bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of Hand Hygiene Practice at Critical Times among Food Handlers in Educational Institutions of the Sagnarigu Municipality of Ghana: A Cross-Sectional Study
Authors: Amegah Kingsley E. , Addo Henry O. , Ashinyo Mary E. , Fiagbe Loveland , Akpanya Serene , Akoriyea Samuel K. , Dubik S. Dajaan 
Published: October 2020

Abstract
Introduction: Food handlers’ hands serve as a vehicle for potential foodborne pathogenic contamination which constitutes a public health risk. In Ghana, there are always constant reports of outbreaks of foodborne diseases in schools. However, determinants of hand hygiene practice among educational institutions food handlers are little known. The study, therefore, aimed to assess the determinants of hand hygiene practice at critical times among educational institutions’ food handlers in the Sagnarigu Municipality of Ghana.Methods: This was a cross-sectional survey among educational institutions food handlers in the Sagnarigu Municipality. Two hundred and six food handlers were selected through convenience sampling in the educational institutions. At the same time, structured questions that were developed from previous studies were used to assess food handlers’ hand hygiene practice at critical times. Data were analyzed using descriptive statistics, bivariate and multivariate logistic regression models. All variables with their respective confidence intervals (95%) and adjusted odds ratios were declared significant at P-values less than .05.Results: Hand hygiene practice at critical times among the food handlers were relatively good at a rating of 66.0% (95% CI: 59.1, 72.5%). Good hand hygiene practice at critical times was less likely among food handlers with no food safety training (AOR 0.04; 95% CI: 0.00, 0.41) and food handlers who had insufficient knowledge of hand hygiene (AOR 0.06; 95% CI 0.01, 0.25). Good hygiene practice at critical times was 99% lower in food handlers with a negative attitude as compared to food handlers with positive attitudes towards hand hygiene at critical times (AOR 0.01; 95% CI 0.00, 0.07). Only 17.0% of the food handlers demonstrated proper handwashing techniques, whereas a good number (85.4%) of the food handlers did not wash their hands after touching money. Conclusion: Good hand hygiene practice at critical times was relatively good. Food safety training, knowledge of hand hygiene and attitudes towards hand hygiene were independent predictors of hand hygiene practice at critical times. Concerned stakeholders and organizations should focus on WASH interventions that seek to improve educational institutions food handlers’ knowledge and attitudes towards hand hygiene, coupled with training on food safety.
Supply Versus Demand of Health Care Facilities in a Competitive Context: Case of Tuberculosis Care in Douala-Cameroon.
Authors: Yakam Andre Nana , Koncy Prisca Fosso , Martin Njocke , Samuel Bowong , Louis Fono Aimé , Jürgen Noeske 
Published: October 2020

Abstract
Background: Identifying the socio-economic factors associated with the supply and demand of health facilities (HF), including their spatial model, can contribute to the decision-making of the creation of the HF. This study aims to contribute to this issue in the competitive context of the tuberculosis diagnosis and treatment centres (DTC) in Douala, Cameroon. Methods: The “observed” number of patients attending the DTCs was compared to the “expected” number, using a bivariate analysis. Multivariate analysis using logistic regression and the analysis of variance were used to identify the factors associated to attendance of DTCs. Spatial analysis was performed to access the spatial-economic model hiding behind the distribution of the DTCs.Results: There is a spatial-economic model hiding behind the distribution of DTCs in Douala, which dictate their solicitation. The decentralization policy advocated by the national program against tuberculosis (NTP) is not always followed by the patients: The “expected” and the “observed” number of patients in DTCs are not correlated. Patients seeking treatment in DTCs closer to their residence are mainly women and patients from relative poor households, while attendance of DTC was associated with the quality of serviceConclusion: Attendance HF is dictate by the spatial-economic model. The policy of creating HF for TB is not followed by patients in competitive context. Attendance of HF by TB patients is associated with some socioeconomics factors;
Development of a chiral HPLC method for the separation and quantification of hydroxychloroquine enantiomers
Authors: Xiong Xisheng , Wang Kun , Tang Tao , Fang Jinzhi , Chen Yijun 
Published: October 2020

Abstract
Hydroxychloroquine (2-[[4-[(7-Chloroquinolin-4-yl) amino]pentyl](ethyl) amino]-ethanol, HCQ), an effective anti-malarial drug, has been applied in the clinics for potential treatment of severe coronavirus disease 2019 (COVID-19). Although the clinical benefits of HCQ require extensive clinical data to confirm, the existence of a chiral center in the molecule to possess two optical isomers suggests that there might be an enantiomeric difference on the treatment of COVID-19. Due to poor resolution and the inability of quantification by previously reported methods for the analysis of HCQ enantiomers, it is necessary to develop an analytical method to achieve baseline separation for quantitative and accurate determination of the enantiomeric purity in order to compare the efficacy and toxicity profiles of different enantiomer. In this study, we developed and validated an accurate and reproducible normal phase chiral HPLC method for the analysis of two enantiomers of HCQ, and the method was further evaluated with biological samples. With this newly developed method, the relative standard deviation of all analytes was lower than 5%, and the limit of quantification was 0.27 μg/ml, 0.34 μg/ml and 0.20 μg/ml for racemate, R- and S-enantiomer, respectively. The present method provides an essential analytical tool for preclinical and clinical evaluation of HCQ enantiomers for potential treatment of COVID-19.
Serial measurements of Paraoxonase-1 (PON-1) activity in horses with experimentally induced endotoxemia
Authors: Scavone Donatella , Sgorbini Micaela , Borges Alexandre Secorun , de Oliveira-Filho Josè Paes , Vitale Valentina , Paltrinieri Saverio 
Published: October 2020

Abstract
Background: Paraoxonase-1 (PON-1) is an antioxidant enzyme, whose activity decreases during the acute phase response in many species. Little is known about PON-1 and its role as a negative acute phase protein during septic inflammation in horses, but promising findings about its utility in diagnosing SIRS and predicting the outcome in diseased horses, were recently highlighted. The objective of the study was to investigate the behaviour of PON-1 in horses after experimentally induced endotoxemia. To this aim, PON-1 activity was measured on 66 plasma samples collected from six clinically healthy mares, previously included in another study, before and at multiple time points between 12 and 240 hours after intravenous infusion of Escherichia coli O55:B5 lipopolysaccharide (LPS). Results: compared with baseline values, a progressive transient decrease of PON-1 activity was observed starting from 24 hours post-infusion, with lowest values observed between 3 to 7 days post-infusion, followed by a normalisation to pre-infusion levels the tenth day.Conclusions: the results of this study suggest that measurement and monitoring of PON-1 activity might be useful to evaluate progression and recovery from endotoxemia in horses. Further studies in horses with naturally occurring sepsis are warranted.
Spring warming drives past and future shifts in Great Plains storm intensity
Authors: Sun Chijun , Shanahan Timothy , DiNezio Pedro , McKay Nicholas , Roy Priyadarsi 
Published: October 2020

Abstract
The climate of the Great Plains is dominated by mesoscale convective systems (MCS), which supply a significant portion of warm season rainfall and are responsible for severe weather and flooding across the region. However, little is known about past behavior and long-term drivers of these systems, limiting our ability to predict future changes in hydroclimate and extreme weather for much of the central US. Here, we generate a new record of past MCS activity and hydroclimate variability from central Texas and compare it against the results of transient climate model simulations to understand the underlying causes of past changes in extreme weather and climate in the central US. We find that changes in storm activity and hydroclimate in the southern Great Plains over the last the 20,000 years were dominated by changes in the strength of the Great Plains Low Level Jet, driven by springtime land surface temperature changes. These results suggest that a similar dynamical response to future warming will lead to enhanced MCS activity and an increase in extreme weather and flooding across the southern and central Great Plains in the future.
Identification of Autophagy-Related Long Non-Coding RNA Prognostic Signature for Clear Cell Renal Cell Carcinoma
Authors: Cui Yankang , Zhang Shaobo , Miao Chenkui , Liang Chao , Chen Xiaochao , Yan Tao , Bu Hengtao , Dong Huiyu , Li Junchen , Li Jie , Wang Zengjun , Liu Bianjiang 
Published: October 2020

Abstract
Background: Studies over the past decade have shown that long non-coding RNAs (lncRNAs) play an essential role in the tumorigenesis and progression of kidney renal clear cell carcinoma (KIRC). Meanwhile, autophagy has been demonstrated to regulate KIRC pathogenesis and targeting therapy resistance. However, the prognostic value of autophagy-related lncRNAs in KIRC patients has not been reported before.Methods: In this study, we obtained transcriptome data of 611 KIRC cases from the TCGA database and 258 autophagy-related mRNAs from the HADb database to identify autophagy-related lncRNAs by co-expression network. A prognostic model was then established basing on these autophagy-related lncRNAs, dividing patients into high-risk and low-risk groups. Survival analysis, clinical variables dependent receiver operating characteristic (ROC) analyses, univariate/multivariate Cox analyses, and clinical correlation analysis were performed based on risk signature with R language. Gene set enrichment analysis (GSEA) was then performed to investigate the potential mechanism of the risk signature promoting KIRC progression with GSEA software. Results: A total of 17 lncRNAs were screened out and all these lncRNAs were found significantly related to KIRC patients' overall survival in subsequent survival analyses. Besides, the overall survival time in the high-risk group was much poorer than in the low-risk group. The ROC analysis revealed that the prognostic value of risk signature was better than age, gender, grade, and N stage. Univariate/multivariate analyses suggested that the risk signature was an independent predictive factor for KIRC patients. Immune-related pathways were dramatically enriched in high-risk patients according to GSEA. Conclusions: In summary, our identified 17 autophagy-related lncRNAs had prognostic value for KIRC patients which may function in Immunomodulation.
Regional Trends and Associated Factors of Childhood Visual Impairment: A Case Study in Shandong Province, China
Authors: Han Lizhen , Jia Jinzhu , Wang Lu 
Published: October 2020

Abstract
Background: Visual impairment is a common child health problem. We hopes to analyze the regional trend, related factors and spatial distribution of children's visual impairment in Shandong province, to explore the spatial changes brought by time and their influencing factors, so as to provide scientific basis for prevention of childhood visual impairment.Methods: This study covers five complete cross-sectional surveys (Physical examination data in Shandong province) from 2013 to 2017, involving about 29.24 million students. The 11th International Classification of Diseases was selected as the diagnostic standard. Spatial autocorrelation and hotspot analysis methods in ArcGIS software were used to analyze spatial features. The associated factors were analyzed by multinomial logistic regression.Results: The visual impairment prevalence showed a trend of decreasing first and then increasing from 2013-2017, with slight changes. In terms of regional spatial differences, Weihai and Yantai have the highest VI rates in all years, and there was a large-scale spatial aggregation phenomenon. The southern low-value clusters, however, showed a weakening year by year. Further exploration revealed that the per capita disposable income of rural households, the growth rate of gross domestic product, total retail sales of consumer goods and number of full-time teachers were verified as risk factors for regional visual impairment levels.Conclusions: The slight rebound of the prevalence of visual impairment and the high rate in the eastern and northern regions of Shandong province need more attention. It is suggested that relevant departments should focus on the influence of regional economic and educational factors when formulating relevant strategies.
Heat Shock Modulates The Expression of Sirtuins and Var Genes in The Malaria Parasite Plasmodium Falciparum
Authors: Anagu Linda O. , Hulse David R. , Chakravorty Srabasti J , Horrocks Paul D. , Merrick Catherine Jill 
Published: October 2020

Abstract
Background: In the malaria parasite Plasmodium falciparum the expression of ‘var’ virulence genes is regulated through epigenetic mechanisms. Two deacetylase enzymes of the sirtuin family have been implicated in this epigenetic control in laboratory-adapted parasites. A previous study of var gene expression in parasites isolated directly from Gambian malaria patients found that high expression levels of severe-disease-associated var variants correlated with high expression of the PfSir2A sirtuin, and these expression patterns also correlated with patient phenotypes of fever and hyperlactataemia. Together, the observations suggest a mechanism through which stress phenotypes in the human host might be sensed via a parasite sirtuin, and virulence gene expression modulated accordingly. Methods: In vitro experiments were conducted using recently-laboratory-adapted Kenyan isolates of P. falciparum to follow up the correlative findings of the field study. To investigate a potential cause-and-effect relationship between host stress factors and parasite gene expression, qPCR was used to measure the expression of sirtuins and var genes after cultured parasites had been exposed to 2h or 6h of heat shock at 40°C or elevated lactate at 5mM.Results: Heat shock was shown to influence the expression of both sirtuins and var genes, whereas exposure to lactate was not. Heat shock in the trophozoite stage resulted in modest upregulation of the expression of sirtuins, particularly PfSir2B, by 2-3 fold in all strains tested. Interestingly, when heat shock was applied in ring stages PfSir2A was still upregulated but PfSir2B was downregulated. This correlated with a general upregulation of ring-stage var transcription, and particularly of severe-disease-associated upsA and upsB var genes, but there was no clear pattern in the dominant var gene(s) ultimately expressed by heat-shocked parasites. Conclusions: This study demonstrates for the first time that heat stress in recently-laboratory-adapted isolates of P. falciparum results in altered sirtuin expression – PfSir2B as well as PfSir2A – and also the upregulation of var gene expression. These may be strategies evolved by the parasite to survive heat stress when a human host experiences malarial fevers. By contrast, the association between hyperlactataemia and sirtuin/var gene expression that was previously observed in vivo appears to be coincidental rather than causative.
ISRIB prevents synaptic plasticity disruption and cognitive deficits in live rat model of Alzheimer’s disease
Authors: Hu Neng-Wei , Hu Zhengtao , Yu Pengpeng , Wang Deguo , Wu Yong , Qi Yingjie , Ondrejcak Tomas , Klyubin Igor , Xu Jitian , Yang Yin , Rowan Michael J. 
Published: October 2020

Abstract
BackgroundGrowing evidence shows that targeting the integrated stress response (ISR) through the inhibition of phosphorylation of eIF2α provides beneficial effects in animal models of neurodegenerative diseases including Alzheimer’s disease (AD). However, those results are inconsistent and somehow conflicting likely due to the important role of ISR in both cell death and survival. Aβ-triggered pathologies including microvascular hypoxia, neuronal hyperactivation, neuroinflammation are common inducers of the ISR. The small-molecule inhibitor of the ISR called ISRIB, which only partially restores protein synthesis and confers neuroprotection without adverse effects on the pancreas most probably due to its state-dependent action, remarkably enhances cognition in animals.MethodsTo elucidate the roles of ISR in AD pathogenesis, we systemically treated exogenous Aβ-injected animals with ISRIB. Both Aβ-facilitated long-term depression (LTD) and Morris water maze were used to characterize Aβ-induced dysfunction. ResultsAcute treatment with ISRIB prevented Aβ-facilitated LTD and repeated treatment abrogated the spatial learning and memory deficits in exogenous Aβ-injected animals. Moreover, ISRIB restored aberrant high level of ATF4 to normal but did not affect the aberrant high level of phosphorylated eIF2α in the hippocampus of exogenous Aβ-injected rats. ConclusionsTargeting the ISR by suppressing the eIF2α cascade with ISRIB may provide protective effects against the synaptic and cognitive disruptive effects of Aβ which likely mediate the early stage of sporadic AD.
A Systematic Review of the Health Worker-Patient Relationship in China
Authors: Mao Ying , Ning Wei , Zheng Junyao , Zhang Ning , Xie Tao , Liu Jinnan , Lu Yongbo , He Rongxin 
Published: October 2020

Abstract
BackgroundWith a surge of medical disputes in recent years, the health worker-patient relationship (HWPR) in China is presently in a tense situation. Meanwhile, consequent social problems have begun to emerge, such as the practice of defensive medicine and distrust between health workers and patients. Although many empirical studies about the HWPR have been conducted in China, no related systematic reviews have been found. This study can convey the general findings from China to other areas of the world.MethodsA systematic review and meta-analysis of the HWPR and related determinants were conducted. Six databases were comprehensively searched for articles to include in the review, with no restrictions on language. Articles published between January 1, 2000 and January 1, 2020 were included.ResultsAmong the 3,290 records initially identified, 11 studies met the selection criteria. A total of 96,906 individuals were included in the review. The meta-analysis indicated that health workers who were male (male vs. female, OR: 1.48, 95% CI: 1.42- 1.55), older (≤50 vs. >50, 0.86, 0.80-0.93), less educated (undergraduate or below vs. masters or above, 1.39, 1.21-1.60), working in a non-surgical department (surgery vs. other, 0.92, 0.88-0.96), and had a senior title (intermediate or below vs. senior, 0.77, 0.74-0.81) were more likely to be pessimistic about the HWPR or to encounter medical disputes. Patients who were rural residents (urban vs. rural, 0.92, 0.87-0.97), highly educated (below undergraduate vs. undergraduate or above, 0.75, 0.72-079), and had no medical insurance (medical insurance vs. no medical insurance, 0.77, 0.67-0.89) were more likely to be pessimistic about the HWPR or to encounter medical disputes. Furthermore, mutual trust could improve rapport between health workers and patients. The 25 other related factors were analysed and described using a narrative approach.ConclusionOn average, 55.73% of health workers consider the HWPR to be tense, which is higher than the proportion of patients who hold this view (33.7%). The HWPR was significantly associated with individual factors and socioeconomic factors of both health workers and patients, as well as factors related to the health worker-patient interaction. More targeted strategies should be developed to improve the HWPR.
Microstructure and Mechanical Properties of C/C Composites with Different Configuration of Unidirectional Macropores
Authors: Jia Jiangang , Ju Jiakang , Liu Shunwei , Ji Genshun 
Published: October 2020

Abstract
The unidirectional porous C/C composites with different channel-diameter and channels-row spacing were prepared by a space-holder route. The effects of different channel-diameter and channels-row spacing on the mechanical properties and microstructures of the porous C/C composites were studied. Results show that increasing the channel-diameter or reducing the channels-row spacing helps to obtain finer PyC grains but significantly reduce the matrix density of the composites, and, in turn, the compressive strength of the composites. Porous C/C composites with lower porosity or higher density (e.g., S5,2) present relatively high strength, whereas C/C porous composites with lower density or higher porosity show a pseudo-plastic fracture mode and relatively lower strength. The compression strength in the load parallel to channel direction is higher than that in the load perpendicular to channel direction of the same composite.
A Study on the Influence of Project Leadership on Project Management and Performance
Authors: Theophanus Momanyi N. 
Published: October 2020

Abstract
The current study was a survey into the issue of project leadership influence on project management and performance. It has objectively focused on effects of leadership skills, experience, quality and styles in enhancing project performance. Further, the study sought to answer questions on the impact of aligning, motivating, directing and influencing in enhancing project performance. Apart from conducting a review of past studies, theoretical foundations were also reviewed to underpin the hypotheses that guided the study. Quantitative data was collected using structured questionnaires and analysed descriptively. Further, regression analyses were done and results confirmed a positive and strong connection concerning leadership components and management functions on project performance. From obtained outcomes, recommendations are given for future studies to focus on, as well as for improvement in different industries while implementing various projects.