bluuebunny/crossref_metadata_2025 huggingface dataset:
Pregabalin and Persistent Postoperative Pain Following Posterior Spinal Fusion in Children and Adolescents
Authors: Helenius Linda , Yrjälä Tommi , Oksanen Hanna , Pajulo Olli , Löyttyniemi Eliisa , Taittonen Markku , Helenius Ilkka
Published: August 2021

Background:

Surgical correction of spinal deformity requires major surgical intervention with extensive manipulation of the spine and neural elements. Persistent postoperative pain affects patient quality of life and can also cause financial burden for patient families and for society. We aimed to investigate the effect of perioperative pregabalin on the incidence of persistent pain following instrumented spinal fusion.

Methods:

We conducted a randomized, double-blinded, and placebo-controlled single-center clinical trial. Adolescents and children 10 to 21 years old with a spinal deformity who were scheduled for pedicle screw instrumentation and fusion were randomized into either the pregabalin or placebo group. Patients received 2 mg/kg of pregabalin or a placebo twice daily preoperatively and for 5 days postoperatively. The duration of follow-up was 2 years. The primary outcomes were cumulative opioid consumption during the first 48 hours postoperatively and the incidence of persistent postoperative pain over the course of the 2-year follow-up.

Results:

Sixty-four of 77 eligible patients were enrolled in the study, with all patients completing the 2-year follow-up. Thirty-three patients were randomized into the pregabalin group and 31 into the placebo group. There was no significant difference in cumulative 48-hour opioid consumption between the study groups. The Scoliosis Research Society 24-Item Questionnaire pain domain score improved significantly, from a mean value of 3.8 in both groups to 4.3 in the pregabalin and 4.0 in the placebo group at 2 years postoperatively, with no differences between the study groups at any time point (p = 0.317). The Scoliosis Research Society total scores of the study groups were similar (p = 0.678). Back pain, as measured with use of a visual analogue scale, improved significantly (p = 0.001) with no significant differences at any time point (preoperatively and 6 months, 1 year, and 2 years postoperatively).

Conclusions:

Perioperative pregabalin does not reduce postoperative opioid consumption or the incidence of persistent postoperative pain following instrumented posterior spinal fusion for spinal deformities in an adolescent population.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
MOON’s Strategy for Obtaining Over Eighty Percent Follow-up at 10 Years Following ACL Reconstruction
Authors: Marx Robert G. , Wolfe Isabel A. , Turner Brooke E. , Huston Laura J. , Taber Caroline E. , Spindler Kurt P. ,   and the MOON Group
Published: August 2021

The Multicenter Orthopaedic Outcomes Network (MOON) study of anterior cruciate ligament (ACL) reconstruction has achieved >80% follow-up for study subjects who were enrolled from 2002 to 2005; patient-reported outcome measures (PROMs) were reported at 2, 6, and 10 years through a carefully designed protocol that included surgeon involvement to encourage subjects to complete and return questionnaires. The process included emails and telephone calls from the central coordinating center, from research coordinators at each local institution, and lastly, from the subjects’ surgeons for those who were less inclined to complete the follow-up. In order to quantify the effect of site and surgeon involvement, the enrollment year of 2005 was monitored for the 10-year follow-up (n = 516 subjects). In contact efforts made by the coordinating center, 73.8% (381) of study subjects were reached by the central site coordinator, contact information was verified, and questionnaires were subsequently sent, completed, and returned. An additional 54 subjects (10.5% of the overall study population) returned the questionnaire after local study site involvement, indicating the importance of individual surgeon and local site involvement to improve follow-up rates in multicenter studies in orthopaedic surgery. Follow-up rates were higher when a specific individual (the surgeon or the research coordinator) was given the task of final follow-up.
Prevalence of Demodex Folliculorum and Demodex Brevis in Patients with Blepharitis and Chalazion
Authors: AKKUCUK Serife , Kaya Ozlem Makbule , Aslan Lokman , Ozdemir Talat , Uslu Ugur
Published: August 2021

Purpose: Demodex folliculorum and Demodex brevis are common ectoparasites on skin that also can lead to blepharitis and chalazion. The aim of our study is to determine the prevalence of Demodex spp. in eyelashes of patients diagnosed with chronic blepharitis and chalazion. Methods: This study included 330 patients diagnosed with chronic blepharitis, 70 patients diagnosed with chalazion and 130 volunteers without any ocular problems. Patient eyelashes were examined under a light microscope at magnifications of × 40, × 100 and × 400. Demodex spp. were determined. Results: Parasite prevalence was significantly higher in blepharitis (75.5%) and chalazion groups (70%) compared to the control group (16.2%) (p <0.001). The prevalence of D. folliculorum in the blepharitis group and D. brevis in the chalazion group was found to be significantly higher compared to other groups (p <0.05). The average number of mites per eyelash was found to be significantly higher in patients with Demodex positive blepharitis (p = 0.001) and in chalazion patients (p = 0.047) than in the control group. It has been determined that mite positivity increases with age in blepharitis and control groups (p <0.05). In the group with blepharitis, it was found that mite positivity was significant in the presence of symptoms (p = 0.0001) and Demodex positivity decreased as the education level of individuals increased (p = 0.039). Conclusion: The results of the study show that Demodex acari infestations should be considered in chronic blepharitis and chalazion.
In-silico analysis of BCL2 gene using multiple bioinformatics tools to identify the most lethal mutations that are crucial for its structural and functional integrity
Authors: Ghani Usman , Ali Yasir , Gul Karim , sohail Aamir , Ullah Rahmat , Anjum Tayyaba , jalil Fazal
Published: August 2021

BCL2 was the first ever known gene for anti-apoptotic activity, that encodes for essential proteins of the external mitochondrial membrane. Regarding tumorigenesis, deregulated BCL2 expression and related proteins have been recognized as characteristic of several human cancers and there is concrete evidence that the deregulated expression of BCL2 like proteins plays a vital role in tumor development, persistence and therapeutic resistance. Therefore, it is important to identify the polymorphisms of BCL2 that are both structurally and functionally important for research to find their possible malfunctions and therapeutics. For this reason, in our research, we have used a variety of bioinformatics tools to recognize the most destructive nsSNPs that may be important for the structure and function of BCL2. In silico tools, PROVEAN, SIFT, SNP&GO, PhD SNP, and PolyPhen2 included a variety of other tools such as I Mutant, MutPred, and ConSurf, to study their conservation profiles to validate their stability, structural, and functional impacts. Post-transcriptional alteration sites were also predicted followed by application of 3-D mapping with I-TASSER and Phyre2 tools. Furthermore, the gene interactions were mapped via STRING and GeneMANIA. We also found that nsSNPs Q118R (rs759928495), G193R (rs1197820694), R129C (rs777784952), and Ll81V (rs752310933) are the most destructive nsSNPs in BCL2 genes that can have a vital part in BCL2 protein defects and possibly cause different cancers. Gene-gene interactions showed relation of BCL2 with other genes depicting its importance in several pathways and co-expressions. This research is the first of its kind and offers future prospects for the development of dedicated medicines as well. In the animal models, the effects of BCL2 can also be tested in diseases. Such should be the study of BCL2 proteins from cancer patients. The effects of BCL2 can also be tested on animal models.
Assessing Uncertainties in Estimating Surface Energy Fluxes from Remote Sensing over Natural Grasslands in Brazil
Authors: Käfer Pâmela Suélen , Rocha Nájila Souza da , Veeck Gustavo Pujol , Diaz Lucas Ribeiro , Costa Savannah Tâmara Lemos da , Kaiser Eduardo André , Robérti Débora Regina , Rolim Silvia Beatriz Alves
Published: August 2021

Evapotranspiration (ET) is one of the main fluxes in the global water cycle. As the Pampa biome carries a rich biodiversity, accurate information on the ET dynamics is essential to support its proper monitoring and establish conservation strategies. In this context, we assessed an operational methodology based on the S-SEBI model to estimate energy fluxes over the natural grasslands of the Brazilian Pampa between 2014-2019. The S-SEBI is a remote sensing-based ET model that requires a minimum of meteorological inputs, being fully applicable for regions lacking in situ observations. Therefore, we investigated the model performance considering radiation data from both ERA5 reanalysis and Eddy Covariance measurements. Furthermore, comparisons from satellite-based estimates with in situ data were performed with and without energy balance closure (EBC). Results showed that the RMSE is impacted in 0.32 mm/day when reanalysis data are used, indicating that the meteorological inputs have low sensitivity on daily ET estimates from the S-SEBI model. In contrast, the instantaneous energy balance components are more affected. The strong climate seasonality of the Brazilian Pampa impacts the evaporative fraction, which is more evident in late summer and autumn and may compromise the performance of the model. The effects in the daily ET are lower when in situ data without EBC are considered as ground truth. However, they are less correlated with the remote sensing-based estimates. These insights are useful to monitor water and energy fluxes from local to regional scale and provide the opportunity to capture ET trends over the biome.
Effect of the Variability of Wind Forcing on ENSO Simulation in an OGCM: Case of Canonical and Protracted Event
Authors: Arora Anika
Published: August 2021

This study is an attempt to understand the onset and evolution of canonical El Niño (~ 18–24 months; CE) and protracted El Niño (> greater than 3 years; PE) compared to the normal state (NS) in an ocean model. Indo-Pacific warm pool indicates higher values of SST before the onset of strong canonical El Niño compared to the normal state and protracted El Niño. The ocean model used in the study shows systematic SST bias in the Indo-Pacific Ocean with higher (cooler) values of temperature in western (eastern) Pacific during NS, CE, and PE exhibiting La Niña like conditions. The ocean model exhibits deeper thermocline depth in the western equatorial Pacific Ocean (PO) during PE and CE compared to NS indicating higher values of heat content (warm water volume). Despite the presence of higher warm water volume in the western PO before the onset of El Niño, the difference in the variability of surface wind forcing during the preceding months determines the type of El Niño. The interplay of surface wind forcing among the NS, PE, and CE states without altering the ocean state can modify the subsurface propagation in the equatorial Pacific Ocean. A change in longitudinal extent of upwelling Kelvin waves towards eastern PO along with the change in surface wind forcing decides the fate of El Niño in the eastern Pacific.
Determinants of adherence to iron-folic acid supplementation among postnatal mothers in Addis Ababa referral hospitals, Ethiopia
Authors: Taye Tigist Alemu , Sinaga Mesele , Taye Abonesh
Published: August 2021

Abstract: In Ethiopia, adherence to iron-folic acid supplementation is extremely low. There were only 5% who took more than 90 tablets during their pregnancy. However, only limited data is available on the determinant factors of non-adherence. Therefore, the aim of this study was to identify determinants of adherence to iron-folic acid supplementation among postnatal mothers in three referral hospitals of Addis Ababa, Ethiopia.Methods: An institutional based unmatched case-control study was conducted on 240 women who have been at postnatal care. Data were collected using interviewer administered questionnaire. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Bivariate and multivariate logistic regressions were employed to identify the determinants at p-value < 0.25 and < 0.05, respectively.Results: The major determinant factors of adherence to iron-folic acid supplementation were, mothers age group 29-33 [AOR=1.66, 95% CI: 2.010-0.0492], ANC initiation time [AOR=4.21, 95% CI: 2.3-10.6], counseling on IFAS [AOR=3.89, 95% CI: 1.8-8.4], time taken to travel to health facility [AOR=3.17,95% CI:1.35-7.4], gravidity [AOR=2.08,95% CI:1.06-4.09], morning sickness [AOR 0.33, 95% CI: 0.15-0.69] and planned pregnancy [AOR=4.2, 95% CI: 1.6-10.9].Conclusion: This study highlighted age of participants, planned pregnancy, antenatal care initiation time, morning sickness, gravidity, counseling and distance to health facility are the key factors that have independently associate with adherence. Counseling should be given for clients on the correct dosage and duration of supplementation to prevent anemia and neural tube defects.
Comparative analysis of diversity and environmental niches of soil bacterial, archaeal, fungal and protist communities reveal niche divergences along environmental gradients in the Alps
Authors: Malard Lucie A , Mod Heidi K , Guex Nicolas , Broennimann Olivier , Yashiro Erika , Lara Enrique , Mitchell Edward A. D. , Niculita-Hirzel Helene , Guisan Antoine
Published: August 2021

Although widely used in ecology, comparative analyses of diversity and niche properties are still lacking for microorganisms, especially concerning niche variations. In this study, we identified important topoclimatic, edaphic, spatial and biotic drivers of the alpha and beta diversity of bacterial, archaeal, fungal and protist communities. Then, we calculated the niche breadth and position of each taxon along environmental gradients within all taxonomic groups, to determine how these vary within and between groups. Quantifying the niches of microbial taxa is necessary to then forecast how taxa and the communities they compose might respond to environmental changes. We found that edaphic properties were the most important drivers of both community diversity and composition for all microbial groups. Protists presented the largest niche breadths, followed by bacteria and archaea, with fungi displaying the smallest. Niche breadth generally decreased towards environmental extremes, especially along edaphic gradients, suggesting increased specialisation of microbial taxa in highly selective environments. Overall, we showed that microorganisms have well defined niches, as do macro-organisms, likely driving part of the observed spatial patterns of community variations. Assessing niche variation more widely in microbial ecology should open new perspectives, especially to tackle global change effects on microbes.
Assessment of anti-SARS-CoV-2 antibodies post-Coronavac vaccination in the Amazon region of Brazil.
Authors: Bichara Carlos David Araújo , Queiroz Maria Alice Freitas , Amoras Ednelza da Silva Graça , Vaz Gergiane Lopes , Vallinoto Izaura Maria Vieira Cayres , Bichara Cléa Nazaré Carneiro , Amaral Isabella Pinheiro Costa , Ishak Ricardo , Vallinoto Antonio Carlos Rosário
Published: August 2021

Background. The race to develop a vaccine against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has raised questions regarding the safety of immunizers, efficacy regarding the production of neutralizing antibodies, and the longevity of the immune response, especially when related to variables such as sex and age.Objective. The present study evaluated the frequency of seropositivity for anti-SARS-CoV-2 (S1 and S2) total antibodies and anti-SARS-CoV-2 (receptor binding domain - RBD - S1) neutralizing antibodies in individuals vaccinated with the immunizing agent Coronavac (Sinovac).Method. This was a cross-sectional study involving 358 individuals divided into two groups. Group 1 consisted of 205 volunteers who were tested for anti-SARS-CoV-2 total antibodies (S1 and S2); group 2 consisted of 153 individuals tested for the presence of anti-SARS-CoV-2 neutralizing antibodies (RBD-S1).Results. Seropositivity was greater than 70% in both groups, though approximately 20% of individuals showed no antibody production. The frequency of anti-SARS-CoV-2 total antibodies (S1 and S2) displayed a significantly different distribution between the sexes but not according to age. The frequency of anti-SARS-CoV-2 (RBD-S1) neutralizing antibodies was 93% in the age group from 21 to 40 years, which was significantly lower with advancing age, to 76% (41 to 60 years), 72% (61 to 80 years) and 47% (>80 years).Conclusion. Our results reveal a high prevalence of anti-SARS-CoV-2 total antibodies (S1 and S2) and anti-SARS-CoV-2 (RBD - S1) neutralizing antibodies in individuals who received both doses of the Coronavac vaccine, suggesting a lower efficiency of the humoral immune response among those older than 60 years of age, which might be associated with senescence of the immune system.
Decomposition Dynamics of Cooking-oil-soaked Paper in Media With a Low Inorganic Nitrogen Content
Authors: Ciesielczuk Tomasz , Rosik-Dulewska Czesława
Published: August 2021

Many paper-related products are in daily use all over the world. Although paper is one of the most recycled materials in the European Union, no end-of-waste criteria have been defined. Typical paper and cardboard should be recycled, but paper materials with impurities, such as water, cooking oil, sand, or plastic, are much more problematic. In particular, paper polluted with cooking oil or butter (e.g., pizza boxes) is difficult waste. Composting could be a solution, but in many municipal solid waste collection systems, this waste type is collected with the mixed waste stream. Paper and cardboard contain potentially much CH4 and, in landfills, are a source of CO2 and CH4. Incineration of these materials also causes CO2 emission. The aim of this study was to investigate the degradation of cooking-oil-polluted paper in media with a low inorganic nitrogen content. Office paper usually used for printouts was used as pre-test material. Two types of paper usually used in the kitchen were used: pizza box cardboard and parchment paper highly polluted with cooking oil. Two types of low inorganic nitrogen media were tested: mature municipal waste compost (MSWC) and leaf mold. The decrease in mass of both paper sample types was correlated with process time. All tested samples—raw cellulose materials and paper with cooking oil added—were partly or completely decomposed after 6 weeks of bioprocessing without an additional dose of inorganic nitrogen.
Unmet Need for Family Planning Among Married Women in Zambia: Lessons from the 2018 Demographic and Health Survey
Authors: Namukoko Harriet , Likwa Rosemary Ndonyo , Hamoonga Twaambo E. , Phiri Million
Published: August 2021

Introduction: Unmet need for family planning among married women is still high in Africa. In the year 2018, one in every five married women in Zambia had an unmet need for family planning. Unmet need for family planning can increase the number of unintended pregnancies and abortions, both of which have the potential to increase the proportion of women of child bearing age who are at high risk of birth complications. Studies have shown that factors explaining unmet need for family planning vary significantly from country to country, depending on access and availability of family planning services for women. We conducted this study to understand the determinants of unmet need for family planning in Zambia. Knowledge of factors associated with unmet need for family planning can help governments and stakeholders to identify health strategies to reduce unwanted fertility and prevent maternal and child mortality.Methods: The study used datasets from the Zambia Demographic and Health Survey which was a representative cross-sectional survey conducted in 2018. Zambia conducted a Demographic and Health to capture health indicators which are used to measure progress of implementation of health sector interventions. We did analysis on a sample of 7, 597 married women aged 15-49 years. Chi-square test and multivariate logistic regression were used to analyse determinants of unmet need for family planning. Stata version 14.2 was used to analyse weighted data and survey commands were applied to account for the complex sample design. Results: Study findings have revealed that half of the married women were still not using contraception by 2018. Unmet need for family planning among married women is still a public health issue in Zambia. In multivariate regression analysis; age, parity, household wealth and exposure to media-based family planning messages were found to be significantly associated with unmet need for family planning among married women.Conclusion: There is need to enhance family planning policy and programming in the country in order to achieve desired health outcomes. Mass media campaigns and community-based outreach activities with special focus on the young women can achieve significant results in reducing unmet need for family planning. Further, there should be some deliberate interventions to conduct family planning talks during in health facilities targeting women who visit maternal and children care clinics.
Optimizing the Fermentation Conditions and Determining the Disease Control and Growth Promotion Function of Bacillus Amyloliquefaciens 3-5
Authors: Ma Ting , Yang Chengde , Cai Fengfeng , Cui Lingxiao , Li Zhezhe , Wang Yidan
Published: August 2021

Bacillus spp. are helping to develop towards sustainable agriculture and have become a research hotspot in the field of plant pathology because they have great development potential such as control fungal plant diseases. Bacillus Amyloliquefaciens 3-5 was used as antagonistic bacteria in this experiment. The optimal medium for solid-state fermentation of B. amyloliquefaciens 3-5 contained bran (35%), rice hull powder (40%), corn gluten (20%), bean flour (15%), corn starch (1.5%), beef extract (2.5%) and MgSO4 (1.5%), and the optimal fermentation conditions included an inoculum of 6%, a solids content of 36 g/L, a feed-to-water ratio of 1:1, a fermentation temperature of 32 ℃, an initial pH of 7.0 and fermentation time of 44 h. When the dosage of the B. amyloliquefaciens 3-5 agent was 10%, the thick stems, root length and plant height of cucumber were significantly higher than those of the control (P＜0.05), and the growth rates were 77.45 %, 35.77 %, and 53.33 %, respectively in pot experiments. Compared with the control, and the preventive effect and therapeutic effect on cucumber Fusarium wilt were 72.09 % and 48.83 % by the application of B. amyloliquefaciens 3-5 agent，which showed that cucumber Fusarium wilt was successfully controlled by a newly isolated strain of B. Amyloliquefaciens 3-5. These results suggested that the prevention and control effect of B. amyloliquefaciens 3-5 agent on cucumber Fusarium wilt could not be underestimated.
Waste tea residue adsorption coupled with electrocoagulation for improvement of copper and nickel ions removal from simulated wastewater
Authors: Nizeyimana Jean Claude , Lin Shanshan , Khan Junaid , Yifeng Wu , dongxu Han , Xiangru Liu
Published: August 2021

The present research deals with the removal of copper and nickel ions from synthesized wastewater by using simple, cheap, cost-effective and sustainable activated green waste tea residue (AGWTR) adsorption coupled with electrocoagulation (ADS/EC) process in presence of iron electrode. Considering previous studies, their adsorbents used for treating their wastewaters firstly activate them by applying either chemicals or activating agents. Our adsorbent was prepared without applying neither chemicals nor any activating agents. The operating parameters of both metals were optimized: pH (4.0), hydraulic retention time (HRT = 30 min), adsorbent dose (1 mg.L− 1), initial concentration (20 mg.L− 1) and Fe-Fe electrode was found to be better with compared to the other electrodes with a current density of 1.19 mA/cm2. In the process of ADS/EC, The removal efficiency was obtained as 100% for copper and 99.99% for nickel ions. After the ADS/EC process, Fourier transform infrared (FT-IR) spectroscopy, Scanning Electron Microscopy (SEM) and EDS analysis were used to characterize the adsorbent green waste tea residue. The results showed seven clear peaks of functional groups that were detected in the range of 1000–4000 cm− 1, the rough-stone-like with various larger holes and higher amounts of carbon containing traces of different elements, respectively. The adsorption isotherm and kinetic model results showed that the Langmuir and the pseudo-second-order were well-fitted to the adsorption experimental data better than the Freundlich and pseudo-first-order models for both Cu2+ and Ni2+ with their maximum adsorption capacity of 15.6 and 15.9 mg.g− 1, respectively. These indicate that the dominant adsorption occurs in a monolayer of homogeneous adsorbent surfaces on AGWTR and its kinetic mechanism belongs to chemical adsorption. Based on the above results, it is well understood that the use of the ADS coupled with EC technique is the cheapest compared with single ADS and EC technique for heavy metal removal due to remarkable low adsorption dose, energy consumption and also it is a suitable technique for developind countries. Therefore, the AGWTR shows the greatest potential to improve the quality of water contaminated with different heavy metals in the environment.
Spatial Self-Similar Transformation and Novel Line Rogue Wave of the Fokas System
Authors: Zhang Jie-Fang , Jin Mei-Zhen
Published: August 2021

Fokas system is a natural and simple extension of the (2+1)-dimensional Schrödinger equation which can be used to describe optical pulse propagation in the nonlocal optical fibers. We first propose a two-dimensional spatial self-similar transformation of the Fokas system which is translated into the (1+1)-dimensional nonlinear Schrödinger equation. And then construct its abundant line rogue waves excitation. It is found that the spatial coherent structure line rogue waves induced by the Akhmediev breathers and Kuznetsov-Ma solitons also have the short life characteristics which possessed for the line rogue waves induced by the Peregrine solitons and other higher-order rogue waves and multi-rogue waves of the (1+1) dimensional standard NLS equations. This is completely different from the evolution characteristics of line soliton structures induced by bright solitons and the multi-solitons, which keeping their shape and amplitude unchanged. The diagram shows the evolution characteristics of the resulting all kinds of line rogue waves. The new excitation mechanism of line rogue waves revealed contributes to the new understanding of the coherent structure of high-dimensional nonlinear wave models.
A Study On The Effect of Different Elicitors On Capsaicin Accumulation in Cell Suspension Cultures of Capsicum Assamicum (Bhut Jolokia)
Authors: Nisha Swet , Bora Ajitabh , Gogoi HK , Dwivedi SK , Handique PJ
Published: August 2021

Elicitation of cell suspension cultures of Capsicum assamicum (Bhut Jolokia) for enhancement of capsaicin content was tried using different elicitors such as cellulase, vanillin, methyl jasmonate, salicylic acid and sinapic acid in different concentrations for 24, 48 and 72 hours. Cell suspension culture was established in B5 media supplemented with 3.5 mM 2,4-D (2,4-diphenoxyacetic acid) and 1.1 mM Kin and elicitors were introduced at the end of exponential phase. All the elicitors, except methyl jasmonate, led to significant increase in production of capsaicin. Sinapic acid, when added in 22 µM concentration and incubated for 24 hours, led to highest capsaicin accumulation of 0.5% (5068 µg/g) which was highest among all the treatments.
Facilitators and barriers affecting general practitioners’ choice to work in primary care units in Austria
Authors: Burgmann Sarah , Huter Sebastian , Mayerl Hannes , Abuzahra Muna E. , Siebenhofer Andrea
Published: August 2021

Background

General practitioner (GP) workforce shortages are a global threat to primary health care systems. In Austria, nearly 75 % of qualified GPs are not working as contracted GPs within the social health insurance system. This study aims to explore the facilitators and barriers for non-contracted GPs to work in a primary care unit (PCU).
Methods

We conducted twelve semi-structured, problem-focused interviews among purposively sampled non-contracted GPs. To extract categories of facilitators and barriers for working in a PCU, transcribed interviews were inductively coded using qualitative content analysis. These subcategories were then grouped into categories of thematic criteria and mapped on the macro-, meso-, micro-, and individual levels.
Results

We identified 36 factors, including 18 facilitators and 18 barriers. Most facilitators were located on the micro-level, while most barriers were located on the macro-level. Teamwork, which allows focus on professional medical work, shared responsibilities, flexibility in working time and work-life balance, mainly make PCUs attractive as workplaces and correspond with individual demands. By contrast, the absence of a clear vision for reform and insufficient implementation produce general ignorance and resistance. The conditions of contracts with social health insurance providers, including the remuneration system, requirements for PCUs and high workload with little time for individual patient care, are seen as inflexible and discouraging. Combined with insufficient vocational training and the low perceived status of GPs and PHC generally, GPs voiced concerns about being an entrepreneur and businessperson.
Conclusions

Targeted and proactive measures are necessary to attract non-contracted GPs to leave their current individual work-life arrangement and consider working in a PCU, especially considering the higher perceived risks. Multi-faceted efforts are needed to approach factors on all levels. Addressing system barriers should include a reform strategy with a clearly stated mission, defined PHC role, and tangible stakeholder commitment, as well as a modernized remuneration system and supportive measures to equip GPs with essential competences and skills. Proactive communication and exchange could promote the already existing attractive working conditions in PCUs and attract non-contracted GPs into the public sector.
Bioprospecting Studies of Actinomycete Bioactive Compound on Bla CTX-M -Extended -Spectrum Beta- Lactamase (ESBL) Producing Escherichia Coli and Klebsiella Species
Authors: Gururajan Gayathri , Kaliyaperumal Kathireshan , Ramasamy Balagurunathan
Published: August 2021

Forty one Extended Spectrum Beta Lactamase (ESBL) producing E. coli and Klebsiella species were analyzed for the presence of bla CTX-M genes by Uniplex Polymerase Chain Reaction (PCR) in which 15 isolates harbored bla CTX-M genes. Transconjugation studies were carried out to demonstrate the transfer of antibiotic resistance using E. coli K12J62-2 (F – rif r lac -) strain among which UTEC31 and UTK2 strains showed successful transconjugation. Sequence analysis revealed the presence of bla CTX-M-15 genes. Antibacterial activity of Streptomyces sp PUT23 was evaluated against CTX-M ESBL producing E. coli and Klebsiella sp. was determined. The ethyl acetate extract showed inhibitory activity and Reversed phase thin layer chromatography (RP-TLC) analysis revealed two fractions, EFI and EF2. Bioautogram of EF2 fraction demonstrated inhibitory activity with a minimum inhibitory concentration (MIC) value 156 μg/ml. The EF2 fraction was identified as a flavonoid upon chemical characterization. Sequencing of 16S rRNA gene and phylogenetic analysis of Streptomyces sp. strain PUT23 revealed its close relatedness to S. griseus. This study revealed the rapid spread and dominance of CTX-M producing E. coli and Klebsiella sp. in the suburban community of South Chennai, Tamil Nadu which has to be considered as a serious public health issue. There is an urgent need for newer and effective antimicrobials and bioactive compounds derived from Streptomyces species proved to be a promising and efficient resource. Further characterization and purification of EF2 fraction are needed and could be used in the formulation of new therapeutics against ESBL mediated infections.
Performance of Disc, Conventional and Automatic Screen Filters Under Rainbow Trout Fish Farm Effluent for Drip Irrigation System
Authors: Hasani Abed Mohammad , Nikmehr Saman , Maroufpoor Eisa , Aminpour younes , Bargués Jaume Puig
Published: August 2021

This study aims to investigate the performance of disc, conventional screen, and automatic screen filters when rainbow trout fish effluent is used for irrigation. The experiments were performed in a fish farm, located in the north-west of Iran. The disc and conventional screen filters were tested at pressures of 150 and 300 kPa, and the automatic screen filter at 200 and 300 kPa. The filtration experiments continued until the backwashing was reached. The results showed that (1) the initial head loss of disc and conventional screen filters was 40 kPa, while for the automatic screen filter was 5 kPa. (2) In the disc filter, with increasing working pressure, the filtered volume significantly (P<0.05) increased from 9.7 to 14.5 m3 m-2 (10 kPa)-1, but for conventional and automatic screen filters, it was constant at 5.5 and 7.0 m3 m-2 (10 kPa)-1, respectively, and all of them had significant (P<0.05) differences. (3) In the disc filter, with increasing the working pressure, the filtered volume to reach backwashing significantly (P<0.01) increased from 80.9 to 104.4 m3 m-2, while in the conventional screen filter increased from 14.1 to 16.4 m3 m-2. This volume at two working pressures was 29.5 m3 m-2 for the automatic screen filter. These volumes were significantly different (P<0.01) between filters. (4) The mass retention for the disc, conventional, and automatic screen filters were 28.88, 9.11, and 7.72 g min-1 m-2, respectively and tended to increase at lower working pressures. Based on this index, the difference in the performance of the filters was significant (P<0.01). (5) Overall, the best performance was for the disc filter, and after that was the automatic screen filters, but the period of time to operate for the filters until backwashing time was less than half an hour, which is not applicable under farm conditions.
Effect of COVID-19 Pandemic On Accidental Ingestions In Children: Observational Study
Authors: Sadeq Hussain , Husain Entesar H , Almutawa Farah , Al-Qabandi Wafa’a , AlSaleem Talal
Published: August 2021

BackgroundCoronavirus disease-19 (COVID-19) was declared by the World Health Organization (WHO) as a global pandemic on March 2020. Several measures have been attempted to contain the spread of the virus including school closures and lockdown. These measures have resulted in children staying at home with potential hazard exposure such as accidental drug or foreign body ingestions. In this study, we want to investigate the impact of COVID-19-related measures on admissions of children with accidental foreign body or drug ingestion. Methods All accidental ingestion admissions to pediatric wards at Al-Amiri hospital during the pandemic from March 2020 till February 2021 were retrospectively reviewed. They were compared with admission data from the pre-pandemic period from March 2019 till February 2020. Results There were 90 admission with accidental ingestion during the Pandemic compared to 138 admissions in the pre pandemic period. The mean age of admission during non-COVID-19 period was 3.9 ± 2.6 years, and 4.1 ± 2.9 years during pandemic period. The most common cause of accidental ingestion in children in both periods was medication ingestion. Coin ingestion was the second common cause during the pandemic compared to detergent in the pre-pandemic period. ConclusionsDespite children’s stay at home during COVID-19 pandemic, there was a reduction in hospitalization with accidental ingestion. This emphasizes the significance of family availability and constant observation of children at home as an important safety measure.
Evaluating Treatment strategies for Non-small Cell Lung Cancer during COVID-19: A Propensity Scores Matching Analysis
Authors: Yu Minhao , Cheng Yalin
Published: August 2021

Background
We had different understanding of treatment strategies to which we preferred conduct surgery for early-stage patients and delay treatment for late-stage non-small cell lung cancer patients at beginning of the COVID-19 pandemic. However, as we learned more about other guidelines, we were not sure whether our strategies have caused adverse results.
Methods
We divided patients hospitalized from September 2019 to February 2020 into experimental and control groups, and evaluated treatment strategies by patients’ prognosis. Propensity scores matching was used to adjust selection bias.
Results
Therapy discontinuation in the experimental group were significantly higher than the control group (P༜0.001). The differences of cancer progression and the number of deaths between the two groups were not significant (P = 0.376, 0.128, respectively). There were significant differences in non-surgical treatment and discontinued therapy for late-stage patients (P༜0.001, ༜0.001, respectively), while the differences of surgical treatment and therapy discontinuance for early-stage patients were not significant (P = 0.243, 0.243, respectively). The cancer progression and death toll differences in both early and late stage between the two groups were not significant (P = 0.608, 0.489, 0.197, 0.197, respectively). Multivariate analysis revealed therapy discontinuation did not predicted progress-free survival independently (hazard ratio = 1.007, 95% confidence interval: 0.653–1.552, P = 0.976).
Conclusions
For patients in regions with low risk for COVID-19 infections, surgery should not be delayed for early-stage patients if the hospital has adequate medical resources and strict testing and prevention measures are utilized. Delaying treatment less than three months can not significantly impact the prognosis of late-stage non-small cell lung cancer patients.
Optical Solitons in Bragg Gratings Fibers for The Nonlinear (2+1)-Dimensional Kundu-Mukherjee-Naskar Equation Using Two Integration Schemes
Authors: Zayed Elsayed M. E. , Shohib Reham , Alngar Mohamed E. M.
Published: August 2021

The current work handles for the first time, dispersive optical solitons in fiber Bragg gratings for the nonlinear (2+1)-dimensional Kundu-Mukherjee-Naskar equation. Two integration schemes, namely, the modified Kudryashov's approach and the addendum to Kudryashov's methodology are applied. Dark, bright and singular soliton solutions are obtained. Also, combo bright-singular soliton solutions are introduced.
Enhancement Production of Phenolic Compounds in The Cell Suspension Culture of Iberis Amara L.: The Effect of Chitosan Elicitation
Authors: Taghizadeh Marzieh , Nekonan Marzieh Sabagh , Setorki Mahbubeh
Published: August 2021

Iberis amara L. medicinal herb is well-known for having pharmacological values although its use has been challenged by the low levels of secondary metabolites. To address this issue, this study focused on evaluating the effect of explant, photoperiod, and plant growth regulators (PGRs) to find the optimum medium for inducing callus and establishing cell suspension in I. amara, followed by investigating the chitosan effect on some secondary metabolites. From our observations, the optimum condition for induced callus was achieved from the leaf explants in Murashige and Skoog (MS) media completed with 3 mg L− 1 6-benzylaminopurine(BAP) and 1 mgL− 1 1-naphthalene acetic acid(NAA) under 16-h light/8-h dark photoperiod. The MS enhanced with 3 mgL− 1BAP, 1 mg L− 1NAA, and 2% (w/v) sucrose appeared to be optimum conditions for suspension establishment. Thus, the cells were exposed to different concentrations of chitosan (200, 100, 50, and 0 mg L− 1) in their exponential growth stage from day 8 to 12 and day 12 to 16 following sub-cultures (T1) and sub-cultures (T2), respectively. The results showed that the 50 mgL− 1 chitosan significantly improved the total phenol, flavonoid, flavonol, and anthocyanin content in the I. amara in a dose-dependent manner. The highest malondialdehyde (MDA) amount, as a result of lipid peroxidation, was observed under the 200 ppm chitosan elicitation. Overall, these novel findings demonstrated the possibility of applying the cell suspension of I. amara treated with chitosan as a helpful approach for improving synthesizing phenolic compounds under controlled and sterile conditions without genetic modifications in medicinal herbs.
Atmosphere-Driven Cold SST Biases Over The Western North Pacific in The GloSea5 Seasonal Forecast System
Authors: Cho Ajin , Song Hajoon , Tak Yong-Jin , Yeh Sang-Wook , An Soon-Il , Lee Sang-Min , Ji Hee-Sook , Hyun Yu-Kyung
Published: August 2021

The predictability of the sea surface temperature (SST) in seasonal forecast systems is crucial for accurate seasonal predictions. In this study, we evaluate the prediction of SST in the Global Seasonal forecast system version 5 (GloSea5) hindcast with particular interest over the western North Pacific (WNP) in which the SST can modify atmospheric convection and the East Asian weather. GloSea5 has a cold SST bias in the WNP that grows over at least 7 months. The bias originates from the surface heat flux in which the latent heat flux bias shows the biggest contribution. We identify the overestimated cloud in the first few days after initialization that causes insufficient shortwave radiation and negative bias of the surface net heat flux. Uncoupled ocean model experiments infer that the ocean model is unlikely the primary source of the SST bias.
Application of New Techniques of Signal Processing for Detection of Wear Mechanisms in Turning of AISI 4340 Using Acoustic Emission
Authors: Maia Luis Henrique Andrade , Abrão Alexandre Mendes , Vasconcelos Wander Luiz , Júnior Jánes Landre , Machado Álisson Rocha , Sales Wisley Falco
Published: August 2021

In this study, the short-time Fourier transform (STFT) technique was used to determine the wear mechanisms acting on uncoated and AlCrN-coated carbide tools and their variations during the machining process. To this end, tensile tests were performed on hardened AISI 4340 steel to characterize the acoustic emission (AE) signals and subsequently isolate the steel deformation and fracture mechanisms from the signs of tool wear during the steel turning. Machining tests were carried out using the following parameters: cutting speeds of 150, 200 and 250 m/min and feed rates of 0.10 and 0.20 mm/rev. The results demonstrate that AE signals in conjunction with STFT analysis can be used to identify abrasive wear, adhesive wear and other phenomena that occur during cutting.
The Role of Harvesting in Population Control in Presence of Multiple Stochastic Noise Sources
Authors: Mandal Saroj Kumar , Jana Dipak Kumar , Poria Swarup
Published: August 2021

In this paper, we compare the role of constant and Michaelis-Menten type harvesting in single species population control in presence of stochastic noises sources. Steady state probability distributions and stationary potentials of the population for the two types of harvesting are determined by Fokker-Planck equations. Stochastic bifurcation analysis and mean first passage times have been computed. Noise induced critical transitions are observed depending on the strength of the noises. The extinction possibility of population in stochastic control with Michaelis-Menten type harvesting is higher than the constant rate of harvesting. One of the findings is the transition of the population from bistable to tristable for weak noise and Michaelis-Menten type harvesting. Another finding is noise enhanced stability phenomenon for negatively correlated noises. In case of population control, constant rate of harvesting is better in deterministic case whereas Michaelis-Menten type harvesting is better in stochastic case. The stochastic control is more efficient than deterministic control as average population size in stochastic case is lower than the deterministic case. The results obtained in this study can throw light on toxic phytoplankton blooms and its control in marine ecosystem. Moreover, the study can be useful to explain wild prey population outbreak and its control in deep forest.
A Fluorescently-labeled Tumor-specific Peptide for Intraoperative Visualization of Non-muscle Invasive Bladder Cancer: A Clinical Study
Authors: Shang Wenting , Peng Li , He Kunshan , Guo Pengyu , Deng Han , Chi Chongwei , Liu Yu , Chen Ziyin , Tian Jie , Xu Wanhai
Published: August 2021

Bladder cancer is the fifth most common malignancy in humans. Cystoscopy under white light imaging is the gold standard for bladder cancer diagnosis, but these tumors are difficult to visualize and can be overlooked, resulting in high recurrence rates. We previously developed a phage display-derived peptide-based near-infrared imaging probe, PLSWT7-DMI, which binds specifically to bladder cancer cells and is nontoxic to animals. Here, we report the first-in-human application of this probe for near-infrared fluorescence endoscopic detection of bladder cancer. The purity, efficacy, safety, and nontoxicity of the probe were confirmed prior to its clinical application. Twenty-two patients diagnosed with suspected non-muscle invasive bladder cancer were enrolled in the present study. Following intravesical administration of the probe, the entire mucosa was imaged under white and near-infrared imaging using an in-house developed endoscope that could switch between these two modes. The illuminated lesions under near-infrared light were biopsied and sent for histopathological examination. We observed a 5.1-fold increase in the fluorescence intensity in the tumor samples compared to normal tissue, and the probe demonstrated a sensitivity and specificity of 91.2% and 90%, respectively. Common diagnostic challenges, such as small satellite tumors, carcinoma in situ , and benign suspicious mucosa, were visualized and could be distinguished from cancer. Further, no adverse effects were observed in humans. These first-in-human results indicate that PLSWT7-DMI-based near-infrared fluorescence endoscopy is a safe and effective approach for the improved detection of bladder cancer, and may enable thorough resection to prevent recurrence.