bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early detection of cervical cancer in western Kenya: Determinants of healthcare providers performing a gynaecological examination for abnormal vaginal discharge or bleeding
Authors: Mwaliko Emily , Hal Guido Van , Bastiaens Hilde , Dongen Stefan Van , Gichangi Peter , Otsyula Barasa , Naanyu Violet , Temmerman Marleen 
Published: July 2020

Abstract
Background
In western Kenya, women often present with late-stage cervical cancer despite prior contact with the health care system. The aim of this study was to predict primary health care providers’ behaviour in examining women who present with abnormal discharge or bleeding
Methods
This was a cross-sectional survey using the theory of planned behaviour (TPB). A sample of primary health care practitioners in western Kenya completed a 59-item questionnaire. Structural equation modelling was used to identify the determinants of providers’ intention to perform a gynaecological examination. Bivariate analysis was conducted to investigate the relationship between the external variables and intention.
Results
Direct subjective norms, direct perceived behavioural control (PBC), and indirect measures of attitude predicted the intention to examine patients. Negative attitudes toward examining women had a suppressor effect on the prediction of health workers’ intentions. However, the main predictors with the highest coefficients were the external variables being a nurse as opposed to a clinical officer and workload of attending 20–50 patients per day. In bivariate analysis with intention to perform a gynaecological examination, there was no evidence that working experience, being female, having a lower workload, or being a private practitioner were associated with a higher intention to conduct vaginal examinations. Clinical officers and nurses were equally likely to examine women.
Conclusions
The TPB is a suitable theoretical basis to predict the intention to perform a gynaecological examination. Overall, the model predicted 47% of the variation in health care providers’ intention to examine women who present with recurrent vaginal bleeding or discharge. Direct subjective norms (health provider’s conformity with what their colleagues do or expect them to do), PBC (providers need to feel competent and confident in performing examinations in women), and negative attitudes toward conducting vaginal examination accounted for the most variance. External variables in this study also contributed to the overall variance. As the model in this study could not explain 53% of the variance, investigating other external variables that influence the intention to examine women should be undertaken.
Cognitive Visual Dysfunctions in Children with Autism Spectrum Disorders and Other Developmental Delays
Authors: Seo Jin Kyung , Kim Young Hoon , Park Eu Gene 
Published: July 2020

Abstract
Background: Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders characterized by a triad of social, communicative, and imaginative impairments. Although early detection and intervention are important to improve functional outcomes in ASD, similar features between ASD and other developmental delays may impede timely diagnosis. In this study, we aimed to investigate the feasibility of Cognitive Visual Assessment Questionnaire (CVAQ) in differentiating ASD from other developmental delays.Methods: We retrospectively reviewed the medical records of 115 pediatric patients (80 males, 35 females) with ASD and other developmental delays who had the Modified Checklist for Autism in Toddlers (M-CHAT) and CVAQ performed at Uijeongbu St. Mary's Hospital from January 2017 to June 2019. Results: The mean age at M-CHAT and CVAQ was 31.8 months (range, 14.1 – 48). The proportion of ASD was significantly higher in patients with screen-positive M-CHAT than those with screen-negative M-CHAT (P = 0.035). The sensitivity of CVAQ for detecting ASD was 83.3% and 94.1% in 14.1 – <24 months and 24 – <36 months age groups, respectively. Among patients with screen-negative M-CHAT, the mean number of failed tasks related to dorsal stream pathway was greater in ASD compared to other developmental delays, although the differences were not statistically significant (P = 0.437).Conclusions: Our study demonstrates that autistic individuals may have a specific impairment in dorsal stream functioning. CVAQ also showed improved sensitivity for detecting ASD in toddlers. When coupled with clinical observation and judgement, CVAQ is a useful alternative screening tool for differentiating ASD from other developmental delays in young children.
Transcriptome Analysis and Differential Gene Expression Profiling of Two Contrasting Quinoa Genotypes in Response to Salt Stress
Authors: Shi Pibiao , Gu Minfeng 
Published: July 2020

Abstract
Background: Soil salinity is one of the major abiotic stress factors that affect crop growth and yield, which seriously restricts the sustainable development of agriculture. Quinoa is considered as one of the most promising crops in the future for its high nutrition value and strong adaptability to extreme weather and soil conditions. However, the molecular mechanisms underlying the adaptive response to salinity stress of quinoa remain poorly understood. To identify candidate genes related to salt tolerance, we performed reference-guided assembly and compared the gene expression in roots treated with 300 mM NaCl for 0, 0.5, 2, and 24 h of two contrasting quinoa genotypes differing in salt tolerance.Results: The salt-tolerant (ST) genotype displayed higher seed germination rate and plant survival rate, and stronger seedling growth potential as well than the salt-sensitive (SS) genotype under salt stress. An average of 38,510,203 high-quality clean reads were generated. Significant Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were identified to deeper understand the differential response. Transcriptome analysis indicated that salt-responsive genes in quinoa were mainly related to biosynthesis of secondary metabolites, alpha-Linolenic acid metabolism, plant hormone signal transduction, and metabolic pathways. Moreover, several pathways were significantly enriched amongst the differentially expressed genes (DEGs) in ST genotypes, such as phenylpropanoid biosynthesis, plant-pathogen interaction, isoquinoline alkaloid biosynthesis, and tyrosine metabolism. 117 DEGs were common to various stages of both genotypes, identified as core salt-responsive genes, including some transcription factor members, like MYB, WRKY and NAC, and some plant hormone signal transduction related genes, like PYL, PP2C and TIFY10A, which play an important role in the adaptation to salt conditions of this species. The expression patterns of 21 DEGs were detected by quantitative real-time PCR (qRT-PCR) and confirmed the reliability of the RNA-Seq results. Conclusions: We identified candidate genes involved in salt tolerance in quinoa, as well as some DEGs exclusively expressed in ST genotype. The DEGs common to both genotypes under salt stress may be the key genes for quinoa to adapt to salinity environment. These candidate genes regulate salt tolerance primarily by participating in reactive oxygen species (ROS) scavenging system, protein kinases biosynthesis, plant hormone signal transduction and other important biological processes. These findings provide theoretical basis for further understanding the regulation mechanism underlying salt tolerance network of quinoa, as well establish foundation for improving its tolerance to salinity in future breeding programs.
The Mental Health Crises of the Families of COVID-19 Victims: A Qualitative Study
Authors: mohammadi fateme , Oshvandi Khodayar , Shamsaei Farshid , Cheraghi Fateme , bijani mostafa 
Published: July 2020

Abstract
Background: The bereaved families of COVID-19 victims are among the most vulnerable social groups in the COVID-19 pandemic. This highly infectious and contagious disease has afflicted these families with numerous psychological crises which have not been studied much yet. The present study is an attempt at investigating the psychological challenges and issues which the families of COVID-19 victims are faced with. The present study aims to identify the Mental Health crises which the families of COVID-19 deceased victims are going through.Methods: A qualitative research, the present study uses a conventional content analysis design. The participants were 16 members of the families of COVID-19 victims selected from medical centers in Iran from February to May 2020 via purposeful sampling. Sampling continued to the point of data saturation Data were collected via semi-structured individual interviews conducted online. The collected data were analyzed according to the conventional qualitative content analysis approach.Results: Analyses of the data yielded two main themes—emotional shock and fear of the future—with nine categories. Conclusion: The families of COVID-19 deceased victims are affected by various psychological crises which have exposed them to a deep sense of loss and emotional shock. In addition, the instability in the family following the loss of a family member and job insecurity due to the COVID crisis have caused them to be very worried about the future. Therefore, there is an urgent need for a cultural context which recognizes and supports all the various aspects of the mental health of these families.
Estimating Clinical Burden and Valuation of Weight Management Strategies (using Willingness to Pay - WTP) for Overweight and Obesity in Primary Care Setting in Borneo Sarawak, Malaysia
Authors: Ahmed Zafar , Bari Euphrasia Anak , Ahmed Noormah Z , Puteh Sharifa Ezat Wan 
Published: July 2020

Abstract
Background

Overweight and obesity is one of the most serious public health challenges of the 21st century. Despite the consequences of obesity, participation in weight management programs. Aim of this study is to estimate the clinical burden of obese patients in government primary care clinics in Kuching, Sarawak. We use randomized patients from these clinics to carry out a willingness to pay study for weight management and estimated the economic burden of overweight and obesity management in primary care setting in Sarawak. Identifying their willingness to pay will help in formulation and implementation of policies for effective weight management therefore improve the quality of care in future. Clinic based cross-sectional study involving 252 randomly overweight and obese patients (with BMI ≥ 23), age 18 to 59 years old, who attended outpatient department.
Results

Patients indicated their preference for three hypothetical weight reduction programs: diet, exercise, drug and combination of all. Data from secondary sources was used to estimate the prevalence of overweight and obesity in Sarawak. Out of 1,504,779 patients aged 18 to 59 years attending government health clinics in Sarawak, it was estimated that overweight and obesity would account for approximately 30% of total adult patients (451,433 patients). Conversion to USD was based on December 2015 conversion rate of USD 100 to MYR 430.31. The median willingness to pay was MYR 44.87 (USD 11.56), MYR 88.80 (USD 21.01), and MYR 60.18 (USD14.24) for Drug and Exercise, Diet and Exercise and Drug, Diet and Exercise respectively.
Conclusion

Resource allocation for weight management intervention in Sarawak, Malaysia depend on evaluation of weight management intervention (objectively measured by WTP) and the availability of fixed budget from State Health Department. The total WTP for weight reduction intervention via diet and exercise was MYR 22, 512, 963.71 (USD 5,231,801.19), while weight reduction intervention via drug, diet and exercise was MYR of 40, 087, 250.40 (USD 9,315,900.30 ) and weight reduction intervention via drug and exercise was MYR 27, 167, 237.94 (USD 6,313,410.78). Clinical and economic burden of overweight and obesity in Sarawak is substantial. Therefore implementation of effective policies and programs are essential in tackling obesity.
Melatonin Enhanced Short-term Salt Tolerance Through Improving Water Status in Maize Seedlings&nbsp;
Authors: Zhang Ningning , Yan Jiakun , Li Meng 
Published: July 2020

Abstract
Background: The beneficial effects of melatonin (MT) on enhancing plant salt stress tolerance has been widely studied. However, the underlying mechanism that involved in MT-mediated the detailed process of plant water uptake and transport under salt stress condition remains largely unknown. To detect the underlying mechanisms that exogenous melatonin application enhances plant salt resistance, the influence of MT (1 μM) on maize (Zea mays L.) seedlings growth under short-term salt stress (2h, 100 mM NaCl) was investigated. Result: Results showed exogenous MT had increased the endogenous MT content in maize root. Under normal condition exogenous MT application did not affected the growth of seedlings significantly, whereas under salt stress condition MT application produced 99% in root and 20.2% in biomass higher than that without MT. Salt stress decreased the leaf net photosynthetic rate, leaf stomatal conductance, leaf transpiration rate, root hydraulic conductance and whole plant hydraulic conductance (Lp) significantly, but exogenous application of MT mitigated these salt stress-induced decreases. Plants treated with MT held higher photosynthetic rate (24.3%), stomatal conductance (39.4%), and transpiration rate (40.7%) compared with untreated plants under salt stress. Compared with normal condition, salt decreased Lp by only 61% in melatonin-treated seedlings and decreased by 97% in untreated seedlings. RT-PCR and the aquaporin inhibitor mercury were used to detect role of aquaporin in this process. Under salt stress, melatonin increased specific aquaporin gene (ZmPIP1;6, ZmPIP2;3 and ZmPIP2;7) expression, and under HgCl2 treatment, there was no significant difference in transpiration rates of seedlings with and without MT, which confirmed that the aquaporin played an important role in exogenous MT-induced improved maize root water uptake capacity under salt stress.Conclusions: Taking all these results into consideration, this study indicates that exogenous melatonin pre-treatment enhances maize resistance to short-term salt stress by regulating Lp through improving expression and activity of root aquaporin.
Impact of Epley manoeuvre on self-perceived disability: A randomised controlled trial in primary care
Authors: Muñoz Ricard Carrillo , Moreno Jose Luis Ballve , Balboa Ivan Villar , Matos Yolanda Rando , Puertolas Oriol Cunillera , Perez Estrella Rodero , Curto Xavier Monteverde , Ripollès Carles Rubio , Farres Noemi Moreno , Agudelo Olga Lucia Arias , Ortega Jesus Almeda 
Published: July 2020

Abstract
Background: Posterior canal benign paroxysmal positional vertigo (pc-BPPV) causes physical, functional, and emotional impairment. The treatment of choice is the Epley manoeuvre (EM). The purpose of the study was to compare the impact of the EM and a sham manoeuvre in primary care on self-perceived disability.Method: Randomised, double-blind, sham-controlled clinical trial conducted in primary care with a follow-up of 1 year. Patients aged ≥18 years old diagnosed with pc-BPPV according to the Dix-Hallpike test (DHT) were randomised to an intervention (EM) group or a control (sham manoeuvre) group. The main study covariables were age, sex, history of depression and anxiety, presence of nystagmus in the DHT, patient-perceived disability assessed with the Dizziness Handicap Inventory-screening version (DHI-S). Data were analyzed using bivariate and multivariate mixed Tobit analyses. Results: Overall, 134 patients were studied: 66 in the intervention group and 68 in the control group. Median age was 52 years (interquartile range [IQR], 38.25–68.00 years) and 76.12% of the patients were women. The DHT triggered nystagmus in 40.30% of patients. The median total DHI-S score for the overall sample at baseline was 16 (IQR, 8.00–22.00); 16 [IQR, 10.5–24.0] vs 10 [6.0–14.0] for women vs men (P<0.001) and 16 [IQR, 10.0-24.0] vs 12 [IQR, 8.0–18.0] for patients without nystagmus vs those with nystagmus (P=0.033).Patients treated with the EM experienced a mean reduction of 2.03 points in DHI-S score over the follow-up period compared with patients in the sham group. Conclusion: Pc-BPPV affects the quality of life of primary care patients. A single EM can improve self-perceptions of disability by around 2 points on the DHI-S scale, Trial registration: ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513
Effects of Corn Steep Liquor on ß-poly(L-malic Acid) Production in Aureobasidium Melanogenum
Authors: Wang Genan , Zhang Pan , Shi Bingyi , Zhao Tingbin , Yin Haisong , Qiao Changsheng 
Published: July 2020

Abstract
ß-poly(L-malic acid) (PMLA) is a water-soluble biopolymer used in medicine and other industries. However, the concentration of PMLA produced by microorganisms was too low for large-scale production. In this experiment, corn steep liquor (CSL) was selected due to its high nutritional value and low-cost growth factor to increase the production capacity of PMLA in the strain Aureobasidium melanogenum, and the strain’s CSL-influenced metabolic change was investigated. The PMLA production, cell growth, and yield (Yp/x) of A. melanogenum increased by 32.76%, 41.82%, and 47.43%, respectively, with the addition of 3 g/L CSL. Metabolomics analysis showed that the intracellular metabolites of A. melanogenum, such as amino acids, organic acids, and key intermediates in the TCA cycle, increased after the addition of CSL. Meanwhile, the data found that tyrosine may play a key role in the PMLA biosynthesis. These results demonstrated that the addition of CSL is an efficient approach for improving the production of PMLA.
Dependency and Vulnerability of Intensive Care Medicine in Times of COVID-19 Crisis
Authors: Lingitz Marie-Therese , Roth Georg A. , Krenn Claus G. 
Published: July 2020

Abstract
Background. Since December 2019, Coronavirus Disease-2019 (COVID-19) spread rapidly all over the world, resulting in pandemic. Through high hospitalization rates and via potentially exponential expansion of the disease, the COVID-19 crisis places a tremendous strain on healthcare systems, especially on limited numbers of hospital and Intensive Care Unit (ICU) – beds and equipment.Methods. The aim of this study was to elucidate the possible dependency of ICUs in European Countries with Austria as a pars pro toto in particular on long transglobal supply chains and its potential vulnerability by reported shortages of essential medicines and limited capacities in times of globalization and asserted economic advantages versus the pandemic threat of COVID-19. From 3 April to 8 April 2020 we performed a short survey with heads of Austria’s ICU-wards in different institutions following a structured questionnaire to enquire their personal experience and assessment.Results. We surveyed nearly half of the head physicians of ICUs (n=40) in Austria. 55 percent (n=22) are already treating COVID-19 affected patients at their ICU department. Only 45 percent (n=18) of them had received the amount of personal protective equipment they deemed enough, and 90 percent (n=36) of surveyed ICUs were already informed about shortage supplies concerning personal protective equipment. 45 percent (n=18) already reported infections within their medical personnel. 35 percent (n=14) already reported supply difficulties in several pharmaceuticals, whereas 73 percent (n=29) were informed or already warned by their economic or purchase departments about further potential or real shortages concerning essential pharmaceuticals in near future. Conclusions. Summarizing the results of our survey we would like to draw attention to the lessons we can learn from the COVID-19 crisis in the European Union: European Countries with Austria as a pars pro toto should establish a national production of key equipment and disposables ,at least a minor part of personal protective equipment as well as key pharmaceuticals. European countries need to improve far distance supplies and invest in maintaining critical infrastructure especially in those with limited capacities such as health care in general and ICUs in particular.
Tissue-specific 5-hydroxymethylcytosine landscape of the human genome
Authors: He Bo , Zhang Chao , Zhang Xiaoxue , Fan Yu , Zeng Hu , Liu Jun'e , Meng Haowei , Bai Dongsheng , Peng Jinying , Zhang Qian , Tao Wei , Yi Chengqi 
Published: July 2020

Abstract
5-Hydroxymethylcytosine (5hmC) is an important epigenetic mark that regulates gene expression. Charting the landscape of 5hmC in human tissues is fundamental to understand its regulatory functions. Here, we systematically profiled the whole-genome 5hmC landscape at single-base resolution for 19 types of human tissues. We found that 5hmC preferentially decorates gene bodies and outperforms gene body 5mC in reflecting gene expression. Approximately one-third of 5hmC peaks are tissue-specific differentially hydroxymethylated regions (tsDhMRs), which are deposited in regulatory elements that regulate the expression of nearby tissue-specific functional genes. In addition, tsDhMRs are enriched with tissue-specific transcription-factor-binding sites and may rewire tissue-specific gene expression networks. Moreover, tsDhMRs are associated with SNPs identified by genome-wide association study (GWAS), linked to tissue-specific phenotypes and diseases. Collectively, our results show the tissue-specific 5hmC landscape of the human genome and demonstrate that 5hmC serves as a fundamental regulatory element affecting tissue-specific development and diseases.
In Vitro Propagation via Organogenesis and Formation of Globular Bodies of Salvia Plebeia: A Valuable Medicinal Plant
Authors: Wu Qinggui , Yang Honglin , Sun Yuxi , Hu Jinyao , Zou Lijuan 
Published: July 2020

Abstract
Background: As a highly valued medicinal plant, Salvia plebeia R. Brown belongs to the Lamiaceae family that has been subjected to over exploitation in its natural habitat for phytochemical and pharmacological studies. Alternative collection methods need to be developed for the large-scale propagation of Salvia plebeian. Results: Here, efficient and simple, direct organogenesis (from shoot tips and cotyledonary nodes explants) and Globular bodies (GBs) induction (from hypocotyl explants) systems were developed for the in vitro propagation of Salvia plebeia. The highest and number of regenerated shoots (7.0±0.82) per shoot tips was obtained on Murashige and Skoog (MS) medium supplemented with a combination of 0.1 mg L-1 indole-3-acetic acid (IAA) and 1.0 mg L-1 6-benzyladenine (6-BA), the proliferation of shoots and shoots rooted were carried out on the same medium treatments almost synchronously. Similarly, MS medium supplemented with 0.1 mg L-1 IAA and 1.0 mg L-1 thidiazuron (TDZ) yielded the maximum number of shoots (37.5±1.34) with 100% shoot sprouting frequency. Simultaneously, a protocol was developed for GBs induction from hypocotyl explants, and it produced 17.4 GBs per explant with 82.7% response on MS medium supplemented with TDZ (1.0 mg L-1) and IAA (0.1 mg L-1), and produced GBs that were morphologically similar to globular embryos and successfully germinated on hormone-free MS medium. The acclimatized plantlets with well-developed root systems were successfully shifted to the natural soils with a 100% survival rate. Conclusions: Taken together, this protocol can be efficiently used for mass propagation, germplasm preservation and likely also for gene transfer of Salvia plebeia.