bluuebunny/crossref_metadata_2025 huggingface dataset:
Demonstrate the Capacity, Vulnerability and Community Based Disaster Risk Management Scenario of the vulnerable Groups in the Coastal Belt Area Dacope and Chalna in Khulna District of Bangladesh
Authors: Debnath Pronab Kumar
Published: May 2020

Cyclones, floods and salinity are the most common hazards in the coastal zone of Bangladesh. The Dacope and Chalna are the coastal zones located in the south-western region of the country which has the experience to face devastating disasters. There are mentionable positive changes seen in the area since 2004. Despite that, there are many vulnerable peoples in the region. This study has been conducted to demonstrate the capacities & vulnerabilities and community-based disaster risk management of the area. The data and information have been collected via stakeholder consultation, literature study, and field visits. There are many peoples live on the shore and roadside. The illiteracy, lack of negotiation, lack of cyclone shelters and its capacity, corruption in relief, etc. made them vulnerable. The good social bonding, indigenous knowledge, experience, different volunteer groups have been found as their capacities. They use different measures for disaster risk management.
Research on the Flow Resistance Coefficient of a Multi-Hole, Secondary Pressure-Reducing Sleeve Valve
Authors: Xu Dong-tao , Ge Chang-rong , Meng Xiang-rui , Xu Shu-fang , Yu Xiao-guang
Published: May 2020

To solve the problem of valve noise, a multi-hole sleeve valve with secondary pressure-reducing function is presented in this paper. During the flow design of the valve, the flow resistance coefficient of the valve served as an important parameter. Because of two pressure-reducing components assembled to a multi-hole sleeve valve, the flow resistance coefficient of the valve changed. Thus, correction of the flow resistance coefficient had to be affected. In this paper, the relationship between the flow rate and flow resistance coefficient of the valve was first mapped and established. Then, the flow rate of the sleeve was obtained using SolidWorks simulation software. Locally refined finite element mesh technology was applied to the simulation to improve simulation accuracy. A parallel flow test platform for the regulating valve was established, and the flow rate of the multi-hole sleeve valve was detected at different openings, thus, verifying the reliability of the numerical simulation results. Finally, the simulation flow rate of the valve at different openings was substituted into the mapping relationship formula, in this way, the flow resistance coefficient of the sleeve valve was obtained. By using the modified flow resistance coefficient, the flow rate characteristics of the multi-hole, secondary pressure-reducing sleeve valve were efficiently and accurately established.
High BTBD7 Expression Positive Correlated with SLUG Predicted Poor Prognosis in Hormone Receptor Negative Breast Cancer
Authors: Zi-xiong Li , Ze-nan Huang , Luo Hui , Xiong-bin Yang , Yu-lin Wang , Jie-xin Chen , Xiao-kai Ma , wang tiantian , Ling Lin
Published: May 2020

There is a poor prognosis of metastasis in hormone receptor negative breast cancer (HRNBC), including triple-negative breast cancer (TNBC) and HER-2 overexpression breast cancer. Recent studies have indicated that BTB/POZ domain-containing protein 7 (BTBD7) regulates SLUG which is a key EMT (epithelial-mesenchymal transformation)-associated protein. The role of BTBD7 in HRNBC, however, has not been identified. In this study, The Cancer Genome Atlas (TCGA) was used to identify BTBD7 mRNA expression in breast cancer. In addition, GO and Metascape were used to identify differentially expressed genes. Immunohistochemical staining were applied to determine the protein expression of Btbd7 and Slug in paraffin-embedded samples from 144 HRNBC patients and 30 benign lesion patients. In cancer tissue, 64.9% in TNBC and 70.0% in HER-2+ overexpression breast cancer of Btbd7 protein was expressed when compared with a 20% expression in benign lesion tissues. Increased Btbd7 expression was further associated with larger tumor volume and poor TNM stages in HRNBC patients. Higher BTBD7 mRNA expression level was associated with shorter disease free survival (DFS) time from TCGA data. Higher Btbd7 protein expression in HRNBC tissue was associated with shorter DFS and OS time. Btbd7 protein expression significantly correlated with Slug expression in HRNBC tissue. Combining Btbd7 and Slug expression had a high predictive value for 3-year and 5-year DFS. As such, the positive expression of Btbd7 may contribute towards the development of breast cancer, specifically HRNBC via the up-regulation of Slug expression. Btbd7 was concluded to be an important predictor for the diagnosis of HRNBC patients.
Prognostic value of inflammation-based indices in patients with resected hepatocellular carcinoma
Authors: Kong Weihao , Yang Mingwei , Zhang Jianfeng , Cheng Ya , Dai Tianxing , Zhang Jian , Wang Guoying , Zhang Jianlin
Published: May 2020

Purpose: As is well recognized that inflammation plays a crucial role in the genesis and progression of various cancer. Here we investigate the prognostic value of a novel index: the combination of neutrophil to lymphocyte ratio and platelet distribution width (coNLR-PDW) in post-operation patients with resectable hepatocellular carcinoma (HCC).Methods: 250 HCC patients who underwent hepatectomy were retrospectively analyzed. The receiver operating characteristic (ROC) curve was utilized to determine the optimal cutoff values of continuous variables, including the neutrophil-lymphocyte ratio (NLR) and platelet distribution width (PDW). Kaplan-Meier method and the Log-rank test were used to compare survival differences across three groups stratified by the coNLR-PDW score. Univariate and multivariate regression analyses were adopted to identify independent factors of HCC patient’s prognosis.Results: 1.59 and 13.0 were perceived as the optimal cutoff value for NLR and PDW based on the ROC curve, respectively. Kaplan-Meier method revealed that higher coNLR-PDW score predicts poorer overall survival (OS) and disease-free survival (DFS) (P <0.001). coNLR-PDW was demonstrated as independent factor for both OS and DFS using Cox regression analysis (HR: 3.674, 95%CI: 2.092-6.452, P <0.001 for OS; HR: 2.166, 95%CI: 1.523-3.082, P <0.001 for DFS).Conclusion: coNLR-PDW is recognized as a valuable biomarker for predicting the survival of patients with HCC.
Antimicrobial resistance patterns of WHO priority pathogens isolated in children from a tertiary care hospital in Southern India: A descriptive and time trend analysis
Authors: Mogasale Vijayalaxmi V , Saldanha Prakash , Pai Vidya , PD Rekha , Mogasale Vittal
Published: May 2020

Background

There is global consensus that Antimicrobial Resistance (AMR) poses an unprecedented challenge to modern medicine as we know it today; and the lack of new antibiotics in the pipeline is compounding the threat to contain emerging drug-resistant infections. In 2017, the World Health Organization (WHO) has articulated a priority pathogens list (PPL) to provide strategic direction to research and development of new anti-microbials. Anti-microbial resistance patterns of selected ‘drug-bug’ combinations based on the WHO-PPL in one tertiary health care facility in India are explored in this paper.
Methods

Culture reports of laboratory specimens, collected between 1st January 2014 and 31st October 2019 from paediatric patients in a tertiary care hospital in India, were retrospectively extracted. The antimicrobial susceptibility patterns for selected antimicrobials based on the WHO-PPL are analysed and reported.
Results

Of 12,256 culture specimens screened, 2,335 (19%) showed culture positivity; of which 1,556 were organisms from the WHO-PPL. E. coli was the most common organism isolated (37%) followed by Staphylococcus aureus (16%). Total 72% of E. coli were extended-spectrum beta-lactamases producers, 55% of Enterobacteriaceae were resistant to 3rd generation cephalosporins, and 53% of Staphylococcus aureus were Methicillin resistant. Time-trend analysis of the data showed continued high resistance to carbapenem in E coli, Klebsiella pneumoniae and Enterobacter cloacae.
Conclusions

The AMR trends and prevalence patterns are likely to be different, across various local settings, than as defined at the national level or the WHO-PPL. This difference needs to be recognised in decision and policy making. It is critical, that the evidence used at national and global levels, have reasonable geographical and population representation through standardised and more granular AMR surveillance, in order to improve the effectiveness of the overall national AMR response.
Effect of Grand Ethiopian Renaissance Dam on the Water Footprint of Aswan High Dam Hydropower
Authors: Elbaradei Sherine Ahmed , Abdelkader Sarah Ehab
Published: May 2020

Construction of the Ethiopian Grand Renaissance dam (GRD) has many impacts and implication on the water share and future use in Egypt. Especially the period of the reservoir filling will have a great effect on the Nile River and its water in Egypt. Many of these effects of the GRD on Egypt has been studied before, but no study was done on the effect of its existence on the hydropower water footprint of the High Aswan dam. This research is concerned by simulating the effect of the different GRD reservoir filling scenarios on the water footprint of the hydropower generated from the High Aswan dam. Also, the effect on the hydropower of the Aswan dam itself is also simulated and assessed. Mathematical modeling is used to reach those goals. Three filling scenarios of the GRD were investigated: namely 3 years, 5 years, and 6 years. It was found that as the filling duration of the GRD decreases the negative effect on the hydropower water footprint increases.
Development of significant disease in a cohort of patients with non-specific enteritis on capsule endoscopy. Clinical suspicion and a high base line Lewis score are predictive of Crohn’s disease.
Authors: Sihag Sandeep , Tan Brandon , Semenov Serhiy , Ismail Mohd Syafiq , Ryan Barbara , O'Connor Anthony , Breslin Niall , Douglas Atiyekeogbebe Rita , McNamara Deirdre
Published: May 2020

Introduction: As with isolated ileitis the findings of nonspecific small bowel enteritis (NSE) on capsule endoscopy (CE) poses a clinical challenge. There is lack of available evidence to help clinicians to predict significant disease and long-term prognosis.Aim: To define the natural history of NSE in an Irish cohort. Methods: Patients with a finding of NSE were identified from a database. Subsequent investigations, treatments and diagnosis were recorded. Patients were grouped based on ultimate diagnosis: Crohn’s disease (CD), Irritable bowel syndrome (IBS), NSAIDs enteritis (NSAIDs), persistent NSE and no significant disease (NAD).Results: 88 patients, 46 (52%) male, mean age 52 +- 17.8 years were included with a mean follow up of 23 +- 19 months. The ultimate diagnoses were NAD=43 (49%), CD =17 (19%), IBS =14 (16%), NSAIDs =12 (14%) and persistent NSE=2 (2%). Significantly, more patients diagnosed with CD on follow up were referred with suspected CD. CD= 14/17 (82%) vs 13/57 (23%), p < 0.001. While a diagnosis of CD was associated with a positive baseline Lewis score (>135); 11/17 (65%) CD versus 16/ 71 (23%). Female gender was associated with an ultimate diagnosis of IBS (OR 5, p <0.02). Older age was associated with NSAIDs enteritis, while more subjects without significant gastrointestinal disease were anemic on presentation.Conclusion: The majority (49%) of NSE patients do not develop significant small bowel disease. CD occurred in 19% of NSE patients on follow up. Clinical suspicion and capsule severity are predictive of Crohn’s disease on initial CE.
A pilot study of thiamine and folic acid in hemodialysis patients with cognitive impairment
Authors: Lu Renhua , Fang Yan , Zhou Yijun , Che Miaolin , Shen Jianxiao , Liu Qian , Zhang Haifen , Pan Shuting , Lin Yan , Wang Qin , Mou Shan , Ni Zhaohui , Gu Leyi
Published: May 2020

Background: This study aimed to explore the effectiveness of thiamine and folic acid supplementation on the improvement of the cognitive function in patients with maintenance hemodialysis. Methods: In the present study, we randomly assigned patients undergoing hemodialysis who had the Montreal Cognitive Assessment (MoCA) score lower than 26 to treatment group (n=25, thiamine 90mg/day combined with folic acid 30mg/day) or control group (n=25, nonintervention). All subjects were followed up for 96 weeks. The primary outcome was the improvement of the MoCA score. The secondary outcomes included homocysteine level, survival and safety. Results: Patients in treatment group had an increase of the MoCA score from 21.95±3.81 at baseline to 25.68±1.96 at week 96 (P<0.001, primary outcome), as compared with the MoCA score from 20.69±3.40 to 19.62±3.58 in control group. Thiamine combined with folic acid treatment also resulted in lower level of serum homocysteine in treatment group compare with control group at week 96 (P<0.05, secondary outcome). 3 patients and 9 patients died during follow-up period in treatment and control group respectively (P=0.048). The proportion of adverse events in treatment group was significantly lower than that in control group. Conclusion: Hemodialysis patients with cognitive impairment treated with thiamine and folic acid had a significant improvement in MoCA score. Trial registration: Clinical trial registration number: ChiCTR-IPR-17012210.
Autophagy flux modulates Tax viral protein distribution pattern in human T-cell lymphotropic virus type 1 (HTLV-1) infection
Authors: Ducasa Nicolás , Grasso Daniel , Benencio Paula , Papademetrio Daniela , Biglione Mirna , Kashanchi Fatah , Garcia Maria Noe , Berini Carolina
Published: May 2020

Background

Viruses can evade the host's immune response promoting their survival and proliferation by different mechanisms. It has recently been observed that viruses can also manipulate autophagy mechanism/pathway for their own benefit. Autophagy is a conserved catabolic process for intracellular components, such as proteins and organelles, and it is important in maintaining cellular homeostasis. Human T-cell lymphotropic virus type 1 (HTLV-1) is the causative agent of HTLV-1 associated Myelopathy/ Tropical Spastic Paraparesis (HAM/TSP), Adult T-cell Leukemia/Lymphoma (ATLL) and Bronchiectasis. HTLV-1 has been reported to regulate autophagy favoring viral production. Viral protein Tax blocks the fusion of the autophagosome with the lysosome, preventing degradation and increasing the accumulation of autophagosomes. Yet, the role of autophagy in HTLV-1 infection has not been fully described. The aim of this study was to determine if the autophagic state conditions regulate HTLV-1 infection.
Results

Tax was distributed in specific patterns and spherical structures in infected Jurkat, HeLa and MT2 cell lines. Autophagic flux treatments modified Tax behavior in infected HeLa and MT2 cell lines as analyzed by confocal microscopy and flow cytometry, respectively. Utilizing relative quantification of mRNA by qPCR, the variation of other viral genes was analyzed, observing a similar pattern for each treatment.
Conclusions

These results provide evidence that the autophagic state is shown to control HTLV-1 infection. In addition, Tax can be observed in spherical structures linked to the plasma membrane which could be involved in promoting viral propagation. By carrying out this research, we hope to elucidate fundamental mechanisms for the propagation of HTLV-1 that would involve the use of the autophagic pathway, providing a potential therapeutic target to prevent the development of pathologies associated with HTLV-1 infection.
Comparative Evaluation of Two Commercial Real-time Pcr Kits (Quantifast™ and Abtes™) for the Detection of Plasmodium Knowlesi and Other Plasmodium Species in Sabah, Malaysia
Authors: Nuin Nor Afizah , Tan Angelica Fiona , Lew Yao Long , Piera Kim A , William Timothy , Rajahram Giri Shan , Jelip Jenarun , Mohammad Rashidah , Cooper Daniel J , Barber Bridget E , Anstey Nicholas M , Chua Tock H , Grigg Matthew J
Published: May 2020

Introduction: The monkey parasite Plasmodiumknowlesi is an emerging public health issue in Southeast Asia. In Sabah, Malaysia, P. knowlesiis now the dominant cause of human malaria. Molecular detection methods for P. knowlesiare essential for accurate diagnosis and in monitoring progress towards malaria elimination of other Plasmodium species.However,recent commercially available PCR malaria kits have unpublished P. knowlesigene targets or have not been evaluated against clinical samples.Methods:Two real-time PCR methods currently used in Sabahfor confirmatorymalaria diagnosis and surveillance reportingwere evaluated: theQuantiFast™ Multiplex PCR kit (Qiagen, Germany) targeting the P. knowlesi18S SSU rRNA;and the abTES™ Malaria 5 qPCR II kit (AITbiotech, Singapore), with an undisclosedP. knowlesi gene target. Diagnostic accuracywas evaluatedusing 52P. knowlesi, 25P. vivax, 21 P. falciparum, and 10 P. malariaeclinical isolates, and 26 malaria negative controls, and compared against a validated referencenested PCR assay. The limit of detection (LOD) for each PCR method and Plasmodium species was also evaluated. Results:The sensitivity of the QuantiFast™ and abTES™ assays for detecting P. knowlesiwas comparable at 98.1% (95%CI 89.7-100) and 100%(95%CI 93.2-100) respectively. Specificity of the QuantiFast™ and abTES™ for P. knowlesiwas high at 98.8% (95%CI 93.4-100) for both assays.The QuantiFast™ assay demonstrated falsely-positive mixed Plasmodium species at low parasitaemias in both the primary and LOD analysis. Diagnostic accuracy of both PCR kits fordetecting P. vivax, P. falciparum, and P. malariae was comparable to P. knowlesi.The abTES™ assay demonstrated a lower LOD for P. knowlesiof ≤0.125 parasites/µL compared to QuantiFast™ witha LOD of20 parasites/µL.Hospital microscopy demonstrated a sensitivity of 78.8% (95%CI 65.3-88.9) and specificity of 80.4% (95%CI 67.6-89.8) compared to reference PCR for detecting P. knowlesi.Conclusion:The QuantiFast™ and abTES™ commercial PCR kits performed well for the accurate detection of P. knowlesi infections. Although the QuantiFast™ kit is cheaper, the abTES™ kit demonstrated a lower LOD, supportingits use as a second-line referral-laboratory diagnostic toolin Sabah, Malaysia.
Outcome of Pulmonary Spherical Ground-glass Opacities on Ct in Patients With Coronavirus Disease 2019 (Covid-19): A Retrospective Analysis
Authors: Li Wangjia , Hu Liangbo , Huang Junhao , Lv Fajin , Fu Binjie , Chu Zhigang
Published: May 2020

Background: Pulmonary spherical ground-glass opacities (GGOs) are commonly detected on initial chest CT scan in patients with coronavirus disease 2019 (COVID-19).We aimed to investigate the evolution of spherical GGOs to better understand their clinical significance.Materials and Methods:A retrospective study of 33 consecutive patients with confirmed COVID-19 and pulmonary spherical GGOs was performed from January 21, 2020, to March 6, 2020. The initial and follow-up CT images and clinical data were reviewed. The initial CT manifestations of spherical GGOs and their subsequent changes were mainly evaluated. Results:A total of 101 pulmonary spherical GGOs, including 38 with and 63 without consolidation, were found in 33 patients. Of the 101 spherical GGOs, 71 (70.3%) and 30 (29.7%) showed progression and direct absorption on follow-up CT images, respectively. GGOs with consolidation were more likely to progress than those without (84.2% vs. 61.9%, p = 0.017). The 71 progressed lesions mainly showed an increase in size and/or density and most (70.4%) of them extended toward the pleura and developed from spherical to patchy. Internal consolidation appeared and increased in 18 (25.4%) and 22 (31.0%) lesions, respectively. During absorption, all the previous progressed and directly absorbed lesions exhibited a simultaneous decrease in size and density. On each patient’s final CT, more lesions with progression had a residual mixed GGO (40.8% vs. 6.7%, p = 0.002) and fewer had pure GGO (39.4% vs. 60.0%, p = 0.016) than those with direct absorption.Conclusion: In patients with COVID-19, most pulmonary spherical ground-glass opacities would progress, especially those with consolidation, and develop into patchy, subpleural lesions.
Piloting a multidisciplinary and integrated road traffic injury surveillance system in Kaduna Metropolis, Kaduna Nigeria.
Authors: Babalola Obafemi Joseph
Published: May 2020

Background

African has the highest road fatality rate per 100,000 population, but Nigeria accounts for a quarter of the World Health Organization Afro region road traffic injury (RTI) related deaths. The Nigeria Federal Road Safety Corps (FRSC) is the sole agency for RTI surveillance. RTI data generated from a single source is inadequate, under-reported, and defective for effective planning to achieve SDG 3.6 target. This pilot study aimed to describe under-reporting of single RTI surveillance data source by FRSC, and feasibility of multidisciplinary and integrated RTI surveillance systems in Kaduna metropolis, Nigeria.
Methods

The WHO Injury Surveillance Guideline, and Centres for Disease Control and Prevention Surveillance Training Manual were adapted for this study. Selected RTI reporting sites for this study were FRSC, police, and three major health facilities. Trained data collectors used a pretested RTI data tool adapted from the existing tools to collect information on road traffic crashes and the injured from February – July 2016. Data linked by the deterministic method were merged, duplicates removed, and analysed for frequencies, proportions, and Chi-square odds ratio for associations between exposure variables and moderate to fatal injury. Statistical significance for all calculations was set at p-Value < 0.05.
Results

Of the 667 road traffic crashes (RTC), FRSC reported 103 (15.4%). Of the 1,062 people injured, FRSC and Police reported 183 (17.2%), and 381 (35.9%) respectively, pedestrians were 180 (17%), and 374 (35.2%) were in 25–34 years age group. Overall, 110 (10.4%) were fatally injured and died including 62.7% (69/110) who were initially rescued alive from the crash site. Among the 252 motorcycle riders, protective helmet was used by 26 (10.3%). Also, 136 (26.4%) vehicle users from 516, used a seat belt during the crash. Moderate to fatal injury was associated with being a vehicle operator during the crash (OR 1.7, C.I. 1.3–2.2, p = 0.000).
Conclusion

Road traffic crashes and injuries were under-reported with single source RTI surveillance systems common to low and middle – income countries like Nigeria. However, a multidisciplinary and integrated RTI surveillance system is feasible and recommended to generate quality data for action.
Evaluating the Irrigation Effect of Continuous Flushing During Up-and-down Motion of Instruments Using a Computational Fluid Dynamics Model
Authors: Guo Linxi , Shi Xin , Li Xiangfen , Zhao Yuanxi , su qin
Published: May 2020

Background:The viscous environment caused by the rotation of Nickel-titanium (Ni-Ti) instruments in a static solution inside the root canal during mechanical preparation may increase the difficulty of endodontic debridement and the risk of instrument fatigue fracture. Therefore, this study aimed to investigate the effect of continuous flushing during up-and-down motion of instruments using a three-dimensional computational fluid dynamics (CFD) numerical model.Results:After30s simulation,water entering the canal formed an "efficient replacement area" in upper part of the canal and transported to the apical part of the canal.Increasing the velocity and amplitude of the motion of the instrument caused less time of flushing water to reach the apical area; and the replacement of the original solution was primarily improved by increasing the amplitude.Conclusions:Continuous flushing during up-and-down movement of the instrument significantly helped to rapidly replace the original solution with water at the coronal and middle part of the canal and dilutedthe viscosity of the original solution to some extend in the whole canal.It is therefore beneficial to add continuous water flushing to the instruments used in the preparation process.Furthermore, the amplitude of the movement in file’s up-and-down motion should be appropriately increased to improve its irrigation effect in clinical practice.
Extended spectrum beta-lactamase and ﬂuoroquinolone resistance genes among Escherichia coli and Salmonella isolates from diarrheal children, Burkina Faso.
Authors: DEMBELE Rene , Konaté Ali , Traoré Oumar , Kaboré Wendpoulomdé A. D. , Soulama Issiaka , Kagambèga Assèta , Traoré Alfred S. , Guessennd Nathalie K. , Aidara-Kane Awa , Gassama-Sow Amy , Barro Nicolas
Published: May 2020

Background
The emergence and spread of multidrug-resistant gram-negative bacteria (MDR) has become a major public health concern worldwide. This resistance is caused by enzymes-mediated genes (i.e., extended spectrum beta-lactamases) that are common in certain Enterobacterioceae species. However, the distribution of these genes is poorly documented in Burkina Faso. This study aims to determine the prevalence and distribution of the resistant genes coding for broad spectrum beta-lactamases and quinolones in rural Burkina Faso.
Methods
Multiplex PCR assays were carried out to detect ESBL-encoding genes, including blaOXA, blaTEM, blaCTX-M, blaSHV. The assays also assessed the presence of quinolone resistance gene namely qnrA, qnrB and qnrS in the quinolone-resistance DEC and Salmonella strains.
Results
The Extended-Spectrum Beta-Lactamases (ESBL) resistance phenotype was reported in all the E. coli isolates (5/5). Cross-resistance phenotype to quinolones (CRQ) was shown by one Salmonella strain (1/9) and three E. coli (3/5). Cross-resistance phenotypes to fluoroquinolones (CRFQ) were harboured by one Salmonella (1/9) and carbapenemase phenotypes were detected in two E. coli strains (2/5). Whilst the blaOXA genes were detected in 100% (5/5) of E. coli isolates and in 33.33% (3/9) Salmonella isolates. One strain of E. coli (1/5) harbored the blaCTX−M gene and the qnrB gene simultaneously.
Conclusions
This study identified β-lactam (bla) and quinolone resistance (qnr) genes in multidrug-resistant E. coli and Salmonella spp. in rural Burkina Faso. Our finding which highlighted the enterobacteriaceae strains resistance to β-lactams and quinolones are of high interest for adequate management of antimicrobial resistant genes outbreak in Burkina Faso.
Can lean reduce infections? A systematic review and meta-analysis of prospective studies
Authors: Patrone Carlotta , Cristina Maria Luisa , Spagnolo Anna Maria , Schinca Elisa , Ottria Gianluca , Dupont Chiara , Alessio-Mazzola Mattia , Sartini Marina
Published: May 2020

Background: Lean is largely applied to the health sector and on the healthcare-associated infections (HAI). The latter are a plague for our society. However, a few results on the improvement of the outcome have been reported in literature. The purpose of this study is to analyze if the lean application can reduce the healthcare-associated infections rate.Methods: A comprehensive search was performed on PubMed/Medline, Scopus, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the following keywords: "lean" and "infection" from August to December 2019. Inclusion criteria were: 1) research articles with quantitative data and relevant information on lean methodology and its impact on healthcare infections; 2) prospective studies. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines has been used.Results: 22 studies were included in the present meta-analysis. Lean application demonstrated a significant protective role on healthcare-associated infections rate (RR 0.50 [0.38-0.66]) with significant impact on central line-associated bloodstream infections (CLABSIs) (RR 0.47 [0.28-0.82]). There was a significant correlation between lean application and healthcare worker satisfaction and compliance, but no significant decrease of mortality has been reported.Conclusions: Lean has a positive impact on the decreasing of HAIs and on the improvement of compliance and satisfaction of the staff.
Characteristics and Clinical Significance of Microcirculation in Populations Residing at Different Altitudes
Authors: Ma Siqing , He Zong-Zhao , Luo Jun-Ming , Song Kang , Xu Jing-Yuan , Wang Hao , Duan Zhi-Li , Qiu Hai-Bo
Published: May 2020

Background: This study aimed to evaluate changes in microcirculation, physiological characteristics, and the pathomechanism of and potential treatment alternatives for severe septic shock among healthy individuals residing at different altitudes.Methods: Seventy individuals, 35 from Xining and 35 from Nanjing, were recruited, and their body temperature, pulse, respiration, mean arterial pressure, peripheral blood oxygen saturation, and blood cell parameters were determined. Microcirculation indices of sublingual microcirculation were monitored using the sidestream dark field method.Results: Erythrocyte counts and hemoglobin levels were significantly higher among individuals from Xining than among those from Nanjing (P < 0.05); however, platelet counts were significantly lower among those from Xining (P < 0.05). Microcirculation indices of total vessel density, perfused vessel density, and the proportion of perfused vessels were significantly higher among individuals from Xining than among those from Nanjing; however, the microvascular flow index was lower among those from Xining. Microvascular density was significantly higher among individuals from Xining than among those from Nanjing.Conclusion: Microvascular densit may be a physiological adaptation among populations at moderate-to-high altitudes.
Cangrelor ameliorates CLP-induced pulmonary injury in sepsis by inhibiting GPR17
Authors: Luo Qiancheng , Liu Rui , Liu Guorong , Hang Min , Chen Guo , Xu Lei , Jin Qinqin , Guo Dongfeng , Kang Qi
Published: May 2020

BackgroundSepsis is a common complication of severe wound injury and infection, with a very high mortality rate. The P2Y12 receptor inhibitor, cangrelor, is an antagonist antiplatelet drug.MethodsIn our study, we investigated the protective mechanisms of cangrelor in CLP-induced pulmonary injury in sepsis, using mouse models.ResultsTdT-mediated dUTP Nick-End Labeling (TUNEL) and Masson staining showed that apoptosis and fibrosis in lungs were alleviated by cangrelor treatment. Cangrelor significantly promoted surface expression of CD40L on platelets and inhibited CLP-induced neutrophils in Bronchoalveolar lavage fluid (BALF). We also found that cangrelor decreased the inflammatory response in the CLP mouse model and inhibited the expression of inflammatory cytokines, IL-1β, IL-6, and TNF-α. Western blotting and RT-PCR showed that cangrelor inhibited the increased levels of G-protein-coupled receptor 17 ༈GPR17༉induced by CLP. Conclusion: Our study indicated that cangrelor repressed the levels of GPR17, followed by a decrease in the inflammatory response and a rise of neutrophils in BALF, potentially reversing CLP-mediated pulmonary injury during sepsis.
Deep-red emitting Mg2TiO4:Mn4+ phosphor ceramics for plant lighting
Authors: Wang Zixin , LIN Hui , Zhang Dawei , Shen Yiming , Li Yang , Hong Ruijin , Tao Chunxian , Han Zhaoxia , Chen Lei
Published: May 2020

In this study, deep red emitting Mg2TiO4:Mn4+ phosphor ceramics were synthesized by the high temperature solid-state reaction method. The ceramics can be excited by the 465 nm blue light and had a narrow emission with a full width at half maximum (FWMH) value of 31 nm. The peak wavelength was located at 658 nm, which matched the most efficient wavelength for photosynthesis. The crystal field strength (Dq) and the Racah parameters (B and C) are estimated by Tanabe-Sugano diagram. The thermal conductivity of the ceramics was 7.535 W/(m·K) at room temperature, which was one order of magnitude higher than that of the traditional packaging method using silicone gel. A set of phosphor converted LEDs were fabricated by mounting the phosphor ceramics onto the 460 nm blue LED chips and the CIE coordinates can move from the blue light region to the purple light region with the thickness of the ceramic increasing. These results indicated that the Mg2TiO4:Mn4+ phosphor ceramic was suitable for plant lighting when combined with a blue LED chip.
Comparison of short-term outcomes between Chinese surgical robot “Micro Hand S” assisted and laparoscopic total mesorectal excision for rectal cancer
Authors: Wang Yanlei , Wang Guohui , Li Zheng , Hao Ling , Yi Bo , zhu shaihong
Published: May 2020

Background As the first domestically produced Chinese surgical robot for clinical use, the Micro Hand S robot has been applied to total mesorectal excision (TME) for rectal cancer in our center since 2017. The aim of this study was to evaluate the safety and feasibility of the Micro Hand S robot-assisted TME (R-TME) in comparison with laparoscopic TME (L-TME).Methods Between May 2017 and February 2018, patients who underwent R-TME and L-TME in the Third Xiangya Hospital were prospectively included in this study. The data including intraoperative outcomes, postoperative outcomes, pathological outcomes, and functional outcomes were analyzed and compared.Results Totally, 30 patients underwent L-TME and 21 patients underwent R-TME. The patient characteristics of the two groups were similar. Regarding intraoperative and postoperative outcomes, the R-TME group had significantly less blood loss (95.2 vs. 130.0 ml, p = 0.022), shorter time to first flatus (2.1 vs. 2.9 d, p = 0.017) and first liquid intake (2.8 vs. 3.7 d, p = 0.027) than the L-TME group. There were no significant difference in the operative time, conversion, protective ileostomy, length of hospital stay, pain score, complications, and 30-day mortality between the two groups (p > 0.05). In addition, the pathological and functional outcomes also did not differ significantly.Conclusion The Micro Hand S robot-assisted total mesorectal excision is safe and feasible for rectal cancer. However, prospective and large sample size trials are needed to further confirm this conclusion.Trial registration:Clinicaltrial.gov, NCT02752698, Registered on 27 April 2016, https://clinicaltrials.gov/ct2/show/study/NCT02752698?term=Micro+hand&cntry=CN&draw=2&rank=1
Evolutionary Engineering of Lactobacillus Bulgaricus Reduces Enzyme Usage and Enhances Conversion of Lignocellulosics to D-lactic Acid by Simultaneous Saccharification and Fermentation
Authors: J. Vishnu Prasad , Sahoo Tridweep K. , S. Naveen , Jayaraman Guhan
Published: May 2020

BackgroundSimultaneous saccharification and fermentation (SSF) of pre-treated lignocellulosics to biofuels and other platform chemicals has long been a promising alternative to separate hydrolysis and fermentation processes. However, the disparity between the optimum conditions (temperature, pH) for fermentation and enzyme hydrolysis leads to execution of the SSF process at sub-optimal conditions, which can affect the rate of hydrolysis and cellulose conversion. The fermentation conditions could be synchronized with hydrolysis optima by carrying out the SSF at a higher temperature, but this would require a thermo-tolerant organism. Economically viable production of platform chemicals from lignocellulosic biomass has long been stymied because of the significantly higher cost of hydrolytic enzymes. The major objective of this work is to develop an SSF strategy for D- lactic acid production by a thermo-tolerant organism, in which the enzyme loading could significantly be reduced without compromising on the overall conversion. ResultsA thermo-tolerant strain of Lactobacillus bulgaricuswas developed by adaptive laboratory evolution (ALE) which enabled the SSF to be performed at 45 °C with reduced enzyme usage.Despite the reduction of enzyme loading from 15 FPU/gbiomass to 5 FPU/gbiomass, we could still achieve ~8% higher cellulose to D-LA conversion in batch SSF, in comparison to the conversion by separate enzymatic hydrolysis and fermentation processes at 45 °C and pH 5.5. Extending the batch SSF to an SSF with pulse-feeding of 5% pre-treated biomass and 5 FPU/g-biomass, at12-hour intervals (36th h – 96th h), resulted in a titer of 108 g/L D-LA and 60% conversion of cellulose to D-LA.This is one among the highest reported D-LA titers achieved from lignocellulosic biomass.ConclusionsWe have demonstrated that the SSF strategy, in conjunction with evolutionary engineering, could drastically reduce enzyme requirement and be the way forward for economical production of platform chemicals from lignocellulosics. We have shown that fed-batch SSF processes, designed with multiple pulse-feedings of the pre-treated biomass and enzyme, can be an effective way of enhancing the product concentrations.
YouTube as a Source of Patient Information for Bipolar Disorder: A Content-Quality and Optimization Analysis
Authors: Szmuda Tomasz , Żydowicz Weronika Magdalena , Ali Shan , Fedorow Karolina , Słoniewski Paweł
Published: May 2020

Background YouTube is currently the second most popular website in the world and it is often used by patients to access health information online. Our aim was to evaluate the content-quality of YouTube videos relating to bipolar disorder. Methods We chose the first 30 videos for four different search phrases: ”bipolar disorder,” ”bipolar disorder treatment,” ”bipolar disorder symptoms” and ”manic depression.” Video contents were evaluated by two independent final year medical students using the validated DISCERN instrument. Qualitative data, quantitative data and the upload source was recorded for analysis. Results Out of the total 120 videos, 80 videos met our inclusion criteria and were evaluated. The mean DISCERN score was 63.5 (out of 75 possible points). This indicates that the quality of YouTube videos on bipolar disorder is excellent. Reliability between the two raters was excellent (intraclass correlation coefficient = 0.96). Nearly all videos had symptoms of the disorder (100%) and the impact of the disorder on daily life (98.8%). Videos were mostly uploaded by educational channels (61.3%) and hospitals (16.3%). Videos that had a doctor speaker had a significantly higher average daily views, comments and a video power index (P<0.05). Conclusions The quality of YouTube videos on bipolar disorder is good. We have included a list of the top-quality videos in our paper as they may be used by patients and physicians as a reference to find the most reliable videos for patient education. Having a doctor speaker in a video optimizes a video for higher audience engagement.
A novel data-driven approach reveals gene networks and biological processes underlying autism
Authors: Gialloreti Leonardo Emberti , Enea Roberto , Micco Valentina Di , Giovanni Daniele Di , Curatolo Paolo
Published: May 2020

Background:

Developments in gene-hunting techniques identified several ASD associated genes. The considerable significance of cluster analysis associated with gene network studies has led to reveal many disrupted key pathways in ASD, even if its genetic underpinnings remain a challenging task. This study aims to determine, through a novel data-driven approach, how networks of mutated genes impact biological processes underlying autism.
Methods:

We analyzed the VariCarta dataset, which presents more than 200,000 genomic variant events collected from 13,069 people with ASD. Firstly, we created a whole-genome and an exome sequencing subset. Then, for each subset we compared pairwise patients of each group to build “patient similarity matrices”. Hierarchical-agglomerative-clustering and heatmap were performed to identify clusters of patients with common occurrences of gene networks within these matrices. The subsequent enrichment analysis (EA) highlighted biological processes that might be impacted by the mutated genes of each subgroup.
Results:

Considering the whole-genome matrix, we identified three main genetic clusters of ASD patients, each one characterized by a network of shared genetic variants. We isolated 11,609 genetic variants shared by at least two subjects in each cluster; 4,187 of these variants (36.1%) were common to the three clusters. Only 331 patients (2.5%) shared none or very few mutated genes with anyone else. The EA highlighted common or cluster-specific biological processes related to the variants. Most of the common abnormal processes were involved in neuron projections guidance and morphogenesis, cell junctions and synapse assembly. Exome sequencing alone was not effectual in identifying ASD subgroups.
Limitations:

Caution is warranted when interpreting our results, as we did not compare them with a control group and did not verify if the identified subgroups where actually associated with different phenotypes. Future work will have to ascertain the strength and reproducibility of these results.
Conclusions:

Itemizing not just single mutated genes, but also gene networks and specific biological processes that characterize different ASD subpopulations might allow to better understand which networks of genetic variants play a major role in the etiopathology of ASD. The proposed methodology may represent a novel approach to help disentangle ASD complexity and an instrument to boost more focused genotype-phenotype studies.
Bayesian Binary Logistic Generalized Linear Mixed Models of Female Genital Mutilation
Authors: Workie Mekuanint Simeneh
Published: May 2020

Background: Female genital mutilation could be a global public unhealthiness, and it's practiced by many communities in Africa, special Ethiopia. In Ethiopia, the factors related to FGM practices are poorly understood. Therefore, this study aimed to assess the prevalence of female genital mutilation and its associated factors with FGM among reproductive age women within the country. Method: A secondary data analysis was disbursed supported the Ethiopia Demographic and Health Survey 2016. Bayesian binary Logistic Regression GLMM, which allows taking into consideration both individual and population variability in model parameter estimate was employed.Results: The general prevalence of female genital mutilation among participants (15-49 years old) in Ethiopia was found to be 69.6%. From Bayesian random intercept binary logistic analysis it had been found that rural, Muslim, middle Wealth index, rich Wealth index people, Secondary and above were statistically significant with Female genital mutilation. Conclusion: Rural residence, Muslim religion, middle wealth index , rich wealth index, people 25-34 years old, the people 35-49 years old, ever heard of female genital mutilation, occupation of girls were positively related to female genital mutilation practice. On the opposite hand, husband/partner's primary education level, husband/partner's secondary and above educational level, husband/partner occupation (merchant and others) were negatively related to female genital mutilation. Despite the presence of various interventions, the prevalence of female genital mutilation continues to be very high within the country.
Actions taken by female sex workers (FSWs) after condom failure in semi urban Blantyre, Malawi
Authors: Twizelimana Donatien , Muula Adamson S
Published: May 2020

Background

Little is known about action taken by female sex workers (FSWs) after condom failure during sexual intercourse. The objective of this study was to investigate the actions taken by FSWs after condom failure among FSWs in semi – urban, Blantyre in Malawi.

Methods

A cross sectional, qualitative study was conducted among FSWs in Blantyre, Malawi between May and July 2019. Snowballing technique was used to recruit study participants in four purposively selected study sites. Focus group discussions and in-depth interviews were conducted by trained research assistants among 40 FSWs. Data were analyzed using thematic content analysis.

Results

Study participants reported different actions taken after condom failure. Many FSWs reported to have stopped sex immediately and changed the condom and then resumed sexual intercourse. Other than condom replacement no further actions were taken. Few FSWs reported to have stopped sexual intercourse and thereafter sought medical care which included post-exposure prophylaxis for HIV, sexually transmitted infections’ treatment, and emergency hormonal contraceptives. Urination, vaginal douche, and squatting after condom failure were reported as actions taken by some participants with the aim to avoid HIV transmission and pregnancy. Some FSWs interviewed reported to have not stopped sexual intercourse and no any other actions were taken after condom failure. Some FSWs reported to have douched, squatted or asked for higher pay from their clients after condom failure.

Conclusion

We reported some inadequate behaviors among FSWs after condom failure. Health programs should develop interventions for safe sex among FSWs to prevent STIs including HIV, and unplanned pregnancies. There is a need to address misconceptions related to health illiteracy among FSWs. There are interpersonal, structural and policy factors hindering FSWs’ access to health care providers.
Out-of-hospital cardiac arrest patients with an initial non-shockable rhythm could be candidates for extracorporeal cardiopulmonary resuscitation: a retrospective study.
Authors: Tanimoto Atsunori , Sugiyama Kazuhiro , Tanabe Maki , Kitagawa Kanta , Kawakami Ayumi , Hamabe Yuichi
Published: May 2020

Background

Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising treatment for refractory out-of-hospital cardiac arrest (OHCA). Most studies evaluating the effectiveness of ECPR include patients with an initial shockable rhythm. However, the effectiveness of ECPR for patients with an initial non-shockable rhythm remains unknown. This retrospective single-center study aimed to evaluate the effectiveness of ECPR for patients with an initial non-shockable rhythm, with reference to the outcomes of OHCA patients with an initial shockable rhythm.

Methods

Adult OHCA patients treated with ECPR at our center during 2011–2018 were included in the study. Patients were classified into the initial shockable rhythm group and the non-shockable rhythm group. The primary outcome was the cerebral performance category (CPC) scale score at hospital discharge. A CPC score of 1 or 2 was defined as a good outcome.

Results

In total, 186 patients were eligible. Among them, 124 had an initial shockable rhythm and 62 had an initial non-shockable rhythm. Among all patients, 158 (85%) were male, with a median age of 59 (interquartile range [IQR], 48–65) years, and the median low flow time was 41 (IQR, 33–48) min. Collapse was witnessed in 169 (91%) patients, and 36 (19%) achieved return of spontaneous circulation (ROSC) transiently. Proportion of female patients, presence of bystander cardiopulmonary resuscitation, and collapse after the arrival of emergency medical service personnel were significantly higher in the non-shockable rhythm group. The rate of good outcomes at hospital discharge was not significantly different between the shockable and non-shockable groups (19% vs. 16%, p=0.69). Initial shockable rhythm was not significantly associated with good outcome after controlling for potential confounders (adjusted odds ratio 1.58, 95% confidence interval: 0.66–3.81, p=0.31). In the non-shockable group, patients with good outcomes had a higher rate of transient ROSC, and pulmonary embolism was the leading etiology.

Conclusions

The outcomes of patients with an initial non-shockable rhythm are comparable with those having an initial shockable rhythm. OHCA patients with an initial non-shockable rhythm could be candidates for ECPR, if they are presumed to have reversible etiology and potential for good neurological recovery.