bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptomic analysis of flower induction for long-day pitaya by supplementary lighting in short-day winter season
Authors: Xiong Rui , Liu Chengli , Xu Min , Wei Shuang-Shuang , Huang Jia-quan , Tang Hua
Published: February 2020

Background: Pitayas are currently attracting considerable interest as a tropical fruit with numerous health benefits. However, as a long-day plant, pitaya plants cannot flower in the winter season from November to April in Hainan, China. To harvest pitayas with high economic value in the winter season, it is necessary to provide supplementary lighting at night to induce flowering. To further explore the molecular regulating mechanisms of flower induction in pitaya plants exposed to supplementary lighting, we used de novo RNA sequencing-based transcriptomic analysis for four stages of pitaya plants subjected to light induction.
Results: We assembled 68113 unigenes in total, comprising 29782 unigenes with functional annotations in the NR database, 20716 annotations in SwissProt, 18088 annotations in KOG, and 11059 annotations in KEGG. Comparisons between different samples revealed different numbers of significantly differentially expressed genes (DEGs). A number of DEGs involved in energy metabolism-related processes and plant hormone signaling were detected. Moreover, we identified many CONSTANS-LIKE , FLOWERING LOCUS T , and other DEGs involved in the direct regulation of flowering including CDF and TCP , which function as typical transcription factor genes in the flowering process. At the transcriptomic level, we verified 13 DEGs with different functions in the time-course response to light-induced flowering by quantitative reverse-transcription PCR analysis.
Conclusions: The identified DEGs may include some key genes controlling the pitaya floral-induction network, the flower induction and development is very complicated, and it involves photoperiod perception and different phytohormone signaling. These findings will increase our understanding to the molecular mechanism of floral regulation of long-day pitaya plants in short-day winter season induced by supplementary lighting.
Evaluation of a Rapid Immunochromatographic test kit to the Gold Standard Fluorescent Antibody Test for Diagnosis of Rabies in Animals in Bhutan
Authors: Tenzin Tenzin , Lhamo Kelzang , Rai Purna B , Tshering Dawa , Gyamtsho Pema , Namgyal Jamyang , Wangdi Thrinang , Letho Sangay , Rai Tuku , Jamtsho Sonam , Dorji Chendu , Rinchen Sangay , Lungten Lungten , Wangmo Karma , Lungten Lungten , Wangchuk Pema , Gempo Tshewang , Jigme Kezang , Phuntshok Karma , Tenzinla Tenzinla , Gurung Ratna B , Dukpa Kinzang
Published: February 2020

Background Rabies kills approximately 59,000 people in the world each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance and diagnostic activities, especially in resource poor settings. A total of 179 brain tissue samples collected from different rabies suspect animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) were selected and tested using both rapid immunochromatographic kit and the reference standard fluorescent antibody test (FAT). We evaluated the test sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a rapid antigen detection test kit produced by BioNote, Inc. (Hwaseong-si, Korea) to a FAT for its fit-for-purpose for confirmation of clinical cases of rabies for early response, prevalence of infection (rabies surveillance), freedom for infection and eradication of rabies. ResultsAmong 179 samples examined in this study, there was a concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test results were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9 – 95.6) and specificity of 100% (95% CI: 93.4 – 100) using FAT as the reference standard. The positive and negative predictive values were found to be 100% (95% CI:96.7 – 100) and 84.4% (95% CI: 73.6 – 91.3), respectively. Overall there was 94.4% (95% CI: 90 – 96.9) test agreement between rapid test and FAT (Kappa value = 0.874) with a positive percent agreement and negative percent agreement of 92 and 100%, respectively.Conclusions Our finding demonstrated that the rapid test kit (BioNote) can be used for confirming clinical case of rabies in animals for making rapid decisions including early medical intervention in human exposure and controlling rabies outbreaks in resource poor settings. Keywords: rabies virus; diagnostic test; fluorescent antibody test; rapid anigen test; rapid immunochromatographic test; Bhutan
Sexual And Reproductive Health Needs Of Street-Involved Young People: Findings From A Baseline Survey In Southwest Nigeria
Authors: Olaleye Atinuke O , Obiyan Mary O. , Folayan Morenike O.
Published: February 2020

Background To achieve the Sustainable Development Goal 3, street-involved young people (SIYP) require consideration in the strategies for ensuring universal access to sexual and reproductive healthcare. This study aims to determine the age- and sex-specific sexual and reproductive health (SRH) needs of SIYP in Nigeria. Methods This was a cross-sectional study that recruited 1,505 SIYP aged 10-24 years using respondent-driven and time-location sampling. Data were collected on socioeconomic characteristics, access to SRH information, contraceptive knowledge and use, sexual behavior and sexual practice using interviewer-administered questionnaires. The outcome variables were inconsistent condom use, multiple sexual partners and transactional sex. Binomial regression analysis models were developed to determine risk indicators for outcome variables. Results Though 968 (64.3%) participants were sexually active and 1,089 (72.4%) knew about modern contraception, only 300 (31.0%) sexually active respondents use modern contraceptives. Knowledge of modern contraception (AOR: 0.11; 95% C.I: 0.01-0.82, p=0.03) and being employed (AOR: 0.38; 95% C.I: 0.15-0.95, p=0.04) reduced the odds for inconsistent condom use among male SIYPs. For the female SIYPs, knowledge of modern contraception reduced the odds for inconsistent condom use (AOR: 0.26; 95% C.I: 0.08-0.90, p=0.03), while having access to SRH information significantly increased the odds for inconsistent condom use (AOR: 5.06; 95% C.I: 1.67-15.37, p=0.004). Conclusion There are age- and sex- related differences in the factors associated with risky sexual behaviors among SIYP. Addressing these differences in the delivery of targeted interventions to reduce sexual health risk of SIYP may be required.
Talking to teenagers regarding sexual and reproductive health: Exploration of parents/guardians’ views in Limpopo province, South Africa
Authors: Dilebo Matete E. , Lebese Rachel T. , Ramathuba Dorah U. , MAKHADO LUFUNO
Published: February 2020

Background Sexual and reproductive health are sensitive topics that may not be easily discussed among different age groups in most cultures. Most parents are uncomfortable to communicate with their children about sexual and reproductive health. The rate of teenage pregnancy and sexually transmitted infections continues to rise as parents shift the responsibility of discussing sexual health to other members of the family or teachers. Many sexual and reproductive ill-health exists among teenagers as a result of poor communication with parents or elders. The aim of the study was to explore the views of parents/guardians regarding t the discussion of sexual and reproductive health issues with teenagers. Methods The study was conducted in Capricorn and Mopani Districts of Limpopo Province where teenage pregnancy rates were reported to be very high. A qualitative explanatory approach was used. The population comprised of parents/guardians to teenagers who were pregnant or having children. Data were collected through individual face to face interview guided by one central question. Data were analysed using Tesch's method. Measures to ensure trustworthiness and ethical issues were ensured. Results Two themes emerged from the study: Views regarding discussing sexual and reproductive-related topics between parents and teenagers and Relationship of parents/guardians and their teenagers as an influence of discussions about SRH matters. Conclusion Parents/guardians still view discussing sexual and reproductive health issues with teenagers as taboo and difficult. However, discussing sexual and reproductive health issues with teenagers is seen as a beneficial practise as it might influence them positively and may decrease unwanted sexual risks such as teenage pregnancies and HIV infections.
Global Fund Financing and Human Resources for Health Investments in the Eastern Mediterranean Region
Authors: Okunogbe Adeyemi , Bowser Diana , Gedik Gulin , Naseri Saha , Abu-Agla Ayat , Safi Najibullah
Published: February 2020

Background: Despite the large investments in donor-related health activities in areas of the globe prone to tension and conflict, few studies have examined in detail the impact of these donor investments on human resources for health (HRH). Methods: We used a mixed-methods research methodology comprising both quantitative and qualitative analysis to analyze the Enhanced Financial Reporting System of the Global Fund to Fight AIDS, Tuberculosis and Malaria budget and expenditure data from 2003-2017 for 13 countries in the Eastern Mediterranean Region (EMR). We analysed additional detailed budgetary data over the period 2013-2017 for a sub-set of these countries. Two country-case studies were conducted in Afghanistan and Sudan for a more in-depth understanding of the HRH-related activities that occurred as a result of Global Fund grants. Results: The results show that US$2.2 billion Global Fund dollars had been budgeted and US$1.6 billion were expended over the period 2003-2017 in the 13 Eastern Mediterranean countries. The average expenditures for human resources for health (training and human resources) as a percentage of total expenditure is 28%. Additional detailed budgetary data analysis shows a more conservative investment in HRH with 13% of total budgets allocated to “direct” HRH activities such as salaries, training costs, and technical assistance. HRH-related activities supported by the Global Fund in Afghanistan and Sudan are similar, including pre-service and in-services training, hiring of program coordinators and staff, and top-ups for clinical staff. Conclusions: HRH remains a key issue in strengthening the health systems of low- and middle-income countries. While this study suggests that Global Fund’s HRH investments in the EMR are not lagging behind the global average, there appears to be a need to further scale up these investments considering this region’s unique HRH challenges.
Cloacal swabs are unreliable sources for estimating lower gastro-intestinal tract microbiota in chicken.
Authors: Williams Travis John , Athrey Giridhar N
Published: February 2020

Background The gastrointestinal microbiota in chicken ( Gallus gallus domesticus ) has a central role in health and performance. The ceca are a vital site of functional activity, but assessing cecal microbiota in longitudinal studies remains a challenge. The cecal communities are broadly similar to large intestine samples. Cloacal sampling, due to their proximity to the large intestine, is an alternative, non-invasive method used for assaying and monitoring disease-causing agents, and maybe a viable option for longitudinal studies. Results We collected paired cecal content, and cloacal swab samples from twenty randomly selected commercial broilers raised on two dietary treatments. The microbiota of each sample was assessed using 16S rRNA V4 hypervariable region sequencing on an Illumina MiSeq platform and analyzed using the MOTHUR pipeline. Analysis of fourteen paired samples resulted in 1603 OTU’s assigned to 82 Families. Eleven families were shared between the cecal and cloacal samples, with seven and eleven families unique to cecal content and cloacal swabs, respectively. Paired t-test and Wilcoxon Signed-Rank test showed significant differences in the Chao1 index between the cecal content and cloacal swabs (p-value = 0.000845 and p-value = 0.001397, respectively). However, the Inverse Simpson species diversity estimator was not different using the Wilcoxon Signed-Rank test (p-value = 0.3258) and a paired t-test (p-value = 0.3864). β-diversity between the cloacal swabs and cecal microbiota also showed significant differences based on PERMANOVA (p-value = <0.001), HOMOVA (p-value <0.001), and Weighted Unifrac (WSig = <0.001) testing. Conclusions Cloacal swabs do not approximate either the α or β diversity of cecal samples, based on a paired sample analysis. The high variability of cloacal microbiota has been reported previously, and this study provides additional evidence of the randomness of cloacal microbiota in contrast to cecal microbiota. Our findings indicate that cloacal samples are not suitable for longitudinal studies of gut microbiota patterns. High inter-individual variation of cloacal swab data warrants further assessment of their reliability as a targeted diagnostic method.
Microglial-associated responses to comorbid amyloid pathology and hyperhomocysteinemia in an aged knock-in mouse model of Alzheimer’s disease
Authors: Braun David James , Dimayuga Edgardo , Morganti Josh M. , Eldik Linda J Van
Published: February 2020

Background: Elevated blood homocysteine levels, termed hyperhomocysteinemia (HHcy), is a prevalent risk factor for Alzheimer’s disease (AD) in elderly populations. While dietary supplementation of B-vitamins is a generally effective method to lower homocysteine levels, there is little if any benefit to cognition. In the context of amyloid pathology, dietary-induced HHcy is known to enhance amyloid deposition and certain inflammatory responses. Little is known, however, about the specific effects on microglia resulting from combined amyloid and HHcy pathologies. Methods: The present study used a knock-in mouse model of amyloidosis, aged to 12 months, given 8 weeks of dietary deficiency-induced HHcy to better understand how microglia are affected in this comorbidity context. Results: We found that HHcy-inducing diet increased amyloid plaque burden, altered the neuroinflammatory milieu, and upregulated the expression of multiple damage-associated and “homeostatic” microglial genes. Conclusions: Taken together, these data indicate complex effects of comorbid pathologies on microglial function that are not driven solely by increased amyloid burden. Given the highly dynamic nature of microglia, their central role in AD pathology, and the frequent occurrence of various comorbidities in AD patients, it is increasingly important to understand how microglia respond to mixed pathological processes.
The local transcriptional regulators SacR1 and SacR2 act as repressors of fructooligosaccharides metabolism in Lactobacillus plantarum
Authors: Chen Chen , Wang Linlin , Yu Haiyan , tian huaixiang
Published: February 2020

Background In Lactobacillus plantarum, fructooligosaccharides (FOS) metabolism is controlled by both global and local regulatory mechanisms. Although catabolite control protein A has been identified as a global regulator of FOS metabolism, the functions of local regulators remain unclear. This study aimed to elucidate the roles of two local regulators, SacR1 and SacR2, in the regulation of FOS metabolism in L. plantarum both in vitro and in vivo. Results A reverse transcription-quantitative PCR analysis of one wild-type and two mutant strains ( ΔsacR1 and ΔsacR2 ) of L. plantarum grown on FOS and ribose identified SacR1 and SacR2 as repressors of FOS metabolism in the absence of FOS. Moreover, genes relevant to FOS metabolism could be induced or derepressed by the addition of FOS. The analysis predicted four potential SacR1 and SacR2 transcription factor binding sites (TFBS) in the putative promoter regions of two FOS-related clusters. The binding of SacR1 and SacR2 to these TFBSs both in vitro and in vivo was verified using electrophoretic mobility shift assays and chromatin immunoprecipitation, respectively. A consensus sequence of WNNNNNAACGNNTTNNNNNW was deduced for the TFBS of SacR1 and SacR2. Conclusion Our results identified SacR1 and SacR2 as local regulators that repress FOS utilization by L. plantarum by binding to TFBSs in the promoter regions of FOS-related clusters. The results provide new insights into the complex network regulating oligosaccharide metabolism by lactic acid bacteria.
Effects of contact stress on patellarfemoral joint and quadriceps force in fixed and mobile-bearing medial unicompartmental knee arthroplasty
Authors: Kwon Hyuck Min , Lee Jin-Ah , Koh Yong-Gon , Park Kwan Kyu , Kang Kyoung-Tak
Published: February 2020

Background Unicompartmental knee arthroplasty (UKA) is an effective treatment for end-stage, symptomatic unicompartmental osteoarthritis (OA) of the knee joint. However, patellofemoral (PF) joint degeneration is a contraindication to medial UKA. Therefore, the objective of this study is to evaluate the biomechanical effect on the PF joint in medial UKA using fixed-bearing (FB) and mobile-bearing (MB) design prostheses. Methods A three-dimensional finite-element model of a normal knee joint was developed using medical image data. We performed statistical analysis for each model. The differences in the contact stress on the PF joint and the quadriceps force between the FB and MB designs were evaluated under a deep-knee-bend condition. Results At an early flexion angle, the results of the contact stress were showed that there was no significant difference between the FB and MB medial UKA models compared with the intact model. However, at a large flexion angle, we observed a significant increase in the contact stress of FB models. On the contrary, in the case of the MB models, there was no statistically significant increment compared to the intact model. Our results indicate that with medial UKA, the contact stress increased, and a greater quadriceps force was applied to the PF joint. However, there should be no difficulty in performing UKA on a PF joint with OA, unless there is anterior knee pain. This is because the increase in the contact stress is negligible. Conclusions Our results showed that there was no significant difference in contact stress on the PF joint between medial UKA and intact knee joints. In particular, such a mechanism was easily found in mobile-bearing medial UKA. Therefore, this study biomechanically showed that degenerative changes in the PF joint should not be considered an absolute contraindication for treatment with medial UKA.
Dynamic spinal posture and pelvic position analysis using a rasterstereographic device
Authors: Michalik Roman , Hamm Juliane , Quack Valentin , Eschweiler Jörg , Gatz Matthias , Betsch Marcel
Published: February 2020

Background: Until recently, rasterstereographic analysis of the spine was limited to static measurements. However, understanding and evaluating the motion of the spine under dynamic conditions is an important factor in the diagnosis and treatment of spinal pathologies. Aim of this study was to study the spinal posture and pelvic position under dynamic conditions and compare it to static measurements using a dynamic rasterstereographic system. Methods: A total of 121 healthy volunteers (56 females; 65 males) were included in this observational study. The parameters trunk inclination, trunk imbalance, pelvic obliquity, kyphotic angle, lordotic angle, surface rotation and lateral deviation were studied and compared under static and dynamic (1,2,4,5 km/h) conditions using the system “Formetric 4D Motion ® “ (DIERS International GmbH, Germany). Results: Female volunteers had a higher lordotic angle than males under static conditions (p<0.001). Trunk inclination (5.31° vs. 6.74°), vertebral kyphotic angle (42.53° vs. 39,59°) and surface rotation (3.35° vs. 3.81°) increase under dynamic conditions (p<0.001). Trunk inclination and lordotic angle both show significant changes during walking compared to static conditions (p<0.001). Conclusion: The spinal posture differs between females and males during standing and during walking. Rasterstereography is a valuable tool for the dynamic evaluation of spinal posture and pelvic position, which can also be used to quantify motion in the spine and therefore it has the potential to improve the understanding and treatment of spinal pathologies. Trial registration: retrospectively registered
Custom-made talar component of total ankle replacement implant, with or without lateral articular facet: A finite element analysis
Authors: Zhu Min , Tang Kang-lai , Jin Zhong-min , Xu Zhi , Feng Guo-cheng , Xu Yong-qing
Published: February 2020

Background: The present patient dissatisfaction with and high failure rates of total ankle replacement (TAR) are likely due to current prosthesis designs, which are not patient-specific and anatomy-based, leading to unphysiological motion at the replaced joint. The design of customized prostheses is already possible by means of medical imaging and additive manufacturing technology.Methods: In this study, dome and geometric fixtures of custom-made talar components for TAR were designed, and we investigated two kinds of talar components: 2-surface contact type (Type-1, without lateral articular facet) and 3-surface contact type (Type-2, with lateral articular facet). The effects of the above two prostheses on the loading stress of the prosthesis contact surface were comparatively analysed with three-dimensional finite element models.Results: The maximum and average von Mises stress values of the 3-surface prosthesis were smaller than those of the 2-surface prosthesis. In terms of contact surface pressure, the maximum and average values of the 3-surface prosthesis are almost equal to those of the 2- surface type. In terms of the tangential slip distribution of the contact surface, the maximum and average values of the 3-surface prosthesis were smaller than those of the 2-surface prosthesis.Conclusions: The custom-made talar component of the total ankle replacement implant reproduced the anatomical morphology of the natural articular surfaces well. The 3-surface contact type prosthesis with lateral articular facet, compared to the 2-surface contact type without lateral articular facet, offers better static stability by affecting the internal and external forces.
Topography of the respiratory tract bacterial microbiota in cattle
Authors: McMullen Christopher , Alexander Trevor W. , Léguillette Renaud , Workentine Matthew , Timsit Edouard
Published: February 2020

Background

Bacterial bronchopneumonia (BP) is the leading cause of morbidity and mortality in cattle. While the bacterial composition of the bovine upper respiratory tract (URT) has not been studied in detail, the nasopharynx is generally accepted as the primary source of pathogenic bacteria that cause BP. However, it has recently been shown in humans that the oropharynx may act as the primary reservoir for pathogens that reach the lung. The objective was therefore to describe the bacterial microbiota present along the entire cattle respiratory tract to determine which URT niches may contribute the most to the composition of the lung microbiota.

Methods

Seventeen upper and lower respiratory tract locations were sampled from 15 healthy feedlot steer calves. Samples were collected using a combination of swabs, protected specimen brushes, and saline washes. DNA was extracted from each sample and the 16S rRNA gene (V3-V4) was sequenced. Community composition, alpha-diversity, and beta-diversity were compared among sampling locations.

Results

Microbiota composition differed across sampling locations, with physiologically and anatomically distinct locations showing different relative abundances of 1,137 observed sequence variants (SVs). An analysis of similarities showed that the lung was more similar to the nasopharynx (R-statistic = 0.091) than it was to the oropharynx (R-statistic = 0.709) or any other URT sampling location. Five distinct metacommunities were identified across all samples after clustering at the genus level using Dirichlet multinomial mixtures. This included a metacommunity found primarily in the lung and nasopharynx that was dominated by Mycoplasma . Further clustering at the SV level showed a shared metacommunity between the lung and nasopharynx that was dominated by Mycoplasma dispar . Other metacommunities found in the nostrils, tonsils, and oral microbiotas were dominated by Moraxella , Fusobacterium , and Streptococcus , respectively.

Conclusions

The nasopharyngeal bacterial microbiota is most similar to the lung bacterial microbiota and therefore may serve as the primary source of bacteria to the lung. This finding confirms that the nasopharyngeal microbiota should be the focus of research as it relates to the role of the URT microbiota in BP. As well, this microbiota should be the main target for future interventions and pharmaceuticals aimed at controlling and preventing BP.
Hexanol biosynthesis from syngas by Clostridium carboxidivorans P7 is enhanced by in‑line extraction with a biocompatible solvent to avoid product toxicity
Authors: Kottenhahn Patrick , Philipps Gabriele , Jennewein Stefan
Published: February 2020

Background Clostridium carboxidivorans P7 has the rare ability to metabolize syngas – a mixture of H2, CO and CO2 – by converting it directly into industrially relevant alcohols (hexanol, butanol and ethanol) and the corresponding acids (caproate, butyrate and acetate). The product titers and ratios are highly dependent on the fermentation parameters and the composition of the syngas and growth medium. The hexanol titers produced by C. carboxidivorans P7 have recently been improved by optimizing these conditions, but little is known about the toxicity of hexanol towards Clostridium species. We hypothesized that the hexanol titers currently produced by C. carboxidivorans P7 are limited by product toxicity. Results We tested our hypothesis by exposing C. carboxidivorans P7 to different concentrations of hexanol and found that growth inhibition started at 10–12 mM, with an IC50 of 17.5 ± 1.6 mM. The presence of 20 mM hexanol was acutely toxic to C. carboxidivorans P7 as well as the model acetogen C. ljungdahlii, which does not produce hexanol. To avoid product toxicity, we added a biocompatible solvent (oleyl alcohol) to fed-batch bottle fermentations of C. carboxidivorans. This increased the total hexanol titers by 2.5-fold from 9.4 to 24.4 mM. Cell growth and product profiles in the aqueous phase after fermentation were similar in cultures with and without oleyl alcohol. The extraction phase contained high levels of hexanol (436 ± 101 mM) and butanol (100.3 ± 17.8 mM) as well as low levels of ethanol and traces of caproate. Conclusions Product toxicity was confirmed as a limiting factor during the conversion of syngas to hexanol by C. carboxidivorans P7. The addition of oleyl alcohol as a biocompatible solvent led to a significant increase in hexanol titers by facilitating the efficient and selective extraction of this product. We have therefore identified an in-line extraction strategy that increases the yield of hexanol and should allow for further improvements by genetic adaptation and/or process optimization.
PowerTools: A web based user-friendly tool for future translational study design
Authors: Acharjee Animesh , Larkman Joseph , Cardoso Victor Roth , Gkoutos Georgios V.
Published: February 2020

BackgroundBiomarker identification is one of the major goals of functional genomics and translational medicine research. The advent of NGS lead to a constant and exponential increase of large datasets that have the potential of providing the means for novel biomarker identification for the early diagnosis of complex diseases and/or for patient/disease stratification. Once a biomarker has been identified, a validation study is necessary to assess its value. A study design that considers its appropriateness and cost-effectiveness is paramount. The calculation of a sample size is a challenge that needs to be addressed.MethodsThe workflow of our tool, termed PowerTools, is based on based on the method described by Blaise et al., (2016) [1]. For a given number of input data sets, a simulation step with the random multivariate normal distribution including correlation is considered. As a next step, datasets of variable sizes are generated by random selection of samples. Based on the outcome variable, either classification or regression modes are available. For binary classification ANOVA and linear regression test can be performed and then performance matrices can be evaluated.ResultsWe developed an online framework to streamline power calculations to aid future omics study designs within a translational medicine research context. We make our code freely available on GitHub [2] and we have provided a web interface that can be accessed at online [3].ConclusionsPowerTools offers the potential for designing appropriate and cost-effective subsequent omics study designs.
Prevalence of central nervous system adverse effect and associated factors among HIV patients on efavirenz based ART regimen
Authors: Muche Esileman Abdela , Kiflu Mekdes
Published: February 2020

Background: Efavirenz based antiretroviral regimens served as a first line treatment in our country, however commonly lead to central nervous system toxicity, which is the main reason for non-adherence, switch and discontinuation to antiretroviral therapy. We aimed to assess prevalence of central nervous system adverse effect and associated factors among HIV patients taking efavirenz based regimens. Methods: Hospital based cross-sectional study was conducted on 345 patients who were taking efavirenz based ART medications on follow up at UoGCSH from March 15 to may15, 2018. Information on socio-demographic characteristics and detailed history regarding central nervous system adverse effect were taken from both the patient and medical record.. Both bivariate and multivariate analyses were done using binary logistic regression to find out the associated factors. Level of statistical significance was declared at P value of ≤ 0.05 levels. Result: The central nervous system adverse effects of EFV based ART regimen were observed in 52.8% of participants and vivid dream was the most commonly reported adverse effect. Upon computation of bivariate binary logistic regression economic status, EFV based regimen type, Stage of RVI, alcohol use and concomitant medical condition had shown association on the occurrence of central nervous system adverse effect of EFV based ART regimen. But in multivariate analysis alcohol use (p = 0.004; AOR = 4.450), stage I RVI (p = 0.001; AOR= 0.006) stage II RVI (p = 0.001; AOR=0.017) stage III RVI (P=0.01; AOR=4.13) became significantly associated with the occurrence of CNS adverse effect. Conclusion: More than half of HIV patients taking efavirenz based regimens at UOGCSH experience the central nervous system adverse effect. The most commonly reported central nervous system adverse effects were vivid dream, confusion, and insomnia. Stage III and IV HIV patient need special attention to prevent and decrease central nervous system adverse effect of EFV based regimen. Health workers need to tell the patients to avoid alcohol, especially in the initiation of the treatment.
Potential therapeutic effects of endothelial cells trans-differentiated from Wharton’s Jelly-derived mesenchymal stem cells on altered vascular functions in aged diabetic rat model
Authors: Motawea Shaimaa M. , Noreldin Rasha I. , Naguib Yahya M
Published: February 2020

BackgroundDiabetes mellitus in elderly represents an exceptional subset in the population vulnerable to cardiovascular events. As aging, diabetes mellitus and hypertension share common pathways, an ideal treatment should possess the ability to counter more than, if not all, the underlying mechanisms. Stem cells emerged as a potential approach for complicated medical problems. We tested here the possible role of trans-differentiated endothelial cells (ECs) in the treatment of diabetes mellitus in old rats.MethodsMesenchymal stem cells where isolated from umbilical cord Wharton’s Jelly and induced to differentiate into endothelial like-cells using vascular endothelial growth factor-enriched media. Thirty aged male Wistar albino rats were used in the present study. Rats were divided (10/group) into: control group (18–20 months old, weighing 350–400 g, received single intraperitoneal injection as well as single intravenous injection via tail vein of the vehicles), aged diabetic group (18–20 months old, weighing 350–400 g, received single intraperitoneal injection of 50 mg/kg streptozotocin, and also received single intravenous injection of saline via tail vein), and aged diabetic + ECs group (18–20 months old, weighing 350–400 g, received single intraperitoneal injection of 50 mg/kg streptozotocin, and also received single intravenous injection of 2*106 MSC-derived ECs in 0.5 ml saline via tail vein) groups. Assessment of SBP, aortic PWV, and renal artery resistance was performed. Serum levels of ET1, ANG II, IL-6, TNF-α, MDA, ROS, and VEGF were evaluated, as well as the aortic NO tissue level and eNOS gene expression. Histopathological and immunostaining assessments of small and large vessels were also performed.ResultsInduction of diabetes in old rats resulted in significant increase in SBP, aortic PWV, renal artery resistance, and serum levels of ET1, ANG II, IL-6, TNF-α, MDA, ROS, and VEGF. While there was significant decrease in aortic NO tissue level and eNOS gene expression in the aged diabetic group when compared to aged control group. ECs treatment resulted in significant improvement of endothelial dysfunction, inflammation and oxidative stress.ConclusionWe report here the potential therapeutic role of trans-differentiated ECs in aged diabetics. ECs demonstrated anti-inflammatory, antioxidant, gene modifying properties, significantly countered endothelial dysfunction, and improved vascular insult.
Estimating restricted mean survival time and expected life-years lost in the presence of competing risks within flexible parametric survival models
Authors: Mozumder Sarwar Islam , Lambert Paul , Rutherford Mark
Published: February 2020

We present various measures, specifically the expected life-years list due to a cause of death, that can be predicted for a specific covariate pattern. These can also be summarised at the population-level using standardisation to obtain marginal measures. The restricted mean survival time (RMST) measure can be obtained in the presence of competing risks using Royston-Parmar flexible parametric survival models (FPMs). Royston-Parmar FPMs can be fitted on either the cause-specific hazards or cumulative incidence scale in the presence of competing risks. An advantage of modelling within this framework for competing risks data is the ease at which other alternative predictions to the (cause-specific or subdistribution) hazard ratio can be obtained. The RMST estimate is one such measure. This has an attractive interpretation, especially when the proportionality assumption is violated. In addition to this, compared to similar measures, fewer assumptions are required and it does not require extrapolation. Furthermore, one can easily obtain the expected number of life-years lost, or gained, due to a particular cause of death, which is a further useful prognostic measure. We describe estimation of RMST after fitting a FPM on either the log-cumulative subdistribution, or cause-specific hazards scale. As an illustration of reporting such measures to facilitate interpretation of a competing risks analysis, models are fitted to English colorectal data.
Subjective sleep quality and association with depression syndrome, chronic disease and health-related physical fitness in middle-aged and elderly
Authors: Ho Shu-Chuan , Hsu Min-Fang , Lee Kang-Yun , Lin Tsung-Ching , Liu Wen-Te
Published: February 2020

BackgroundSleep quality as a complex phenomenon is difficult to define and measure objectively, multiple factors are related to sleep quality, such as age, lifestyle, physical activity, and physical fitness, are prominent in the older adult population. The aim of the present study was to evaluate subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and associate with the health-related physical fitness factors, depression symptom, and chronic disease numbers in middle-aged and elderly.MethodsWe enrolled a total of 283 participants with middle-aged and elderly from a rehabilitation clinic or health examination department. The PSQI was used to evaluate sleep quality. The health-related fitness assessment includes anthropometric and physical fitness. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Data were analyzed with SPSS 18.0, descriptive statistics and logistic regression analysis were performed for analysis.ResultsOverall, 27.9% of the participants in this study demonstrated poor sleep quality (PSQI score> 5), 10.2% of the study participants frequently used sleep medication to help them fall asleep, 6.0% reported having significant depressive symptoms (CES-D ≥ 10). The results have three major foundlings (1) depression symptom, number of chronic disease, self-rate health and arthritis were significantly associated with poor sleep quality, (2) age was associated with sleep disturbance, (3) two-min step was associated with longer sleep latency. This results confirmed two-min step was associated with longer sleep latency among the health-related physical fitness items.ConclusionOur studies found that depressive syndromes, chronic disease numbers, poor self-rated health status and arthritis were the main risk factors that influenced subjective sleep quality.
Palliative Performance Scale: Polish validation in hospice setting - a prospective observational study
Authors: Dzierżanowski Tomasz , Gradalski Tomasz , Kozlowski Michael
Published: February 2020

Background: Measuring functional status in palliative care may help clinicians to assess a patient’s prognosis, recommend adequate therapy, avoid futile or aggressive medical care, consider hospice referral, and evaluate provided rehabilitation outcomes. An optimized, widely used, and validated tool is preferable. The Palliative Performance Scale Version 2 (PPSv2) is currently one of the most commonly used performance scales in palliative settings. The aim of this study is the translation and validation process of a Polish translation of this tool (PPSv2-Polish). Methods: Two hundred patients consecutively admitted to a free-standing hospice were evaluated twice during 2 consecutive days for test-retest reliability. In the first evaluation, two different care providers independently evaluated the same patient to establish inter-rater reliability values. PPS-Polish was compared with the Karnofsky Performance Score (KPS), Eastern Cooperative Oncology Group (ECOG) Performance Status (ECOG PS), and Barthel Activities of Daily Living (ADL) Index to determine its construct validity. Results: A high level of full agreement between test and retest was seen (63%), and a good intra-class correlation coefficient of 0.85 (P<0.0001) was achieved. Excellent agreement between raters was observed when using PPSv2-Polish (Cohen’s kappa 0.91; P<0.0001). Satisfactory correlations with the KPS and good correlations with ECOG PS and Barthel ADL were noticed. Persons who had shorter prognoses and were predominantly bedridden also had lower scores measured by the PPSv2-Polish, KPS and Barthel ADL. A strong correlation of 0.77 between PPSv2-Polish scores and survival time was noted (P<0.0001). Moderate survival correlations were seen between KPS, ECOG PS, and Barthel ADL of 0.41; -0.62; and 0.58, respectively (P<0.0001). Conclusion: PPSv2-Polish is a valid and reliable tool measuring performance status in a hospice population and can be used in daily clinical practice in palliative care and research.
Cross cultural adaptation and validation of the Malay Advance Care Planning Questionnaire
Authors: Lim Mun Kit , Lai Pauline Siew Mei , Wong Pei Se , Othman Sajaratulnisah , Mydin Fadzilah Hanum Mohd
Published: February 2020

Background There is a growing interest among the developing countries on advance care planning (ACP) due to the reported benefits of planning ahead in the developed countries. Validated instruments in various languages have been developed to facilitate study on the views of public prior to its implementation. However, instrument to explore the views on advance care planning (ACP) in Malay has not been developed and validated yet, even though Malay is spoken extensively by approximately 220 million people in the Malay Archipelago. There is also a need for instrument in Malay language to facilitate the assessment of knowledge, attitude and practice (KAP) of Malaysians regarding advance care planning (ACP). Therefore, the purpose of this study is to cross-culturally adapt, and examine the internal consistency and reliability of the Malay Advance Care Planning Questionnaire (ACPQ-M) among the Malay speaking community dwellers.Methods The ACPQ was translated according to international guidelines. This validation study was conducted from January to June 2018. Participants who were ≥21 years old, and able to understand Malay were recruited from an urban primary care clinic and a tertiary education institution in Malaysia. A researcher administered the ACPQ-M to participants via a face-to-face interview at baseline and two weeks later. Each interview took approximately 15-20 minutes.Results A total of 222/232 participants agreed to participate (response rate=96.0%). Exploratory factor analysis and confirmatory factor analysis found that the ACPQ-M was a 4-factor model. The Cronbach’s α values for the four domains ranged from 0.674-0.947. Only 157/222 participants completed the test-retest (response rate=71%). At test-retest, quadratic weighted kappa values for all domains ranged from 0.340-0.674, except for two domains which ranged from -0.200-0.467.Conclusions The ACPQ-M was found to be a 4-factor model, and a valid and reliable instrument to assess the KAP regarding ACP. This instrument can contribute to profound understanding of the KAP of Malaysians regarding ACP, and assist policy makers in determining the readiness for legislation of ACP in Malaysia.
The calcilytic drug Calhex-231 ameliorates vascular hyporesponsiveness in traumatic hemorrhagic shock by inhibiting oxidative stress and mitochondrial fission
Authors: Lei Yan , Peng Xiaoyong , Li Tao , Liu Liangming , Yang Guangming
Published: February 2020

Background The calcium-sensing receptor (CaSR) plays a fundamental role in extracellular calcium homeostasis in humans. Surprisingly, CaSR is also expressed in non-homeostatic tissues and is involved in regulating diverse cellular functions. The objective of this study was to determine if Calhex-231 (Cal), a negative modulator of CaSR, may be beneficial in the treatment of traumatic hemorrhagic shock (THS) by improving cardiovascular function, and investigated its relationship to oxidative stress and the mitochondrial fusion-fission pathway. Methods Rats that had been subjected to traumatic hemorrhagic shock were used as models in this study. Hypoxia-treated vascular smooth muscle cells (VSMCs) were also used. The effects of Cal on cardiovascular function, animal survival, hemodynamic parameters, and vital organ function in THS rats were observed, and the relationship to oxidative stress and mitochondrial fusion-fission was investigated. Results Cal significantly improved hemodynamics, elevated blood pressure, increased vital organ blood perfusion and local oxygen supply, and markedly improved the survival outcomes of THS rats. Furthermore, Cal significantly improved vascular reactivity after THS, including the pressor response of THS rats to norepinephrine (NE), and also the contractile response of superior mesenteric arteries, mesenteric arterioles, and isolated VSMCs to NE. Cal also restored the THS-induced decrease in myosin light chain (MLC) phosphorylation, which is the principal mechanism responsible for VSMC contraction and vascular reactivity. Inhibition of MLC phosphorylation antagonized the Cal-induced restoration of vascular reactivity following THS. Cal decreased oxidative stress indexes and increased antioxidant enzyme levels in THS rats, and also reduced reactive oxygen species levels in hypoxic VSMCs. In addition, THS induced expression of mitochondrial fission proteins Drp1 and Fis1, and decreased expression of mitochondrial fusion protein Mfn1 in vascular tissues. Cal reduced expression of Drp1 and Fis1, but did not affect Mfn1 expression. In hypoxic VSMCs, Cal inhibited hypoxia-induced mitochondrial fragmentation and preserved mitochondrial morphology. Conclusions Calhex-231 exhibits outstanding potential for effective therapy of traumatic hemorrhagic shock, due to its ability to improve hemodynamics, increase vital organ blood perfusion, and markedly prolong animal survival. These beneficial effects result from its protection of vascular function via inhibition of oxidative stress and mitochondrial fission.
Trauma care and capture rate of variables of World Health Organisation data set for injury at regional hospitals in Tanzania: first steps to a national trauma registry
Authors: Sawe Hendry Robert , Reynolds Teri A. , Weber Ellen J. , Mfinanga Juma A. , Coats Timothy J. , Wallis Lee A.
Published: February 2020

Background In Tanzania, there is no national trauma registry. The World Health Organization (WHO) has developed a data set for injury that specifies the variables necessary for documenting the burden of injury and patient-related clinical processes. As a first step in developing and implementing a national Trauma Registry, we determined how well hospitals currently capture the variables that are specificed in the WHO injury set. Methods This was a prospective, observational cross-sectional study of all trauma patients conducted in the Emergency Units of five regional referral hospitals in Tanzania from February 2018 to July 2018. Research assistants observed the provision of clinical care in the EU for all patients, and documented performed assessment, clinical interventions and final disposition. Research assistants used a purposefully designed case report form to audit the injury variable capture rate, and to review Ministry of Health (MoH) issued facility Register book recording the documentation of variables. We present descriptive statistics for hospital characteristics, patient volume, facility infrastructure, and capture rate of trauma variables. Results During the study period, 2,891 (9.3%) patients presented with trauma-related complaints, 70.7% were male. Overall, the capture rate of all variables was 33.6%. Documentation was most complete for demographics 71.6%, while initial clinical condition, and details of injury were documented in 20.5% and 20.8% respectively. There was no documentation for the care prior to Emergency Unit arrival in all hospitals. 1430 (49.5%) of all trauma-related visits seen were documented in the facility Health Management Information System register submitted to the MoH. Among the cases reported in the register book, the date of EU care was correctly documented in 77% cases, age 43.6%, diagnosis 66.7%, and outcome in 38.9% cases. Among the observed procedures, initial clinical condition (28.7%), interventions at Emergency Unit (52.1%), investigations (49.0%), and disposition (62.9%) were documented in the clinical charts. Conclusions In the regional hospitals of Tanzania, there is inadequate documentation of the minimum trauma variables specified in the WHO injury data set. Reasons for this are unclear, but will need to be addressed in order to improve documentation to inform a national injury registry.