bluuebunny/crossref_metadata_2025 huggingface dataset:
Orthopaedic Resident Burnout Is Associated with Poor In-Training Examination Performance
Authors: Strauss Eric J. , Markus Danielle H. , Kingery Matthew T. , Zuckerman Joseph , Egol Kenneth A.
Published: October 2019

Background:

Resident burnout—the state of exhaustion, maladaptive detachment, and low sense of accomplishment—is a widely documented phenomenon that affects between 27% and 75% of residents in the United States. To our knowledge, no previous study has examined the relationship between resident burnout and performance on the Orthopaedic In-Training Examination (OITE). The current investigation sought to evaluate whether an association exists between indices of orthopaedic surgery resident burnout as assessed by the Maslach Burnout Inventory (MBI) and performance on the OITE.

Methods:

In a cross-sectional study of the orthopaedic surgery residents at a single large academic institution, the MBI was completed by all trainees in May 2016. The results of the 2016 OITE were documented for each resident, including the percentage of correctly answered questions and OITE percentile ranking. To control for individual test-taking skills, United States Medical Licensing Examination (USMLE) Step-1 and Step-2 scores also were documented for each resident. The relationship between the MBI subscale scores and OITE performance was evaluated.

Results:

The analysis included 100% of the 62 orthopaedic surgery residents in training at our institution. Sixteen (25.8%) of the residents experienced at least moderate emotional exhaustion, while 32 (51.6%) of the residents experienced at least moderate depersonalization and 8 (12.9%) of the residents experienced a moderate sense of impaired personal accomplishment. Postgraduate year (PGY)-2 residents had the highest emotional exhaustion and depersonalization scores compared with residents in other years of training. Each of the 3 MBI indices of burnout was associated with worse OITE performance when controlling for general test-taking ability.

Conclusions:

In this study of orthopaedic surgery residents at a large academic training program, burnout was present among residents in all PGYs of training; it was most prevalent during the second year of training. Increased levels of the 3 components of burnout were associated with worse performance on the OITE. While there is a lack of consensus in the existing literature, this study provides additional evidence that burnout is negatively associated with 1 aspect of overall resident performance.

Clinical Relevance:

Orthopaedic surgery residency training is challenging; residents are tasked to acquire a considerable amount of knowledge, develop complex surgical skills, and hone critical clinical thinking in a relatively short period of time. Identifying modifiable contributors to resident burnout and the development of strategies to promote resident wellness during training are important as we strive toward developing the next generation of capable, competent, and well-balanced orthopaedic surgeons.
The Effect of Prolonged Postoperative Antibiotic Administration on the Rate of Infection in Patients Undergoing Posterior Spinal Surgery Requiring a Closed-Suction Drain
Authors: Urquhart Jennifer C. , Collings Darryl , Nutt Lori , Kuska Linda , Gurr Kevin R. , Siddiqi Fawaz , Rasoulinejad Parham , Fleming Alyssa , Collie Joanne , Bailey Christopher S.
Published: October 2019

Background:

Closed-suction drains are frequently used following posterior spinal surgery. The optimal timing of antibiotic discontinuation in this population may influence infection risk, but there is a paucity of evidence. The aim of this study was to determine whether postoperative antibiotic administration for 72 hours (24 hours after drain removal as drains were removed on the second postoperative day) decreases the incidence of surgical site infection compared with postoperative antibiotic administration for 24 hours.

Methods:

Patients undergoing posterior thoracolumbar spinal surgery managed with a closed-suction drain were prospectively randomized into 1 of 2 groups of postoperative antibiotic durations: (1) 24 hours, or (2) 24 hours after drain removal (72 hours). Drains were discontinued on the second postoperative day. The duration of antibiotic administration was not blinded. All subjects received a single dose of preoperative antibiotics, as well as intraoperative antibiotics if the surgical procedure lasted >4 hours. The primary outcome was the rate of complicated surgical site infection (deep or organ or space) within 1 year of the surgical procedure.

Results:

The trial was terminated at an interim analysis, when 552 patients were enrolled, for futility with respect to the primary outcome. In this study, 282 patients were randomized to postoperative antibiotics for 24 hours and 270 patients were randomized to postoperative antibiotics for 72 hours. A complicated infection developed in 17 patients (6.0%) in the 24-hour group and in 14 patients (5.2%) in the 72-hour group (p = 0.714). The superficial infection rate did not differ between the groups (p = 0.654): 9.6% in the 24-hour group compared with 8.1% in the 72-hour group. Patients in the 72-hour group had a median hospital stay that was 1 day longer (p < 0.001). At 1 year, patient-rated outcomes including leg and back pain and physical and mental functioning were not different between the groups.

Conclusions:

The extension of postoperative antibiotics for 72 hours, when a closed-suction drain is required, was not associated with a reduction in the rate of complicated surgical site infection after posterior thoracolumbar spinal surgery.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of Levels of Evidence.
Enhanced recovery after surgery (ERAS) pathway for primary hip and knee arthroplasty: study protocol for a randomized controlled trial
Authors: Li Jingyi , Zhu Haibei , Liao Ren
Published: October 2019

Background: With the substantially growing trend of the aging populations in China and the rest of the world, the number of total hip and total knee arthroplasty (THA and TKA) cases are increasing dramatically. It’s important to develop practical strategies to improve the quality of healthcare and better outcome for patients undergoing THA and TKA. Enhanced recovery after surgery (ERAS) pathways have been reported to promote earlier recovery and be beneficial for patients. We propose the hypothesis that ERAS pathway could reduce the length of stay (LOS)in hospital for patients undergoing primary THA or TKA.
Methods/Design:This trial is a prospective, open-labelled, multi-centered, randomizedcontrolledtrial that will test the superiority of ERAS pathway in term of LOS in hospital for the patients undergoing primary THA or TKAas compared to current non-ERAS clinical practice.A total of 640 patients undergoing primary THA or TKA will be randomly allocated to either ERAS pathway (ERAS group) or conventional care according to individual participating center(non-ERAS group).The primary outcome is the total LOS in hospital, the secondary outcomes include postoperative LOS, all-cause mortality by 30 days after operation, in-hospital complications, early mobilization, postoperative pain control, total in-hospital cost, and readmission rateby 30 days after discharge from the hospital.
Discussion: This trial is designed to evaluate the superiority of the ERAS pathway to conventional non-ERAS clinical practice in reducing the LOS.The results may provide new insight into the clinical applications of ERAS pathway for total hip and total knee arthroplasty.
Trial registration:The National Institutes of Health Clinical Trials Registry, NCT03517098. Registered 04, May, 2018. https://register.clinicaltrials.gov/prs/app/action/ SelectProtocol?sid=S0007YV7&selectaction=Edit&uid=U0001B4E&ts=2&cx=97eyz9
Influence of plant growth regulators on morphogenic response, biomass and camptothecin production in the callus cultures of Chonemorpha fragrans (Moon) Alston
Authors: Isah Tasiu
Published: October 2019

Background: In vitro morphogenic response of mature seed embryo-derived callus cultures of Chonemorpha fragrans was studied using solid and liquid Murashige and Skoog medium amended with cytokinins or their combinations with naphthalene acetic acid at 0.5 mg L-1.Results: The tested plant growth regulators combination and concentrations could not stimulate organogenesis after three subcultivations of the callus cultures on the same PGRs-amended solid medium, and when cultivated in the liquid but, formation of morphogenic callus was observed. Evaluation of biomass and camptothecin production showed that the PGRs influenced biomass and CPT yield of the callus cultures. The alkaloid yield of various explants of 3–4 weeks old axenic seedlings was higher in roots (0.019 % CPT) followed by mature seed embryos (0.0053 %), cotyledons (0.0039 %), hypocotyls (0.0024 %) and leaves (0.0017 %). There was no significant difference in yield of CPT from callus induced from the various explants. Camptothecin yield of morphogenic callus cultures cultivated in liquid medium was lower than that of solid due to extracellular leaching effect of the alkaloid. Amount of synthesized CPT in the callus cultures also varied with PGR type and concentration amended in the cultivation medium, and showed association with biomass production.Conclusion: Results of the present study suggest that callus cultures offer alternative tissue source for in vitro CPT yield enhancement through biotechnological approaches, with application in the large-scale production of the alkaloid to conserve the ever decimated natural population of the medicinal woody climber for CPT.
Phenotypic Analysis Combined with Tandem Mass Tags (TMT) Labeling Reveal the Heterogeneity of Strawberry Stolon Buds
Authors: Guan Ling , Zhao Mizhen , Qian Yaming , Yu Hongmei , Xia Jin , Wu Ejiao
Published: October 2019

Background: Ramet propagation in strawberry (Fragaria × ananassa) is the most effective way in production. However, the lack of systematically phenotypic observations and high-throughput methods limits our ability to analyze the key factors regulating the heterogeneity in strawberry stolon buds. Results: From observation, we found that the axillary bud located in the first node quickly stepped into dormancy (DSB), after several bract and leaf buds were differentiated. The stolon apical meristem (SAM) degenerated as the new ramet leaf buds (RLB), and the new active axillary stolon buds (ASB) differentiated continually after the differentiation of the first leaf. Using the tandem mass tags (TMT) labeling method, a total of 7,271 strawberry proteins were identified. Between ASB and DSB, the spliceosome DEPs, such as Ser/Arg-rich (SR) and heterogeneous nuclear ribonucleoprotein particle (hnRNP), showed the highest enrichment and high PPI connectivity. This indicated that the differences in DEPs (e.g., SF-3A and PK) at the transcriptional level may be causing the differences between the physiological statuses of ASB and DSB. As expected, the photosynthetic pre-form RLB mainly differentiated from ASB and DSB judging by the DEP enrichment of photosynthesis. However, there are still other specialized features of DEPs between RLB and DSB and between ASB and DSB. The DEPs relative to DNA duplication [e.g., minichromosome maintenance protein (MCM 2, 3, 4, 7)], provide a strong hint of functional gene duplication leading the bud heterogeneity between RLB and DSB. In addition, the top fold change DEP of LSH 10-like might be involved in the degeneration of SAM into RLBs, based on its significant function in modulating the plant shoot initiation. As for RLB/ASB, the phenylpropanoid biosynthesis pathway probably regulates the ramet axillary bud specialization, and further promotes the differentiation of xylem when ASB develops into a new stolon [e.g., cinnamyl alcohol dehydrogenase 1 (CAD1) and phenylalanine ammonia-lyase 1 (PAL1)]. Conclusions: By using phenotypic observation combined with proteomic networks with different types of strawberry stolon buds, the definite dormancy phase of DSB was identified, and the biological pathways and gene networks that might be responsible for heterogeneity among different stolon buds in strawberry were also revealed.
Disaster preparedness among Thai elderly emergency department patients: A survey of patients’ perspective
Authors: Sri Jiraporn , Vanichkulbodee Alissara , Sinsuwan Natchapon , Rojsaengroeng Rapeeporn , Kamsom Anucha , Liu Shan Woo
Published: October 2019

Background: In disaster situations, the elderly are considered to be a particularly vulnerable population. Preparedness is the key to reduce post-disaster damage. There is limited research in middle-income countries on how well elderly emergency department (ED) patients are prepared for disaster situations. The objective of this study was to determine the attitudes and behavior of elderly ED patients toward disaster preparedness. Methods: This study was a cross-sectional face-to-face survey at one urban teaching hospital in Bangkok, Thailand between August 1st and September 30th, 2016. Patients aged 60 and older who presented to the ED were included to this study. We excluded patients who had severe dementia [defined as Short Portable Mental State Questionnaires (SPMSQ) > 8], were unable to speak Thai, had severe trauma and/or needed immediate resuscitation. The survey instruction was adapted from previous disaster surveys. This study was approved by the Vajira Institutional Review Board (IRB). Results: A total of 243 patients were enrolled. Most of them were female [154 patients (63.4%)]. The median age was 72 [Interquartile range (IQR) 66-81] years and the most common underlying diseases were hypertension [148 patients (60.9%)] and diabetes [108 patients (44.4%)]. The majority of patients [172 patients (72.4%)] reported that they had had some teaching about disaster knowledge from a healthcare provider and had experienced a disaster [138 patients (56.8%)]. While 175/197 (81.8%) patients who had underlying diseases reported that they had a medication supply for disaster situations, only 61 (25.1%) patients had an emergency toolbox for disasters. Most patients (159, 65.4%) did not know the emergency telephone number, and 133 (54.7%) patients reported transportation limitations. Conclusions: While most Thai elderly ED patients reported having a medication supply for disaster situations, many lacked comprehensive plans for a disaster situation. Work needs to be done to improve the quality of preparedness in disaster situations among elderly patients. Future research should focus on preparedness knowledge regarding evacuation, and shelter/residence for older patients.
Does Case-based blended-learning expedite the transfer of declarative knowledge to procedural knowledge in practice?
Authors: Turk Bela Rui , Ertl Sebastian , Wong Guoruey , Wadowski Patricia P , Loeffler-Stastka Henriette
Published: October 2019

Background Case-Based Learning (CBL) has seen widespread implementation in undergraduate education since the early 1920s. Ample data has shown CBL to be an enjoyable and motivational didactic tool, and effective in assisting the expansion of declarative and procedural knowledge in academia. Although a plethora of studies apply multiple choice questions (MCQs) in their investigation, few studies measure CBL or case-based blended learning (CBBL)-mediated changes in students’ procedural knowledge in practice or employ comparison or control groups in isolating causal relationships. Methods Utilizing the flexibilities of an e-learning platform, a CBBL framework consisting of a) anonymized patient cases, b) case-related textbook material and online e-CBL modules, and c) simulated patient (SP) contact seminars, was developed and implemented in multiple medical fields for undergraduate medical education. Additionally, other fields saw a solo implementation of e-CBL in the same format. E- cases were constructed according to the criteria of Bloom’s taxonomy. In this study, Objective Structured Clinical Examination (OSCE) results from (n=619) medical students in 2013 before CBBL implementation, and after CBBL implementation in 2015 (n=624) and 2016 (n=643) were analyzed. Results A significant improvement (adjusted p=.002) of the mean OSCE score by 1.02 points was seen between 2013 and 2015 (min=0, max=25). Conclusion E-Case-Based Learning is an effective tool in increasing student satisfaction, improving performance outcomes and may provide a sustainable learning platform for many fields of medicine in future.
Decreasing postoperative cognitive deficits after heart surgery: Protocol for a randomized controlled trial on cognitive training
Authors: Butz Marius , El-Shazly Jasmin , Sammer Gebhard , Tschernatsch Marlene , Kastaun Sabrina , Yenigün Mesut , Braun Tobias , Kaps Manfred , Böning Andreas , Puvogel Ulrike , Bachmann Georg , Mengden Thomas , Schönburg Markus , Gerriets Tibo , Juenemann Martin
Published: October 2019

Background The occurrence of postoperative cognitive deficits, especially after heart surgery, has been demonstrated in several studies. These deficits can clearly be noticed by the patients as well as by their close relatives in daily life. Furthermore, postoperative cognitive deficits can decrease quality of life in social functioning and earning capacity. The aim of this study is to investigate whether early postoperative cognitive training can reduce subjective and objective postoperative cognitive deficits Methods The proposed study is a multicenter, 2-arm randomized controlled trial involving 144 elderly patients undergoing elective heart valve surgery with extracorporeal circulation. Patients will be assigned to either a training group or a control group. The intervention involves a paper-and-pencil-based cognitive training, which is conducted for 36 minutes over a period of 18 days. The training starts about 1 week after surgery and is carried out during the hospitalized rehabilitation phase. The control group will not receive a cognitive training or a placebo intervention. A detailed assessment of psychological functions and health-related quality of life prior to surgery at discharge from rehabilitation and 3 and 12 months after discharge will be performed. The Primary outcome of this trial is the training effect on objective cognitive functions at discharge from rehabilitation. Secondary outcomes are the training effect on objective and subjective cognitive functions (3 and 12 months after discharge), depression, health-related quality of life, and the impact of perioperative cerebral ischemia on the training effect. Perioperative cerebral ischemia will be measured with postoperative magnetic resonance imaging including diffusion-weighted sequences. Discussion Should it be shown that our cognitive training can improve postoperative cognitive deficits as well as quality of life, one possibility could be to integrate this intervention into early rehabilitation. Furthermore, we hope that the investigation of perioperative ischemia by diffusion-weighted magnetic resonance imaging will improve our understanding of neurobiological factors influencing the course of postoperative cognitive plasticity.
Statistical analysis plan for the 5- and 10-year follow-up assessments of the FIDELITY trial
Authors: Sihvonen Raine , Kalske Roope , Englund Martin , Turkiewicz Aleksandra , Toivonen Pirjo , Taimela Simo , Järvinen Teppo
Published: October 2019

Background: The research objectives of the 5- and 10-year assessments of the Finnish Degenerative Meniscal Lesion Study (FIDELITY) are two-fold: 1) to assess the long-term efficacy of arthroscopic partial meniscectomy (APM) in adult (age 35 to 65 years) patients with a degenerative meniscus tear, and 2) to determine the respective effects of APM and degenerative meniscus tear on the development of radiographic and clinical knee osteoarthritis (OA).
Methods and Design: FDELITY is an ongoing multi-centre, randomized, participant and outcome assessor blinded, placebo-surgery controlled trial of 146 patients. This statistical analysis plan (SAP) article describes the overall principles for analysis of long-term outcomes (5- and 10-year follow-ups), including how participants will be included in each analysis, the primary and secondary outcomes and their respective analyses, adjustments for covariates, and the presentation of the results. In addition, we will present the planned sensitivity and subgroup analyses.
Discussion: To study whether APM (resection of torn meniscus tear) per se accelerates or delays the development of knee osteoarthritis in patients with an arthroscopically-verified degenerative tear of the medial meniscus, we are carrying out pre-registered long-term (5- and 10-year) follow-up of our placebo-surgery controlled FIDELITY trial according to statistical principles outlined in detail in this document. We have also outlined the analyses intended to assess our second primary objective, the long-term efficacy of APM on knee symptoms and function.
Can selenium deficiency in Malawi be alleviated through consumption of agro-biofortified maize flour? Study protocol for a randomised, double-blind, controlled trial
Authors: Joy Edward , Kalimbira Alexander , Gashu Dawd , Ferguson Elaine , Sturgess Joanna , Dangour Alan , Banda Leonard , Chiutsi-Phiri Gabriella , Bailey Elizabeth , Langley-Evans Simon , Lark Murray , Millar Kate , Young Scott , Matandika Limbanazo , Mfutso-Bengo Joseph , Phuka John , Phiri Felix , Gondwe Jellita , Ander Louise , Lowe Nicola , Nalivata Patson , Broadley Martin , Allen Elizabeth
Published: October 2019

Background
Micronutrient deficiencies including selenium (Se) are widespread in Malawi and potentially underlie a substantial disease burden, particularly among poorer and marginalised populations. Concentrations of Se in staple cereal crops can be increased through application of Se fertilisers – a process known as agronomic (agro-) biofortification – and this may contribute to alleviating deficiencies. The Addressing Hidden Hunger with Agronomy (AHHA) trial aims to establish the efficacy of this approach for improving Se status in rural Malawi.
Methods
A double-blind, randomised, controlled trial will be conducted in a rural community in Kasungu District, Central Region, Malawi. The hypothesis is that consumption of maize flour agro-biofortified with Se will increase serum Se concentration. We will recruit 180 women of reproductive age (WRA; 20–45 years) and 180 school-aged children (SAC; 5–10 years) randomised in a 1:1 ratio to receive either maize flour enriched through agro-biofortification with Se or a control flour not enriched with Se. Households will receive flour (330 g capita -1 day -1 ) for 12 weeks. The primary outcome is Se concentration in serum (µg L -1 ). Serum will be extracted from venous blood samples drawn at baseline (prior to flour distribution) and end-line. Selenium concentration will be measured using Inductively Coupled Plasma Mass Spectrometry (ICPMS).
Discussion
Findings will be communicated to policy stakeholders and participating communities and reported in peer-reviewed journals.
Trial registration
The Addressing Hidden Hunger with Agronomy (Malawi) trial is registered (March 2019; ISCRTN85899451).
Magnitude and factors associated with diabetic complication among diabetic patients attending Gurage Zone hospitals, South West Ethiopia.
Authors: Gebre Bereket Beyene , Assefa Zebene Mekonnen
Published: October 2019

Objective

To assess the magnitude of diabetic complication and associated factors among diabetes mellitus patients attending in Gurage zone hospitals.Results

According to this study the magnitude of diabetic complication among diabetic patients were 61% and the marital status; divorced [AOR: 0.252(0.11, 0.59); p=0.002], poor glycemic control [AOR: 1.88(1.04, 3.39); p=0.036], Body Mass Index >25 [AOR: 4.42(1.32, 14.86); p=0.016] and duration of illness > 6years [AOR:1.79 (1.02, 3.17) ; p=0.044] and 10years [AOR: 4.68(2.07, 10.61); p=<0.001] were significantly associated with diabetic complication.Key terms

Diabetic complications, magnitude, associated factor
Relationship between aspirin use of esophageal, gastric and colorectal cancer patient survival: a meta-analysis
Authors: Lin Juli , Lin Jian-xian , Zheng Chao-hui , Li Ping , Xie Jian-wei , Wang Jia-bin , Lu Jun , Chen Qi-yue , Cao Long-Long , Lin Mi , Huang Chang-ming
Published: October 2019

Background: Many studies have found that use of aspirin can lengthen survival of gastrointestinal cancer. The aim of this study is to assess the survival benefit of aspirin use compared with non- aspirin use for patients with esophageal, gastric or colorectal cancer. Methods: We search online databases, including PubMed、Cochrane Library、Embase and www.clinicaltrials.gov before Feb 1th, 2019 to identify all relevant studies. The overall survival and cancer specific survival of esophageal, gastric and colorectal cancer in aspirin users compared with non-aspirin users. Data extraction and evaluation of studies’ quality were conducted independently by 2 investigators. A meta-analysis was performed to calculate the pooled risk ratios (RRs) for overall survival and cancer specific survival using either a fixed-effects or a random-effects model. Results: 17 studies were finally included in this meta-analysis, comprising more than 71,534 patients. There is no significant differences between post-diagnosis aspirin use and overall survival for esophageal and gastric cancer. The overall survival and cancer specific survival for colorectal cancer benefit associated with post-diagnosis aspirin use represented ［HR= 0.82, 95%CI(0.72, 0.94)］ and［HR= 0.70, 95%CI(0.57, 0.86)］. Overall survival and cancer specific survival for colorectal cancer did not benefit associated with aspirin use pre-diagnosis. The overall survival and cancer specific survival for colorectal cancer benefit associated with both pre and post-diagnosis aspirin use represented［HR=0.75，95%CI(0.61, 0.92)］and［HR=0.78, 95%CI(0.73, 0.85)］. Besides, the survival benefit of post-diagnosis aspirin use appeared to be confined to those patients with mutated PIK3CA tumors［HR= 0.78, 95%CI(0.50, 0.99)］and with positive PTGS2 (COX-2) expression［HR= 0.75, 95%CI(0.43, 1.30)］. Conclusions: These findings provide further indication that post-diagnosis aspirin therapy improved overall survival and cancer specific survival of colorectal cancer, especially for patients with positive PTGS2 (COX-2) expression and mutated PIK3CA tumors. However, it don’t improve overall survival of esophageal and gastric cancer and the meta-analysis is limited mainly to retrospective studies.
Moleculare detection of Bartonella in ixodid ticks and plateau pika (Ochotona curzoniae) in Shiqu county, China
Authors: Tang Tiancai , Liu Chengcheng , Yang Aiguo , Yuan Dongbo , Guo Li , Hou Wei , Mo Xi , Yin Jie , Hao Lili
Published: October 2019

Background Bartonella bacteria have been associated with an increasingly wide range of human and animal diseases and were also recognized to be globally dispersed as emergent pathogens. Ticks and small rodents are known vectors of human and animal bartonellosis and play important roles in maintenance and circulation of bartonellae in nature. In China, Shiqu county is located on the eastern Qinghai-Tibetan plateau and about 26 thousands square kilometers with an average altitude of above 4,200 meters and vast area of pastureland. In present study, the occurrence of Bartonella spp. in ticks and plateau pika was firstly investigated in Shiqu county.Results A total of 818 ticks ( Dermacentor everestianus , 79.0%, 646/818; Haemphysalis qinghaiensis , 21.0%, 172/818), were collected in 4 villages in Shiqu county. Only Bartonella melophagi was detected in tick samples with a total prevalence of 30.1% (246/818). Significant difference was observed (P<0.05) between D.everestianus (17.0%) and H.qinghaiensis (79.1%).The infection rates of Bartonella spp. in ticks from Arizha, Maga, Derongma and Changxgma villages were 4.8%, 76.8%, 12.5% and 18.0%, respectively. Compared with other villages, the infection rate of Bartonella spp. in Maga was higher (P<0.01). As for plateau pika, total infection rate of Bartonella spp was 24.1%, with 20.8% (15/72), 30.9% (25/81), 13.8% (9/65) and 29.4% (20/68) in Arizha, Maga, Derongma and Changxgma, respectively. Totally, B. queenslandensis , B.grahamii and two unvalidated Bartonella species were detected. No significant difference in infection rates was observed (P>0.05) between theses study sites. Conclusion At present, only D.everestianus and H.qinghaiensis were found in Shiqu county with high infection of Bartonella spp. in theses ticks and plateau pika. The threats to public health by these Bartonella species should be monitored.
Intimate Partner Violence During Pregnancy And Risk Of Still Birth In Hospitals Of Tigray Region Ethiopia
Authors: gebreslasie kahsay zenebe , Weldemariam Solomon , mehari Mihret ab
Published: October 2019

Objective: The objective of this study is to assess intimate partner violence during pregnancy and its associated with still birth among postpartum mothers in Tigray region hospital. Results: The prevalence of still birth was 3.6 %. There was a statistically significant association between exposure to intimate partner violence during pregnancy and still birth. Pregnant women who were exposed to intimate partner violence during pregnancy were three times more likely to have still birth 3.3(95%CI: 1.1-9.7)) as compared to those who were not exposed. Other factor associated with still birth was low birth weight 16.7(95%CI:6-46).
External Dacryocystorhinostomy versus Canalicular Silicone Intubation with Mitomycin C in Primary Acquired Nasolacrimal Duct Obstruction
Authors: Ellakwa Amin Faisal , Elmorsy osama Abdallah , Zaki Marwa Ali
Published: October 2019

Purpose

To compare external dacryocystorhinostomy versus canalicular silicone intubation with the use of Mitomycin C (MMC) in primary acquired nasolacrimal duct obstruction (NLDO).

Methods

the study was carried out at the department of Ophthalmology, Menoufia university Hospital, Egypt, between June 2012 to July 2014. Fifty-six patients who were diagnosed with primary acquired NLDO. Patients were randomly allocated into two groups: thirty cases underwent external DCR and twenty-six cases underwent silicone intubation with MMC.

Results

No significant difference was detected in success and failure rates between external DCR (90%) and silicon intubation with MMC (80.7%) at 6 months follow up. Also, both procedures were associated with low rate of intraoperative adverse events, with no postoperative adverse events were detected, however, intubation was relatively safer than DCR.

Conclusion

Silicon intubation with MMC is as effective and safe as external DCR and should be considered as a minimally invasive procedure in primary acquired NLDO.
The Efficacy of Antipyretic Analgesics Administration Intravenously for Preventing Rocuronium-Associated Pain/Withdrawal Response: A Systematic Review and Meta-Analysis
Authors: Wang Jia , Liu Bin , Cui Yu , Chen Jianfeng
Published: October 2019

Background Rocuronium-associated injection pain/withdrawal response (RAIPWR) was non-ideal but occurred frequently when injection intravenously during anesthesia induction. Many studies had reported that pretreating with antipyretic analgesics (AAs) could reduce the occurrence of RAIPWR, but there was no consensus yet. Therefore, this meta-analysis was designed to systematically evaluate the benefits of AAs on RAIPWR in patients.Methods PubMed, Cochrane Library, Ovid, EMbase, Chinese National Knowledge Infrastructure (CNKI), Wan Fang Data were searched by January 1st 2019 for randomized controlled trials (RCTs) applying AAs to alleviate RAIPWR in patients underwent elective surgery under general anesthesia. Two investigators assessed quality of RCTs and extracted data independently and the meta-analysis was carried on Revman 5.3 software. Plus, we also compared AAs with lidocaine in pros and cons directly, the most reported medicine to prevent RAIPWR.Results Data were analyzed from 10 RCTs totaling 992 patients. The results of Meta-analysis showed that compared to the control group, pretreating with AAs could prevent the total occurrence of RAIPWR [Risk ratio (RR), 0.51; 95% confidence interval (CI), 0.41 to 0.64; P < 0.0001], and took effect on moderate (RR, 0.49; 95%CI, 0.39 to 0.63; P<0.0001) and severe RAIPWR (RR=0.14; 95%CI, 0.08 to 0.24; P<0.00001). When compared to lidocaine, the preventive effect was not so excellent as the latter but injection pain induced by prophylactic occurred less.Conclusion The available evidence suggested that pretreating with AAs intravenously could alleviate RAIPWR.
RNA-seq and metabolome revealed counter effect of chitosan against Botrytis cinerea on grape berries
Authors: pervaiz tariq , Jia Haifeng , Zhang Peian , Haider Muhammad Salman , Lu Suwen , Wei Xinke , Jia Haoran , Fang Jinggui
Published: October 2019

Background: Plants have great potential to protect against biotic and abiotic stresses. Hence, the interaction between defense signaling networks is incredible, which can either be activated with the application of growth elicitors or antimicrobial organic compounds. Results: In this study, chitosan (15kDa) is used against grey mold (Botrytis cinerea) in two grape varieties (Shine-Muscat and Kyoho). The findings depicted that the interaction of DEGs and KEGGs in control and treated samples of grapevine, which provides the evidence for selection of gray mold defense responsive genes and chitosan for subsequent application in grapevine production/postharvest. The genes encoding cyclic nucleotide gated ion channels (CNGCs) and CaM/CML expressed a large number of transcripts, meanwhile, in treated samples, CaM/CML and RPS2 showed the highest number of up-regulated genes. In plant hormone signal transduction pathway, treated samples AUXIAA and SAUR again the highest number of transcripts were found. In correlation with metabolome analysis, 20 differentially expressed metabolites were recorded. In the negative correlation in the control samples of Kyoho vs Shine mascate showed 224 and 157 up and down-regulated respectively. Moreover, antioxidants were also significantly regulated with the chitosan application and reduced the lesion diameter, water loss and disease incidence up to 12 days. In both varieties, the chitosan treatment superoxide dismutase, peroxidase, Malondialdehyde, catalase, and proline content was significantly increased during storage. Conclusion: The results depicted that at gene expression levels was varied at different fruit growth developmental stages, and the most effective in case of plant-pathogen interaction. Chitosan is seen to be more effective in both varieties and it acts as an anti-fungal agent. The transcriptomic study also confirmed that at the transcriptome level expression was higher in treated samples, however in general transcription factor have not much affected with chitosan application.
Overview and factors associated with pregnancies and abortions occurring in sex workers in Benin
Authors: Sullivan Gentiane Perrault , Guédou Fernand Aimé , Batona Georges , Kintin Frédéric , Béhanzin Luc , Avery Lisa , Bédard Emmanuelle , Gagnon Marie-Pierre , Zannou Djimon Marcel , Kpatchavi Adolphe , Alary Michel
Published: October 2019

INTRODUCTION

The behavioural and structural factors related to sex work, place female sex workers (FSWs) at high risk of maternal mortality and morbidity (MMM), with a large portion due to unintended pregnancies and abortions. In the African context where MMM is high amongst the general population, understanding the frequency and determinants of pregnancy and abortion among FSWs is important in order to meet their sexual and reproductive health needs.

METHODS

Data from two Beninese cross-sectional surveys (2013 - 2016) were merged. We first performed exploratory univariate analyses to identify factors associated with pregnancy and abortion (p<0.20) using Generalized Estimating Equations with Poisson regression and robust variance. Multivariate analyses first included all the variables identified in the univariate models and backward selection (p≤0.05) was used to generate the final models.

RESULTS

Mean age was 31 years (N=866). The proportion of FSWs reporting at least one pregnancy during sex work was 16.4%, of whom 42.3% had more than one. Most pregnancies ended up with an abortion (67.6%). FSWs who lived with their boyfriend (adjusted proportion ratio (aPR) = 1.74, 95%CI: [1.1, 2.8]) and did not use condoms consistently with them (aPR=1.83, 95%CI: [1.1, 3.0]) had more pregnancies.

CONCLUSION

One FSW out of five had at least one pregnancy during her sex work practice. Most of those pregnancies, regardless of their origin, ended up with an abortion. Improving access to various forms of contraception and safe abortion is the key to reducing unwanted pregnancies and consequently, MMM among FSWs in Benin.
Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke
Authors: Wang Yanan , Song Quhong , Cheng Yajun , Wei Chenchen , Ye Chen , Liu Junfeng , Wu Bo , Liu Ming
Published: October 2019

Background: It is unclear whether non-high-density lipoprotein cholesterol (Non-HDL-C) is associated with haemorrhagic transformation (HT) after acute ischaemic stroke (AIS). We aimed to explore the association between Non-HDL-C and HT, as well as compare predictive values of Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for HT.Methods: We consecutively enrolled AIS patients within 7 days of stroke onset. Participants were divided into four categories according to quartiles of Non-HDL-C. HT was assessed by follow-up brain imaging. We assessed the association between Non-HDL-C, LDL-C and HT.Results: A total of 2043 patients were included, among whom 232 were identified as HT. Compared with the highest quartiles, the first, second and third quartiles of Non-HDL-C were associated with increased risk of HT (adjusted Odds ratios [ORs] 1.74 [95% Confidence Interval [CI] 1.09-2.78], 2.01[95% CI 1.26-3.20], and 1.76 [95% CI 1.10-2.83], respectively, P for trend=0.024). Similar results were found for LDL-C. There was significant interaction between Non-HDL-C and age (P for interaction=0.021). The addition of Non-HDL-C and LDL-C to conventional factors significantly improved predictive values (Non-HDL-C, net reclassification index [NRI] 0.24, 95%CI 0.17-0.31, P<0.001; LDL-C, NRI 0.15, 95%CI 0.08-0.22, P=0.03).Conclusions: Low Non-HDL-C was associated with increased risks of HT. In addition, Non-HDL-C has similar effects as LDL-C for predicting HT.
The diagnostic performance of optical coherence tomography and optical coherence tomography angiography for early primary open-angle glaucoma: a cross-sectional study
Authors: Li Yanjie , Liu Weishai , Bai Zichao , Cao Rongxia , Ren Haihua
Published: October 2019

Background: Primary open angle glaucoma (POAG) is often delayed in diagnosis and treatment, as it has no acute attack period, and symptoms usually appear at a relatively late stage. Optical coherence tomography angiography (OCTA) on the basis of Carl Zeiss optical coherence tomography with the support of FOURM platform is recently available in China. It is reportedly more sensitive to POAG. We reported the diagnostic utilities of OCTA and OCT which is already in clinical practice. Methods: 15 patients (23 eyes) with early POAG as observation group and 30 health people (30 eyes) as normal control group were enrolled in this cross-sectional study. OCTA-based superficial macula vessel density, superficial macula perfusion density, superficial optic disc vessel density, superficial optic disc perfusion density and OCT-based macula thickness, ganglion cell complex (GCC) thickness and retinal nerve fiber layer (RNFL) thickness were recorded in ​​the two groups. Independent sample t-test and receiver operating characteristic curve were used for statistical analysis. Area under the receiver operating characteristic curves (AUCs) were used to measure the diagnostic utility.Results: The optimal diagnostic utility parameters were the superficial vessel density and perfusion density in the macula (except the center of macula), and the AUCs were above 0.97. Followed by the superficial vessel density and perfusion density in the optic disc area. The OCT-based diagnostic utility parameters were generally lower than that mentioned above, the top three parameters were the inferior RNFL thickness (AUC=0.919), the superior GCC thickness (AUC=0.919) and the inferior GCC thickness (AUC = 0.908).Conclusions: Changes of thickness in macula, GCC, RNFL, and changes of superficial vessel density and perfusion density in the optic disc or in macula can be detected by OCT or by OCTA in early POAG. The OCTA-based diagnostic utility was generally higher than the OCT-based diagnostic utility.
The reverse sleeve in total hip arthroplasty for patients with trochanter valgus deformity: surgical technique and case series
Authors: Kong Xiangpeng , Chai Wei , Yang Minzhi , Ong Alvin , Chen Jiying , Wang Yan , Zhou Yonggang
Published: October 2019

Background: Ttrochanter valgus deformity (TVD) is a rare condition of total hip arthroplasty (THA). The femoral osteotomy might be required to correct the deformity to implant the femoral stem in severe TVD. In this study, we described one unpublished technique of reverse sleeve of S-ROM to get through the complex situation. The aim of this study was to summarize the technical challenges of this special sleeve-implanting method and evaluate its effectiveness and safety. Methods: From January 2006 to December 2014, the patients who had the reverse sleeve to solve the TVD in THA were enrolled. Their demographics, perioperative and postoperative information were recorded. To explore its indication, we measured and analyzed the ratio of greater trochanter/lesser trochanter (G/L ratio) and trochanter valgus angle (TVA). Results: Twelve patients (1 male and 11 female, average age 42.30±10.23) who had the complete clinical data were analyzed. The survivorship of femoral prosthesis were 100% with mean follow-up of 6 years. No other complications were found, except for two patients with intraoperative fracture of femur. The Harris hip score (HHS) increased from preoperative 34.31±14.43 to postoperative 84.12±11.33. All patients’ G/L ratio were larger than1.50. Conclusions: The reverse sleeve of S-ROM was a simple and reliable method for patients with severe TVD, which brought satisfying clinical outcomes in mid-term follow-up. When G/L ratio is larger than 1.50, surgeons should consider this special surgical technique. Keywords: cementless modular stem; reverse sleeve; total hip arthroplasty; trochanter valgus deformity.
PLAC1 Enhances Metastatic Potential and is Associated with PI3K/AKT/NF-κB Signaling Pathway in Colon Cancer
Authors: Ma JIachi , Zhang Shoukai , Liang Danru , Li Lei , Du Jun , Pan Chengwu , Zhang Chensong , Chen Yuzhong
Published: October 2019

Background: To better explore the underlying mechanism of liver metastatic formation by placenta-specific protein 1 (PLAC1) in human colorectal cancer, we investigated the proliferation, invasion and angiogenic capabilities of human colorectal cancer cell lines with different liver metastatic potentials as well as the mechanism of action of PLAC1 in the metastatic process. Methods: The expression of PLAC1 was detected by reverse transcriptase PCR, western blot and real-time PCR. The effect of PLAC1 on metastatic potential was determined by proliferation, invasion, and angiogenesis assays, including an in vitro coculture system consisting of cancer cells and vascular endothelial cells that were used to detect the relationship between cancer cells and angiogenesis. In addition, we also determined PLAC1 downstream targets that preferentially contribute to the metastatic process. Results: PLAC1 was expressed in HT-29, WiDr and CaCo-2 colorectal cancer cells but not in Colo320 colorectal cancer cells. PLAC1 could not only significantly enhance the proliferation of CoLo320 and human umbilical vein endothelial cells (HUVECs) but could also promote the invasion of CoLo320 cells. The angiogenesis of HUVECs was enhanced by PLAC1 in a dose-dependent manner. In cocultured systems, angiogenesis was significantly increased by coculture with HT-29 cells. In addition, PLAC1 could promote angiogenesis in coculture with HT-29 cells. Furthermore, PLAC1-enhanced metastatic potential of colorectal cancer cells was dependent on activation of the PI3K/Akt/NF-κB pathway. Conclusions: The activation of PI3K/Akt/NF-κB signaling by PLAC1 may be critical for the metastasis of colorectal cancer cells. According to our results, we suggest that modification of PLAC1 function might be a promising new therapeutic approach to inhibit the aggressive spread of colorectal cancer.
Screening for tuberculosis infection in children and adolescents in Russia – past, present, future
Authors: Аksenova V. A. , Baryshnikova L. A. , Klevno N. I. , Kudlay D. A.
Published: October 2019

The article presents a brief overview of the establishment and development of screening system in the pediatric population for tuberculosis and latent tuberculosis infection - from Koch alt-tuberculin to modern recombinant tuberculosis allergens for intradermal administration and in vitro laboratory tests. It gives extensive data on clinical research and the introduction into practical public health of the Russian Federation of the test with recombinant tuberculosis allergen as a screening method for tuberculosis in children from 8 to 14 years old inclusively.
ROLE OF THE CIVIL SOCIETY FOR ECONOMY
Authors: Tkachuk Iryna
Published: October 2019

The aim of the article is to shed light upon the essence and functions of the civil society, as well as to outline the features of its functioning. The article considers the views of thinkers of the past and modernity on the essence and significance of civil society, which formed the basis of a modern understanding of its content and role in the development of democracy and society. Also, modern approaches to the interpretation of the content of this concept were reviewed. It is revealed, that those approaches to the interpretation of the civil society of thinkers of the past and present, which take into account its component as economy, were and remain the most studied and time-consuming ones, and eventually do not lose their relevance. The main functional models of civil society are highlighted. It is justified, that the extended functional model, formed on the basis of the models of Merkel-Lauth and Edwards, more fully reflects the functions, performed by the civil society. Different models of interaction of civil society, state, business, family are investigated. It is proposed to consider the civil society as an environment that enables the interaction of the state, business and family in accordance with their natural functioning.
A Filosofia da História de Benjamin Constant
Authors: Campos Gabriel Afonso
Published: October 2019

Em uma tentativa de contribuir para um resgate do pensamento constantiano de forma completa, o trabalho pretende explorar a Filosofia da História de Benjamin Constant demostrando os pontos de convergência entre ela e o pensamento de Immanuel Kant. Percebe-se que Constant utiliza-se do princípio da igualdade como forma de interpretar a História, enquanto Kant se utiliza da liberdade para tal. O ideal buscado por ambos, contudo, aproxima-se de uma sociedade simultaneamente livre e igual.