bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary Calcium Intake and Associated Factors Among Pregnant Women in Loma District, South West Ethiopia, 2020
Authors: Tofu Adisu Hailu , Kassa Yibeltal , Amamo Damene Darota
Published: January 2021

Background: Low dietary calcium intakes could cause harmful effects to the pregnant woman by influencing pregnancy outcome. Adequate intake of dietary calcium during pregnancy reduces the risk of complications and aids in improved birth outcome. Many researchers focus on urban areas to address the issue and our study was focused on rural community. Hence the study is aimed at assessing dietary calcium intake in rural communities.Objective: To assess the dietary calcium intakes and associated factors among pregnant women in Loma, south west Ethiopia from May to July, 2019Methods: -A community based cross-sectional study was conducted in Loma district, Dawuro zone, southwest Ethiopia. Data were collected from 398 pregnant women after random selection from nine kebeles. Simple random sampling technique was employed to select study subjects. Socio-economic and demographic, and health related data was collected using structured, interviewer administered, and pre tested questionnaire. The 24 hr dietary recall was used for three different days with seven days interval as per the recommendation. When dietary data is collected, often it was converted into nutrients, especially the calcium intake by using Ethiopian food composition table. Collected data was checked for completeness, and entered in to Epi Data version 3.02 for data clearance and exported to SPSS version 20 for analysis. AOR with 95% C.I results of multivariate logistic regression was used to assess the statistical significance of associations between independent and dependent variables. The level of statistical significance was declared at p <0.05.Result: The median calcium intake was 543mg per day. From 398 participants, 265(66.6%) were at risk of inadequate intake of calcium. Greater than half 249 (62.6%) respondents had practiced avoiding calcium rich food during their pregnancy. The finding of this study identified that nutritional counseling have strong statistical association with dietary calcium intake of mothers during pregnancy. The chance of dietary calcium intakes during pregnancy who were received nutritional counseling 2.4 times higher than those who were not received nutritional counseling (AOR=2.432 95% CI: 1.072-5.517).Conclusion and recommendation: From the present study, it can be concluded that, majority of pregnant mothers 265(66.6%) had a poor dietary calcium intakes during their pregnancy. It is recommended that consumption of enough calcium and dairy products should be included and emphasized in the nutrition education component of maternal health programs.
Prediction of GOLD Stage in Patients Hospitalized with COPD Exacerbations with Blood Neutrophils and Demographic Parameters as Risk Factors
Authors: Chen Jing , Liquan Guo , Daxi Xiong , Qun Yuan , Zhao Yang
Published: January 2021

Background

Patients hospitalized with chronic obstructive pulmonary disease (COPD) exacerbations are unable to complete the pulmonary function test reliably due to poor health status. Creating an easy-to-use instrument to identify the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage could offer valuable information that assist clinicians to choose appropriate clinical care to decrease the mortality in these patients. The objective of this study was to develop a prediction model to identify the GOLD stage in the hospitalized exacerbation of chronic obstructive pulmonary disease (ECOPD) patients.
Methods

This study involved 155 patients hospitalized for ECOPD. All participants completed lung function tests and the collection of blood neutrophils and demographic parameters. The area under the receiver operating characteristic (ROC) curve was used to confirm the disease severity predictive ability of blood neutrophils and demographic parameters. A support vector regression (SVR) based GOLD stage prediction model was created in the training set (75%) and applied to the testing set (25%).
Results

The percentage of neutrophils (NEU%) combined with the demographic parameters was associated with a higher risk to severe episode of ECOPD. The area under the ROC curve was 0.84. The prediction model could predict the GOLD stage with acceptable prediction accuracy. The root-mean-square error (RMSE) of the forced expiratory volume in one second as the percentage of the predicted (FEV1%pred) was 8.84%. The accuracy of the GOLD stage prediction was 90.24%.
Conclusions

The NEU% and demographic parameters are associated with the pulmonary function of the hospitalized ECOPD patients. The established prediction model could assist clinicians to diagnose GOLD stage and establish appropriate clinical care.
Assessment and Documentation of Indigenous and Introduced Soil and Water Conservation Measures in Some Parts of Southern Ethiopia
Authors: Kanito Dawit , Bekele Tsegaye , Dawit Tesfaye , T/yohannes Seyfu
Published: January 2021

BackgroundIn Ethiopia, soil and water conservation activities were started after the famines of 1973 and 1985. Following this, different conservation measures were implemented by the government, non-government organizations, and the community to facilitate the optimum level of production from a given area of land while keeping soil loss below a critical value. This study was conducted at Wolaita, Hadiya, Kambata Tambaro, and Dawro Zones of Southern Ethiopia. It was designed to identify indigenous and introduced soil and water conservation practices, measure and describe identified practices, and document the identified practice for further reference. ResultsThe result revealed that three types of soil and water conservation practices namely biological, physical, and agronomical were implementing in the study areas. The result from the technical evaluation showed that soil bund and fanya juu has channel depth and embankment height lower than the recommended dimension. The result also indicated that less attention was given to indigenous soil and water conservation practices. Besides, the sustainability gap in constructed conservation practices was widely perceived.ConclusionsFarmers in the study area are well acquainted with soil erosion, its cause, and consequent reduction in land productivity. They confirm that implementing SWC measures are insurance to sustain and boost soil fertility and land productivity. In southern Ethiopia government and peoples were invested much more time, money, knowledge, and manpower to construct SWC measures. But, year by year structures get damage and yet seem not substantial to achieve the sector of sustainable agriculture. Besides, the study revealed that identified practices such as traditional cutoff drain, fanya juu, soil bund, stone-faced soil bund, fanya juu, brushwood, and gabion check-dams have technical, social, and institutional difficulties. The major gap observed with indigenous conservation practices is, it had been taken less attention by different stakeholders including GOs, NGOs, and research institutes. As a result, their respective dimension was not modified, effective measures were not up-scaled and circulated to other areas having similar agroecology and farming system. Thus, apparently, traditional conservation measures are aggravating soil erosion and their construction did not consider the downstream effect on dwelling community, water bodies, and aquatic lives.
Clinical characteristics and outcome of IgG4-related disease with hypocomplementemia: a prospective cohort study
Authors: peng linyi , Lu Hui , Zhou Jiaxin , Zhang Panpan , Li Jieqiong , Liu Zheng , Wu Di , Zhang Shangzhu , Yang Yunjiao , Bai Wei , Wang Li , Fei Yunyun , Zhang Wen , Zhao Yan , Zeng Xiaofeng , Zhang Fengchun
Published: January 2021

Background
Immunoglobulin G4 related disease (IgG4-RD) is a newly recognized systemic, immune-mediated and fibro-inflammatory disease. Hypocomplementemia was found in part of IgG4-RD patients especially in the setting of active disease.
Objectives
This study aimed to clarify the clinical features, treatment efficacy and outcome in IgG4-RD patients with hypocomplementemia.
Methods
312 IgG4-RD patients were recruited in our prospective cohort conducted in Peking union medical college hospital. Patient’s demographic data, clinical characteristics, laboratory parameters, treatment and outcome were analyzed.
Results
Hypocomplementemia was identified in 65(20.8%) cases of untreated IgG4-RD patients at baseline. The average age of hypocomplementemia group was 55.85±10.89 years, with male predominance (72.3%). Compared with normal complement group, patients with hypocomplementemia were likely to have more involved organs,higher IgG4-RD responder index (IgG4-RD RI), higher laboratory parameters such as counts of eosinophils, inflammatory markers༌immunoglobulin G(IgG), IgG1, IgG3, IgG4 and IgE. In addition, lymph nodes, lacrimal gland༌submandibular gland༌parotid gland༌paranasal sinus༌bile ducts and prostate gland were more commonly affected(p < 0.05). Serum C3 and C4 were negatively correlated with the number of involved organs, IgG4-RD RI, hypersensitive C-reactive protein (hsCRP), IgG, IgG1, IgG3 and IgG4. 64(98.5%) patients responded quickly to initial therapy at 3-month follow-up. Fifteen (23.1%) patients relapsed during follow-up with mean recurrence time of 14.2±13.8 months. Compared with normal complement group, there was no significant difference of relapse rate in two groups (P = 0.7559).
Conclusions
Clinical characteristics of IgG4-related disease with hypocomplementemia differs from normal complement group.Serum C3 and C4 at baseline before treatment could be biological markers for disease activity. IgG4-RD with hypocomplementemia responded well to treatment and had no significant difference of relapse rate in IgG4-RD with normal complement.
Application of Treatment Simulation Software for War Injury in Emergency Treatment Training on the Battlefield based on Chinese Visible Human Datasets
Authors: Hu Xin , Liu Li , Xu Zhou , Yang JingYi , Guo HongFeng , Zhu Ling , Wu Yi
Published: January 2021

Background: Proficiency in self-help and mutual aid skills is correlated with the prognosis of injured patients, and this study aims to create treatment simulation software for war injuries that reflect the physical constitution of Chinese people and study its application in first aid training on the battlefield. Methods: Based on thin-sectional, highly precise Chinese Visible Human (CVH) data with high resolution, combined with self-help and mutual medical aid measures such as digital pressure hemostasis, cricothyroid membrane puncture, pneumothorax puncture and bone marrow puncture for battlefield first aid, useing Amira and other softwares to building the simulation software for the technical training of military medical students and basic medical officers was constructed. Eighty medical service students were trained on battlefield first aid technology, and a new training mode for the treatment of war injuries was developed and optimized. Results: Simulation software of hemostasis and puncture for battlefield first aid that was suitable for the technical training of military medical students and its supporting teaching materials 3D-PDF were established. The software included modules of hemostasis of the vertex, face, head-shoulder, shoulder-arm, forearm, upper forearm, lower limb and foot and puncture of the cricothyroid membrane , pneumothorax, and bone marrow cavity. Collaborating with interactive 3D-PDF, it was successfully used for on-site first aid training of military medical students. The questionnaire results showed that the trainees had a high recognition of the human-computer interactive performance of the software with a clear interface and easy operation. The accuracy and richness of the three-dimensional model structure, knowledge of hemostasis and puncture and applied anatomy contained in this software were high, helping trainees to quickly master the knowledge points and operation techniques related to hemostasis and puncture. Conclusion: The system can effectively mobilize the learning enthusiasm of students and fully improve the learning efficiency of the basic materials and applied anatomy of battlefield first aid, as well as the teaching efficiency of teachers. The training simulation of battlefield first aid, comprising a combination of various modes, effectively complemented each other, met many training needs, and achieved satisfactory training results. Additionally, this software could be used in the emergency training of traffic accident injuries and disaster-related injuries.
Evaluation of Knowledge and Preventive Behaviors of Health Care Personnel Working in Military Clinics of Abadan Towards COVID-19
Authors: Hemmatipour Akram , Arizavi Zahra , Moradi Ahmad , jahangirmehr Azam
Published: January 2021

The authors have requested that this preprint be removed from Research Square.
Laparoscopic High Anterior Resection with Transrectal Natural Orifice Specimen Extraction Has Better Short-Term Recovery and Psychological Wellness Outcomes Compared to Conventional Laparoscopy
Authors: Wang Kaijing , Zhang Yuanyuan , Gao Wei , Liu Jie , Liu Meng-Cheng , Zhuang Huiren , Gu Dong-Di , Xiao Lizhen , Jiang Dandi , Liu Yan , Ji Zhonghua , Li Dan
Published: January 2021

Background: Transrectal natural orifice specimen extraction (NOSE) is less invasive compare to traditional laparoscopic-assisted anterior resection (LAR). However, psychological evaluation of patients after transrectal LAR-NOSE is needed to evaluate its clinical feasibility. This study aimed to compare patient outcomes between LAR and LAR-NOSE.Methods: We studied 215 patients with colorectal cancer who underwent surgery between June 2015 and April 2018; they were randomized into two groups: LAR-NOSE (n=109) and LAR (n=106). Data on pain, anxiety, and depression were collected and compared. Pain was assessed by a visual analogue scale (VAS) and anxiety and depression by the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and state-trait anxiety inventory. The overall survival and 5-year disease-free survival (DFS) rates were noted.Results: The extraction success rate in the LAR-NOSE group was 87.1% (95/109 cases). The LAR-NOSE SAS (44.21 ± 8.46) and SDS (37.29 ± 8.98) scores were significantly lower than the LAR scores (51.04 ± 9.12 and 44.65 ± 9.27, respectively; P<0.05) 1 week postoperatively. The LAR VAS scores were significantly higher on postoperative days 1–3 (P<0.05). LAR-NOSE was associated with faster operational and intestinal recovery times, less blood loss, and shorter postoperative hospitalization (P<0.05). However, 5-year DFS between the groups was the same.Conclusion: patients in the LAR-NOSE group showed better outcomes related to postoperative anxiety and depression, postoperative complications, and short-term postoperative recovery. Our results suggest transrectal NOSE as a feasible and potentially preferable method for treatment in selected patients.Registration No: SHDFYY2015-098 Date:2015.02.01
CYSTM1: A Novel Biomarker for Hepatocellular Carcinoma Prognosis
Authors: Du Jun , Wang Jinguo
Published: January 2021

Background: The expression and molecular mechanism of cysteine rich transmembrane module containing 1 (CYSTM1) in human tumor cells remains unclear. The aim of this study was to determine whether CYSTM1 could be used as a potential prognostic biomarker for hepatocellular carcinoma (HCC).Methods: We first demonstrated the relationship between CYSTM1 expression and HCC in various public databases. Secondly, Kaplan–Meier analysis and Cox proportional hazard regression model were performed to evaluate the relationship between the expression of CYSTM1 and the survival of HCC patients which data was downloaded in the cancer genome atlas (TCGA) database. Finally, we used the expression data of CYSTM1 in TCGA database to predict CYSTM1-related signaling pathways through bioinformatics analysis.Results: The expression level of CYSTM1 in HCC tissues was significantly correlated with T stage (p = 0.039). In addition, Kaplan–Meier analysis showed that the expression of CYSTM1 was significantly associated with poor prognosis in patients with early-stage HCC (p = 0.003). Multivariate analysis indicated that CYSTM1 is a potential predictor of poor prognosis in HCC patients (p = 0.036). The results of biosynthesis analysis demonstrated that the data set of CYSTM1 high expression was mainly enriched in neurodegeneration and oxidative phosphorylation pathways.Conclusion: CYSTM1 is an effective biomarker for the prognosis of patients with early-stage HCC and may play a key role in the occurrence and progression of HCC.
Gastric-Type Mucinous Adenocarcinoma of the Cervix in A Woman With Peutz-Jeghers Syndrome
Authors: tong tong , Fan Qiong , Shi Shu , Li Yuhong , Wang Yudong
Published: January 2021

Background: Peutz-Jeghers syndrome(PJS) is a very rare autosomal dominant disorder with predisposition to multiple neoplasms. Gastric-type adenocarcinoma (GAS) is a less common carcinoma of the cervix than squamous cell carcinoma, which is more aggressive and has lower 5 year survival rate than usual type endocervical adenocarcinoma (ECA), and unrelated to human papilloma virus(HPV) infection as well. We present a 32 year-old patient with Peutz-Jeghers syndrome who was found to have gastric-type adenocarcinoma of the cervix. Case presentation: A 32-year-old woman without sexual life ever who was diagnosed Peutz-Jeghers syndrome when she was two years old presented with watery discharge for more than 6 months. A tumor around 6cm was found on the cervix and she was diagnosed gastric-type mucinous adenocarcinoma of the cervix clinical stage IB3. She was treated with artery intervention chemotherapy for one course followed by radical surgery and then systematic chemotherapy.Conclusions: The case suggests more thorough cancer screening for patients with PJS as the disorder is rare and has high risk of malignancies. Young patients with Peutz-Jeghers syndrome, including those without sexual life, who have watery discharge or bleeding should be screened for cervical carcinoma even if cytologic results or human papilloma virus (HPV) is negative.
Outcome Prediction after Neoadjuvant Chemotherapy (NAC) for Breast Cancer, using Tumor-Infiltrating Lymphocytes within Fibrotic Foci of Tumor Stroma (FF-TILs)
Authors: Asano Yuka , Kashiwagi Shinichiro , Kouhashi Rika , Yabumoto Akimichi , Takada Koji , Ishihara Sae , Goto Wataru , Morisaki Tamami , Shibutani Masatsune , Tanaka Hiroaki , Hirakawa Kosei , Ohira Masaichi
Published: January 2021

Background: Tumor-infiltrating lymphocytes (TILs), which are indicators for monitoring an immune response, are generally mononuclear immunocytes that aggregate with tumors and are thought to have a close relationship with cancer cells. On the other hand, a fibrotic focus (FF) within the stroma of a tumor is a histological formation that plays an important role in the cancer microenvironment with regard to proliferation and development. Here, we focus on TILs that exist within the FF and we have performed pathological evaluations.Methods: Of the 320 patients were treated with neoadjuvant chemotherapy (NAC), 239 subjects who were able to evaluate FF-TILs were targeted. Lymphocytes that infiltrate the FF are FF-TILs.Results: The disease-free survival (DFS) period after NAC for the high-FF-TIL group was found to be significantly longer than that for the low-FF-TIL group for all cases (p < 0.001) and for all subtypes of triple-negative breast cancer (TNBC) (p = 0.001), human epidermal growth factor receptor 2-enriched breast cancer (HER2BC) (p = 0.010), and hormone receptor-positive breast cancer (HRBC) (p = 0.003). In multivariable analysis as well, high-FF-TIL group classification was an independent factor for recurrence after NAC for all cases (p < 0.001, hazard ratio (HR) = 0.198) and all subtypes of TNBC (p = 0.006, HR = 0.172), HER2BC (p = 0.025, HR = 0.135), and HRBC (p = 0.007, HR = 0.228).Conclusions: It is suggested that FF-TILs are a useful factor for predicting recurrence of breast cancer after NAC.Article headings: NAC for breast cancer by evaluation of FF-TILs
SUVmax Reduction Predicts Long-Term Survival in Patients of Non-pCR Both in the Tumor and Lymph Nodes after Neoadjuvant Chemoradiotherapy in Esophageal Squamous Cell Carcinoma
Authors: Nagaki Yushi , Motoyama Satoru , Sato Yusuke , Wakita Akiyuki , Fujita Hiromu , Sasaki Yoshihiro , Imai Kazuhiro , Minamiya Yoshihiro
Published: January 2021

Background: A pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) ensures long-term survival in esophageal squamous cell carcinoma (ESCC) patients following esophagectomy, but pCR patients are a minority. The aim here was to identify prognostic factors in patients with non-pCR ESCC after NACRT. Methods: This is a retrospective study. Investigated were 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) among non-pCR ESCC patients divided into pT0N0, primary site pCR (pT0N+), lymph node pCR (pT+N0), and non-pCR in both the tumor and lymph nodes (pT+N+) subgroups after NACRT and esophagectomy. Focusing on the SUVmax reduction rate in the primary tumor in 88 patients who underwent FDG-PET before and after NACRT, we used univariate and multivariate Cox proportional hazard models to identify prognostic factors.Results: Although there were no significant survival differences among non-pCR ESCC patients with pT0N+, pT+N0, or pT+N+, and survival rate among pT+N+ patients was the poorest. After setting a 60% cutoff for the SUVmax reduction rate in the tumor, RFS curves for non-pCR patients significantly differed between patients above the cutoff and those below it. For pT+N+ patients, the SUVmax reduction rate (<60% vs ≥60%) was an independent prognostic factor of OS, DSS, and RFS.Conclusion: Because ESCC patients with SUVmax reduction rates of <60% in the tumor after NACRT and categorized as pT+N+ after NACRT had significantly poorer prognoses, even after esophagectomy, a change in treatment strategy may be an option to improve survival.
MRI Volumetric Changes in Hippocampal Subfields in Psychosis: a Protocol for a Systematic Review and Meta-analysis
Authors: Nasa Anurag , Mosley Olivia , Roman Elena , Kelliher Allison , Gaughan Caoimhe , Levins Kirk J. , Coppinger David , O’Hanlon Erik , Roddy Darren William , Cannon Mary
Published: January 2021

Background: The hippocampus has for long been known for its abilities to form new, declarative memory. However, emerging findings across conditions in the psychosis spectrum also implicate its role in emotional regulation. Systematic reviews have demonstrated consistent volume atrophic changes in the hippocampus. The aim of the systematic review and metanalysis which will follow from this protocol will be to investigate the volume-based neuroimaging findings across each of the subfields of the hippocampus in psychosis independent of diagnosis.Methods: Volume changes across subfields of the hippocampus in psychotic illnesses will be assessed by systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). MRI neuroimaging studies of patients with a definitive diagnosis of psychosis (including brief pre diagnostic states) will be included. Studies lacking adequate controls, illicit drug use, medical psychosis, history of other significant psychiatric comorbidities or emphasis on age groups above 65 or below 16 will be excluded. Subfields investigated will include the CA1, CA2/3, CA4, subiculum, presubiculum, dentate gyrus, stratum, molecular layer, granular cell layer, entorhinal cortex and fimbria. Two researchers will independently conduct the search and selection procedures to gather suitable studies. One reviewer will independently perform all the data extraction, and another reviewer will then systemically check all the extracted information using the original articles to ensure accuracy. Statistical analysis will be performed using the metafor and meta packages in R Studio with application of the random effects model.Discussion: This study will provide insight into the volumetric changes in psychosis of the subfields of the hippocampus, independent of diagnosis. This may shed light on the intricate neural pathology which encompasses psychosis and will open avenues for further exploration of the structures identified as potential drivers of volume change.Systematic review registration: PROSPERO CRD42020199558
Gut Microbiota Changes After Metabolic Surgery in Adult Diabetic Patients With Mild Obesity: a Randomised Controlled Trial
Authors: Lau Eva , Belda Eugeni , Picq Paul , Carvalho Davide , Ferreira-Magalhães Manuel , Silva Maria Manuel , Barroso Isaac , Correia Flora , Vaz Cidalia Pina , Miranda Isabel , Barbosa Adelino , Klement Karine , Dore Joel , Freitas Paula , Prifti Edi
Published: January 2021

Background: Roux-en-Y gastric bypass (RYGB) surgery is one of the most efficient procedures for the treatment of obesity, also improving metabolic and inflammatory status, in patients with mild obesity. The underlying mechanisms have not been fully understood, but gut microbiota is hypothesized to play a key role. Our aim was to evaluate the association between gut microbiota changes and anthropometric, metabolic and inflammatory profiles after metabolic surgery compared with medical therapy, in type 2 diabetic (T2DM) adults with mild obesity (BMI 30-35 Kg/m2).Methods: DM2 was an open-label, randomised controlled clinical trial (RCT: ISRCTN53984585) with 2 arms: (i) surgical, and (ii) medical. The main outcome was gut microbiota changes after: metabolic surgery (Roux-en-Y gastric bypass - RYGB) versus standard medical therapy. Secondary outcomes included anthropometric, metabolic and inflammatory profiles. Clinical visits, blood workup, and stool samples were collected at baseline and months (M)1, 3, 6, 12. Gut microbiota was profiled using 16S rRNA targeted sequencing.Results: Twenty patients were included: 10 in surgical and 10 in medical arm. Anthropometric and metabolic comparative analysis favoured RYGB over medical arm. At M12, the percentage of weight loss was 25.5% vs. 4.9% (p<0.001) and HbA1c was 6.2% vs. 7.7% (p<0.001) respectively.We observed a continuous increase of genus richness after RYGB up until M12. In the medical arm, genus richness ended-up being significantly lower at M12. Composition analysis indicated significant changes of the overall microbial ecosystem (permanova p=0.004, [R2=0.17]) during the follow-up period after RYGB. There was a strong association between improvement of anthropometric/metabolic/inflammatory biomarkers and increase in microbial richness and Proteobacterial lineages.Conclusions: This was the first RCT studying composite clinical, analytic, and microbiome changes in T2DM patients with class 1 obesity after RYGB versus standard medical therapy. The remarkable phenotypic improvement after surgery occurred concomitantly with changes in the gut microbiome, but at a lower level.Trial registration: ISRCTN53984585 (http://www.isrctn.com/ISRCTN53984585)
Clinical Outcomes and Independent Risk Factors for 90-day Mortality in Critically-ill Patients Infected With SARS CoV-2: a Multicenter Study in Turkish Intensive Care Units
Authors: Gundogan Kursat , Akbudak Ismail Hakki , Hanci Pervin , Halacli Burcin , Temel Sahin , Gullu Zuhal , Inci Kamil , Bilir Yeliz , Bozkurt Firdevs Tugba , Yildirim Fatma , Simsek Meltem , Yuksel Recep Civan , Eren Esma , Altintas Neriman Defne , Talan Leyla , Elay Gulseren , Guven Goksel , Kara Iskender , Aydin Emre , Yilmaz Seda , Mengi Tugce , Sari Sema , Akbas Turkay , Cinleti Burcu Acar , Ayhan Nazire Ates , Ozbek Deniz Aral , Sahin Taha Koray , Acikgoz Asli , Esbah Ali Umit , Firat Ahmet , Aydemir Ferhan , Gurkok Mehmet Cagatay , Zerman Avsar , Gumus Ayca , Turkoglu Melda , Aydogdu Muge , Ulu Ramazan , Celik Jale Bengi , Balci Canan , Kirakli Cenk , Karakoc Emre , Ozyilmaz Ezgi , Ersoy Ebru Ortac , Ocal Serpil , Sen Irem Akin , Tor Ibrahim Hakki , Comert Bilgin , Ergan Begum , Saracoglu Kemal Tolga , Ergil Julide , Yuksel Ummu Gulsum , Tutar Nuri , Sungur Murat , Topeli Arzu
Published: January 2021

Background: There are limited data on long-term outcome and mortality predictors of COVID-19 from different parts of the world. The aim of this study was to determine risk factors of 90-day mortality in critically-ill patients infected with SARS-CoV-2 in Turkish ICUs. Methods: This multicenter, retrospective study was performed in 26 ICUs in Turkey. All patients with confirmed SARS-CoV2 infection, requiring more than 24 hours of ICU follow-up were included in the study. Demographics, clinical characteristics, laboratory variables, respiratory support, treatment types, and survival data were recorded. Results: A total of 421 patients were included in the study. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. 90-day mortality rate was 55.1%. Factors independently associated with 90-day mortality were receiving invasive mechanical ventilation (HR 4.09 [95% CI: 2.20-7.63]), admission lactate level > 2 mmol/L (2.78 [1.93-4.01]), age ≥ 60 years (2.45 [1.48-4.06)]), having cardiac arrhythmia during ICU stay (2.01 [1.27-3.20]), receiving vasopressor treatment (1.94 [1.32-2.84]), positive fluid balance of ≥ 600 ml/per day during ICU follow-up (1.68 [1.21-2.34]), admission PaO2/FiO2 ratio of ≤ 150 mmHg (1.66 [1.18-2.32], and baseline ECOG score ≥ 1 (1.42 [1.00-2.02]. Conclusion: This study has shown that long-term mortality was high in critically-ill COVID-19 patients in Turkish ICUs. Invasive mechanical ventilation, high lactate level, older age, presence of cardiac arrhythmia, need for vasopressor treatment, positive fluid balance, severe hypoxemia and not having fully-active performance were related with mortality.
Trends and Socioeconomic Factors in Smoking and Alcohol Consumption Among Chinese Adults: Evidence From National Health Service Surveys
Authors: Liu Kehui , Ding Yan , Lu Xiang , Wang Zhonghua
Published: January 2021

Background: Smoking and excessive drinking are risk factors for many diseases. With the rapid economic development in China, it is important to identify trends in smoking and alcohol consumption and factors that contribute to these behaviors to ensure the health of the population.Methods: we analyzed pooled cross-sectional data from the fourth, fifth, and sixth National Health Service Surveys conducted in Jiangsu Province in 2008, 2013, and 2018, respectively. Trends in smoking and alcohol use were analyzed with descriptive statistics, and bivariate and multivariate logistic regression was used to identify contributing factors.Results: Among total sample, smoking rate was 23.95%, in which the incidence of mild, moderate and severe smoking was 5.75%, 4.63% and 13.56%, respectively; drinking rate was 23.29%, in which non-excessive drinking and excessive drinking were 19.80% and 3.49%, respectively. From 2008–2018, overall and light-to-moderate smoking rates first increased and then decreased while heavy smoking rate declined; and alcohol consumption increased while excessive drinking increased before decreasing. The varying tendency of smoking and drinking rates in urban area was similar to rural area, however there was a significant gap in incidence between urban and rural area. Socioeconomic factors, demographic, health-related and year variables were significant associated with smoking and drinking. Conclusion: Preventive measures such as education and support services along with stricter regulations for tobacco and alcohol use are needed to improve public health in China.
A Strategy That Improves the Culture of Information Use at Primary Health Care Units in Ethiopia
Authors: Abera Wondwosen Shiferaw , Halallo Brook Abate , Beshir Ismael Ali , Desta Binyam Fekadu , Argaw Mesele Damte
Published: January 2021

Background: Health systems require high-quality data production for health service delivery and program improvement. Ethiopia’s health sector was challenged with lack of quality data from its routine health information system which is an essential element of evidence-based decision making. To overcome this, the Ethiopian Ministry of Health introduced a health information system (HIS) performance monitoring tool named the connected woreda strategy (CWS). This study aims to assess the effectiveness of the CWS to improve culture of information use at primary health care entities. Methods: The study employed a repeated cross-sectional study design through pre and post testing of district health offices using connected woreda assessment tools. A total of 78 districts were enrolled in this study to assess their performance on the implementation of the CWS. The CWS assessment checklist is comprised of 54 questions, all of which were assigned numeric number response types and categorized into HIS capacity (30%), data quality (30%), and administrative data use (40%) and further categorized as districts that meet the highest standards, (>90% of common set of criteria) i.e. ‘model woredas’, districts that meet medium standards, (between 65% to 90% score of common set criteria) i.e. ‘candidate woredas’ and districts that meet lowest standards (<65 of common set of criteria) i.e. ‘emerging woredas’. Finally, the data were analyzed using the SPSS-version 25 software. Results: A total of 78 districts were employed and described and a paired sample t-test was used to measure the performance of districts on CWS implementation. Due to CWS implementation, 10% of districts were ‘models’ in HIS performance; ‘candidate’ districts increased from 40% to 73%; and ‘emerging’ districts decreased from 60% to 17%. Finally, overall CWS scores showed significant improvements after the intervention with 73.4 ± 10.48 SD compared to before intervention 60.4±13.69 SD, with t (77) =-7.18 and p=0.001. Conclusions: This study has revealed that the CWS implementation has a positive effect towards cultural transformation of use of data for decision making at primary health care entities. Thus, scaling up the connected woreda implementation is recommended at the national level to improve the performance of primary health care entities.
Agricultural Transfer Labor Wage Platform Based on Image Content Feature Retrieval and Internet of Things
Authors: Wu Ying , Liu Jikun
Published: January 2021

Quick and accurate information identification of agricultural transfer labor wage platform is an essential function of labor intelligent management in the new era. Based on the content feature retrieval, this study constructs an artificial intelligence identity information recognition system and links the system to the salary platform. Simultaneously, this study uses the feature recognition to extract database information and realize intelligent salary assessment. In addition, the deep learning features used in this study are based on the positional information of the sift features and are finally calculated by the activation map to obtain a global vector of an image. Finally, this study design testing experiment to verify the performance of the algorithm. Through the output of the feature picture, it can be seen that the research algorithm has certain effects and can be used as a follow-up system practice.
Describing people with cognitive impairment and their complex treatment needs during routine care in the hospital – cross-sectional results of the intersec-CM study
Authors: Kracht Friederike , Boekholt Melanie , Schumacher-Schönert Fanny , Nikelski Angela , Chikhradze Nino , Lücker Petra , Vollmar Horst , Hoffmann Wolfgang , Kreisel Stefan , Thyrian Jochen René
Published: January 2021

Background: Cognitive impairment is an important determinant in health care. In the acute hospital setting cognition has a strong impact on treatment and care. Cognitive impairment can negatively affect diagnostics and treatment success. However, little is known about the individual situation and specific risks of patients with cognitive impairments (PCI) during hospital stays. The aim of the present research is to describe and analyze the treatment needs of PCI in acute hospital care. Methods: The analyses use baseline data of the ongoing multisite, longitudinal, randomized controlled intervention trial intersec-CM (Supporting elderly people with cognitive impairment during and after hospital stays with Intersectoral Care Management), which recruited 402 participants at baseline. We assessed sociodemographic aspects, cognitive status, functional status, frailty, comorbidities, level of impairment, formal diagnosis of dementia, geriatric diagnoses, delirium, depression, pharmacological treatment, utilization of health care services and health care related needs.Results: The sample under examination had been on average mildly cognitively impaired (MMSE M=22.3) and had a mild to moderate functional impairment (Barthel Index M=50.4; HABAM M=19.1). The Edmonton Frail Scale showed a mean of 7.4 and half of the patients (52.3%) had been assigned a care level. About 46.9% had a geriatric diagnosis, 3.0% had a diagnosis of dementia. According to DSM-V 19.2% of the patients had at least one main symptom of depression. The mean number of regularly taken drugs per patient was 8.2. Utilization of health care services prior to the hospital stay was rather low. On average, the sample showed 4.38 care related needs in general, of which 0.60 needs were unaddressed at the time of assessment.Conclusions: Descriptive analyses highlight an in-depth insight into impairments and different care needs of PCI. The results emphasize the need for gender-specific analyses as well as an increased attention to the heterogeneity of needs of PCI related to specific wards, settings and regions where they are admitted. Our results indicate also that PCI represent a high proportion of older patients in acute hospital care.Trial registration: The intersec-CM trial is registered at ClinicalTrials.gov (NCT03359408).
Phylogeny and pathogenicity of Fusarium solani species complex (FSSC) associated with potato tubers
Authors: Gherbawy Youssuf A. , Hussein Mohamed A. , Hassany Nabila A. , Shebany Yassmin M. , Hassan Sabry , El-Dawy Eman G. A.
Published: January 2021

Potato (Solanum tuberosum L.) is among the top five crops growing worldwide following cereals, rice, wheat, barley and corn due to its high carbohydrate content and adaptability. Potatoes are particularly valued in developing countries as a rich source of vitamins C and B6, starch and essential amino acids. Fusarium solani species complex (FSSC) is a common pathogen of potato, causing dry rot in the Upper Egypt. In this study were isolated and identified FSSC from potato tubers based on the morphological followed by molecular characteristics. 187 isolates of Fusarium solani were achieved from infected and non-infected potato tubers gathered from different markets in the Upper Egypt. Dependent upon the morphological characteristics, sequence data from amplifying β-tubulin and specific translation elongation factor (TEF-1α) genes, all of the selected FSSC isolates were divided into three major groups (F. keratoplasticum, F. falciforme and F. solani). All the tested FSSC were capable of producing amylases. All of the isolates were examined for their pathogenic ability on healthy potato tubers, which showed pathogenic effects; with lesion sizes were quite variable. F. solani SVUFs73 showed a highly virulent effect.
Small-scale convective turbulence constrains microbial patchiness
Authors: Christensen Alexander , Piggott Matthew , Sebille Erik van , Reeuwijk Maarten van , Pawar Samraat
Published: January 2021

Microbes play a primary role in aquatic ecosystems and biogeochemical cycles. Patchiness is a critical component of these activities, influencing biological productivity, nutrient cycling and dynamics across trophic levels. Incorporating spatial dynamics into microbial models is a long-standing challenge, particularly where small-scale turbulence is involved. Here, we combine a realistic simulation of turbulence with an individual-based microbial model to test the key hypothesis that the coupling of motility and turbulence drives intense microscale patchiness. We find that such patchiness is depth-structured and requires high motility: Near the fluid surface, strong convective turbulence overpowers motility, homogenising motile and non-motile microbes equally. In deeper, thermocline-like conditions, highly motile microbes are up to 1.6-fold more patch-concentrated than non-motile microbes. Our results demonstrate that the delicate balance of turbulence and motility that triggers micro-scale patchiness is not a ubiquitous consequence of motility, and that the intensity of such patchiness in real-world conditions is modest.
Three-dimensional analysis of anterior talofibular ligament strain patterns during cadaveric ankle motion using a miniaturized ligament performance probe
Authors: Takeuchi Yoshitaka , Inokuchi Ryota , Takao Masato , Glazebrook Mark , Oliva Xavier , Yamazaki Takayuki , Kubo Maya , Lowe Danielle , Matsui Kentaro , Katakura Mai , Ozeki Satoru
Published: January 2021

BackgroundMeasuring the strain patterns of ligaments at various joint positions informs our understanding of their function. However, few studies have examined the biomechanical properties of ankle ligaments; further, the tensile properties of each ligament, during motion, have not been described. This limitation exists because current biomechanical sensors are too big to insert within the ankle. The present study aimed to validate a novel miniaturized ligament performance probe (MLPP) system for measuring the strain patterns of the anterior talofibular ligament (ATFL) during ankle motion.MethodsSix fresh-frozen, through-the-knee, lower extremity, cadaveric specimens were used to conduct this study. An MLPP system, comprising a commercially available strain gauge (force probe), amplifier unit, display unit, and logger, was sutured into the midsubstance of the ATFL fibers. To measure tensile forces, a round, metal disk (a “clock”, 150 mm in diameter) was affixed to the plantar aspect of each foot. With a 1.2-Nm load applied to the ankle and subtalar joint complex, the ankle was manually moved from 15° dorsiflexion to 30° plantar flexion. The clock was rotated in 30° increments to measure the ATFL strain detected at each endpoint by the miniature force probe. Individual strain data were aligned with the neutral (0) position value; the maximum value was 100.ResultsThroughout the motion required to shift from 15° dorsiflexion to 30° plantar flexion, the ATFL tensed near 20° (plantar flexion), and the strain increased as the plantar flexion angle increased. The ATFL was maximally tensioned at the 2 and 3 o’clock (inversion) positions (96.0 ± 5.8 and 96.3 ± 5.7) and declined sharply towards the 7 o’clock position (12.4 ± 16.8). Within the elastic range of the ATFL (the range within which it can return to its original shape and length), the tensile force was proportional to the strain, in all specimens.ConclusionThe MLPP system is capable of measuring ATFL strain patterns; thus, this system may be used to effectively determine the relationship between limb position and ATFL ankle ligament strain patterns.
Sexual violence in medical students and specialty registrars in Flanders, Belgium: a population survey
Authors: Geldof Malaurie , Tijtgat Jens , Dewulf Laura , Haezeleer Matthias , Degryse Nicolas , Pouliart Nicole , Keygnaert Ines
Published: January 2021

Background: Sexual violence has globally been recognized as harmful to young people’s health. In medical school, which is a highly competitive environment, the risk is supposedly even bigger. In this study we firstly aimed to investigate the magnitude and precipitating factors of sexual violence in medical students and specialty registrars in Flanders, Belgium. Secondly, we wanted to assess the reactive behaviours as well as the knowledge of possible types of bystander reactions as well as potential support resources for victims of sexual violence. Methods: This study was initiated and coordinated by the Flemish medical student representation organisation (VGSO). A survey containing demographic and behaviour-specific questions based on the UNMENAMAIS and SAS-V questionnaire was sent to all undergraduate, graduate and postgraduate students of the 5 medical schools in Flanders. Participants were asked to limit their responses to internship-related events. Further questions concerning reactions to sexual violence, assailants, bystander reactions and general knowledge concerning support after sexual violence were asked. Results: We received 3015 valid responses to our survey, obtaining a response rate of 29% in the potential target population. Within the total study population, 1168 of 3015 participants (38,73%) reported having been victim of at least one type of sexual violence as explored by our survey. This percentage was the highest in GP specialty registrars (53%), followed by specialty registrars (50%) and master students (39%). Assailants of sexual violence varied, most often they were medical staff members, students or patients. In most types of sexual violence, nobody reacted to this behaviour. Women (57.3%) talked about what happened afterwards more often than men (39.7%). When asked about their knowledge of possible bystander reactions and support services for sexual violence, 60% of the respondents did not know about their existence. Conclusions: Sexual violence is still a relatively frequent issue in medical students and specialty registrars. Patients form an important part of the assailants. In a third of reported sexual violence cases, nobody reacted. In addition, male victims seem to underreport. There is still much need for sensitisation on support mechanisms and centres for victims and witnesses of sexual violence.
Marker-trait association analysis for drought tolerance in smooth bromegrass
Authors: Saeidnia Fatemeh , Majidi Mohammad Mahdi , Mirlohi Aghafakhr
Published: January 2021

Background: Little information is available on the application of marker-trait association (MTA) analysis for traits related to drought tolerance in smooth bromegrass. The objectives of this study were to identify marker loci associated with important agronomic traits and drought tolerance indices as well as fining stable associations in a diverse panel of polycross derived genotypes of smooth bromegrass. Phenotypic evaluations were performed at two irrigation regimes (normal and deficit irrigation) during two years; and association analysis was done with 626 SRAP markers. Results: The results of population structure analysis identified three main subpopulations possessing significant genetic differences. Under normal irrigation, 68 and 57 marker-trait associations were identified using general linear model (GLM) and mixed linear mode1 (MLM), respectively. While under deficit irrigation, 61 and 54 markers were associated with the genes controlling the studied traits, based on these two models, respectively. Some of the markers were associated with more than one trait. It was revealed that markers Me1/Em5-11, Me1/Em3-15, and Me5/Em4-7 were consistently linked with drought-tolerance indices. Conclusion: Following marker validation, the MTAs reported in this panel could be useful tools to initiate marker-assisted selection (MAS) and targeted trait introgression of smooth bromegrass under normal and deficit irrigation regimes, and possibly fine mapping and cloning of the underlying genes and QTLs.