bluuebunny/crossref_metadata_2025 huggingface dataset:
Levels, Trends and Determinants of Technical Efficiency of General Hospitals in Uganda: Data Envelopment Analysis and Tobit Regression Analysis
Authors: Ayiko Rogers , Mujasi Paschal N. , Abaliwano Joyce , Turyareeba Dickson , Enyaku Rogers , Anguyo Robert , Odoch Walter , Bakibinga Pauline , Aliti Tom
Published: September 2020

Background: General hospitals provide a wide range of primary and secondary healthcare services. They accounted for 38% of government funding to health facilities, 8.8% of outpatient department visits and 28% of admissions in Uganda in the financial year 2016/17. We assessed the levels, trends and determinants of technical efficiency of general hospitals in Uganda from 2012/13 to 2016/17. Methods: We undertook input-oriented Data Envelopment Analysis to estimate technical efficiency of 78 general hospitals using data abstracted from the Annual Health Sector Performance Reports for 2012/13, 2014/15 and 2016/17. Trends in technical efficiency was analysed using Excel while determinants of technical efficiency were analysed using Tobit Regression Model in STATA 15.1. Results: The Average Constant Returns to Scale, Variable Returns to Scale and Scale Efficiency of general hospitals for 2016/17 were 49% (95% CI, 44% - 54%), 69% (95% CI, 65% - 74%) and 70% (95% CI, 65% - 75%) respectively. There was no statistically significant difference in the efficiency scores of public and private hospitals. Technical efficiency generally increased from 2012/13 to 2014/15, and dropped by 2016/17. Some hospitals were persistently efficient while others were inefficient over this period. Hospital size, geographical location, training status and average length of stay were statistically significant determinants of efficiency at 5% level of significance. Conclusion: The 69% average variable returns to scale technical efficiency indicates that the hospitals could generate the same volume of outputs using 31% (3,439) less staff and 31% (3,539) less beds. Benchmarking performance of the efficient hospitals would help to guide performance improvement in the inefficient ones. There is need to incorporate hospital size, geographical location, training status and average length of stay in the resource allocation formula and adopt annual hospital efficiency assessments.
Variation in Anopheles distribution and predictors of malaria infection risk across regions of Madagascar 
Authors: Arisco Nicholas , Rice Benjamin L , Tantely Luciano M , Girod Romain , Emile Gauthier N , Randriamady Hervet J , Castro Marcia C , Golden Christopher D
Published: September 2020

Background Deforestation and land use change is widespread in Madagascar, altering local ecosystems and creating opportunities for disease vectors, such as the Anopheles mosquito, to proliferate and more easily reach vulnerable, rural populations. Knowledge of risk factors associated with malaria infections is growing globally, but these associations remain understudied across Madagascar’s diverse ecosystems experiencing rapid environmental change. This study aims to uncover socioeconomic, demographic, and ecological risk factors for malaria infection across regions through analysis of a large, cross-sectional dataset.Methods The objectives were to assess(1) the ecological correlates of malaria vector breeding through larval surveys, and (2) the socioeconomic, demographic, and ecological risk factors for malaria infection in four ecologically distinct regions of rural Madagascar. Risk factors were determined using multilevel models for the four regions included in the study.Results The presence of aquatic agriculture (both within and surrounding communities) is the strongest predictive factor of habitats containing Anopheles larvae across all regions. Ecological and socioeconomic risk factors for malaria infection vary dramatically across study regions and range in their complexity.Conclusions Risk factors for malaria transmission differ dramatically across regions of Madagascar. These results may help stratifying current malaria control efforts in Madagascar beyond the scope of existing interventions.
Comparison of Health Care Utilization Among Patients Affiliated and Not Affiliated with Healthcare Professionals in China
Authors: Si Yafei , Zhou Zhongliang , Su Min , Hu Han , Yang Zesen , Chen Xi
Published: September 2020

Background Doing “more” in healthcare can be a major threat to the delivery of high-quality health care. It is important to identify the supplier-induced demand (SID) of health care. This study aims to test SID hypothesis by comparing health care utilization among patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals.Methods We used coarsened exact matching to compare the health care utilization and expenditure between patients affiliated and not affiliated with healthcare professionals. Using the cross-sectional data of the China Labour-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22788 patients not affiliated with healthcare professionals. The main outcomes were outpatient rate and expenditure as well as inpatient rate and expenditure.Results The matched outpatient rate of patients not affiliated with healthcare professionals was 0.6% higher (P=0.754) than that of their counterparts, and the matched inpatient rate was 1.1% lower (P=0.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, P<0.001) than their counterparts did per outpatient visit (1126 CNY [95% CI 885-1368] vs. 446 CNY [95% CI 248-643]), while patients not affiliated with healthcare professionals paid insignificantly less (2061 CNY or 336 USD, P=0.751) than their counterparts did per inpatient visit (15583 CNY [95% CI 12052-19115] vs. 17645 CNY [95% CI 4884-30406]).Conclusion Our results lend support on supplier-induced demand hypothesis and highlight the need for policies to address the large outpatient care expenses of patients not affiliated with healthcare professionals. Our study also suggests that as the public becomes more informed, the demand of health care may persist while heath care expenditure per outpatient visit may decrease sharply due to the decline in supplier-induced demand. As significant misbehaviors performed by providers, it’s important to create right incentives to offer less avoidable healthcare service during outpatient visits may work to reduce healthcare costs.
Association Between Supportive Interventions and Healthcare Utilization and Outcomes in Patients on Long-Term Prescribed Opioid Therapy Presenting to Acute Healthcare Settings: a systematic review and meta-analysis
Authors: Deschamps Jean , Gilbertson James , Straube Sebastian , Dong Kathryn , MacMaster Frank P. , Korownyk Christina , Montgomery Lori , Mahaffey Ryan , Downar James , Clarke Hance , Muscedere John , Rittenbach Katherine , Featherstone Robin , Sebastianski Meghan , Vandermeer Ben , Lynam Deborah , Magnussen Ryan , Bagshaw Sean M , Rewa Oleksa G
Published: September 2020

Background Long-term prescription of opioids by healthcare professionals has been linked to poor individual patient outcomes and high resource utilization. Supportive strategies in this population regarding acute healthcare settings may have substantial impact. Methods We performed a systematic review and meta-analysis of primary studies. The studies were included according to the following criteria: 1) age 18 and older; 2) long-term prescribed opioid therapy; 3) acute healthcare setting presentation from a complication of opioid therapy; 4) evaluating a supportive strategy; 5) comparing the effectiveness of different interventions; 6) addressing patient or healthcare related outcomes. We performed a qualitative analysis of supportive strategies identified. We pooled patient and system related outcome data for each supportive strategy.Results A total of 5664 studies were screened and 19 studies were included. A total of 9 broad categories of supportive strategies were identified. Meta-analysis was performed for the “supports for patients in pain” supportive strategy on two system-related outcomes using a ratio of means. The number of emergency department (ED) visits were significantly reduced for cohort studies (n = 6, 0.36, 95% CI [0.20-0.62], I2 = 87%) and randomized controlled trials (RCTs) (n = 3, 0.71, 95% CI [0.61-0.82], I2 = 0%). The number of opioid prescriptions at ED discharge was significantly reduced for RCTs (n = 3, 0.34, 95% CI [0.14-0.82], I2 = 78%).Interpretation For patients presenting to acute healthcare settings with complications related to long-term opioid therapy, the intervention with the most robust data is “supports for patients in pain”. Study registration CRD42018088962
Canine helminthiases and associated risk factors in Kigali city, Rwanda
Authors: Ntampaka Pie , Niragire François , Nyaga Philip Njeru , Habarugira Gervais
Published: September 2020

Background: Canine helminthiases pose a public health risk to humans and livestock; however, the prevalence of canine helminthiases in Rwanda is unknown. This study aimed to determine the prevalence of canine helminthiases and to identify the risk factors of such infections in Kigali, the capital city of Rwanda. A cross-sectional study involved 93 dogs selected across Kigali city. Faecal samples were collected from apparently healthy dogs and helminth eggs were identified and quantified under microscope using McMaster technique. Risk factors for canine helminthiases were analysed by multivariable binary logistic regression analysis.Results: The overall prevalence of intestinal helminthiases in dogs was 39.8% ±5.08 (α=0.05). The most prevalent species was Ancylostoma spp with 32.3% ± 4.85 (30/93). About 38.7% and 3.4% (n= 31) of dogs suffering from ancylostomosis and/or toxocarosis had high egg counts per gram (EPG) of faeces (≥ 550) each. Approximately 97.3% (36/37) of dogs infected with helminths had mono-infection. Logistic regression analysis showed that dog's age (1 to 2. 5 years old and at least 5 years old) and location (Gasabo and Kicukiro) were significantly associated with the prevalence of canine helminthiases. The adjusted odds ratio (AOR) of dogs suffering from helminthiases was more than 61% lower in dogs dewormed once to twice a year compared to those who were never dewormed. In addition, the AOR was more than 5 times higher for dogs fed on raw animal origin supplements, leftovers from family food and restaurants compared to those who ate food prepared for them. The AOR was also more than 8 times higher for dogs that ate leftovers from household food and scavenged compared to those who ate food prepared for them. Conclusions: All the identified helminths including Ancylostoma spp, Toxocara canis, and tapeworms are zoonotic and they pose a public health risk to humans. There is an urgent need of increasing the awareness among pet owners on the role of dogs in the transmission of zoonotic helminthiases to other animals and also to humans. Moreover, it is highly relevant to inform and to take effective control measures in dog populations.
Intermediate outcomes of ab externo circumferential trabeculotomy and canaloplasty in POAG patients with prior incisional glaucoma surgery
Authors: Wang Huaizhou , Xin Chen , Han Ying , Shi Yan , Ziaei Sarah , Wang Ningli
Published: September 2020

Background: To compare the efficacy and safety of ab externo circumferential trabeculotomy (ECT) and canaloplasty on primary open angle glaucoma (POAG) patients with failed filtering surgery and intact schlemm’s canal (SC). Methods : We conducted a retrospective chart review of POAG patients with failed filtering surgery and intact SC, who further received ECT and canaloplasty. The primary outcome measures were intraocular pressure (IOP) and the number of topical medications at each follow-up point.The secondary outcome compared the quantified success rate at1-year follow-up between the groups. Results: Twenty-nine eyes were recruited in the ECT group and 19 eyes in canaloplasty group. The postoperative IOP and the number of topical medications decreased significantly in both groups(p<0.001). The IOP at 3-month and 6-monthwas significantly lower in the ECT group (p=0.039, p=0.001) than in the canaloplasty group. Although the IOP at 12-mon was similar between the two groups, the number of topical medications was less in the ECP group (p=0.040). Hyphema (72.4%) and ciliary body detachment (27.6%), which mainly resolve spontaneously, were two leading complications in the ECT group. The prevalence of hyphema was higher in ECT than in canaloplasty group (p<0.001). Conclusion: For POAG with failed filtering surgery and intact SC, canaloplasty may be safer, whereas ECT presented better IOP control.
SP1 induced Long non-coding RNA AGAP2-AS1 promotes cholangiocarcinoma proliferation via silencing of CDKN1A 
Authors: Ji Hao , Wang Juan , Lu Binbin , Li Juan , Zhou Jing , Wang Li , Xu Shufen , Peng Peng , Hu Xuezhen , Keming Wang
Published: September 2020

Background: LncRNA can regulate gene at various levels such as apparent genetics, alternative splicing, and regulation of mRNA degradation. However, the molecular mechanism of LncRNA in cholangiocarcinoma is still unclear. This deserves further exploration. Methods:We investigated the expression of AGAP2-AS1 in 32 CCA tissues and two CCA cell lines. We found a LncRNA AGAP2-AS1 which induced by SP1 has not been reported in CCA, and Knockdown and overexpression were used to investigate the biological role of AGAP2-AS1 in vitro. CHIP and RIP were performed to verify the putative targets of AGAP2-AS1. Results:AGAP2-AS1 was significantly upregulated in CCA tumor tissues.SP1 induced AGAP2-AS1 plays an important role in tumorigenesis. AGAP2-AS1 knockdown significantly inhibited proliferation and caused apoptosis in CCA cells. In addition, we demonstrated that AGAP2-AS1 promotes the proliferation of CCA. Conclusions: We conclude that the long non-coding RNA AGAP2-AS1 plays a role in promoting the proliferation of cholangiocarcinoma.
Study of a robotic system to detect water leakage and fuel debris -System proposal and feasibility study of visual odometry providing intuitive bird's eye view-
Authors: Wang Zhenyu , Endo Gen , Takahashi Masashi , Nabae Hiroyuki , Suzumori Koichi , Nobuyoshi Tsuzuki , Takahashi Hideharu , Kimoto Kazushi , Ihara Tomonori , Kikura Hiroshige
Published: September 2020

To obtain the necessary information on fuel debris and water leakages during the decommissioning task of the Fukushima Daiichi Nuclear Power Plant, an ultrasonic-based method was proposed for future internal investigation of the primary containment vessel (PCV). In this article, we describe the rotatable winch mechanism and visual localization method, which were used to aid the investigation. We used the rotatable winch mechanism to adjust the height and orientation of the ultrasonic sensor and localized the robot with cameras to localize the sensor, to provide assisting information for data combination. We studied the feasibility of the conventional visual odometry method for application to the situation and performed localizing accuracy evaluation experiments with a mobile robotic platform prototype. The results showed that the visual odometry method could generate intuitive bird’s-eye-view maps, and provided an average error rate of 35 mm/1500 mm, which met the required maximum error rate of 100 mm/1500 mm for the grating movement. Experiments were also conducted with adjustable parameter ranges that could provide the required accuracy.
Platelet to Lymphocyte Ratio is Correlated with a Delay in Feeding Resumption Following a Transhiatal Esophagectomy With Cervical Anastomosis
Authors: Asmar Antoine El , Ghabi Elie , Saber Toufic , Abou-Malhab Christina , Akl Bernard , Rassi Ziad El
Published: September 2020

Introduction: The lymphocytic population, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are prognostic tools predictive of adverse outcomes for several solid tumors and oncologic surgeries, one of which is esophageal adenocarcinoma. Furthermore, delayed resumption of oral feeding postoperatively is associated with significant morbidity. Given the controversies regarding post-op nutritional support in these patients, this study investigates the prognostic role of the lymphocytic percentage, the NLR and the PLR in predicting prolonged length of hospital stay (LOHS) and ICU stay (LOICUS) as well as delayed oral feeding following transhiatal esophagectomy (THE) for adenocarcinoma of the esophagogastric junction (AEG). Methods: 40 consecutive patients who underwent transhiatal esophagectomy performed by a single surgeon for Siewert type II and type III adenocarcinoma of the esophagogastric junction at a tertiary referral center was selected. Retrospective data collection was performed from the patients’ medical records and statistical analysis was performed using Pearson correlation and Student’s T-test and Chi-square testing.Results: An increased LOHS was correlated with a lower preoperative lymphocyte percentage (p=0.043), higher NLR (p=0.010) and PLR (p=0.015), and an increased number of packed red blood cell (PRBCs) transfusions perioperatively (p=0.030). An increased LOICUS was correlated with a lower preoperative lymphocyte percentage (p=0.033), higher NLR (p=0.018) and PLR (p=0.044), an increased number of PRBCs transfusions (p=0.001) and patients’ comorbidities (p<0.05). A delay in feeding resumption was correlated with a lower preoperative lymphocyte percentage (p=0.022), higher NLR (p=0.004) and PLR (p=0.001), an increased PRBCs transfusions (p=0.001) and diabetes mellitus (p=0.033). Multivariate analysis with automatic linear modeling showed that only the preoperative PLR was a powerful predictor for the delay of feeding resumption (p<0.01).Conclusion: The lymphocyte percentage, PLR and NLR are found to be associated with prolonged hospitalization and ICU stay, delayed oral feeding following THE for Siewert type II and III AEG. We hope by this series, to have set, at least one preliminary cornerstone, in the creation of a prognostic model, capable of assessing the need for an intraoperative jejunostomy placement, in patients undergoing esophagectomy for distal esophageal carcinoma.
Pharmacological intervention to restore connectivity deficits of neuronal networks derived from ASD patient iPSCs with a TSC2 mutation
Authors: Alsaqati Mouhamed , Heine Vivi M , Harwood Adrian J.
Published: September 2020

Background Tuberous sclerosis complex (TSC) is a rare genetic multisystemic disorder resulting from autosomal dominant mutations in the TSC1 or TSC2 genes. It is characterised by hyperactivation of the mechanistic target of rapamycin complex 1 (mTORC1) pathway and has severe neurodevelopmental and neurological components including autism, intellectual disability and epilepsy. In human and rodent models, loss of the TSC proteins causes neuronal hyperexcitability and synaptic dysfunction, although the consequences of these changes for the developing central nervous system is currently unclear.MethodsHere we apply Multi-electrode array (MEA)-based assays to study the effects of TSC2 loss on neuronal network activity using Autism Spectrum Disorder (ASD) patient-derived iPSCs. We examine both temporal synchronisation of neuronal bursting, and spatial connectivity between electrodes across the network. Results We find that ASD patient-derived neurons with a functional loss of TSC2, in addition to possessing neuronal hyperactivity, develop a dysfunctional neuronal network with reduced synchronisation of neuronal bursting and lower spatial connectivity. These deficits of network function are associated with elevated expression of genes for inhibitory GABA signalling and glutamate signalling, indicating a potential abnormality of synaptic inhibitory-excitatory signalling. mTORC1 activity functions within a homeostatic triad of protein kinases, mTOR, AMP-dependent protein Kinase 1 (AMPK), and Unc-51 like Autophagy Activating Kinase 1 (ULK1) that orchestrate the interplay of anabolic cell growth and catabolic autophagy while balancing energy and nutrient homeostasis. The mTOR inhibitor rapamycin suppresses neuronal hyperactivity, but does not increase synchronised network activity, whereas activation of AMPK restores some aspects of network activity. In contrast, the ULK1 activator, LYN-1604 increases the network behaviour, shortens the network burst lengths, and reduces the number of uncorrelated spikes.LimitationsAlthough a robust and consistent phenotype is observed across multiple independent iPSC cultures, the results are based on one patient. There may be more subtle differences between patients with different TSC2 mutations or differences of polygenic background within their genomes. This may affect the severity of the network deficit or the pharmacological response between TSC2 patients.ConclusionsOur observations suggest that there is a reduction in the network connectivity of the in vitro neuronal network associated with ASD patients with TSC2 mutation, which may arise via an excitatory/inhibitory imbalance due to increased GABA-signalling at inhibitory synapses. This abnormality can be effectively suppressed via activation of ULK1.
Feasibility of remote digital monitoring using wireless Bluetooth monitors, the Smart AngelTM app and an original web platform for patients following outpatient surgery: A prospective observational pilot study.
Authors: Chevallier Thierry , Buzancais Gautier , Occean Bob-valery , Rataboul Pierre , Boisson Christophe , simon natacha , Lannelongue Ariane , Chaniaud Noemie , Gricourt Yann , Lefrant Jean-Yves , cuvillon philippe
Published: September 2020

Background: Remote monitoring of mean arterial blood pressure (MAP), heart rate (HR) or oxygen saturation (SpO2) remains a challenge in outpatient surgery. This study evaluates a new digital technology (Smart AngelTM) for remotely monitoring hemodynamic data in real time: data transmitted from the patient's home to a central server, using a dedicated web-based software package.Methods: Adults scheduled for elective outpatient surgery were prospectively enrolled. In the first 5 postoperative days, patients completed a self-report questionnaire (pain, comfort, nausea, vomiting) and recorded SpO2, HR and MAP via two wireless Bluetooth monitors connected to a 4G tablet to transmit the data to a website, in real time, using Smart AngelTM software. Before transmission to the website, these data were also self-reported by the patient on a paper form. The primary outcome was the proportion of variables (self-monitored physiological data + questionnaire scores) correctly transmitted to the hospital via the system compared with the paper version.On Day 5, a system usability scale survey (SUS score 1-100) was also attributed.Results: From May 2018 to September 2018, data were available for 29 out of 30 patients enrolled (1 patient was not discharged from hospital after surgery). The remote monitoring technology recorded 2038 data items (62%) compared with 2656 (82%) items recorded on the paper form (p=0.001). The most common errors with the remote technology were software malfunctioning when starting the MAP monitor and malfunctioning between the tablet and the Bluetooth monitor. No serious adverse events were noted. The SUS score for the system was 85 (68-93) for 26 patients. Conclusion: This work evaluates the ability of a pilot system for monitoring remote physiological data using digital technology after ambulatory surgery and highlights the digital limitations of this technology. Technological improvements are required to reduce malfunctioning (4G access, transmission between apps).Trial registration: ClinicalTrials.gov (NCT03464721) (March 8, 2018)
Potential research ethics violations against an indigenous tribe in Ecuador: a mixed methods approach
Authors: Ortiz-Prado Esteban , Simbana-Rivera Katherine , Gomez-Barreno Lenin , Tamariz Leonardo , Lister Alex , Baca Juan Carlos , Norris Alegria , Adana-Diaz Lila
Published: September 2020

Background: Biomedical and ethnographic studies among indigenous people are common practice in health and geographical research. Prior research misconduct has been documented, particularly when obtaining genetic material. The objective of this study was to crossmatch previously published data with the perceptions of the Waorani peoples about the trading of their genetic material and other biological samples. Methods: We conducted a mixed methods study design using a tailored 15-item questionnaire in 72 participants and in-depth interviews in 55 participants belonging to 20 Waorani communities asking about their experiences and perceptions of participating in biomedical investigations. Additionally, we conducted a systematic review of the literature in order to crossmatch the published results of studies stating the approval of an ethics committee and individual consent within their work. Results: A total of 40 men (60%) and 32 women (40%), with a mean age of 57 ± 15 years agreed to be interviewed for inclusion. Five main categories around the violation of good clinical practices were identified, concerning the obtention of blood samples from a recently contacted Waorani community within the Amazonian region of Ecuador. These themes are related to the lack of adequate communication between community members and researchers as well as the voluntariness to participate in health research. Additionally, over 40 years, a total of 38 manuscripts related to the use of biological samples among Waorani people were published. The majority of the studies (68%) did not state within their article obtaining research ethics board approval, and 71% did not report obtaining the informed consent of the participants prior to the execution of the project. Conclusion: Clinical Research on the Waorani community in the Ecuadorian Amazon basin has been performed on several occasions. Unfortunately, the majority of these projects did not follow the appropriate ethical and professional standards in either reporting the results or fulfilling them. The results of our investigation suggest that biological and genetic material, has been used by researchers globally, with some omitting the minimum information required to guarantee transparency and good clinical practices. We highlight the importance of stating ethics within research to avoid breaches in research transparency.
Physical mapping of repetitive oligonucleotides facilitates the establishment of a genome map-based karyotype to identify chromosomal variations in peanut
Authors: Fu Liuyang , Wang Qian , Li Lina , Lang Tao , Guo Junjia , Wang Siyu , Sun Ziqi , Han Suoyi , Huang Bingyan , Dong Wenzhao , Zhang Xinyou , Du Pei
Published: September 2020

Background: Chromosomal variants play important roles in crop breeding and genetic research. The development of single-stranded oligonucleotide (oligo) probes simplifies the process of fluorescence in situ hybridization (FISH) and facilitates chromosomal identification in many species. Genome sequencing provides rich resources for the development of oligo probes. However, little progress has been made in peanut. Thus, the identification of chromosomal variants in peanut remains a challenge, owing to a lack of efficient chromosomal markers. Results: A total 114 new oligo probes were developed, based on the genome-wide tandem repeats (TRs) identified from the reference sequences of the peanut variety Tifrunner (AABB, 2n = 4x = 40) and the diploid species Arachis ipaensis (BB, 2n = 2x = 20). These oligos were classified into 28 types, based on their positions, and overlapping signals in chromosomes. For each oligo types, a single and representative oligos was selected and modified with 6-carboxyfluorescein (FAM) and 6-carboxytetramethylrhodamine (TAMRA). Based on these 28 probes, a new multiplex #3 cocktail was developed with FAM-modified TIF-439, TIF-185-1, TIF-134-3, and TIF-165-3, and TAMRA-modified Ipa-1162, Ipa-1137, DP-1, and DP-5. This cocktail enabled the establishment of a genome map-based karyotype after sequential FISH/genomic in situ hybridization (GISH) and in silico mapping. Furthermore, we identified 14 chromosomal variants of peanut induced by radiation. A total of 28 representative probes were further chromosomally mapped onto the new karyotype. Among the probes, eight were mapped in the secondary constrictions, and intercalary and terminal regions; four were B genome-specific; one was chromosome-specific; and the other 15 were extensively mapped in the pericentric regions of chromosomes. Conclusions: The development of new oligo probes provides effective tools, which can be used to distinguish various chromosomes of peanut. Physical mapping reveals the genomic organization of repetitive oligos in peanut chromosomes by FISH. Following comparisons with their positions in the reference sequences, a genome map-based karyotype was established and used for the identification of chromosome variations in peanut.
“If you are on duty, you may be afraid to come out to attend to a person”: Fear of crime and security challenges in maternal acute care in Nigeria from a realist perspective.
Authors: Etiaba Enyi , Manzano Ana , Agbawodikeizu Uju , Ogu Udochukwu , Ebenso Bassey , Uzochukwu Benjamin , Onwujekwe Obinna , Ezumah Nkoli , Mirzoev Tolib
Published: September 2020

BackgroundMaternal and Child Health is a global priority. Access and utilization of facility-based health services remain a challenge in low and middle-income countries. Evidence on barriers to providing and accessing services omits information on the role of security within facilities. This paper explores the role of security in the provision and use of maternal health services in primary healthcare facilities in Nigeria. MethodsStudy was carried out in Anambra state, Nigeria. Qualitative data were initially collected from 35 in-depth interviews and 24 focus groups with purposively identified key informants. Information gathered was used to build a programme theory that was tested with another round of interviews (17) and focus group (4) discussions. Data analysis and reporting were based on the Context-Mechanism-Outcome heuristic of Realist Evaluation methodology.ResultsThe presence of a male security guard in the facility was the most important security factor that facilitated provision and uptake of services. Others include perimeter fencing, lighting and staff accommodation. Lack of these components constrained provision and use of services, by impacting on behaviour of staff and patients. Security concerns of facility staff who did not feel safe to let in people into unguarded facilities, mirrored those of pregnant women who did not utilize health facilities because of fear of not being let in and attended to by facility staff.Conclusion Health facility security should be key consideration in programme planning, to avert staff and women’s fear of crime which currently constrains provision and use of maternal healthcare at health facilities.
Changes in Lipid Composition associated with Electronic Cigarette Use
Authors: Middlekauff Holly , Williams Kevin , Su Baolong , Haptonstall Kacey , Araujo Jesus , Wu Xiaohui , Kim Jason , Sallam Tamer
Published: September 2020

Background-Electronic cigarette use is on the rise despite a number of reports linking electronic cigarettes with adverse health outcomes. Recent studies have suggested that alterations in lipid signaling may be one mechanism by which electronic cigarettes contribute to lung pulmonary function. Vitamin E acetate, for example, is synthetic form of Vitamin E transported via lipids, found to be associated with electronic cigarette associated lung injury. Lipids are absolutely critical for normal lung physiology and perturbations in a number of lipid pathways have been associated with respiratory illness. Is it conceivable that electronic cigarette use even in seemingly healthy cohorts are associated with alterations in lipid pathways? Methods- To investigate quantitative alterations in the plasma lipidome associated with electronic cigarette use in healthy we obtained plasma samples from 119 male and female participants with who were either: 1) chronic tobacco cigarette (TC) smokers (>12 months of self-reported TC use), 2) chronic Electronic cigarette (EC) users (>12 months of self-reported EC use), or 3) non-users. We measured quantitative lipid species across different lipid sub-classes from plasma samples using the Sciex Lipidyzer.Results-We found that male and female tobacco and electronic cigarette users had distinct lipidome signatures across a number of lipid species although the vast majority of lipids were unchanged when compared to non-users. Intriguingly, we found that female but not male electronic cigarette users had lower levels of plasmalogens, critical glycerophospholipids secreted by alveoli and required for normal surfactant function.Conclusions- In summary, our study does not reveal striking changes associated with electronic cigarette use but we observed sex-specific changes in lipids known to be critical for lung function.
Impact of Robinia pseudoacacia stand conversion on soil bacterial communities composition and soil properties in Mount Tai, China
Authors: li kun , han xu , ni ruiqiang , shi ge , de-Miguel Sergio , li chuanrong , shen weixing , zhang yikun , Zhang xingzhong
Published: September 2020

Background: Robinia pseudoacacia is a widely planted pioneer tree species in reforestations on barren mountains in northern China. Because of its nitrogen-fixing ability, it can play a positive role in soil and forest restoration. After clear-cutting of planted stands, R. pseudoacacia stands become coppice plantations. The impacts of shifting from seedling to coppice plantations on soil bacterial community and soil properties have not been well described. This study aims to quantify how soil properties and bacterial community composition vary between planted seedling versus coppice stands.Methods: Three 20×20 m plots were randomly selected in each seedling and coppice stand. The bulk soil and rhizosphere soil were sampled in the nine above-mentioned sample plots in the summer of 2017. Bulk soil was sampled at 10 cm from the soil surface using a soil auger. Rhizosphere soil samples were collected by brush. The soil samples were transported to the laboratory for chemical analysis and bacterial community composition and diversity was obtanied through DNA extraction, 16S rRNA gene amplification and high throughput sequencing.Results: The results showed that, compared to seedling plantations, soil quality decreased significantly in coppice stands, but without affecting soil exchangeable Mg2+ and K+. Total carbon (C) and nitrogen (N) were lower in the rhizosphere than in bulk soil, whereas nutrient availability showed an opposite trend. The conversion from seedling to coppice plantations was also related to significant differences in soil bacterial community structure and to the reduction of soil bacterial α-diversity. Principal component analysis (PCA) showed that, bacterial community composition was similar in both bulk and rhizosphere soils in second generation coppice plantations. Specially, the conversion from seedling to coppice increased the relative abundance of Proteobacteria and Rhizobium, but reduced that of Actinobacteria, which may result in a decline of soil nutrient availability. Mantel tests revealed that C, N, Soil organic matter (SOM), nitrate nitrogen (NO3--N) and available phosphorus positively correlated with bacterial community composition, while a variation partition analysis (VPA) showed that NO3--N explained a relatively greater proportion of bacterial distribution (15.12%), compared with C and SOM. Surprinsingly, N showed no relationship with bacterial community composition, which may be related to nitrogen transportation. Conclusions: The conversion from seedling to coppice stands reduced soil quality and led to spatial-temporal homogenization of the soil bacterial community structure in both the rhizosphere and bulk soils. Such imbalance in microbial structure can accelerate the decline of R. pseudoacacia. This may affect the role of R. pseudoacacia coppice stands in soil and forest restoration of barren lands in mountain areas.
Factors contributing to psychological distress in the working population, with a special reference to gender difference - a population-based study
Authors: Viertiö Satu , Kiviruusu Olli , Piirtola Maarit , Kaprio Jaakko , Korhonen Tellervo , Marttunen Mauri , Suvisaari Jaana
Published: September 2020

Purpose Psychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences. Methods We used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study collected in 2012–2016 (target population participants aged 20 +, n=96 668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 years (n=34 468). Psychological distress was assessed using the Mental Health Index (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having minor children, lifestyle-related factors, social support, helping others outside of the home and work-related factors. Results Women reported more psychological distress than men (11.0% vs. 8.8%, respectively, p<0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one’s work was associated with distress in women (OR 1.30 (95% CI 1.00–1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66–4.41). Conclusion Satisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population.
Subcutaneous injection of IFN alpha-2b for COVID-19: an observational study
Authors: Wang Bo , Li Diandian , Liu Tao , Wang Haohua , Luo Fengming , Liu Yanbin
Published: September 2020

Background The global pandemic of coronavirus disease 2019 (COVID-19) infection is ongoing and associated with high mortality. The aim of this study was to investigate the efficacy and safety of subcutaneous injection of interferon alpha-2b (IFN alpha-2b) combined with lopinavir/ritonavir ( LPV/r ) in the treatment of COVID-19 infection, compared with that of using LPV/r alone.
Methods Patients diagnosed with laboratory-confirmed COVID-19 infection in Wuhan Red Cross hospital during the period from January 23, 2020 to March 19, 2020 were included. The length of stay, the time to viral clearance and adverse reactions during hospitalization were compared between patients using oral LPV/r and combined therapy of LPV/r and subcutaneous injection of IFN alpha-2b .
Results A total of 22 patients were treated with LPV/r alone and 19 with combined therapy with subcutaneous injection of IFN alpha-2b. The average length of hospitalization in the combination group was shorter than that of LPV/r group (16±9.7 vs 23±10.5 days; P =0.028). Moreover, the days of hospitalization in early intervention group decreased from 25±8.5 days to 10±2.9 days compared with delayed intervention group ( P =0.001). Combined therapy with IFN alpha-2b also significantly reduced the duration of detectable virus in the upper respiratory tract. No patient in each group was transferred to intensive care unit (ICU) or died during the treatment. There was no significant difference in the adverse effect composition between two groups.
Conclusions Subcutaneous injection of IFN alpha-2b combined with LPV/r shortened the length of hospitalization and accelerated viral clearance in COVID-19 patients, which deserves further investigation in clinical practice.
Green light reduces elongation when partially replacing sole blue light independently from cryptochrome 1a
Authors: Zhang Xue , bisbis Mehdi , Heuvelink Ep , Jiang Weijie , Marcelis Leo F. M
Published: September 2020

Although green light is often neglected it can have several effects on plant growth and development. Green light is probably sensed by cryptochromes (crys), one of the blue light photoreceptor families. The aim of this study is to investigate the possible interaction between green and blue light and the involvement of crys in the green light response of plant photomorphogenesis. We hypothesize that green light effects on morphology only occur when crys are activated by the presence of blue light. Wild-type Moneymaker (MM), cry1a mutant (cry1a) and two CRY2 overexpressing transgenic lines (CRY2-OX3 and CRY2-OX8) of tomato (Solanum lycopersicum) were grown in a climate chamber without or with green light (30 µmol m− 2 s− 1) on backgrounds of sole red, sole blue and red/blue mixture, with all treatments having the same photosynthetic photon flux density of 150 µmol m− 2 s− 1. Green light showed no significant effect on biomass accumulation, nor on leaf photosynthesis and leaf characteristics such as leaf area, specific leaf area, and chlorophyll content. However, in all genotypes, green light significantly decreased stem length on a sole blue background, whereas green light did not affect stem length on sole red and red/blue mixture background. MM, cry1a and CRY2-OX3/8 plants all exhibited similar responses of stem elongation to green light, indicating that cry1a, and probably cry2, is not involved in this green light effect. We conclude that partially replacing blue light by green light reduces elongation and that this is independent of cry1a.
The efficacy, safety, and tolerability of levofloxacin quadruple therapy for helicobacter pylori eradication: a randomized, double-blind clinical trial
Authors: Mansour-Ghanaei Fariborz , Masihypour Behnam , Fathalipour Mohammad , Hassanipour Soheil , Sokhanvar Homayoon , Mansour-Ghanaei Alireza , Asgharnezhad Mehrnaz , Joukar Farahnaz
Published: September 2020

BackgroundThe incidence of microbial resistance is increasing, and new rescue regimens are needed in order to treat Helicobacter pylori (H. pylori) infection. To evaluate the efficacy, safety, and tolerability of levofloxacin based quadruple therapies in the eradication of H. pylori.MethodsIn a randomized, double-blind clinical trial, 220 patients with dyspepsia and H. pylori infection were randomly assigned to receive either bismuth subcitrate 240 mg, pantoprazole 20 mg, amoxicillin 1000 mg twice a day, and levofloxacin 500 mg daily for seven days (BPAL-7), or ten days (BPAL-10). The eradication of H. pylori was evaluated two months after the end of treatment, and adverse drug reactions (ADRs) were assessed during the intervention.ResultsAccording to intention-to-treat and per-protocol, the eradication rate was significantly lower in the BPAL-7 regimen 49.1% (95% CI: 39.3–57.8) and 47.6% (95% CI: 39.7–58.4), respectively compared to the BPAL- 10 regimen 62.7% (95% CI: 53.6–72.8) and 62.4% (95% CI: 55.1–72.8), respectively. The incidence of ADRs was not statistically significant between BPAL-7 (33.6%) and BPAL-10 (36.7%) groups.ConclusionAlthough the ADRs were negligible in both groups, these regimens could not be an ideal alternative therapy for H. pylori because of low eradication rates compared to standard regimens.Trial registration: The study reviewed and approved by the Iranian Registry of Clinical Trials (IRCT201406141155N19). This trial was retrospectively registered on July 10, 2015.
Numerical Simulation of Coal Wall Cutting and Lump Coal Formation in a Fully Mechanized Mining Face
Authors: Yuan Yong , Wang Shengzhi , Wang Wenmiao , Zhu Cheng
Published: September 2020

It is difficult to accurately calculate the lump coal rate in a fully mechanized mining face. Therefore, a numerical simulation of the coal wall cutting process, which revealed the crack expansion, development, evolution in the coal body and the corresponding lump coal formation mechanism, was performed in PFC. Moreover, a correlation was established between the cutting force and lump coal formation, and a statistical analysis method was proposed to determine the lump coal rate. The following conclusions were drawn from the results. (1) Based on a soft ball model, a coal wall cutting model was established. By setting the roller parameters based on linear bonding and simulating the roller cutting process of the coal body, the coal wall cutting process was effectively simulated, and accurate lump coal rate statistics were provided. (2) Under the cutting stress, the coal body in the working face underwent three stages—microfracture generation, fracture expansion, and fracture penetration—to form lump coal, in which the fracture direction was orthogonal to the cutting pressure chain. Within a certain range from the roller, as the cutting depth of the roller increased, the number of new fractures in the coal body first increased and then stabilized. (3) Under the cutting stress, the fractured coal body was locally compressed, thereby forming a compact core. The formation and destruction of the compact core caused fluctuations in the cutting force. The fluctuation amplitude was positively related to the coal mass. (4) Because the simulation did not consider secondary damage in the coal, the simulated lump coal rate was larger than the actual lump coal rate in the working face; this deviation was mainly concentrated in large lump coal with a diameter greater than 300 mm.
Rapid establishment of a national surveillance of COVID-19 hospitalizations in Belgium
Authors: Goethem Nina Van , Vilain Aline , Wyndham-Thomas Chloé , Deblonde Jessika , Bossuyt Nathalie , Lernout Tinne , Gonzalez Javiera Rebolledo , Quoilin Sophie , Melis Vincent , Beckhoven Dominique Van
Published: September 2020

Background: In response to the COVID-19 epidemic, caused by a novel coronavirus, it was of great importance to rapidly collect as much accurate information as possible in order to characterize the public health threat and support the health authorities in its management. Hospital-based surveillance is paramount to monitor the severity of a disease in the population.Methods: Two separate surveillance systems, a Surge Capacity survey and a Clinical survey, were set up to collect complementary data on COVID-19 from Belgium’s hospitals. The Surge Capacity survey collects aggregated data to monitor the hospital capacity through occupancy rates of beds and medical devices, and to follow a set of key epidemiological indicators over time. Participation is mandatory and the daily data collection includes prevalence and incidence figures on the number of COVID-19 patients in the hospital. The Clinical survey is strongly recommended by health authorities, focusses on specific patient characteristics and relies on individual patient data provided by the hospitals at admission and discharge.Conclusions: This national double-level hospital surveillance was implemented very rapidly after the first COVID-19 patients were hospitalized and revealed to be crucial to monitor hospital capacity over time and to better understand the disease in terms of risk groups and outcomes. The two approaches are complementary and serve different needs.