bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal Educational Level Determine Mother-to-child Transmission of HIV Among HIV-exposed Infants in Governmental Health Facility of Bahir Dar City, Northwest Ethiopia.
Authors: Birhanu Minyichil , Ergetie Temesgen , Tenna Tiwobista , Ayana Tsehayinesh , Dessie Workie , Belay Workensh
Published: January 2021

Background: Globally at the end of 2011, 3.2 million children under the age of 15 were living with HIV, among these children 91% found in Africa. In Ethiopia, one of every three children born to these women is infected with HIV. This study was done to determine mother-to-child transmission of HIV infection and its factors among HIV-exposed infants on PMTCT service. Method: An institutional-based cross-sectional study was conducted among randomly selected 423 HIV exposed infants on PMTCT service in Bahir Dar city public health facility. Data were collected through chart review by using a pre-tested and structured checklist. Data was entered into Epi-data version 3.1 and exported to SPSS version 20 for analysis. The dependent variable association with explanatory variables was determined using logistic regression. Statistical significance was considered at p-value <0.05 with 95% CI. Result: The proportion of mother-to-child transmission of HIV infection among HIV-exposed infants on PMTCT services was 9.9%. Maternal educational status (AOR=3.196; 95% CI: 1.161-8.797), ANC follow-up (AOR=5.414; 95% CI: 1.860-15.761), age of infant at HIV infection confirmed (AOR=0.088; 95% CI: 0.033-0.238), and maternal CD4 count (AOR=3.162; 95% CI: 1.295-7.720) were factors significantly associated with mother-to-child transmission of HIV.Conclusion: The overall proportion of mother-to-child transmission of HIV infection among HIV exposed infants on PMTCT service were significantly high. This was due to low maternal educational status, absence of ANC follow-up, age of the infant at HIV infection confirmed, and low maternal CD4 count. Therefore, promoting women’s education, antenatal care, age of the infant at HIV test, and maintaining maternal CD4 count should be a great concern for health policymakers and health service providers.
Peripapillary Vessel Density Measurement of Quadrant and Clock-Hour Sectors in Primary Angle Closure Glaucoma Using Optical Coherence Tomography Angiography
Authors: Lin YongDong , Chen ShiRong , Zhang MingZhi
Published: January 2021

Background: The purpose of this study was to investigate peripapillary vessel density of primary angle closure glaucoma (PACG) eyes in quadrant and clock-hour sectors, and the diagnostic ability of peripapillary vessel density was also studied.Methods: This was a cross-sectional study on forty-one PACG patients(50 eyes)and twenty-seven healthy subjects(27 eyes). The optic disc was imaged using a 1050-nm-wavelength swept-source optical coherence tomography system (DRI OCT Triton, TOPCON). Peripapillary vessel density was quantified by imageJ software. Characteristics of peripapillary vessel density of quadrant and clock-hour sectors were analyzed, and diagnostic capability was evaluated by areas under the receiver operating characteristics curves (AUCs).Results: Compared to the control group, four quadrants and each clock-hour sectors of peripapillary vessel density of glaucomatous group decreased to different degrees, and vessel density reduced most at 7 o'clock. Except 4 o'clock, there was not any statistical difference between the diagnostic ability of peripapillary vessel density and peripapillary retinal nerve fiber layer thickness. The inferior quadrant peripapillary vessel density had the best diagnostic value (AUCs0.944), followed by 7 o'clock vessel density (AUCs0.937), average vessel density (AUCs0.926) and 7 o'clock RNFL thickness (AUCs0.922).Conclusions: In PACG, the diagnostic ability of peripapillary vessel density is equivalent to peripapillary retinal nerve fiber layer thickness. Understanding spatial characteristics of peripapillary vessel density in PACG may be helpful for clinical diagnosis and treatment.
Aluminium Release and Fluid Warming: Provocational Setting and Devices at Risk
Authors: Perl Thorsten , Nils Kunze-Szikszay , Bräuer Anselm , Michael Quintel , Roy Terrance , Kerpen Klaus , Telgheder Ursula
Published: January 2021

BACKGROUND: Fluid warming, recommended for fluid rates of > 500 ml h-1, is an integral part of patient temperature management strategies. Fluid warming devices using an uncoated aluminum containing heating element have been reported to liberate aluminum resulting in critical aluminum concentrations in heated fluids. We investigated saline solution (0.9%), artificially spiked with organic acids to determine the influence of fluid composition on aluminum liberation using the uncoated enFlow® device. Additionally the Level1® as a high volume fluid warming device and the ThermoSens® device were investigated. RESULTS: Saline solution spiked with lactate more than acetate, especially at a non acid pH, led to high aluminum liberation. Next to the enFlow® device, aluminum liberation was observed for the Level1® device, but not for the coated TermoSens®-device. CONCLUSION: Uncoated aluminum containing fluid warming devices lead to potential toxic levels of aluminum in heated fluids, especially in non acid fluids containing organic acids and their salts.
Melatonin Enhances Osteoblastogenesis from Senescent Mesenchymal Stem Cells via MMSET Mediated Chromatin Remodeling
Authors: Liu Zhiqiang , Xie Ying , Han Na , Wang Sheng , Wei Xuelei , Wang Jingya , Guo Jing , Jiang Hongmei , Wang Jingjing , Li Xin , Bian Xiyun , Hu Meilin , Zhu Zhongjiao , Wang Lijuan , Zhang Hui , Liu Chunhua , Liu Xiaozhi
Published: January 2021

Large numbers of elderly people have aging-associated osteoporosis, but efficient approaches to ameliorate bone loss are limited due to our poor understanding of the underlying mechanisms. In this study, we found that melatonin levels in bone marrow decreased with age, and melatonin primarily enhanced the osteogenic potential of mesenchymal stem cells (MSCs) derived from elderly donors compared with fetal- or young adult-derived MSCs. Mechanistic studies indicated melatonin treatment alleviated the senescence-related hypermethylation of the MMSET promoter, leading to elevated expression of the histone methyltransferase NSD2, and promoted the histone H3 dimethylation modification at lysine 36 of the osteogenic genes RUNX2 and SP7/OSTERIX as a consequence. MMSET depletion partially abolished the effects of melatonin on osteogenesis in senescent MSCs in vitro. Moreover, melatonin treatment promoted bone formation and alleviated the progression of osteoporosis in a mouse model of aging. Clinically, severity of senile osteoporosis (SOP) in patients was associated with melatonin levels in bone marrow plasma and the MMSET expression in MSCs, and melatonin treatment enhanced osteoblastogenesis from MSCs derived from SOP patients. Our study discovered a previously unreported epigenetic regulatory role for melatonin in alleviating MSC senescence and suggests that melatonin may be a potent agent for preventing aging-associated osteoporosis.
NeoAPACHE Study Protocol Ii. Relationship Between Radiographic Pulmonary Area and Pulmonary Hypertension, Mortality, and Hernia Recurrence in Newborns With CDH.
Authors: Amodeo Ilaria , Pesenti Nicola , Raffaeli Genny , Macchini Francesco , Condò Valentina , Borzani Irene , Persico Nicola , Fabietti Isabella , Bischetti Giulia , Colli Anna Maria , Ghirardello Stefano , Gangi Silvana , Colnaghi Mariarosa , Mosca Fabio , Cavallaro Giacomo
Published: January 2021

To investigate the relationship between radiographic lung area and systolic pulmonary artery pressure (sPAP) on the first day of life, mortality, and hernia recurrence during the first year of life in infants with a congenital diaphragmatic hernia (CDH). Retrospective cohort study on 77 CDH newborns. Lung area was calculated by tracing the lung’s perimeter, excluding mediastinal structures and herniated organs, on the preoperative chest X-ray performed within 24 hours after birth. Echocardiographic sPAP value, deaths, and recurrence cases were recorded. Logistic and linear regression analyses were performed. Deceased infants showed lower areas and higher sPAP values. One cm2 of rising in the total, ipsilateral, and contralateral area was associated with a 22%, 43%, and 24% reduction in mortality risk. sPAP values showed a decreasing trend at birth, with a maximum of 1.84 mmHg reduction per unitary increment in the ipsilateral area. Recurrence patients showed lower areas, with recurrence risk decreasing by 14% and 29% per unit increment of the total and ipsilateral area.In CDH patients, lung area at birth reflects impaired lung development and defect size, being associated with increased sPAP values, mortality, and recurrence risk.Clinical Trial Registration: The trial was registered at ClinicalTrials.gov with identifier NCT04396028.
Preoperative Versus Postoperative Use of Transversus Abdominis Plane Block With Nonliposomal Bupivacaine on Postoperative Narcotic Use: A Retrospective Study.
Authors: Kalu Richard , Boateng Peter , Carrier Lauren , Garzon Jaime , Tang Amy , Reickert Craig , Stefanou Amalia
Published: January 2021

Background: Enhanced recovery protocols optimize pain control via multimodal approaches that include transversus abdominis plane (TAP) block. The aim of this study was to evaluate the effect of preoperative vs postoperative nonliposomal bupivacaine TAP block on postoperative narcotic use after colorectal surgery.Methods: A retrospective cohort study comparing postoperative narcotic use in patients who received preoperative (n = 240) vs postoperative (n = 22) nonliposomal TAP blocks. The study was conducted in a single tertiary care institution and included patients who underwent colorectal resections between August 2018 and January 2020. The study measured narcotics use in the postoperative and follow-up periods, operative details, length of stay, reoperation, and readmission rates.Results: Patients who received postoperative nonliposomal bupivacaine TAP blocks were less likely to require postoperative patient-controlled analgesia (PCA) (59.1% vs 83.3%; p = 0.012) and opioid medications on discharge (6.4% vs 16.9%; p = 0.004) relative to patients who received preoperative TAP. When needed, a significantly smaller amount of opioid was prescribed to the postoperative group (84.5 vs 32.0 mg, p = 0.047). No significant differences were noted in the duration of postoperative PCA use, amount of oral narcotic use, and length of stay.Conclusions: Nonliposomal bupivacaine TAP block administered postoperatively was associated with significantly lower need for postoperative PCA and discharge narcotics. Given the overall short length of stay for the 2 groups, further study is needed to justify the additional cost of liposomal bupivacaine TAP blocks for patients undergoing colorectal resections.
Assessing the Impact of the COVID-19 Pandemic on Medical Student Education
Authors: Castelli Grace , Diab Dinah , Scimeca Alicia , Mehta Chintan , Payne Nicolette , Mershon John , Ray Shagnik , DeLancey John , Lee Cheryl , Posid Tasha
Published: January 2021

Background: The full impact of the COVID-19 global pandemic has yet to be seen, yet medical education has already been critically disrupted. As U.S. hospitals were forced to aggressively limit non-essential care to preserve personal protective equipment and minimize COVID-19 exposure, in-person education and hands-on training was nearly eliminated for students. The objective of this study was to immediately and comprehensively investigate the impact of the COVID-19 pandemic on medical student education. Medical students in the U.S. were invited to complete an online survey about the impacts of the COVID-19 pandemic on their medical education experience. Students provided basic demographic information and answered questions about the impact of COVID-19 on their training/education, finances, and mental health. Results: Medical students reported nearly 18 fewer hours of patient care per week, an immediate switch to virtual learning (74%) along with grading changes (62%), and widespread cancellation of national exams. Additionally, 55% of fourth year students graduated early to provide direct clinical care. Students across years felt that changes from the pandemic would negatively affect their residency applications and that upcoming rotations would be impacted (p<0.001). Students reported that the pandemic had negatively affected their finances, increased their anxiety/stress, increased their feelings of burnout, and negatively impacted their work-life balance (p<0.001). Conclusion: Medical education has been critically impacted by COVID-19. Student perceptions and evaluation of experiences to date should be considered as educators prepare to ready students for academic and professional transitions in the context of continued COVID-19 disruptions and distanced learning.
Comparative Chloroplast Genome Analysis of Impatiens Species (Balsaminaceae) in the Karst Area of China: Insights Into Genome Evolution and Phylogenomic Implications.
Authors: Luo Chao , Huang WuLue , Sun Huayu , Yer Huseyin , Li Xinyi , Li Yang , Yan Bo , Wang Qiong , Wen Yonghui , Huang Meijuan , Huang Haiquan
Published: January 2021

Background: Impatiens, a controversial and complex genus, which belongs to the family Balsaminaceae with approximately 1000 species. The genus is well known for economical, medicinal, ornamental, and horticultural values. However, Due to the morphological features and insufficient genomic resources, their analyses of germplasm identification and molecular phylogeny are very limited. Results: We have sequenced the chloroplast genomes of six different species (I. chlorosepala, I. fanjingshanica, I. guizhouensis, I. linearisepala, I. loulanensis, and I. stenosepala) in the karst area of China and compared them with previously published species and the monospecific sister Hydrocera triflora belonging to Balsaminaceae family. We comtrasted the genome features, repeat sequences, sequence divergence, and constructed the phylogenetic relationships. The 12 complete chloroplast genomes of the Balsaminaceae species ranged in size from 151,538 bp (I. fanjingshanica) to 154,189bp (H. triflora ) encoded 114 total distinct genes except for I. glandulifera and H. triflora, including 81 protein-coding, 29 transfer RNA genes(tRNA), and 4 ribosomal RNA genes (rRNA). Moreover, the characteristics of the long repeats sequences and simple sequence repeats (SSRs) were found. Divergent hotspots regions psbK-psbI,trnT-GGU-psbD, rpl36-rps8, rpoB-trnC-GCA, trnK-UUU-rps16, trnQ-UUG, trnP-UGG-psaJ, trnT-UGU-trnL-UAA, and ycf4-cemA were identified in the 12 Balsaminaceae chloroplast genomes, which could be suitable for species identification and phylogenetic studies. Additionally, phylogenetic relationships based on Maximum likelihood (ML) and Bayesian inference (BI) among whole chloroplast genomes showed that H. triflora was the basal group in Balsaminaceae and I. guizhouensis was the basal group in impatiens species. Besides this, cultivated species(I. balsamina, I. hawkeri, and I. walleriana) were clustered together. Conclusion: Our study provides detailed information about nucleotide diversity hotspots and characterized types of repeats, which can be used for developing molecular markers applicable in Balsaminaceae species. And also we reconstructed and analyzed the relationships of some impatiens species and discovered their status based on the complete chloroplast genomes. The current study might provide valuable significant genomic information for the systematics and evolution in the Balsaminaceae.
Prevalence of Hereditary Cancer Susceptibility Syndromes (HCSS) in Acute Lymphoblastic Leukemia (ALL): A Cross-Sectional Study in a Highly Consanguineous Population.
Authors: Aslam Sara , NA Shabana , Ahmed Mehboob
Published: January 2021

Background: Hereditary cancer susceptibility syndrome (HCSS) has been reported to impact cancer predisposition at an early age, therefore, identification of HCSS has found to be crucial for surveillance, managing therapeutic interventions and referring the patients and their families for genetic counselling. The aims of this study are to assess the prevalence of HCSS as hereditary leukemia and hematologic malignancy syndrome by using ACMG guidelines and to assess parental consanguinity as the criterion for referring patients for the genetic counselling. Methods: A total of 300 acute lymphoblastic leukemia subjects were recruited from the Children’s Hospital, Lahore, Pakistan during the period of December 2018 to September 2019. Structured self-reporting questionnaire based on family and medical history of the disease was utilized for the data collection.Results: In our cohort, 60.40% of ALL patients were identified to have HCSS and among them 40.65% patients solely fulfil the criteria due to the presence of parental consanguinity. Parental consanguinity was shown to have protective impact on the onset at early age of disease [OD=0.44 (0.25-0.77), p-value= 0.00] while family history of cancer increase the risk of cardiotoxicity [OD= 2.46 (1.15-5.24), p-value=0.02]. Parental consanguinity in the population shows no significant impact on the family history of cancer and the number of relatives with cancer. Conclusions: The higher prevalence of HCSS in Pakistani population is attributed to the presence of parental consanguinity in more than 50% of the patients when assessed through ACMG guidelines. Our study suggests revisiting ACMG guidelines for the criterion of parental consanguinity in the highly consanguineous population and formulating the score based criteria for the identification of inherited ALL for genetic counselling.
Sexual Dysfunction in Iranian Older Women and its Predictors: A Cross- Sectional Study
Authors: Naeeni Masoumeh Rajabi- , Dehdari Tahereh , Jamshidimanesh Mansoureh , Janani Leila
Published: January 2021

Background: The population of older women is rapidly increasing in every country in the world, including Iran. Given the effect of Sexual Function (SF) and sexual health on older women’s health, the present study was conducted to determine Sexual Dysfunction (SD) and the factors predicting it in Iranian older women in Karaj. Methods: The present cross-sectional study was conducted on 550 eligible older women selected by stratified cluster sampling from those visiting health centers in Karaj between October 2019 and February 2020. Data were collected using self-report questionnaires including demographic questionnaire, the hospital anxiety and depression scale (HADS), and the Female Sexual Function Index (FSFI). To take account of the effect of sampling design on the analyses, survey command in Stata-14 was used. Results: A total of 94.5% of the participating women had SD, 74.4% reported desire disorder, 79.8% arousal disorder, 57.6% lubrication disorder, 65.3% orgasm disorder, and 72.2% sexual dissatisfaction, and 52.4% had dyspareunia. The participating women’s SF had significant relationships with physical activity, hysterectomy, spouse’s SD, and the intimate and emotional closeness with the spouse (P<0.05). SF had significant inverse relationships with age, duration of marriage and menopause, anxiety, and depression (P<0.001). Nonetheless, SF had no significant relationship with occupation, education, smoking, and type and frequency of childbirth. The results of the linear regression test showed that the duration of menopause (B=-0.04, P=0.023), spouse’s SD (B=-0.95, P<0.001), intimacy (B=13.89, P<0.001), emotional closeness (B=6.49, P<0.001), anxiety (B=-0.08, P=0.033), and depression (B=-0.24, P<0.001) predicted the participating women’s SF significantly. Conclusion: The majority of the participating women had SD. Attention mental health, spousal relationship, and spouse’s sexual health may have significant positive effects on the sexual health of Iranian older women.
Bacteroides Uniformis CECT 7771 Alleviates Inflammation Within the Gut-adipose Tissue Axis, Involving TLR5 Signaling, in Diet-Induced Obese Mice
Authors: Fabersani Emanuel , Portune Kevin , Campillo Isabel , López-Almela Inmaculada , Paz Sergio Montserrat-de la , Romaní-Pérez Marina , Benítez-Páez Alfonso , Sanz Yolanda
Published: January 2021

This study investigated the immune mechanisms whereby administration of Bacteroides uniformis CECT 7771 reduces metabolic dysfunction in obesity. C57BL/6 adult male mice were fed a standard diet or a Western diet high in fat and fructose, supplemented or not with B. uniformis CECT 7771 for 14 weeks. B. uniformis CECT 7771 reduced body weight gain, plasma cholesterol, triglyceride, glucose, and leptin levels; and improved oral glucose tolerance in obese mice. Moreover, B. uniformis CECT 7771 modulated the gut microbiota and immune alterations associated with obesity, increasing Tregs and reducing B cells, total macrophages and the M1/M2 ratio in both the gut and epididymal adipose tissue (EAT) of obese mice. B. uniformis CECT 7771 also increased the concentration of the anti-inflammatory cytokine IL-10 in the gut, EAT and peripheral blood, and protective cytokines TSLP and IL-33, involved in Treg induction and type 2 innate lymphoid cells activation, in the EAT. It also restored the obesity–reduced TLR5 expression in the ileum and EAT. The findings indicate that the administration of a human intestinal bacterium with immunoregulatory properties on the intestinal mucosa helps reverse the immuno-metabolic dysfunction caused by a Western diet acting over the gut-adipose tissue axis.
Fecal Microbiota Dynamics During Disease Activity and Remission in Newly Diagnosed and Established Ulcerative Colitis
Authors: Öhman Lena , Lasson Anders , Strömbeck Anna , Isaksson Stefan , Hesselmar Marcus , Simrén Magnus , Strid Hans , Magnusson Maria
Published: January 2021

Patients with ulcerative colitis (UC) have an altered gut microbiota composition, but the microbial relationship to disease activity needs to be further elucidated. Therefore, temporal dynamics of the fecal microbial community during remission and flare was determined. Fecal samples were collected at 2–6 time-points from UC patients during established disease (cohort EST) and at diagnosis (cohort NEW). Sampling range for cohort EST was 3–10 months and for cohort NEW 36 months. Relapses were monitored for an additional three years for cohort EST. Microbial composition was assessed by Genetic Analysis GA-map™ Dysbiosis test, targeting ≥ 300 bacteria. Eighteen patients in cohort EST (8 with maintained remission and 10 experiencing a flare), provided 71 fecal samples. In cohort NEW, 13 patients provided 49 fecal samples. The microbial composition showed no clustering related to disease activity in any cohort. Microbial dissimilarity was higher between than within patients for both cohorts, irrespective of presence of a flare. Microbial stability within patients was constant over time with no major shift in overall composition nor modification in the abundance of any specific species. Microbial composition was not affected by intensified medical treatment or linked to future disease course. Thus in UC, the gut microbiota is highly stable irrespective of disease stage, disease activity or treatment escalation. This suggests that prolonged dietary interventions or repeated fecal transplantations are needed to be able to induce permanent alterations of the gut microbiota.
Sustainability, Productivity, Profitability and Soil Health With Conservation Agriculture-Based Sustainable Intensification of Oilseed Brassica Production System
Authors: Jat R.S. , Choudhary R.L. , Singh H.V. , Meena M.K. , Singh V.V. , Rai P.K.
Published: January 2021

Conservation Agriculture (CA) practices getting space world-wide to answer many emerging challenges like; declining factor productivity, deteriorating soil health, water scarcity, climate change, and farm profitability and sustainability. Oilseed brassica (Indian mustard, Brassica juncea L.), a winter oilseed grown under rainfed agro-ecosystem vulnerable to low yields, high production cost, degrading soil and water quality, and climatic vagaries. The present study was undertaken on CA-based sustainable intensification of Indian mustard for enhancing inputs efficiencies, farm profitability and sustainability. Permanent beds with residue retention (PB+R) improved mustard equivalent yield (11.4%) and system grain yield (10.6%) compared to conventional tillage without residue (CT-R). Maize-mustard (Mz-M) increased system grain yield (142.9%) as well as mustard equivalent yield (60.7%) compared to fallow-mustard (F-M). Mz-M system under PB+R increased sustainable yield index (376.5%), production efficiency (177.2%), economic efficiency (94%) and irrigation water productivity (66%) compared to F-M under CT-R. PB+R increased soil organic carbon (SOC) stock at 0-15 cm (17.7%) and 15-30 cm (29.5%) soil depth compared to CT-R. Intensification of F-M system with green gram–mustard (GG-M) improved SOC at 0-15 cm (27.4%) and 15-30 cm (20.5%) compared to F-M. CA-based cluster bean-mustard/GG-M system increased N productivity, whereas, P and K productivity improved with Mz-M system compared to F-M under CT-R. Thus, CA-based Mz-M system should be out-scaled in the traditional rainfed fallow-mustard system to improve the farm production and income on holistic basis to make the country self-sufficient in edible oils.
What Facilitates and Hinders the Implementation of Nurse-Led Interventions in Long-Term Dementia Care? A Qualitative Interview Study With Swiss Nursing Experts and Managers
Authors: Hirt Julian , Karrer Melanie , Adlbrecht Laura , Saxer Susi , Zeller Adelheid
Published: January 2021

Background: To support the implementation of nurse-led interventions in long-term dementia care, in-depth knowledge of specific supporting factors and barriers is required. Conditions and structures of caring for people with dementia differ widely, depending on the country and the care context. Our study aimed to describe the experiences and opinions of nursing experts and managers with regard to facilitators and barriers to the implementation of nurse-led interventions in Swiss long-term dementia care.Methods: We conducted a qualitative descriptive study using individual interviews based on qualitative vignettes as a useful stimulus to generate narrations allowing to study peoples’ perceptions and beliefs. The study took place in nursing homes in the German-speaking part of Switzerland and in the Principality of Liechtenstein using purposive sampling. We intended to conduct the interviews face-to-face in a quiet room according to the participant’s choice. However, due to the lockdown of nursing homes during the COVID-19 pandemic in spring 2020, we performed interviews face-to-face and by video. We analysed data thematically following Braun and Clarke to achieve a detailed, nuanced description. To verify our interpretation and to ensure congruence with participants’ perspectives, we conducted member checks. The Standards for Reporting Qualitative Research (SRQR) served to structure our manuscript.Results: Six dyads of nursing home managers and nursing experts from six nursing homes took part in our study (n=12). Our thematic analysis yielded seven themes reflecting facilitators and barriers to implementing nurse-led interventions in Swiss long-term dementia care: «A common attitude and cohesion within the organization», «Commitment on several levels», «A needs-oriented implementation», «The effect and the public perception of the intervention», «A structured and guided implementation process», «Supporting knowledge and competencies», as well as «Resources for implementing the intervention».Conclusions: Successful implementation of nurse-led interventions in dementia care is highly challenging due to the complex nature of interventions. Therefore, it is important to know the facilitators and barriers to optimally design implementation strategies. Our results might support researchers and other key persons involved in implementing nurse-led interventions in Swiss long-term dementia care.
Torsion of Epiploic Appendix Following Chiropractic Movements: A Case Report
Authors: Etezadpour Mohammad , Sharifi Seyed Hassan Seyed , Behnamfar Morteza , Hosseinzadeh Rezvan
Published: January 2021

BackgroundAn epileptic appendix torsion is a rare event that can lead to acute abdominal pain and occurs at any age. Chiropractic is a type of complementary medicine that is performed explicitly by spinal manipulations. Specialists use spinal manipulation to treat many musculoskeletal disorders, usually mechanical back and neck pain, headaches, and spinal stiffness. Case presentationA 49-year-old man with a history of progressive diffuse abdominal pain predominately in the left lower quadrant started three days ago was referred to Ghaem Hospital, Mashhad, Iran. All laboratory tests were normal, and no abnormal findings were observed on ultrasound and X-rays, but the CT scan revealed a definite diagnosis of appendicular torsion. Gastrointestinal rest, antibiotics, analgesics, and fluid therapy were started for the patient. After 72 hours, the patient's general condition improved, and he was discharged from the hospital. In this report, we presented a case who developed acute abdominal pain after spinal manipulation. Chiropractic is not a completely safe treatment and can cause irreversible damage, so we should know this method's dangers and have enough experience to provide the best and safest medical services for patients.
Impact of Working Together for Adults with Autism Spectrum Disorder: A Multifamily Group Intervention
Authors: DaWalt Leann , Hickey Emily , Hudock Rebekah , Esler Amy , Mailick Marsha
Published: January 2021

Background. Adults with autism spectrum disorder (ASD) have lower participation in post-secondary education, higher rates of unemployment/underemployment, and continued difficulties with challenging behavior and mental health problems compared to their peers. Multi-family psychoeducation emphasizes education and problem-solving with the goal of improving outcomes for the individual with the disability.Methods. Using a randomized waitlist control design, the present study evaluated a multi-family group psychoeducation intervention, Working Together, for adults on the autism spectrum without intellectual disability (n=40). Five waves of data were collected at three-month intervals. In this design, families in the intervention condition participated in intervention during the 6 months between baseline and Time 3 data collection; the waitlist control condition received the intervention immediately after the Time 3 data collection. We compared these two conditions, intervention group vs waitlist control group, on key outcomes for the adults with ASD: engagement in work, engagement in positive activities, and behavior problems.Results. Results indicated that the Working Together intervention was associated with increases in engagement as well as decreases in behavior problems, particularly internalizing problems. We also found maintenance of the treatment effect through 6 months post-treatment for the intervention group and replication of the treatment effect within the control group after they received the intervention.Conclusion. Working Together is a promising multi-family group psychoeducation intervention designed to improve functioning during adulthood. These findings highlight the need for more intervention services research during adulthood and specifically the need for family-centered supports.
In Vitro Antioxidant, Membrane Stabilizing and Antimicrobial Properties of Murayya paniculata Wild Plant of Amarkantak (M.P)
Authors: Sonter Shruti , Mishra Shringika , Dwivedi Manish , Singh Prashant
Published: January 2021

The excessive usage of antibiotics in humans and veterinary medicine has lead to the emergence of antibiotic resistance and requirement of novel antibiotics. There has been increased interest towards plants as source of drugs because of their pharmacological potency and long traditional usage. The aim of the current study was to evaluate bioactive components, antioxidant and anti-inflammatory activity from the leaf extracts of Murayya paniculata, a traditionally used Indian medicinal plant. Evaluations were made for phytochemicals, antioxidant, membrane stabilizing and antimicrobial activities. The methanol extract displayed highest flavonoid and phenolic content while the acetone extract demonstrated considerable ABTS inhibitory activity (IC50value:555.18 ± 1.68 µg/mL) and hexane extract exhibited highest H2O2 radical scavenging activity (IC50value: 509.84 ± 3.03 µg/mL). The aqueous extract displayed 19.4 ± 0.66% RBC hemolysis and 80.5 ± 0.66% protection caused by hypotonic solution at high concentration of extract. The fractions of hexane extract revealed a higher zone of inhibition than crude extract. The major components found in the fractions were cyclohexane (40.11%) and 3-(6-Methoxy-3-methyl-2-benzofuranyl) Cyclohexanone (13.68%) analyzed by GC-MS technique. The current results validate the traditional use of the plant and warrant its potential in drug development programs in further investigations.
Overexpression of PVR and PD-L1 and Its Association With Prognosis in Surgically Resected Squamous Cell Lung Carcinoma 
Authors: Lee Jii Bum , Hong Min Hee , Park Seong Yong , Chae Sehyun , Hwang Daehee , Ha Sang-Jun , Shim Hyo Sup , Kim Hye Ryun
Published: January 2021

Background: Targeting T-Cell Immunoreceptor with Ig and ITIM domain-poliovirus receptor (PVR) pathway is a potential therapeutic strategy in lung cancer. We analyzed the expression of PVR and programmed death ligand-1 (PD-L1) in surgically resected squamous cell lung carcinoma (SQCC) and determined its prognostic significance.Methods: We collected archival surgical specimens of 259 patients with SQCC at Yonsei Cancer Center (1998–2020). Analysis of variance was used to analyze the correlations between PVR and PD-L1 expression and patient characteristics. Kaplan–Meier curves were used to estimate recurrence-free survival (RFS) and overall survival (OS). Results: Most patients were male (93%); the majority were diagnosed with stage 1 (47%), followed by stage 2 (29%) and stage 3 (21%). Overexpression of PVR resulted in a significantly shorter median RFS and OS (P = 0.01). PD-L1 expression was not significant in terms of prognosis. Patients were subdivided into four groups based on low and high PVR and PD-L1 expression. Those expressing high levels of PVR and PD-L1 had the shortest RFS (P = 0.03).Conclusions: PVR overexpression is associated with a poor prognosis in surgically resected SQCC. Inhibition of PVR as well as PD-L1 may help overcome the lack of response to immune checkpoint monotherapy.
Helicobacter Pylori Infection Increases the Incidence of Erosive Oral Lichen Planus and Alters the Oral Microbiome Composition
Authors: Zhang Yangheng , Li Shutong , Li Jingyuan , Li Ya , Li Huanjie , Li Wenjuan , Jia Jihui , Ge Shaohua , Sun Yundong
Published: January 2021

Background Oral lichen planus (OLP), a common clinical oral disease, is associated with an increased risk for malignant transformation. The mechanism underlying the pathogenesis of OLP is unknown. Oral dysbacteriosis is reported to be one of the etiological factors for OLP. Although H. pylori infection is associated with various oral diseases, the correlation between H. pylori infection and OLP is unclear. This study aimed to investigate the effect of H. pylori infection on OLP pathogenesis and oral microbiome composition in the Chinese population, which has a high incidence of H. pylori infection.Result In this study, the saliva samples of 30 patients with OLP (OLP group) and 21 negative controls (NC group) were collected. H. pylori infection was detected using the carbon-14 urea breath test. The saliva samples were divided into the following four groups based on the H. pylori infection status: H. pylori-positive OLP (OLP+), H. pylori-positive NC (NC+), H. pylori-negative OLP (OLP−), and H. pylori-negative NC (NC−) groups. The oral microbiome composition was significantly different between the OLP and NC groups and between the OLP− and OLP+ groups. Compared with those in the OLP− group, the incidence of erosive OLP and the salivary levels of cytokines were higher in the OLP+ group. In contrast, the oral microbiome composition and cytokine levels were not significantly different between the NC− and NC+ groups.Conclusions This is the first report demonstrated that H. pylori infection is significantly correlated with the pathogenesis of erosive OLP. The alleviation of H. pylori infection may decrease the incidence of erosive OLP.
Anoikis Resistance and Development in Prostate Cancer: The Possible Role of HPV/EBV Coinfection
Authors: Nahand Javid Sadri , Khanaliha Khadijeh , Mirzaei Hamed , Moghoofei Mohsen , Baghi Hossein Bannazadeh , Esghaei Maryam , Khatami AliReza , Fatemipour Maryam , Bokharaei-Salim Farah
Published: January 2021

Background: This study aimed to evaluate the possible role of EBV/HPV co-infection as an etiologic factor in prostate cancer (PCa) development.Methods: The present case‐control research was conducted on 67 cases with prostate cancer and 40 controls. The expression of cellular and viral factors involved in inflammation, tumor progression, and metastasis were quantitated using ELISA and qRT-PCR.Results: The EBV/HPV co-infection was reported in 14.9% of case group and 7.5% of control group. The high-risk type of HPV, including HPV 16 and 18, were responsible for 50% and 30% of 10 HPV/EBV co-infected PCa samples, respectively. According to the results, a significant relationship was not observed between the PCa and HPV/EBV co-infection (OR=2.9, 95%CI=0.18-45.2, P=0.31). However, the highest percentage of HPV genome integration was found in HPV/EBV coinfected PCa group (8/10, 80%). Moreover, the mean expression levels of inflammatory factors (IL-17, IL-6, TNF-α, NF-κB, VEGF, ROS and RNS), anti-apoptotic mediators (Bcl-2 and Survivin), and anti-anoikis factors (TWIST, N-cad) were higher significantly in the HPV/EBV co-infected PCa cases when comparing with the non-coinfected PCa samples. Nevertheless, the tumor suppressor proteins (p53 and Rb) and the E-cad (inhibiting anoikis resistance) had a significant downregulation in the HPV/EBV co-infected PCa cases than in the non-coinfected PCa samples. Conclusion: HPV/EBV co-infection probably can act as an etiologic factor in PCa through modulation of cellular behavior.
Genome-wide identification, characterization and expression analysis of BES1 gene family in tomato
Authors: Su Deding , Xiang Wei , Wen Ling , Lu Wang , Shi Yuan , Liu Yudong , Li Zhengguo
Published: January 2021

Background: As the key regulators in BR signaling, BES1 family genes regulate thousands of target genes involved in various development processes. So far, the functions of BES1 family are poorly understood in tomato, and a comprehensive genomic and expressional analysis is worth to conduct for this family.Results: Here, nine SlBES1 family members were identified in tomato and classified into five groups based on the conserved motif, gene structure and phylogenetic analysis. Synteny among tomato, Arabidopsis, pepper and rice were further analyzed to obtain insights into evolutionary characteristics. Several cis-elements related to hormone, stress and plant development were exhibited in the promoter regions of SlBES1 family genes. Subcellular localization showed seven members localized both in the nucleus and cytoplasm, implying the presence of dephosphorylated and phosphorylated form of these seven proteins, furthermore, five of them possessed transcription activation activity whereas the left two functioned as transcriptional repressors. Another two members, however, neither localized in the nucleus nor had transactivation activity. Besides, SlBES1.8 showed flower-specific expression while other members expressed ubiquitously in all organs. Moreover, SlBES1 genes exhibited variational expression in response to nine principal plant hormones. Notably, the expression levels of SlBES1 genes presented a dominant downregulated trend in response to stresses.Conclusions: In this study, we systematically analyzed the genomic characterization of SlBES1 family, together with the analyses of protein functional features and expression patterns, our results lay a foundation for the functional research of SlBES1 family.
Demand sensing and digital tracking for maternal child health (MCH) in Uganda: a pilot study for ‘E+TRA Health’
Authors: Wang Dawei , Kerh Rhoann , Jun Sungbum , Lee Seokcheon , Mayega2 Roy , Ssentongo Julius , Oumer3 Andualem , Haque Md , Brunese Priyanka , Yih Yuehwern
Published: January 2021

Background The Electronic tracking system for healthcare commodities (E+TRA Health) is an all-in-one out- of-box solution for supply chain management system of healthcare commodities for lower-level health facilities in rural areas. It aims to support real-time monitoring and decision-making to (1) reduce the time needed to prepare orders, (2) reduce stockout and overstock cases of targeted medical supplies, (3) help improve patient outcomes. In this study, we adopted an integrated approach to analyze the process of information flow, identify and address critical paths of essential supplies associated with maternal health in the Ugandan health system. Methods We apply system engineering principles and work with community partners in hospitals to develop care process workflow charts (based on essential services) for the lifecycle of maternal health continuum of care. Based on this chart, we develop a local cloud-based offline-compatible smart sync platform named “E+TRA Health” to triangulate 1) patient admission, diagnoses, delivery information, testing reports from laboratories, 2) inventory information from main store, stores in Maternal Child Health (MCH) unit, and 3) lab, to identify the critical list of medical and laboratory supplies, their lead times for procurement and then generate reports and suggested procurement plans for real time decision-making. Results The E+TRA Health platform was piloted in two Healthcare Center IV facilities in Uganda over a period of 6 months. The system collected more than 5,000 patient records and managed more than 500 types of medicines. The pilot study demonstrated the functionalities of E+TRA Health and its feasibility to sense demand from point of care. Conclusion E+TRA Health is the first to triangulate supply and demand data from three different departments (main store, lab, and MCH) to forecast and generate orders automatically to meet patient demands. It is capable of generating reports required by MOH in real time compared to one-week lead-time using paper-based systems. This prompts frontline stakeholders to generate efficient, reliable and sustainable strategic healthcare plans with real time data. This system improves patient outcomes through better commodity availability by sensing true patient demands.
Factors Associated With Sarcopenia Screened by Finger-Circle Test Among Middle-Aged and Older Adults: A Population-Based Multisite Cross-Sectional Survey in Japan
Authors: Watanabe Daiki , Yoshida Tsukasa , Nakagata Takashi , Sawada Naomi , Yamada Yosuke , Kurotani Kayo , Tanaka Kenji , Okabayashi Megumi , Shimada Hidekazu , Takimoto Hidemi , Nishi Nobuo , Abe Keiichi , Miyachi Motohiko
Published: January 2021

Background: Prior epidemiological studies have demonstrated the prevalence and the relationship of various factors associated with sarcopenia in older adults; however, few have examined sarcopenia status in middle-aged adults. In the present study, we aimed: 1) to evaluate the validity of the finger-circle test, which is potentially a useful screening tool, for assessing sarcopenia, and 2) to determine the prevalence and factors associated with sarcopenia in middle-aged and older adults.Methods: We conducted a face-to-face survey with 525 adults aged 40−91 years residing in Settsu City, Osaka Prefecture, Japan to evaluate the validity of finger-circle test. The finger-circle test was evaluated calf circumference by referring to an illustration printed on the survey form. To assess sarcopenia, the area under the receiver operating characteristic curves (AUROC) was plotted to evaluate the validity of the finger-circle test compared to sarcopenia evaluation by skeletal muscle mass index (SMI) measured using bioimpedance. We also conducted a multisite population-based cross-sectional anonymous mail surveys of 9337 adults aged 40−97 years residing in Settsu and Hannan Cities, Osaka Prefecture, Japan. Participants were selected through stratified random sampling by sex and age group, in the elementary school zones of their respective cities. We performed multiple logistic regression analysis to explore associations between characteristics and prevalence of sarcopenia.Results: Sarcopenia, defined by SMI, was moderately predicted by a finger-circle test response showing that the subject’s calf was smaller than their finger-circle (AUROC: 0.729, <65 years; 0.653, ≥65 years); such subjects were considered to have sarcopenia. In mail surveys, prevalence of sarcopenia was higher in older subjects (approximately 16%) than in middle-aged subjects (approximately 8−9%). In a multiple regression model, the factors associated with sarcopenia were age, body mass index, smoking status, self-reported health, and number of meals in all the participants.Conclusions: Sarcopenia, screened by the finger-circle test, was present not only among older adults but also among middle-aged adults. These results suggest the importance of providing middle-aged and older adults with the opportunity to individually perform a test that could enable them to identify sarcopenia.Trial registration: UMIN000008105, registered prospectively May 29, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027
Autophagy Induction in C12orf65 Mutation-related Autosomal Recessive Hereditary Spastic Paraplegia 
Authors: Wu Li , Xu Yang , Wang Qin , Xie Zhi-Ping , Dong You-Rong , Liu Jian-Ren , Vinnikov Ilya A. , Lai Qing-Xuan , Chen Wei
Published: January 2021

Background: Spastic paraplegia type 55 (SPG55) is an autosomal recessive complicated hereditary spastic paraplegia. Here we report an SPG55 case with typical neurological phenotypes including optic atrophy, lower extremity spasticity and peripheral neuropathy. Methods: The present study involved one patient in a Chinese family. Neurological examination including the ophthalmology related examinations as well as nerve conduction velocity and a sural nerve biopsy were performed for the patient. We performed a genetic analysis of genes associated with peripheral neuropathy and spastic paraplegia using a multigene next-generation sequencing(NGS) panel and sanger sequencing. Furthermore, we cultured patient’s primary skin fibroblasts, then we examined the cytoplasmic LC3B immunofluorescence in the patient’s primary fibroblast and after two drugs (butylphthalide sodium chloride and idebenone) were used to the target the mitochondria function of the fibroblast.Results: Here we reported an SPG55 case with typical neurological phenotypes including optic atrophy, lower extremity spasticity and peripheral neuropathy. We identified a homozygous C12orf65 nonsense mutation (c.394C>T, p. R132*) in the affected patient. The mutation was associated with active autophagosome formation with increased LC3B puncta in the patient’s fibroblasts compared with an age-matched healthy individual, while the latter phenotype was normalized by Dl-3-N-butylphthalide treatment. Conclusions: This is the first pilot study to characterize the SPG55 mutation in the Chinese population; it will contribute to further research revealing the role of C12orf65 mutations in regulation of mitochondria function and autophagy.