bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Alanine Aminotransferase in Adults with Severe and Complicated Obesity during a Milk-Based Meal Replacement Programme
Authors: Abdalgwad Razk , Rafey Mohammed Faraz , Murphy Conor , Ioana Iulia , O'Shea Paula Marie , Slattery Eoin , Davenport Colin , O'Keeffe Derek Timothy , Finucane Francis Martin
Published: May 2020

Introduction:
Excess adiposity is associated with fat accumulation within the liver, and non-alcoholic steatohepatitis (NASH) is highly prevalent in bariatric patients. Elevated alanine aminotransferase (ALT) is associated with prevalent NASH. We sought to determine the influence of a milk-based meal replacement weight-loss programme on ALT levels in adults with severe and complicated obesity.
Methods
We conducted a retrospective cohort study of patients who completed a 24-week meal replacement programme, comprised of a weight loss phase followed by weight stabilisation and maintenance phases, each eight weeks long. ALT was quantified using an enzymatic assay with spectrophotometric detection. We examined changes over time in ALT using the non-parametric Wilcoxon singed-rank test and the Friedman test.
Results
Of 105 patients, 56 were female, mean age was 51.2 ± 11.2 (range 18.0-71.6) years. There was an unanticipated but transient increase in ALT from 28.0 [20.0, 40.5] iu/l at baseline to 40.0 [26.0, 55.0] iu/l after two weeks (p < 0.0005), followed by a gradual reduction to 21.0 [17.0, 28.3] iu/l by 24 weeks (p < 0.0005). The overall reductions in ALT were more pronounced in patients who had elevated levels at baseline. Body weight decreased from 144.2 ± 28.0 kg at baseline to 121.6 ± 25.4 kg at 24 weeks (p < 0.0005) and body mass index (BMI) decreased from 50.7 ± 8.1 kg m− 2 at baseline to 43.0 ± 7.6 kg m− 2 by 24 weeks (p < 0.0005).
Conclusion
In adults with severe and complicated obesity undergoing a milk-based meal replacement programme, there was an initial unanticipated rise in ALT in the first two weeks, followed by a gradual overall reduction by 24 weeks. These findings suggest that rapid weight loss secondary to significant caloric restriction might induce a transient deterioration in hepatic steatosis prior to an ultimate overall improvement.
Trypanosome infections in naturally infected horses and donkeys of three active sleeping sickness foci in the south of Chad
Authors: Vourchakbé Joël , Tiofack Arnol Auvaker , Mpoame Mbida , Simo Gustave
Published: May 2020

Background Equine trypanosomiases are complex infectious diseases with overlapping clinical signs defined by their mode of transmission. Despite their economic impacts, these diseases have been neglected by the scientific community, the veterinary authorities and regulatory organizations. To fill the observed knowledge gap, we undertook the identification of different trypanosome species and subspecies naturally infecting horses and donkeys within the Chadian sleeping sickness focus. The end objective, being to investigate the potential role of these domestic animals as reservoirs of the human infective Trypanosoma brucei gambienseMethod Blood samples were collected from 155 donkeys and 131 horses in three human African trypanosomiasis (HAT) foci of Chad. Rapid diagnostic test (RDT) and capillary tube centrifugation (CTC) test were used to search for trypanosome infections. DNA was extracted from each blood sample and different trypanosome species and subspecies were identified with molecular tools.Results From 286 blood samples collected, 54 (18.9%) and 36 (12.6%) were respectively positive for RDT and CTC. PCR revealed 144 (50.3%) animals with trypanosome infections. The kappa Cohen coefficients used to evaluate the concordance between the diagnostic methods were low; ranging from 0.087±0.0473 to 0.48 ± 0.0698. Trypanosomes of the subgenus Trypanozoon were the most prevalent (29.4%), followed by T. congolense forest (11.5%), T. congolense savannah (4.9%) and T. vivax (4.5%). Two donkeys and one horse from the Maro HAT focus were found with T. b. gambiense infections. Between animal species and HAT foci, no significant differences were observed in the infection rates of different trypanosomes. Conclusion This study revealed several trypanosome species and sub species in donkeys and horses, highlighting the existence of AAT in HAT foci of Chad. The identification of T. b. gambiense in donkeys and horses suggests considering these animals as potential reservoir for HAT in Chad. The presence of both human-infective and human non infective trypanosomes species highlights the need for developing joined control strategies for HAT and AAT.
Home Range and Habitat Selection of Female Mountain Nyalas (Tragelaphus Buxtoni) in the Human-Dominated Landscape of the Ethiopian Highlands
Authors: Atickem Anagaw , Klapproth Matthias , Fischer Martha , Zinner Dietmar , Loe Leif Egil
Published: May 2020

Background: Human settlement and agricultural activities restrict increasingly the range of large mammals in many cases contributing to declining numbers of ungulates. Here, we studied home range size and habitat selection of female mountain nyalas in the northern end of the Bale Mountains National Park (BMNP) (31 km2) surrounded by human settlement. We collected data on space use of seven adult female mountain nyalas equipped with Global Positioning System (GPS) collars. Home range size was estimated using fixed kernel density and habitat selection was determined by resource selection functions.Results: We found that female mountain nyalas have much smaller (5.7 km2) home ranges than the 19 km2 home range size predicted for a 170 kg, group-living species living in mixed habitats. Home ranges were 30% larger in night time than daytime. We suggest that the night time extension beyond the park boundaries were caused by both push and pull effects. The presumably high livestock and other ungulates grazing pressure within the protected area may cause forage-driven excursions out of the park, in particular during agricultural crop seasons. In addition, mountain nyalas are probably attracted by humans as shields against hyena predation. Resource selection index indicates bush land and forest habitat are the most preferred habitat types while agriculture and human settlements are least preferred habitats.Conclusions: Given that mountain nyalas are found in high density (24 individuals/km2) and the size of the northern part of the Bale Mountain National Park, which is currently under protection by the park authorities for the mountain nyala conservation, is too small for the predicted home range size of large ungulates, we suggest protecting additional area may be needed for the long-term conservation of the endangered mountain nyala.
Production and Verification of the First Atlantic Salmon (Salmo salar L.) Clonal Lines
Authors: hansen tom , Penman David , Glover Kevin Alan , Fraser Thomas , Vågseth Tone , Thorsen Anders , Sørvik Anne Grete Eide , Fjelldal Per Gunnar
Published: May 2020

Background In several fish species homozygous and heterozygous clonal lines have been produced using gynogenetic and androgenetic techniques. These lines are standardized and can be reproduced over generations. In rainbow trout such lines have existed for decades and has become important research tools in genome studies as well as in studies of commercially important traits. The Atlantic salmon is one of the best studied fish species globally, but all experiments are done on fish of wild or domesticated origin and access to standardized immortal fish lines would be of great benefit. Here, we describe the protocols developed to produce mitotic gynogenes, and from these the first clonal lines in Atlantic salmon.Results Atlantic salmon eggs fertilized with UV irradiated sperm combined with a pressure shock applied at 4700–4800 minC at 8 oC gave all homozygous (doubled haploid) gynogenetic progeny with high survival. From the six first maturing females, five all homozygous clonal lines were produced by meiotic gynogenesis and were verified as clonal and identical to their mother with microsatellite markers.Conclusions We have now produced the first documented cloned Atlantic salmon lines. This work demonstrates the potential for production of further Atlantic salmon clonal lines, potentially with distinct characteristics. Such lines will provide an important resource for further elucidation of phenotypic and genetic traits in this globally important species.
Are tagged fish like others? Insights from growth and stress physiological profile in two marine fish species
Authors: Alfonso Sébastien , Zupa Walter , Manfrin Amedeo , Fiocchi Eleonora , Dioguardi Maria , Dara Mariano , Cammarata Matteo , Lembo Giuseppe , Carbonara Pierluigi
Published: May 2020

Background: Telemetry applied to aquatic organisms has recently developed greatly. Physiological sensors have been increasingly used as tools for fish welfare monitoring. However, for the technology to be used as a reliable non-invasive welfare indicator, it is important that the tagging procedure does not disrupt fish physiology, behaviour and performance. In this communication, we share our medium-term data on stress physiological profile and growth performance after tag implantation in two important marine fish species for European aquaculture, the sea bream ( Sparus aurata ) and the European sea bass ( Dicentrarchus labrax ). Results: Blood samples after tag implantation (46 days for the sea bream and 95 days for the sea bass) revealed no differences between tagged and untagged fish in cortisol, glucose and lactate levels, suggesting that the tag implantation does not induce prolonged stress in these species. Moreover, the specific growth rates were similar in the tagged and untagged fish of both species. Conclusion: Tag implantation does not have medium-term consequences for the stress physiology and growth performance of these two marine fish species in a controlled environment. These observations support the use of accelerometer tags as valuable tools for welfare monitoring in aquaculture conditions, as they do not affect the fish’s welfare and health. This study also shows that tagged fish can be sampled during experiments and considered a representative portion of the population, as they display growth and physiological parameters comparable to those of untagged fish.
Basic epidemiological parameter values from data of real-world in mega-cities: the characteristics of COVID-19 in Beijing, China
Authors: Wang Xiaoli , Pan Yang , Zhang Daitao , Chen Lijuan , Jia Lei , Li Xinyu , Yang Peng , Wang Quanyi , Macintyre C. Raina
Published: May 2020

Background. With the spread of SARS-CoV-2 worldwide, understanding the basic epidemiological parameter values of COVID-19 from real-world data in mata-cities is essential for disease prevention and control. Methods. To investigate the epidemiological parameters in SARS-CoV-2 infected cases in Beijing, we studied all confirmed cases and close contacts in Beijing from 1 Jan to 3 Apr 2020. The epidemiological and virological characteristics were analyzed.Results. A total of 602 cases were positive for SARS-CoV-2, including 585 confirmed case-patients and 17 asymptomatic infections. The imported cases were mainly from Wuhan and then predominantly from abroad. Among 585 confirmed case-patients, the median age was 39 years. About 13.68% were severe and critical patients. The mean incubation period was 6.31 days. The secondary attack rate among households was higher than social contacts (15.55 vs.4.56%). The secondary attack rate of healthcare workers (HCWs) was higher than non-HCWs’ (7.26 vs. 4.24%). The basic reproduction number was 2.0, and the average serial interval was 7.64 days. No significant genetic variant was found.Conclusions. The transmissibility of SARS-CoV-2 was relatively high, especially among households and from HCWs, which should be focused on. So far, there is no evidence of widespread circulation of SARS-CoV-2 in communities in Beijing.
Osteogenic and Fluorescent Characterization of Pig-Derived Mesenchymal Stem Cells Between eGFP Transgenesis and Non-viral Plasmid Transfection
Authors: Hsieh Ming-Kai , Wu Chia-Jung , Wang Chi-Yun , Tsai Tsung-Ting , Niu Chi-Chien , Lai Po-Liang , Wu Shinn-Chih
Published: May 2020

BackgroundWidely used in recent years, mesenchymal stem cells (MSCs) expressing enhanced green fluorescent protein (eGFP) can be tracked during migration to injury sites, while also supporting tri-lineage differentiation. However, the relationship between the expression of green fluorescence and the magnitude of osteogenic differentiation is not clearly defined. Despite increasing use of eGFP-MSCs derived from the transgenic pigs and non-viral eGFP plasmid transfected MSCs in recent years, it remains unclear which cells are suitable for tracking during osteogenic differentiation, and whether the transfected plasmid alters osteogenic potential.MethodsWe compared the expression of green fluorescence and the magnitude of osteogenic differentiation between eGFP MSCs from a transgenic pig (group 1) and non-virally transfected eGFP-MSCs using transIT®-2020 (group 2). Non-transfected MSCs were used as control group (group 3). We also use a scaffold to compare the osteogenic induction environments created by 2-D monolayer cultures and 3-D cultures, respectivelyResultsIn the monolayer culture, flow cytometry from day 7 to day 28 showed that the percentage of green fluorescent cells in groups 1 and 2 were 99.6% and 59.7% of total cell counts, respectively. Quantification showed that eGFP expression peaked on day 7, decreased after day 14, and plateaued to day 28 in group 1 and group 2. Significant aggregation of eGFP over bone-like nodules was appreciated in group 1. In 3-D culture, eGFP expression increased from day 7 to day 28 in both groups, and was higher in group 1 than in group 2 at each time point. Osteogenic profiles and immunohistochemistry showed more significant osteogenic activity in group 1 and group 3 than in group 2. ConclusionsThe expression of eGFP in the test groups did not significantly change after osteogenic induction. However, quantification data was different in monolayer and 3-D cultures due to spatial limitations, differing extracellular environments, and heterogeneous cell morphology and methods of division. Osteogenic profiles and immunohistochemistry data confirmed that osteogenic potential did not change in transgenic pig-derived MSCs. However osteogenic potential decreased in pig MSCs (pig MSCs) treated with the transfection reagent, likely from related toxicity.
Mapping of QTLs Detected in a Broccoli Double Diploid Population for Plant Height and Leaf Characteristics
Authors: Huang Jingjing , Sun Jifeng , Liu Eryan , Liu Yumei , Fang Zhiyuan , Yang Limei , Zhuang Mu , Zhang Yangyong , Lv Honghao , Wang Yong , Han Fengqing , Ji Jialei , Li Zhansheng
Published: May 2020

Background The planting density of broccoli can directly affect the yield and overall health of plants. So there is necessary to reveal the regulatory genes of planting density in broccoli by QTL mapping. In this study, the important planting density-dependent factors of broccoli, plant height (PH), maximum outer petiole length (PL) and leaf width (LW), were investigated during 2017 and 2018. The mapping of QTLs for PH, PL and LW were performed, and the interaction between QTLs and the environment was also analyzed by a DH population constructed with 176 genotypes derived from F1 obtained by crossing the broccoli inbred lines 86101 (P1) and 90196 (P2).Results A linkage group including a total of 438 SSR markers were constructed covering a length of 1168.26 cM using QTL IciMapping 4.0 software. Finally, there were mainly four QTLs (phc1, phc2, phc4-1, phc4-2), one QTL (plc6), and two QTLs (lwc1, lwc3) corresponding for PH, PL and LW recurred during the two years. In three environments, inclusive composite interval mapping (ICIM) analysis showed that there was a major QTL for PH at 7.20 cM on chromosome 1 between molecular markers 8C024 and sf4482 with a high explanatory contribution rate of 20.05%. The QTL at the 11.10 cM position of chromosome 6 was located for the PL with a high explanatory contribution rate of 20.02% between the molecular markers sc2170 and sf43960. The QTL at the 147.00 cM position of chromosome 3 was located on LW with a high explanatory contribution rate of 19.97% between molecular markers of Sc52751 and RA2-E12.Conclusions According to the QTL results of planting density in broccoli by a DH population, the possible positions of candidate genes were screened to provide a basis for further locating and cloning genes for plant height, maximum outer petiole and leaf width.
A longitudinal study of bonding failure related to aspects of traumatic birth experience among Japanese mothers
Authors: Suetsugu Yoshiko , Haruna Megumi , Kamibeppu Kiyoko
Published: May 2020

Background:
A traumatic birth experience may affect mother-infant bonding. This study examined the relationship between aspects of traumatic birth experience and bonding failure for mothers at 1 month and 4 months after delivery.
Methods:
This longitudinal study surveyed 130 mothers at 1 month (T1) and 4 months (T2) after delivery. We performed multiple regression analysis with the Postpartum Bonding Questionnaire (PBQ) as the dependent variable and the Impact of Event Scale-Revised (IES-R), Edinburgh Postnatal Depression Scale (EPDS), Relationship Questionnaire (RQ), Family Adaptation, Partnership, Growth, Affection, and Resolve score (F.APGAR), and demographic data as independent variables.
Results:
The IES-R and the EPDS were relevant factors for the PBQ at T1. The IES-R was not a relevant factor, but the EPDS was a relevant factor for the PBQ at T2. The IES-R at T1 was not a predictor for the PBQ at T2. The PBQ at T1 was the largest predictor for the PBQ at T2, when compared with the EPDS, F.APGAR, and dismissive attachment pattern (RQ) at T1.
Conclusions:
A traumatic birth experience had a strong influence on bonding failure at T1. However, the important factor affecting bonding failure was not a traumatic birth experience, but depression at T2. If a traumatic birth experience is accompanied by depression at T2, it may affect bonding failure. The bonding failure affected by the traumatic birth experience at T1 could affect bonding failure at T2. Health professionals should assess the degree of the traumatic birth experience and start to care for mothers at T1.
Skin Cancers in People with Albinism in Togo in 2019: Results of Two Rounds of National Mobile Skin Care Clinics
Authors: Saka Bayaki , Akakpo Sefako Abla , Teclessou Julienne Noude , Gnossike Piham , Adam Saliou , Kassang Panawe , Elegbede Yvette , Mouhari-Toure Abas , Darre Tchin , Kombate Koussake , Pitche Palokinam
Published: May 2020

Objective: The aim of this study was to determine the prevalence and histological types of skin cancers in people with albinism (PWA) in Togo in 2019.Methods: This is a cross-sectional study of medical records of PWA systematically examined during two mobile skin care clinics in 2019, as part of a programme for the prevention and management of skin cancers in these subjects. Results: During the study period, 280 (95.2%) of the 294 PWA consulted, had developed skin lesions. Of the 280 patients, the pathological reports from the medical records of 33 patients (11.8%) had concluded to keratinocytes skin cancers. The mean age of these 33 patients was 38.6±15.2 years and the sex-ratio was 1. Their occupations were mainly resellers (21.2%), traders (15.2%) and farmers (12.2%). In the 33 patients, 54 cases of keratinocytes skin cancers were identified, with some patients having more than one case or histological type. These 54 keratinocytes skin cancers were divided into 21 cases of invasive squamous cell carcinomas, 2 cases of Bowen’s disease and 31 cases of basal cell carcinomas. These keratinocytes skin cancers mainly occurred in the cephalic region (33 cases; 61.1%), the upper limbs (15 cases; 27, 8%) and the trunk (4 cases; 7.4%).Conclusion: The results of this study show a high prevalence of skin cancers among PWAs in Togo in 2019, only keratinocytes skin cancers. In addition, they illustrate the role of ultraviolet rays with regard to the localization of skin cancers and the occupations of patients. Popularization and compliance with photo protection measures, systematic and regular examination of the skin of these PWAs will allow early detection and treatment of these skin cancers.
Clinical teaching of undergraduate nursing students: Are the nurses in practice in Uganda ready?
Authors: Drasiku Amos , Gross Janet L. , Jones Casey , Nyoni Champion N.
Published: May 2020

Background: Nurses with degree qualifications offer better nursing care compared to nurses prepared at lower levels. University based nursing degrees have been sanctioned as entry into professional nursing and several low-resource states have introduced university based nursing degrees. The clinical teaching of students enrolled in such degrees is challenged, as most nurses in practice do not have university degrees and are incompetent in moulding the clinical reasoning processes which is inherent within degree education. A university in Uganda established a bachelor’s degree in Nursing program and was expecting to use nurses in practice at a teaching hospital for the clinical teaching of undergraduate nursing students. This study reports on the perceptions of the nurses in practice regarding their readiness for the clinical teaching of undergraduate nursing students.Methods: A qualitative descriptive research study was conducted among 33 conveniently sampled nurses from ARRH who had been supervising Diploma and/or Certificate in Nursing students. Five focus group discussions and three informant interviews were used to generate the data. Data were transcribed verbatim and analysed using an inductive approach through thematic analysis.Results: The nurses in practice perceived themselves as ready for clinical teaching of undergraduate nursing students. Three themes emerged namely; “ Willingness to teach undergraduate students ” “ Perceived attributes of undergraduate students ”, and “ The clinical practice environment ”.Conclusion: The nurses in practice need support in the execution of the clinical teaching role of undergraduate nursing students. The nature of supports would include, continuing professional development specific to clinical teaching, engaging the educators in the clinical environment, positively engaging power gradients and address insecurities among the nurses and the students. Students in these programmes should be exposed to the clinical environment earlier within the programme, and be exposed to interprofessional and trans-professional education.
Adjuvant Therapy by High-Speed Burr May Cause Intraoperative Bone Tumor Seeding: An Animal Study
Authors: Wang Pai-han , Wu Chia-Lun , Chen Chao-Ming , Wang Jir‐You , Wu Po-Kuei , Chen Wei-Ming
Published: May 2020

BackgroundBone tumors are often treated with intralesional curettage. High-speed burring, an adjuvant therapy, was performed to maximize the tumor cell killing; however, tumor recurrence might still occur, which may be caused by residual tumor or local tumor spread during surgery.MethodsA porcine cadaver (femur) was utilized to determine whether the use of a high-speed burr causes bone cement spray. To mimic residual tumor after curettage, luminescent cement was smeared on two locations of the bone cavity, the wall and the bottom. The cavity in the femoral bone was then placed in the middle of a sheet of drawing paper featuring 10 cm, 20 cm, and 30 cm concentric circles. The luminescent cement was then burred totally with a high-speed burr.ResultsThe intensity of the area in the wall in circle I was 72.6% ± 5.8%; within circle II, it was 22.1% ± 4.2%; and within circle III, it was 5.4% ± 1.5%. The intensity of the area within the bottom of the femoral bone within circle I was 66.5% ± 6.1%, within circle II was 28.1 ± 4.8%, and within circle III, it was 5.4% ± 1.4%. The amount of luminescent cement seeding decreased with distance, but there was no difference while burring at different locations of the bone cavity. Under the handpiece cover, a greater amount of cement spray was retained in circle I during burring of the cement in the bottom of the cavity and less was sprayed out in circle III.ConclusionsHigh-speed burring may cause tumor seeding, which could extend to 20 cm. The intensities of spray did not decrease, even when the handpiece cover was used. The correlation between high-speed burring and tumor seeding was highly suspect in this pilot study.
Polish Cross-Cultural Adaptation of the Lower Limb Functional Index (LLFI) Demonstrates a Valid Outcome Measure for the Lower Limb Region and Joints
Authors: Bejer Agnieszka , Podufały Agnieszka , Kyc Sylwia , Michałek Magdalena , Mataczyński Piotr , Domka-Jopek Elżbieta , Melloh Markus , Gabel Charles Philip
Published: May 2020

Background: Patient reported outcome measures (PROMs) are recommended to enable the standardization of collected data and provide accurate representation of the patients’ subjective opinions of their functional capabilities. The purpose of this study was to perform linguistic and cross-cultural adaptation to establish a Polish version of the Lower Limb Functional Index (LLFI), and to evaluate the psychometric properties of internal consistency, reliability, error score, validity, and factor structure with standardized criteria PROMs in a population with lower limb problems.Methods: Linguistic and cultural adaptation complied with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines to produce the Lower Limb Functional Index - Polish version (LLFI-PL). The study recruited subjects (n = 125, age = 52.86 ± 19.53 years, range 20–87, 56% female, injury duration = 17.69 ± 18.39 weeks, range 5–71). Baseline reliability and criterion validity included the LLFI-PL, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Euroqol Health Questionnaire 5-Dimensions (EQ-5D-5L), and an 11-point pain Numerical Rating Scale, with retest at 3–7 days. Practicality for readability was considered within the face and content validity. Completion and scoring time were also calculated.Results: Statistical analysis showed excellent internal consistency (α = 0.94) and high test-retest reliability (ICC = 0.96). The error score found the SEM = 3.49% with MDC90 = 8.11%. Validity analysis showed strong correlations between the LLFI-PL with the WOMAC (r=-0.81) and moderate with the EQ-5D-5L (r=-0.63). Exploratory factor analysis confirmed a single-factor structure. Times for completion (172 ± 33 seconds) and scoring (20 ± 9 seconds) were determined.Conclusions: The LLFI-PL is a psychometrically sound questionnaire for Polish-speaking patients with lower limb musculoskeletal conditions. The results support the findings of previous original-English, Spanish, and Turkish versions for internal consistency, validity, reliability, error score, and factor structure.
Mesenchymal stem cells modified by FGF21 and GLP1 ameliorate lipid metabolism while reducing blood glucose in type 2 diabetic mice
Authors: Xue Binghua , Xiuxiao Xiao , Yu Tingting , Xiao Xinhua , Xie Jie , Ji Qiuhe , Wang Li , Na Tao , Meng Shufang , Geng Peiliang , Qian Lingjia , Duan Haifeng
Published: May 2020

Objective: The purpose of the study was to investigate the therapeutic effects and safety of genetic modified mesenchymal stem cells (MSCs) in type 2 diabetes mellitues (T2DM).Methods: MSCs derived from adipose tissue were modified with over-expression of FGF21 and GLP1, which was achieved through lentiviral particles transduction. The cells were transplanted to the BKS.Cg-Dock7m+/+Leprdb/Nju mice (T2DM mice model). The injections of physiological saline (0.1 mL), Liraglutide (0.5mg/kg) were employed as negative and positive controls respectively. The protein analyses were performed using ELISA or western blot analysis, while quantitative real-time PCR was adopted for gene expression.Results: The genetic modification had no effects on morphology, differentiation ability, or immunophenotype of MSCs. Moreover, MSC-FGF21+GLP1 cells exhibited significantly increased expression of FGF21 and GLP1. In T2DM model mice, the transplantation of MSC-FGF21+GLP1 cells ameliorated blood glucose and weight, promoted the secretion of insulin, enhanced the recovery of liver structures, and improved lipid profiles. Moreover, FGF21 and GLP1 exhibited synergistic effects in regulation of glucolipid metabolism through controlling the expression of insulin, srebp1 and srebp2.Conclusion: The stem cell treatment based on MSCs modified by FGF21 and GLP1 genes is an effective approach for treatment of T2DM.
Prevalence and Significance of Serum 14-3-3η(eta) in Juvenile Idiopathic Arthritis
Authors: Reyhan Iris , Zhukov Olga S. , Lagier Robert J. , Bridgeforth Robert F. , Popov Joanna M. , Naides Stanley J. , Reiff Andreas
Published: May 2020

Background Prompt diagnosis of juvenile idiopathic arthritis (JIA) is important to avoid long term complications. Elevated serum 14-3-3η levels improve the diagnostic sensitivity of rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody in adult rheumatoid arthritis (RA), and have been associated with more severe phenotype. We investigated the prevalence and clinical significance of serum 14-3-3η in different types of JIA.Methods JIA patients (n = 152) followed by the Pediatric Rheumatology Core at Children’s Hospital of Los Angeles were categorized into 5 groups: polyarticular JIA RF+ (PJIA RF+; n = 39), PJIA RF- (n = 39), psoriatic arthritis (PsA; n = 20), enthesitis-related arthritis (ERA; n = 18), and oligoarticular JIA (OJIA [control group]; n = 36). RF, CCP antibody, and 14-3-3η were measured for all patients. 14-3-3η serum levels ≥ 0.2 ng/mL were considered positive. Disease activity was assessed by the Juvenile Arthritis Disease Activity Score-71 (JADAS-71).Results Elevated 14-3-3η levels were detected in 35/152 (23%) patients, and across all groups tested. Most patients with 14-3-3η had titers ≥ 4 times above the cutoff value. The majority (23, 67%) of 14-3-3η-positive patients were also positive for RF or CCP antibodies, 17 (49%) were positive for all 3, and 12 (8%) were single-positive for 14-3-3η. The highest prevalence of 14-3-3η was in PJIA RF + patients (49%), followed by OJIA (22%). Positivity for 14-3-3η was not significantly associated with disease activity or age at diagnosis.Conclusion Serum 14-3-3η can be detected in all forms of JIA tested but appears to be most common in PJIA RF+. 14-3-3η does not appear to correlate with disease activity in JIA.
What lies beneath? Above ground and sediment carbon storage in mangroves along a sea to shore gradient in Lindi, Tanzania
Authors: Cleyndert Georgia de Jong , Cuni-Sanchez Aida , Seki Hamidu A , Shirima Deo D , Munishi Pantaleo K.T. , Burgess Neil , Marchant Robert
Published: May 2020

Background: Mangrove forests have gained recognition for their potential role in climate change mitigation due to the carbon sequestration of the productive ecosystems and storage in the sediments that are trapped by the mangrove tree roots and pneumatophores. Africa hosts about 19% of the world’s mangroves, yet there are relatively few studies that have examined the carbon stocks of African mangroves, and the studies available report great differences among sites and amongst the different pools of carbon stocks, particularly between the above ground carbon stored in trees (AGC) and organic carbon stored within the sediment - ‘soil organic carbon (SOC)’. We investigate if AGC and SOC carbon stocks differ with increasing seaward distance for estuarine mangroves in Tanzania and, how our results compare to those reported elsewhere across Africa.Results: AGC ranged between 10.9-54.9 Mg C ha-1. Stem density, basal area, mean diameter and mean height increased with increasing seaward distance, but percentage of small stems (5.0-9.9 cm diameter) decreased. SOC for 0-1m depth ranged from 153.7-483.6, with a mean of 301.7 Mg C ha-1. SOC was significantly negatively correlated with seaward distance. Overall, our estimates of AGC are similar to those reported elsewhere in Tanzania but our estimates of SOC are higher as we sampled at a greater depth. There are important methodological differences in previous studies in Africa. Conclusion:This study indicates that seaward distance has an important effect on both AGC and SOC stocks in the Lindi region of Tanzania and there is the need to standardise methodological approaches to make results easily comparable across sites. The high SOC value is likely to be much greater if the full extent of the sediment system is assessed and so if Tanzania and other African nations are to fully benefit from carbon offsetting schemes, it is essential that the contribution of mangrove sediment carbon is considered.
Growth differentiation factor 15 is associated with cardiovascular outcomes in patients with coronary artery disease
Authors: Li Man , Duan Lei , Cai Yulun , Li Huiying , Hao Benchuan , Chen Jianqiao , Liu Hongbin
Published: May 2020

Background: Growth differentiation factor-15 (GDF-15) is a marker of inflammation, oxidative stress and it is associated with adverse prognosis in cardiovascular disease. The aim of the present cohort study is to investigate the prognostic value of GDF-15 in patients with coronary artery disease (CAD) during long-term follow up.Method: A total of 3641 consecutive patients with CAD were prospectively enrolled into the study and followed up for all cause death and major adverse cardiovascular events (MACEs) up to 6.4 years. Plasma GDF-15 was measured and clinical data and long-term events were registered. The patients were subsequently divided into three groups by the levels of GDF-15 and the association of GDF-15 level with MACEs was evaluated.Result: After a median follow-up at 6.4 years later, 775 patients (event rate of 21%) had developed MACEs and 275 patients died (event rate of 7.55%). Kaplan–Meier analysis indicated that the patients with GDF-15 > 1800 ng/L were significantly associated with an increased risk of MACEs and all cause death. After adjustment for potential confounders, GDF-15 > 1800 ng/L. were independently associated with the composite of major adverse cardiovascular events (MACEs) (HR 1.74; 95% CI: 1.44–2.02; p<0.001) and all-cause death (HR 2.04; 95% CI 1.57– 2.61; p<0.001). For MACEs a significant increase of receiver operator characteristic curve (ROC)curve was seen after addition of GDF-15 to a clinical model 0.628(95% CI 0.605–0.651; p <0.001).For long-term all-cause death a significant increase of ROC curve was seen after addition of GDF-15 to a clinical model 0.817(95% CI 0.787–0.846; p<0.001).Conclusions: In the setting of CAD, GDF-15 is associated with long-term all-cause death, MACEs and provides incremental prognostic value beyond traditional risks factors.
Cross-sectional study of prevalence and determinants of uncontrolled Hypertension among South African adult residents of Mkhondo municipality
Authors: Masilela Charity , Pierce Brendon , Adeniyi Oladele Vincent , Benjeddou Mongi
Published: May 2020

Background: Achieving the blood pressure treatment target in individuals with hypertension is a serious global health challenge. Furthermore, the actual burden of uncontrolled hypertension is poorly understood especially in the developing countries. Therefore, this study comprehensively examined the rate and factors associated with uncontrolled hypertension in individuals receiving care at the primary healthcare facilities in the rural areas of Mkhondo Municipality in the Mpumalanga Province, South Africa.Methods: In this cross-sectional study, individuals attending care for hypertension were recruited from January 2019 to June 2019 at three primary healthcare centres, namely, Piet Retief hospital, Mkhondo town clinic and Thandukukhanya community health centre. Uncontrolled hypertension was defined as systolic blood pressure ≥ 140mmHg and diastolic blood pressure ≥ 90mmHg in accordance with the South African Hypertension Society guideline (2014). Multivariate logistic regression (Forward LR method) analysis was used to identify the significant determinants of uncontrolled hypertension.Results: The majority of the participants were; 55 years old and above (69.0%), Zulus (81.2%), non-smokers (84.19%) and had been diagnosed with hypertension for more than a year prior to the study (72.64%). The overall prevalence of uncontrolled hypertension was 56.83% (n=187) with no significant difference between sexes, 57.38% males versus 56.88% females, respectively. In the multivariate logistic regression model analysis after adjusting for confounding variables, obesity (AOR=2.90; 95% CI 1.66-5.05), physical activity (AOR=4.79; 95% CI 2.15-10.65) and HDL-C (AOR=5.66; 95% CI 3.33-9.60) were the significant and independent determinants of uncontrolled hypertension in the cohort.ConclusionThe high rate of uncontrolled hypertension in the study setting, can be largely attributed to obesity, physical activity and dyslipidaemia. Treatment will require the collaborative efforts of individuals, clinicians and health authorities. All these determinants should be addressed decisively so as to achieve the treatment blood pressure targets in the study population.
What are the Most Important Problems in Functioning Among Patients with Shoulder Pain? An Analysis of the Patient-Specific Functional Scale
Authors: Røe Yngve , Rysstad Tarjei , Tveter Anne Therese , Sandbakk Torill Bjugan , Jæger Marit , Grotle Margreth
Published: May 2020

Background Shoulder pain is a common and often persistent health condition with substantial impact on daily functioning. The primary aim of the present study was to identify important functional problems among patients with shoulder pain, using the Patient-Specific Functional Scale (PSFS). A secondary aim was to investigate differences between primary- and secondary care patients.Methods The study had a cross-sectional design and included patients seeking care for shoulder pain in a primary- and a secondary outpatient clinic. Background variables, pain, physical activity level and the PSFS, were registered with a questionnaire package. Meaningful concepts from the PSFS responses were extracted and linked to the International Classification of Functioning, Disability and Health (ICF), according to the refined linking rules. Frequency for the ICF categories was estimated for primary- and secondary care, separately. Differences between primary and secondary care were investigated by calculating confidence intervals for the sample proportions, at ICF chapter level.Results Of the total 177 patients, 84 were recruited from primary care and 93 from secondary care. The primary care sample reported functional problems linked to 226 ICF categories, while 337 in secondary care. Of the linked ICF categories 87.7% belonged to the Activities and Participation component of the ICF. Seventeen categories were identified in > 3% of the patients, of those the most frequent were: Recreation and leisure (d920), Lifting and carrying objects (d430)’, Doing housework (d640), Hand and arm use (d445) and Remunerative employment (d850). Categories included in the ICF chapters Self-care (d5) and Domestic life (d6) were significantly more frequent in the secondary care sample, while there was a trend that b7 Neuromusculoskeletal and movement-related functions were more frequent in primary care.Conclusion The present findings indicate that patients with shoulder pain report a wide range of functional problems, from basic functions related to mobility to more complex functions related to work and leisure activities. This study also discovered differences in the report of functional problems between primary and secondary care patients. The large variation in the experiences between patients supports the use of an individualised measure to support assessment of functioning among shoulder patients.Trial registration Not applicable
Intraoperative Three-Dimensional Imaging in Ankle Syndesmotic Reduction.
Authors: Beck Markus , Brunk Manuela , Wichelhaus Alice , Mittlmeier Thomas , Rotter Robert
Published: May 2020

PurposeInjuries of the distal syndesmosis in ankle fractures are traditionally treated with a temporary adjusting screw fixation. Conventional fluoroscopic and X-ray examinations cannot reliably diagnose malpositions of the fixed tibiofibular syndesmosis. Postoperative computer tomography allows a reliable control of the transfixed region. The aim of the study was to clarify whether an intraoperative 3D image intensifier examination can detect malpositions of the syndesmosis already intraoperatively and whether the examination has an influence on the postoperative revision rate.MethodsIn 200 patients with tibiofibular syndesmosis injuries, an intraoperative 3D scan was performed after reduction of the distal tibiofibular syndesmosis and placement of the adjusting screw. Postoperative computer tomography of both ankle joints was performed in all patients.Results15% of all intraoperative 3D scans (30 patients) showed a finding requiring correction in the area of the ankle fork. In 7% of the cases, a malposition of the fibula in the tibial incisura requiring correction was found. Further corrections were necessary due to the extent and position of the osteosynthesis material (7%) and for the removal of joint bodies (1%). Postoperative computer tomographies of the ankle joints showed no deformities requiring revision.ConclusionAn intraoperative 3D scan allows a reliable assessment of the injured ankle region and reduces the postoperative revision rate. This makes a postoperative routine CT examination of the ankle joint dispensable.
Clinicians’ Experience of Providing Care: A Rapid Review
Authors: Iqbal Maha Pervaz , Manias Elizabeth , Mimmo Laurel , Mears Stephen , Jack Briony , Hay Liz , Harrison Reema
Published: May 2020

Background Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progressed in relation to provider experience. This review aims to explore this knowledge gap by capturing evidence of clinician experience, and how this experience is defined and measured in the context of health system change and innovation. Methods: A rapid review of published and grey literature review was conducted utilising a rapid evidence assessment methodology. 79 studies retrieved from the literature were included in the review. 14 articles were identified from the grey literature search and one article obtained via hand searching. In total, 94 articles were included in the review. This study was commissioned by and co-designed with the New South Wales, Ministry of Health. Results: Clinician experience of delivering health care is inconsistently defined in the literature, with identified articles lacking clarity regarding distinctions between experience, engagement and work-related outcomes such as job satisfaction. Clinician experience was commonly explored using qualitative research that focused on experiences of discrete health care activities or events in which a change was occurring. Such research enabled exploration of complex experiences. In these contexts, clinician experience was captured in terms of self-reported information that clinicians provided about the health care activity or event, their perceptions of its value, the lived impacts they experienced, and the specific behaviours they displayed in relation to the activity or event. Moreover, clinician’s experience has been identified to have a paucity of measurement tools. Conclusion: Literature to date has not examined clinician experience in a holistic sense. In order to achieve the goals identified in relation to value-based care, further work is needed to conceptualise clinician experience and understand the nature of measurement tools required to assess this. In health system application, a broader ‘clinician pulse’ style assessment may be valuable to understand the experience of clinical work on a continuum rather than in the context of episodes of change/care.
Spatiotemporal Variability and Trends in Rainfall and Temperature in Alwero Watershed, Western Ethiopia
Authors: ALEMAYEHU ARRAGAW , Maru Molla , Bewket Woldeamlak , Assen Mohammed
Published: May 2020

Background Climate analysis at relevant time scales is important for water resources management, agricultural planning, flood risk assessment, ecological modeling and climate change adaptation. This study analyses spatiotemporal variability and trends in rainfall and temperature in Alwero watershed, western Ethiopia. The study is based on gridded monthly rainfall and maximum and minimum temperature data series at a resolution of 4 × 4 km which were obtained from the National Meteorological Agency of Ethiopia for the period 1983–2016. The study area is represented by 558 points (each point representing 4 × 4 km area).Results Mean annual rainfall of the watershed is > 1600 mm. Annual, June-September (Kiremt), March-May (Belg) rainfall totals exhibit low inter-annual variability. Annual and October-February (Bega) rainfall show statistically significant increasing trends at p = 0.01 level. May and November rainfall show statistically significant increasing trends at p = 0.01 level. March shows statistically significant decreasing trend at p = 0.1 level. The mean annual temperature of the watershed is 25 0C with standard deviation of 0.31 0C and coefficient of variation of 0.01 0C. Mean annual minimum and maximum temperatures show statistically non-significant decreasing trends. Bega season experienced statistically significant deceasing trend in the maximum temperature at p = 0.01 level. The year-to-year variability in the mean annual minimum and maximum temperatures showed that the 2000s is cooler than the preceding decades. Unlike our expectations, annual and seasonal rainfall totals showed increasing trends while maximum and minimum temperatures showed decreasing trends.Conclusions Our results suggest that local level investigations such as this one is important in developing context-specific climate change adaptation and agricultural planning, instead of coarse-scale national level analysis guiding local level decisions.
The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials
Authors: Feng Xiaojin , Hu Jialing , Hua Fuzhou , Zhang Jing , Zhang Lieliang , Xu Guohai
Published: May 2020

Background There is no consensus on whether intraoperative hypotension is associated with postoperative cognitive impairment. Hence, we performed a meta-analysis to evaluate the correlation of intraoperative hypotension and the incidence of postoperative delirium (POD) or postoperative cognitive dysfunction (POCD).Methods We searched PubMed, Embase, and Cochrane library databases to find randomized controlled trials (RCTs) in which reported the relationship of intraoperative hypotension and POD or POCD. The retrieval time is up to January 2020, without language restrictions. Quality assessment of the eligible studies was conducted by two researchers independently using the Cochrane evaluation system.Results Five RCTs were included. For the incidence of POD, there are two studies with 99 participants in the low-blood pressure (LP) group and 94 participants in the high-blood pressure (HP) group. For the incidence of POCD, there are four studies with 360 participants in the LP group and 341 participants in the HP group, with a study contains both POD and POCD. No significant difference between the LP and the HP group was observed in the incidence of POD (RR = 3.30, 95% CI 0.80 to 13.54, P = 0.10), or POCD (RR = 1.26, 95% CI 0.76 to 2.08, P = 0.37). Furthermore, it also demonstrated that intraoperative hypotension prolonged the length of ICU stay, but did not increased the mortality, the length of hospital stay, and mechanical ventilation (MV) time.Conclusions There is no significant correlation between intraoperative hypotension and the incidence of POD or POCD.