands, 21 patients (22.3%) were confirmed to have IgH clonality (IgH BMI), while 16 (17.0%) were classified with BMI based on the assessment of PET/CT (PET BMI). Each IgH rearrangement PCR and PET/CT showed the high negative predict value of detecting the BMI. However, the combined assessment of IgH rearrangement and PET/CT could increase a diagnostic accuracy and specificity with 87.2% and 97.0%, respectively. The survival outcome of patients with double positive PET BMI and IgH BMI was significantly worse than that with either single positive PET BMI or IgH BMI, and even less than patients with neither PET BMI nor IgH BMI. (3-year PFS: 50.0% vs 75.4% vs 97.9%, p = 0.007, 3-year OS: 50.0% vs 75.6% vs 80.1%, p = 0.035, respectively).
Conclusion

This study suggested that the combined evaluation of PET/CT and IgH rearrangement could give additional information of predicting therapeutic outcomes in patients with negative morphologic BMI as an important part of the prognosis.
Providing Information Improved Adequate Storage and Disposal of Opioids by Bereaved Family Caregivers
Authors: Okizaki Ayumi , Miura Tomofumi , Fujishiro Noriko , Igarashi Naoko , Matsumoto Yoshihisa , Naito Akemi Shirado , Shima Yasuo , Kinoshita Hiroya , Reddy Akhila , Morita Tatsuya , Miyashita Mitsunori
Published: June 2021

Context:

Poor understanding regarding the safe use, secure storage, and adequate disposal of unused opioids may contribute to the opioid epidemic. It is unclear what happens to unused opioids in the households of deceased cancer patients.
Objectives:

Our aim was to investigate the patterns of use, storage, and disposal of unused opioids among families of deceased cancer patients.
Methods:

A questionnaire was administered to families of deceased cancer patients. Questions were related to the use, storage, and disposal of opioids prescribed to their deceased family member.
Results:

Completed questionnaires were received from the families of 240 patients. Of these, 129 (53.8%) and 99 (41.3%) participants were aware of the danger of diversion and need for safe disposal, respectively. One (0.4%) participant reported diversion. In total, 177 participants (73.8%) stored opioids securely, 6 (2.5%) had unused opioids at home, and 142 (59.2%) returned unused opioids to medical health providers. Knowledge of safe opioid disposal increased the rate of returning opioids to medical health providers (84.8% vs. 53.2%; p < 0.001) and decreased the rate of participant disposal (13.3% vs. 37.6%; p < 0.001). Prior knowledge of the risks of opioid diversion was associated with storing opioids securely (91.9% vs. 80.7%; p = 0.028).
Conclusion:

Most families of deceased cancer patients follow safe use, secure storage, and adequate disposal of prescribed opioids. Awareness of opioid diversion and the need for adequate disposal increased the prevalence of safe practices.
The Reverberation of Corona Pandemic in Developing Countries Special Reference To Ethiopia
Authors: Ayalew Abebe Temesgen , Aynalem Elsabet Getachew
Published: June 2021

Purpose - The present COVID 19 virus has unexpected social problem with an overwhelming financial influence happening in each family circle. This research aimed to assess the overall influence of COVID 19 in selected cities in Ethiopia which has high population density, commercial, high local population movement and tourist attractive towns.Design/Methodology/Approach - For a random sampling illustration 50,000 defendants are assessed through virtual mode commencing 17 cities of Ethiopia. For verifying the demonstrative of the statistics, demographic characters from online survey non behalf of time-based variations for each sample size. While survey in each city inadequate information collection is not bounded, studies for defendant’s IP address not correspond to the nation; studies labeled as redundant, assessments with illegal replies, and studies irrational accomplishment period for each sample.Findings - From this research one can understand the pecuniary influences increasing in alarming rate and incapable: out of the total respondents 45 percent of a family member missing their job and 59 percent of defendants report that a household member has closed their business. The rest households owning small businesses and among families with the lowermost income aforementioned for the pandemic, 71 percent information shows that a family member missing their job and 61 percent report that a household member has stopover their private business. Deteriorations in food safety and healthiness are among the incapable influences.Originality/value – Virtual method of survey, random sampling and statistical regression analysis was better in signifying the COVID virus effect in different aspects
Epsilon Near Zero (ENZ) Based Kagome Photonic Crystal Fiber for Low Loss, High Birefringence and Near Zero Flat Dispersion in THz Regime
Authors: Asaduzzaman Sayed , Rehana Hasin , Aziz M. D. Tanzil , Faragallah Osama S. , Baz Mohammed , Eid Mahmoud M. A. , rashed ahmed nabuh zaki
Published: July 2021

In this research, we have proposed two novel types of Kagome PCFs one is slotted core PCF (S-KPCF) and another one is circular PCF (C-KPCF). FEM has been applied with boundary condition to investigate the optical properties of Proposed PCFs. HRS material along with Epsilon Near Zero (ENZ) material has been applied in core and TOPAS was used as background material. Numerical investigation takes place a wider frequency range for 0.8 THz to 2 THz. Slotted core PCF (S-KPCF) shows eminent birefringence of 2.98×10− 2, Lower EML of 0.232 cm− 1, lower confinement loss of 2.76×10− 8, Bending loss 10.76×10− 9, Total loss of 0.232cm− 1 at frequency 1THz. Besides circular core PCF (C-KPCF) shows eminent birefringence of 8.69×10− 2, Lower effective material loss of 0.746 cm− 1, lower confinement loss of 2.80×10− 7, Bending loss 7.76×10− 9, Total loss of 0.746cm− 1 at 1THz. Both PCFs show flat dispersion near zero (for S-KPCF is -0.997ps/nm/Km and for C-KPCF is -0.797ps/nm/Km) range. V-Parameter of both of the PCF indicates that both PCF is multimode PCF. Comparison of the proposed PCFs shows that C-KPCF shows better results than S-KPCF and both PCFs shows better results than previous PCFs.
Identification of Possible Inhibitors of SARS-CoV-2 Main Protease From Some Bioactive Compounds of Artemisia Annua: An in Silico Approach
Authors: Johnson Titilayo , Adegboyega Abayomi , Ojo Oluwafemi , Jega Amina , Iwaloye Opeyemi , Ugwah-Oguejiofor Chinenye , Asomadu Rita , Chukwuma Ifeoma , Ejembi Stephen Ejembi , Ugwuja Emmanuel
Published: June 2021

The inhibitory potential of Artemisia annua, a well-known antimalarial herb, against several viruses including the coronavirus is increasingly gaining recognition. The plant extract has shown significant activity against both the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the novel SARS-CoV-2, that is currently ravaging the world. It is therefore necessary to identify the bioactive compounds of the plants that are responsible for this activity, for the purpose of designing drugs against SARS-CoV-2. In this study, we employed in silico techniques comprising of molecular docking, binding free energy calculations, pharmacophore modelling as well as druglikeness, pharmacokinetics and toxicity predictions, to identify potential inhibitors of the SARS-CoV-2 main protease (Mpro) from 168 bioactive compounds of Artemisia annua. Rhamnocitrin, Isokaempferide, Kaempferol, Quercimeritrin, Apigenin, Penduletin, Isoquercitrin, Astragalin, Luteolin-7-glucoside and Isorhamnetin were ranked highest; with docking scores ranging from -7.84 to -7.15 kcal/mol compared with -6.59 kcal/mol demonstrated by the standard ligand. Rhamnocitrin, Isokaempferide and Kaempferol, like the standard ligand interacted with important active site amino acid residues like HIS 41, CYS 145, ASN 142, and GLU 166, among others. These compounds also possess acceptable druglike properties and safety profile. Hence, they could be considered for experimental studies and further development into drugs against SARS-CoV-2.
Patient-Reported Outcomes in a Chinese Cohort of Osteogenesis Imperfecta Unveil Psycho-Physical Stratifications Associated with Clinical Manifestations
Authors: Chen Peikai , Tan Zhijia , Zhou Yapeng , Yin Shijie , Dong Zhongxin , Qiu Yan , Xu Jichun , Li Kangsen , Qiu Anmei , Dong Lina , Shek Hiu Tung , Liu Jingwen , Yeung Eric Hiu Kwong , Gao Bo , Cheung Kenneth Man Chee , To Michael Kai-Tsun
Published: June 2021

Background: Osteogenesis imperfecta (OI) is a rare congenital disorder that greatly compromises the quality of bones, inflicting debilitating distress both physically and psychologically to patients and caregivers. Over the decades, much efforts have been channeled towards understanding genetic mechanisms and exploring new treatments. Nonetheless, it has recently become more aware that the patient reported outcomes (PRO) and health status during treatment, healing and rehabilitation, are important basis that facilitates smoother communication, refines interventions strategies and achieves higher quality of life. To date, systematic studies and analyses of PRO in OI patients remain scarce.Results: Here, harnessing the Patient-Reported Outcomes Measurement Information System (PROMIS), we report a cross-sectional and longitudinal study in a cohort of 90 OI patients from southern China, covering both children and adult age-groups. In the young group where both self and parental surveys were obtained, we identified two clusters of comparable sizes showing different outlooks in physical mobility and emotional experiences. One cluster is more positive about themselves than the other. Remarkably, we found a concordance of 84.7% between self and parental assessments, suggesting the stability of the stratification and validity of the PROMIS instruments. We further found that clinical subtyping, deformity, leg length discrepancy and limited joint mobility were significantly associated with this patient stratification, with the cluster with poorer physical functioning and higher psychological depression showing higher percentage of more severe deformity. Analyses of longitudinal data suggested that patients tend to stay in the same psychological state, in both clusters. Adult patients also showed a continuous spectrum of self-evaluation that matches their clinical manifestations. Conclusion: By probing deep into the subjective quantitation of patient reported outcomes, our study demonstrates the diverse sociopsychological spectrum among OI patients that matches their objective clinical manifestations, which may serve as the basis for evaluating clinical interventions and help achieve better patient-centric medical practices and health maintenance.
Association and Interaction Between Dietary Patterns and Gene Polymorphisms in Liangshan Residents with Hyperuricemia
Authors: Li Tingting , Li Shuangjing , Tian Tian , Nie Zhichao , Xu Wangdong , Liu Longjian , Jia Hong
Published: June 2021

Background: Hyperuricemia (HUA) is caused by genetic and dietary factors. However, little is known about the ways in which diet and gene interactions influence HUA or the role of dietary patterns in HUA. Objectives: We aimed to explore the association between dietary patterns and HUA as well as dietary patterns and gene interactions in HUA among the Yi ethnic group of China. Methods: Food consumption information was collected using a semi-quantitative food frequency questionnaire. Vein blood samples were collected after overnight fasting from all participants and DNA was extracted from peripheral blood leukocytes. Dietary patterns were derived using factor analysis.Results: The study included 2646 participants aged 18–88 years with a HUA prevalence of 26.8%. Three major dietary patterns were identified and shown to be associated with HUA prevalence, with meat-based diets having a higher association with HUA than plant-based or regionally specific diets. The frequency of the T allele at ABCG2 rs2231142 and SLC2A9 rs11722228 loci was higher in HUA than in non-HUA populations. An additive interaction between a meat-based diet and the rs2231142 locus was associated with the risk of HUA. The relative excess risks of interaction (RERI), attributable proportion of interaction (AP), and synergy index (S) were 0.482 (95% CI 29 = 0.012,0.976),0.203 (95% CI = 0.033,0.374), 1.544 (95% CI = 1.012,2.355), respectively. Conclusions: The meat-based dietary pattern was associated with an increased risk of HUA. There was an additive interaction between a meat-based dietary pattern and the ABCG2 rs2231142 locus in study participants. Individuals with the rs2231142 T allele had a higher frequency of HUA than those with the rs2231142 GG allele. Individuals with the rs2231142 T allele but a healthy dietary pattern could have a reduced HUA risk.
Construction and Confirmatory Factor Analysis of Panoramic Quality Assessment Tool for Investigator-Initiated Trials
Authors: Lv Wenwen , Hu Tingting , Jiang Jiayuan , Qu Tiantian , Shen Enlu , Duan Jiacheng , Miu Xin , Zhang Weituo , Qian Biyun
Published: June 2021

Introduction. Investigator initiated trials (IITs) are laid on the optimization and improvement of already existing therapies or treatment approaches and attempts to answer problems faced by clinicians in their daily practice. However, the quality assessment for conducting these sometimes complex studies is scarce of evidence. Our study aims at developing a handy quality assessment tool for IITs and providing investigators with resources to conduct their studies effectively. Furthermore, patient safety and data quality will also be kept as top priorities.Data and methods. The framework of the quality assessment tool was based on the literature studies and accepted guidelines and the Delphi method. Confirmatory factor analysis (CFA) is used to further evaluate the validity and feasibility of the conceptual quality assessment tool. Results. The panorama quality assessment tool for IITs contains four critical quality attributes, including progress, quality, regulation, scientificity, and 13 observed quality indexes. 272 IITs were collected, finally, 252 IITs were included in the validity and feasibility assessment. The majority of the studies (60.29%) were in Randomized Controlled Trial (RCT), and 41.18% of the studies were multi-center. In order to test for validity and feasibility of IITs quality assessment tool, CFA method was showed a fit for the model (CMIN/DF=1.868, GFI=0.916; CFI=0.936; TLI=0.919; RMSEA=0.063). Multiple types of studies of clinical studies, including RCT, prospective cohort study, retrospective, and real-world research fitted well in the tool by assessing their subject management, reasonable clinical research methods, and quality control methods. However, RCT ended with lower scores than prospective cohort study, retrospective and real-world research in enrollment progress (7.02 vs. 7.43, 9.63, 7.85, respectively). Conclusions. The panorama tool for overall quality assessment of IITs from this study combines the advantages of both qualitative and quantitative recognized evaluation indexes, which are further validated by CFA. The panorama evaluation tool can timely and dynamically find errors, take actions to prevent major bias. It is hoped that this framework can provide project management departments with resources for effective and dynamic management of their research and avoid waste of resources, as well as a manner to improve the quality of IIT in the future.
Toxicological Evaluation of Human Adipose-derived Mesenchymal Stem Cells (hADSCs) and hADSCs-derived Exosomes
Authors: Zhou Yang , Zhao Bo , Zhang Xin-Liao , Lu Yi-jun , Cheng Jian , Fu Yu , Zhang Ning-Yan , Li Pei-Xin , Zhang Jing , Zhang Jun
Published: June 2021

Background: Human adipose tissue-derived stem cells (hADSCs) are considered an ideal source of cells for regenerative medicine. Mesenchymal stem cells derived-exosomes (MSC-Exos) are being opined as new cell-free therapeutics for numerous human diseases. For future clinical applications, the safety of allogenic hADSCs and hADSCs-derived exosomes (hADSCs-Exos) needs to be addressed and verified in pre-clinical animal models. This study sought to evaluate the toxicity of hADSCs and hADSCs-Exos by performing in vivo and in vitro toxicological assessments.Methods: We used IVIS to track the biodistribution of GFP-labeled hADSCs and the PKH26-labeled in a mouse model. The tumorigenicity of hADSCs and hADSCs-Exos was analyzed by soft agar colony formation assay and nude mice tumorigenicity test in vitro and in vivo. The acute animal toxicity and allergenicity test were used to explore the toxicological proﬁle of hADSCs and hADSCs-Exos in mice.Results: We found that hADSCs-Exos accumulated faster in the tissues of mice and were also cleared more rapidly compared to hADSCs. Both hADSCs and hADSCs-Exos have little risk of tumorigenicity, and hADSCs-Exos had lower toxicity and lower immunogenicity than hADSCs.Conclusion: Our study is the first to compare the safety between hADSCs and hADSCs-Exos, and revealed that hADSCs-Exos are safer for application as systemic therapy, without complications in toxicological assessment, and have a better prospective utility as a treatment agent and for drug delivery.
HMGA1 Attenuates Doxorubicin-Induced Cardiomyocyte Pyroptosis By Inhibiting SOX9
Authors: Liu Yaxiu , Tang Yao , Fu Hui , Fu Shuang , Zheng Xinbin , Ma Yeshuo , Yin Deling
Published: June 2021

Doxorubicin (DOX) is widely used as an anti-tumor drug with severe cardiotoxicity, encephalotoxicity, nephrotoxicity and so on, especially cardiotoxicity, which severely limit its application. Researchers have extensively studied the mechanisms of DOX-induced cardiotoxicity. However, the underlying mechanism of DOX-induced cardiotoxicity needs to be further evaluated. Studies reveal that High-mobility group AT-hook1 (HMGA1) and Sex-determining-region-Y (SRY)-related HMG box-containing protein 9 (SOX9) contribute to caspase-3-mediated apoptosis, but whether HMGA1 and SOX9 participate in caspase-3/gasdermin E (GSDME)-mediated pyroptosis remains unknown. This study was performed to investigate whether HMGA1 and SOX9 participate in DOX-induced cardiomyocyte pyroptosis induced by DOX in vitro, and to reveal the molecular mechanisms of HMGA1 and SOX9 in regulating DOX-induced cardiomyocyte pyroptosis via caspase/GSDME pathway. Results showed that the expression of HMGA1 is significantly up-regulated while SOX9 is down-regulated in HL-1 cells after DOX treatment. We found that both inhibition of HMGA1 by small interfering RNA (siRNA) and overexpression of SOX9 by transfection of SOX9 plasmid significantly promote cardiomyocyte pyroptosis induced by DOX. In addition, HMGA1 interacts with SOX9. Finally, our results show that silencing SOX9 reverses cardiomyocyte pyroptosis induced by silencing HMGA1 after DOX treatment.
Advanced Cryptography & Block Chain Based Cloud Environment for Secured E-Health Record
Authors: A Sonya , G Kavitha
Published: June 2021

There has been noteworthy issues that must be tackled by the healthcare sector along with handling the security concerns that are intensely linked with offering of healthcare services, inculcating novel electronic healthcare systems, and secure data communication with different healthcare and government institutions. These security related concerns project several privacy preserving methodologies pertaining to the privacy and security of EHRs (electronic health records) in the cloud. The EHRs comprises of information related to demographics, medical histories, digital images, medications, lab reports, billing details and other sensitive patient information. All this sensitive patient information is kept highly secured and resides in third party servers with definite access controlling mechanism. The conventional system employs various cryptography algorithm for authorization, encryption, decryption, key generation and validation algorithms. There is proposal of a new cryptography algorithm for combating the limitations of AES, RSA and ABS. For securing the healthcare data residing in the cloud, the research presents effective utilization of new hybrid cryptography algorithm and Blockchain technology with smart contract. Unlike the prevailing three cryptographic algorithms, the proposed algorithm offers enhanced time, accuracy, efficiency and key generation and performance. Overall, there is a drastic transformation in securing the healthcare records using the proposed approach.
A Turkish Plague Tale: Dying Healthcare Workers in Pandemics
Authors: NESANIR Nasir , KARCIOGLU Ozgur , BAHADIR Alican , FINCANCI Sebnem KORUR
Published: June 2021

Background: The aim of the present study is to analyze the data obtained in the pandemics to highlight the picture that emerged in the struggle against the disease in Turkey, with special emphasis on the deaths of healthcare workers (HCW). Methods: In this report, the age, gender, province and institution of employment, distribution of death by months, occupation, chronic disease status, and death rates by occupation of 403 active HCW who died due to COVID-19 disease from the beginning of the epidemic until May 31, 2021 were evaluated. Results: A majority (n=351, 87.1%) of the HCW who lost their lives due to COVID-19 are male. More than one third (36.0%) of all COVID-19 deaths in HCW are physicians; 13.2% (n=53) was pharmacists and 6.0% (n=24) was nurses and midwives. Working in private sector is overrepresented in deaths. Death due to COVID-19 is 8.32 per 10,000 among physicians; 13.78 in male physicians; while only 0.56 in female physicians. Mortality among HCW has slowed down since the vaccine was introduced.Conclusions: Deaths that have occurred or may occur due to COVID-19 are mostly preventable deaths. Deceased HCW are significantly younger than all COVID-19 deaths, which suggests that HCW have not been protected necessarily. Likewise, the number of deaths among blue-collar workers in healthcare is more frequent in those younger than 50 years old is an indication of the class nature of the pandemic. Trial registration: The article has not been pre-registered because it does not include reports of a health care intervention on human participants.
Parturients Perception of Care Providers Attitude Towards Women During Labour And Delivery In Southwest Cameroon
Authors: Tankeng Clovis Achassi , Halle-Ekane Gregory , Mokom Alfred Awa , Ngunyi Yannick Lechedem , Wambo André Gaetan Simo , Ngouakam Hermann , Yenshu Emmanuel Vubo
Published: June 2021

Background: The period of labour and childbirth for women is a delicate moment and predisposes them to disrespectful care which has been reported in many countries. In Cameroon, data which could help in formulating policies to modify these attitudes is rare.Objectives: To assess parturients’ perception on the respect and disrespect of women by care providers as well as determining the prevalence, types and predisposing factors of physical and verbal abuse during labour and delivery, in the Buea and Limbe Regional hospitals, Cameroon. Methods: It was a hospital based cross-sectional study carried out in Buea and Limbe Regional hospitals from February 15th to April 20th 2021. It involved parturients aged between 15 and 45 in their first eight weeks post-delivery. Data was collected using a structured questionnaire, and the collected data was entered into and analyzed with SPSS version 25. Dependent variables were dichotomized and a bivariate logistic regression model was fitted to obtain the determinants of mistreatments during labour and delivery, while Chi-squared test was used to establish association between socio-demographic characteristics and care categories. A P-value <0.05 was considered statistically significant. Results: We sampled 274 parturients aged between 15 and 42 (mean=26.69yrs and SD= + 5.34). Sixty-nine (25.18%) of the respondents reported at least a physical and/or verbal mistreatment. The most common physical and verbal mistreatments were abdominal fundal pressure to facilitate expulsion and scolding. Muslims were more likely to report insult. Parturients perceived both respectful and disrespectful forms of care.Conclusion: Disrespectful care during labour and delivery may not be uncommon in our country as suggested by the findings in this study. There is need for development of interventions to address the drivers of disrespect and abuse which will encourage clients’ future facility utilization. More studies are needed in other areas of the country to support this evidence.
Identifying Child Anxiety Through Schools-Identification to Intervention (iCATS-i2i): Protocol for Single-Arm Feasibility Trial
Authors: Reardon Tessa , Ball Susan , Breen Maria , Brown Paul , Day Emily , Ford Tamsin , Gray Alastair , Green Iheoma , Hill Claire , Jasper Bec , King Thomas , Larkin Michael , Macdonald Ian , Morgan Fran , Pollard Jack , Sancho Michelle , Sniehotta Falko F , Spence Susan H , Stallard Paul , Stainer Jason , Ukoumunne Obioha C , Violato Mara , Williams Chloe , Williamson Victoria , Creswell Cathy
Published: June 2021

Background: Anxiety disorders are common among primary-school aged children, but few affected children receive evidence-based treatment. Identifying and supporting children who experience anxiety problems through schools would address substantial treatment access barriers that families and school staff often face. We have worked with families and school staff to co-design procedures that incorporate screening, feedback for parents, and the offer of a brief intervention in primary schools. This study sets out to assess the feasibility of a subsequent school-based cluster randomised controlled trial to evaluate these procedures. Our objectives are to ensure our procedures for identifying and supporting children with anxiety difficulties through primary schools are acceptable and there are no negative impacts, to estimate recruitment and retention rates, and to identify any changes needed to study procedures or measures. Methods: We will recruit six primary/junior schools in England (2 classes per school), and invite all children (aged 8-9) (n=360) and their parent/carer and class teacher in participating classes to take part. Children, parents and class teachers will complete questionnaires at baseline and 12-week follow-up. Children who ‘screen positive’ on a 2-item parent-report child anxiety screen at baseline will be the target population (expected n=43). Parents receive feedback on screening questionnaire responses, and where the child screens positive the family is offered support (OSI: Online Support and Intervention for child anxiety). OSI is a brief, parent-led online intervention, supported by short telephone sessions with a Children’s Wellbeing Practitioner. Participants’ experiences of study procedures will be assessed through qualitative interviews/discussion groups. Discussion: Evidence-based procedures for identifying and supporting children with anxiety difficulties through primary schools would improve children’s access to timely, effective intervention for anxiety difficulties.Trial registration: ISRCTN registry: ISRCTN30032471. Retrospectively registered on 18.5.2021. https://www.isrctn.com/ISRCTN30032471
Inverse Association Between Age and Risk of Lymph Node Metastasis in Patients With Early Gastric Cancer: A Surveillance, Epidemiology, and End Results Analysis
Authors: Wang Weijun , Pang Suya , Wang Zeyu , Jiang Xin , Lin Rong
Published: June 2021

Background: Recent studies have shown that young patients with gastric cancer (GC) are at a more advanced stage and have poor survival, but the cause is still unclear. And the prognosis of GC is closely related to Lymph node metastasis (LNM). It has been reported that age and LNM of superficial colorectal cancer are inversely proportional, but the relationship between age and prognosis in early gastric cancer (EGC) is currently unclear. Therefore, we aimed to study the relationship between age and the risk of LNM in EGC.Materials and Methods: We screened out patients with EGC who underwent surgery from the SEER research database from 1975 to 2016, and retrospectively analyzed the proportion of LNM in different age groups. The correlation between age and LNM was examined using univariate analysis and multivariate logistic regression analysis.Results: We included 9231 patients with EGC, and divided into 18-39 years old (2.3%), 40-49 (6.1%), 50-59 years old (15.7%), 60-69 years old (24.8%), 70-79 years old (27.2%) and ≥89 years old (23.9%) age group, and the proportions of lymph node metastasis were 20.3%, 23.3%, 21.0%, 19.8%, 18.1%, and 13.2 %. We found that as the age increases, the risk of LNM and postoperative survival time of EGC patients decrease (p<0.001). Conclusions: This study found that age in patients with EGC was inversely related to the risk of LNM, and positively correlated with postoperative survival. For older patients with EGC, endoscopic treatment is more appropriate. For young patients with EGC, LNM should be considered when choosing endoscopic treatment.
Association of body mass index and hypoglycemia with mortality rates among sepsis patients: a retrospective sub-analysis of the FORECAST Study
Authors: Tanikawa Atsushi , Kudo Daisuke , Ohbe Hiroyuki , Kushimoto Shigeki
Published: June 2021

We assessed the influence of admission hypoglycemia on mortality in sepsis patients according to body mass index (BMI). We included 1,184 patients (age ≥ 16 years) with severe sepsis diagnosed using Sepsis-2 criteria. The outcome was in-hospital mortality. Using multivariate logistic regression, we examined the association between hypoglycemia and in-hospital mortality. Overall, 1,103 patients were analyzed. Patients were divided into groups according to the initial blood glucose level, i.e., < 70 (hypoglycemia) or ≥ 70 (non-hypoglycemia) mg/dL, and BMI, i.e., < 18.5 (low), 18.5–24.9 (normal), or ≥ 25 (high) kg/m2. Hypoglycemia was noted in 65 patients, with low (n = 13), normal (n = 38), and high BMI (n = 14). Hypoglycemia patients showed higher in-hospital mortality than those without in the normal BMI group but not in the low and high BMI groups. In multivariate logistic regression, hypoglycemia was non-significantly associated with higher mortality in all patients (p = 0.268). However, there was a significant interaction between normal BMI patients and hypoglycemia on in-hospital mortality but not between low or high BMI patients and hypoglycemia (p = 0.0476). Hypoglycemia at admission in sepsis patients was associated with high mortality in normal BMI patients but not in low or high BMI patients. This association may be used as a prognostic marker in sepsis patients.
β-adrenergic Receptor Inhibition Enhances Oncolytic Herpes Virus Propagation Through STAT3 Activation in Gastric Cancer
Authors: Hu Jiali , Lu Ruitao , Zhang Yu , Li Wei , Hu Qian , Chen Cuiyu , Liu Zhaoqian , Zhang Wei , Chen Ling , Xu Ran , Luo Jia , McLeod Howard L. , He Yijing
Published: June 2021

BackgroundOncolytic viruses (OVs) are considered a promising therapeutic alternative for cancer. However, OVs could activate the host innate immunity, then impair the viral propagation in tumor cells. In this study, we explored the effect of propranolol, a non-selective β-blocker , on the antitumor efficacy of T1012G virus in gastric cancer models.Results Cell viability assay detected a 97.9% decrease of T1012G IC50 in HGC-27 when it was pretreated with propranolol along with a 7-fold increase of virus titers compared with T1012G only group (P < 0.001). Moreover, propranolol pretreatment caused sustained tumor regression (335.3± 36.92 mm3 vs. 1118 ± 210.0 mm3, P<0.01) and enhanced the viral propagation (4-fold increase, P < 0.01) compared with T1012G only group. Propranolol pretreatment significantly enhanced the p-STAT3 (2.9-fold, P<0.05) and suppressed p-PKR (65.94% ± 10.11%, P<0.05) compared with T1012G only group. In addition, propranolol could counteract IFN-α/β-mediated inhibition of viral propagation (compared with IFNα: 5.1-fold, P<0.001; IFNβ: 4.6-fold, P<0.01) or enhancement of PKR activation (IFNα: 92.57% ± 1.77%, P<0.001, IFNβ: 99.34%± 0.13% decrease, P<0.001). Conclusions In summary, β-blocker pretreatment could improve the propagation and therapeutic efficacy of T1012G in human gastric cancer by regulating STAT3-PKR signaling cascade, even in the presence of type I IFNs . These data support new strategies of improving the efficacy of OVs in gastric cancer.
Macrophages-Derived, LRG1-Enriched Extracellular Vesicles Exacerbate Aristolochic Acid Nephropathy Via A TGFβR1-Dependent Manner
Authors: Jiang Wenjuan , Dong Jiahui , Du Changlin , Xu Chuanting , Xu Songbing , Feng Rui , Huang Cheng , Li Jun , Ma Taotao
Published: June 2021

Aristolochic acid nephropathy (AAN) is a progressive kidney disease caused by some herbal medicines, but treatment remains ineffective. We previously found NADPH oxidases 4 (NOX4), which regulates oxidative stress, play an important role in kidney injury model. However, its regulatory mechanism of action in AAN is still obscure. In this study, we established AAN model in vivo, a co-culture system of macrophage and TEC, and macrophage/TEC conditioned media culture model in vitro respectively. We found macrophages infiltration promoted injury，oxidative stress and apoptosis of TEC. Furthermore, the role of macrophage in AAN was dependent on macrophages-derived EV. Importantly, we found that macrophages-derived, Leucine-rich α-2-glycoprotein 1(LRG1)-enriched EV induced TEC injury and apoptosis of via a TGFβR1-dependent process. Mechanistically, macrophages-derived, LRG1-enriched EV mediating TECs injury by upregulating NOX4 in AAN model. This study may help design a better therapeutic strategy to treat AAN patients.
Lumbar Epidural Metastasis of Breast Cancer Resembling Lumbar Disc Herniation
Authors: Fukunaga Takanori , Umegaki Masao , Bamba Yohei , Tsuchida Yasuaki , Ninomiya Koshi , Matsumoto Katsumi , Kishima Haruhiko , Sasaki Manabu
Published: June 2021

A 49-year-old woman who had breast cancer suffered from left leg pain. Initial MRI indicated lumbar disc herniation compressing S1 nerve root. The pain was uncontrollable with conservative treatments and she underwent surgical decompression. Intraoperative findings showed that left S1 nerve root was compressed by soft and gray tumor locating ventrally. We resected the tumor and S1 nerve root was adequately decompressed. Bone tissue around the tumor was intact, and there was no finding of bone metastasis. Pathological examination demonstrated adenocarcinoma as same as original breast cancer. We should constantly consider differential diagnosis as metastatic lesion in case of malignancy.
Multivariate Analysis of Psychosomatic Complaints as Predictors of Conduct Problems in Swedish Adolescents
Authors: Brooks Samantha Jane , Titova Olga E , Ashworth Emma , Bylund Simon BA , Feldman Inna , Schiöth Helgi B
Published: June 2021

Background: Conduct disorders may be linked to common physical conditions in childhood and adolescence, and are often under reported during mainstream school years, which may lead to more serious mental health concerns in adulthood. The aim of the study was to examine the link between specific psychosomatic complaints and adolescent conduct problems. Methods: 3,132 Swedish adolescents (age range 15-18 years, 47% boys) completed the Uppsala Life and Health Cross-Sectional Survey (LHS) at school. LHS question scores were grouped in alliance with DSM-5 conduct disorder criteria and psychosomatic complaints (PSC). Multivariate analyses assessed the effects of PSC, age, and gender on conduct problem scores.Results: Main effects of gender; age; and PSC were observed. Adolescents with higher PSC scores had higher conduct problem scores. In reference to DSM-5 conduct disorder sub-categories, gender, age, and self-reported PSC were associated with increased conduct problems across all domains. Specifically, boys had higher serious violation of rules scores than girls, particularly older boys with higher PSC scores. Conclusions: These findings suggest that measures of psychosomatic complaints can be used to identify children at risk of developing conduct disorders in the future, to help raise the likelihood of a healthy life into adulthood.
Epidemiology and Determinants of Knowledge, Attitude and Practice of Preventing COVID-19 Positive Patients at Southern Tigray Ethiopia: A Facility Based Cross-Sectional Study.
Authors: Mohammed Abdukadir Nigus , Berhe Reda Haddish , Said Said Mussa
Published: July 2021

Background: The novel corona virus is a serious health problem world widely and is spreading in an immune naive population. Deaths are rising sharply, and health systems are under strain. There are confirmed cases of the virus in Ethiopia that found to have the problem. Therefore, the present study intended to assess epidemiology and determinant of knowledge, attitude, and practice of preventing COVID-19 positive patients at Southern Tigray Ethiopia.Methods: A facility based cross-sectional study was conducted from August 6, to October 26, 2020 in selected health care facilities of south Tigray. Multi-stage sampling technique was employed. Descriptive statistics were employed to describe the characteristics of the cross-section and to estimate the prevalence of clients having knowledge, attitude and practice of prevention. Bivariate analysis was performed using binary logistic regression.Results: A total of 170 COVID-19 positive patients were involved and eligible on the survey with the response rate of 98%. Of these participants, 106(62.4%) were male. Over half (51.2%) of the COVID-19 positive patients had good knowledge on transmission of COVID-19; about 64.4% had more accurate knowledge on prevention; ; about 62.9% had more positive attitude on prevention; and about half, 47.1% had poor practices of the precautionary measures against COVID-19. Participants who had more accurate knowledge for preventing COVID-19and more positive attitude of preventing COVID-19were 95%times (AOR=0.05, 95% CI =0.012 – 0.18) and 68% (AOR=0.32, 95% CI = 0.1 - 1.02) less likely, respectively, to implement the precautionary measures of COVID-19.Conclusion: Our findings suggest the need for effective and tailored health education programs aimed at improving COVID-19 knowledge, thereby leading to more favorable attitudes and to implementation and maintenance of safe practices.