bluuebunny/crossref_metadata_2025 huggingface dataset:
Program on high value cost-conscious education in Intensive Care: Educational program on prediction of outcome and cost awareness on Intensive Care admission
Authors: Wagenberg Linda van , Beurskens Charlotte J. P. , Stegeman Inge , Müller Marcella C. A.
Published: January 2020

Introduction: Intensive Care (ICU) involves extended and long lasting support of vital functions and organs. However, current training programs of ICU residents mainly focus on extended support of vital functions and barely involve training on cost-awareness and outcome. We incorporated an educational program on high-value cost-conscious care for residents and fellows on our ICU and measured the effect of education.
Methods: A cohort study with factorial survey design, in which residents and fellows ICU were asked to evaluate clinical vignettes, was performed on the mixed surgical-medical ICU of the Amsterdam University Medical Centre. Residents were offered an educational program focusing on outcome and costs of ICU care. Before and after the program they filled out a questionnaire, which consisted of 23 vignettes, in which known predictors of outcome of community acquired pneumonia (CAP), pancreatitis, acute respiratory distress syndrome (ARDS) and cardiac arrest were presented, together with varying patient factors (age, body mass index (BMI), acute kidney failure (AKI) and haemato-oncological malignancy). Participants were asked to either admit the patient or estimate mortality.
Results: BMI, haemato-oncological malignancy and severity of pancreatitis were discriminative for admission to ICU in clinical vignettes on pancreatitis and CAP. After education, only severity of pancreatitis was judged as discriminative. Before the intervention only location of cardiac arrest (in- vs out of hospital) was distinctive for mortality, afterwards this changed to presence of haemato-oncological malignancy.
Conclusion: We incorporated an educational program on high-value cost-conscious care in the training of ICU physicians. Based on our vignette study, we conclude that the improvement of knowledge of costs and prognosis after this program was limited.
Analysis of virulence factors and antibiotic resistance genes in Group B Streptococcus from clinical samples
Authors: Mudzana Raymond , Mavenyengwa Rooyen T , Gudza-Mugabe Muchaneta
Published: January 2020

Background : Streptococcus agalacticae (Group B Streptococcus, GBS) is one of the most important causative agents of serious infections among neonates. GBS virulence factors are important in vaccine development, whilst antibiotic resistance genes are necessary in understanding the resistance mechanisms used by pathogens. This study was carried out to identify virulence genes and antibiotic resistance genes associated with GBS isolated from pregnant women. Methods: A total of 43 GBS isolates were obtained from 420 vaginal samples collected from HIV positive and negative women who were 13-35 weeks pregnant attending Antenatal Care at Chitungwiza and Harare Central Hospitals in Zimbabwe. Identification tests of GBS isolates was done using standard bacteriological methods including molecular tests. Antibiotic susceptibility testing using 3 antibiotics was done using the modified Kirby-Bauer method. The boiling method was used to extract DNA and Polymerase Chain Reaction (PCR) was used to screen for 13 genes. Data was fed into SPSS 24.0 and the Spearman rank correlation test used to determine correlation among genes. Results: Nine distinct virulence gene profiles were identified. The profiles hly-scpB-bca-rib 37.2% (16/43) and hly-scpB-bca 18.6% (8/43) were common. The following virulence gene frequencies were obtained namely hly 97.8% (42/43), scpB 90.1% (39/43), bca 86.0% (37/43), rib 69.8% (30/43) and bac 11.6% (5/43). High resistance to tetracycline 97.7% (42/43) was reported followed by clindamycin 55.8% (24/43) and erythromycin 30.2% (13/43). Antibiotic resistance genes among the resistant and intermediate-resistant isolates showed high frequencies for tetM 97.6% (41/42) and low frequencies for ermB 34.5% (10/29), ermTR 10.3% (3/29), mefA 3.4% (1/29), tetO 2.4% (1/42) and linB 0% (0/35). The atr housekeeping gene yielded 100% (43/43) positive results, whilst the mobile genetic element IS1548 yielded 9.3% (4/43). Conclusion: The study showed high prevalence of multiple virulence genes hly, scpB, bca and rib in S. agalactiae strains isolated from pregnant women. Tetracycline resistance was found to be predominantly caused by the tetM gene, whilst macrolide resistance was predominantly due to the presence of erm methylase, with the ermB gene being more prevalent. It was also observed that in vitro phenotypic resistance is not always accurately predicted by resistance genotypes.
Comparison of two caries prevention programs among Thai kindergarten: a randomized controlled trial
Authors: Pisarnturakit Pagaporn Pantuwadee , Detsomboonrat Palinee
Published: January 2020

Background: Intensified preventive regimen based on a ‘high-risk’ approach has been proposed instead the routine prevention that is generally given to the whole population. The effectiveness of these regimens may still be an issue. Therefore, the aim of this study was to compare two preventive programs carried out in a Public School for kindergarten children. Methods: The data from clinical examinations were used to assess the caries risk for 121 children. Children with at least 2 carious lesions were considered as high risk for dental caries development. These children were randomized into two groups. Half (High risk basic-HRB group) were provided the basic prevention regimen (oral-hygiene instruction and hands-on brushing practice for teachers and caregivers, daytime tooth brushing supervised by teachers at least once a week, newly erupted first permanent molar sealant, provision of toothbrush, fluoride-containing dentifrice, and a guidebook), which was also given to low-risk children (Low risk basic-LRB group). The other half (High risk intensive-HRI group) were additionally given an intensified preventive regimen (F-varnish application, primary molar sealant, and silver diamine fluoride (SDF) application on carious lesions). Clinical examinations were performed semiannually to determine the dmfs caries increment of the three groups. Results: The 89 children completed the 24-month examination were 3- to 5-year-old with 19, 35, and 35 children in the LRB, HRB, and HRI group, respectively. The new caries development at 24 months of the HRB group (75%) was higher than that of the HRI group (65.7%) and the LRB group (21.1%). One-way analysis of variance (ANOVA) indicated no significant differences of caries increment between the HRB and HRI groups in caries increment at the end of our study (p=0.709). Conclusions: The negligible difference in caries increment between the HRI and HRB groups implies that intensified prevention produced minimal additional benefit. Offering all children only basic prevention could have obtained virtually the same preventive effect with substantially less effort and lower cost.
A structured mixed method process evaluation of a randomized controlled trial of Individual Placement and Support (IPS)
Authors: Fyhn Tonje , Ludvigsen Kari , Reme Silje E , Schaafsma Frederieke
Published: January 2020

Background The effect of Individual Placement and Support (IPS) has been widely documented, but in many studies, the majority of participants remains unemployed. Structured process evaluations that use mixed methods are scarce, although they could identify components that may enhance the effect of IPS. The aim of the current study is to provide a description of a structured mixed methods process evaluation of IPS in Norway. Methods The process evaluation was conducted alongside a randomized controlled trial including six IPS centers, comparing IPS with treatment as usual in a population of patients in treatment for moderate to severe mental illness. Mixed methods were used in the process evaluation, and outcome measures were reach, barriers and facilitators, and fidelity. Results The intervention reached the intended target group. All centers reached fair to good fidelity within the project period. Certain fidelity items seemed to indicate implementation issues related to employer contact, community-based services, and integration with health services. Less than half of the participants regarded their illness as a barrier for participation in IPS. Participants were overall satisfied and found the intervention useful, emphasizing the availability of the employment specialist and their consistent job focus, as well as the freedom to disclose their illness or not. Conclusions Certain fidelity items indicated implementation issues during the first year, namely providing community-based services, ensuring quality in employer contact, and integration with health treatment. The employment specialist clearly played an important role for participants. Most participants described this relationship as positive, empowering, and encouraging. Trial Registration The study was registered on clinicaltrials.gov prior to the inclusion period (reg.no: NCT01964092, registered 17/07/2013, https://clinicaltrials.gov/ct2/show/NCT01964092 ).
Predictors of hookah smoking among women in the south of Iran: a cross-sectional study
Authors: Dadipoor Sakineh , Heyrani Ali , aghamolaei teamur , Shahsavari Saeideh , Ghaffari Mohtasham , Ghanbarnezhad Amin
Published: January 2020

Background The prevalence of hookah smoking has grown over the past decades in Iran especially in the south of the country more than other geographical areas. The present research aims to determine the socio-demographic predictors of hookah smoking among women in the south of Iran. Method This research was conducted on 400 female hookah smokers selected through the multi-stratified sampling method. Data were collected from October 2018 to September 2019 using a researcher-made questionnaire. Ordinal logistic regression analysis was run to determine the influential behavioral and socio-demographic factors involved in hookah smoking. Variables with a P-value < 0.05 in the final fitting model were declared to be associated with the outcome variable. Results Participants’ age ranged between 15 and 85 years (mean=34.91±13.3 years). As for demographic factors, women in the 35-50 age group (p=.01) and those above 50 years (p=.02) showed more tendency to smoke hookahs than those below 20 years of age. The ‘ever-married’ group tended to smoke hookahs three times as much as the ‘never married’ (p=.002). Those of a low socio-economic status (SES) showed a stronger tendency to smoke hookahs than those of a high SES (6.5 times as strong) (p=.000). The statistical analysis of behavioral factors showed that the following were associated with a higher frequency of hookah smoking among women: lower age of beginning to smoke hookahs (p<.001) <15 years, 15-30 years (p=.003), longer duration of hookah smoking (p=.000), hookah smoking among family members (p=.000), absence of either parent in family (single-parent families) (p=.000), beginning to smoke hookahs with peers (p=.000) and a lack of prior intention to cease smoking (p=.000). Conclusion As the present results showed, hookah smoking was ordinary and popular among women in the present research. Increasing the social unacceptance of hookahs, focus on those surrounding women smokers, quitting the habit of hookah smoking and effective interventions to decrease one’s intention to smoke hookahs can help to reduce such unhealthy behaviors.
Quantitative proteomics analysis of lysine 2-hydroxyisobutyrylation in IgA nephropathy
Authors: Huang Shaoying , Zheng Fengping , Lin Hua , Zhou Xianqing , Xu Huixuan , Zhang Cantong , Dai Weier , Zhang Xinzhou , Sui Weiguo , Tang Donge , Dai Yong
Published: January 2020

Protein posttranslational modification (PTM) is an indispensable regulatory element that can fine-tune protein functions and regulate diverse cellular processes. Lysine 2-hydroxyisobutyrylation (Khib) is a PTM that was recently identified and is thought to play a role in a wide variety of active cellular functions. In this report, for the first time, we comparatively studied the 2-hydroxyisobutyrylation proteome in peripheral blood mononuclear cells from a new-onset biopsy-proven immunoglobulin A nephropathy (IgAN) group and a normal control group based on liquid chromatography-tandem mass spectrometry (LC-MS/MS). Altogether, 7405 proteins were identified and added to a Khib library. Of these proteins, we identified 111 with upregulated expression and 83 with downregulated expression. Furthermore, we identified 428 Khib modification sites on 290 Khib-modified proteins, including 171 sites with increased modification on 122 Khib-modified proteins and 257 specific sites with reduced modification on 168 Khib-modified proteins. Importantly, the abundance of lipocalin 2 was increased in the differentially expressed proteins, and a KEGG-based functional enrichment analysis showed that Khib proteins clustered in the IL-17 signaling pathway and phagosome category, which may have important associations with IgAN. Our data enlighten our understanding of Khib in IgAN and indicate that Khib may have important regulatory roles in IgAN.
Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour
Authors: Etherington Nicole , Rodrigues Isabel Braganca , Giangregorio Lora , Graham Ian D. , Hoens Alison M , Kasperavicius Danielle , Kelly Christine , Moore Julia E. , Ponzano Matteo , Presseau Justin , Sibley Kathryn M. , Straus Sharon
Published: January 2020

Background A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, which accounts for the interface between social identity factors and structures of power, offers a novel approach to understanding how context shapes individual decision-making and behaviour. We aimed to develop a tool to be used alongside applications of the TDF to incorporate an intersectionality lens when identifying implementation barriers and enablers. Methods An interdisciplinary Framework Committee (n=17) prioritized the TDF as one of three models, theories, and frameworks (MTFs) to enhance with an intersectional lens through a modified Delphi approach. The modified Delphi involved two rounds of online voting followed by a final majority vote. In collaboration with the wider Framework Committee, a subgroup considered all 14 TDF domains and iteratively developed recommendations for incorporating intersectionality considerations within the and its domains TDF. An iterative approach aimed at building consensus was used to finalize recommendations. Results Consensus on how to apply an intersectionality lens to the TDF was achieved after 12 rounds of revision. Two overarching considerations for using the intersectionality-enhanced TDF were developed by the group as well as two to four prompts for each TDF domain to guide interview topic guides. Conclusions Through an expert-consensus approach, we developed a tool for applying an intersectionality lens alongside the TDF. By considering the role of intersecting social factors when selecting, tailoring, and implementing KT interventions, they may become more effective.
Transcriptional reprogramming strategies and miRNA-mediated regulation networks of Taxus media induced into callus cells from tissues
Authors: Chen Ying , Zhang Meng , Jin Xiaofei , Tao Haoran , Wang Yamin , Peng Bo , Fu Chunhua , Yu Longjiang
Published: January 2020

Background Taxus cells are a potential sustainable and environment-friendly source of taxol, but they have low survival ratios and slow grow rates. Despite these limitations, Taxus callus cells induced through 6 months of culture contain more taxol than their parent tissues. In this work, we utilized 6-month-old Taxus media calli to investigate their regulatory mechanisms of taxol biosynthesis by applying multiomics technologies. Our results provide insights into the adaptation strategies of T. media by transcriptional reprogramming when induced into calli from parent tissues. Results Seven out of 12 known taxol, most of flavonoid and phenylpropanoid biosynthesis genes were significantly upregulated in callus cells relative to that in the parent tissue, thus indicating that secondary metabolism is significantly strengthened. The expression of genes involved in pathways metabolizing biological materials, such as amino acids and sugars, also dramatically increased because all nutrients are supplied from the medium. The expression level of 94.1% genes involved in photosynthesis significantly decreased. These results reveal that callus cells undergo transcriptional reprogramming and transition into heterotrophs. Interestingly, common defense and immune activities, such as “plant–pathogen interaction” and salicylic acid- and jasmonic acid-signaling transduction, were repressed in calli. Thus, it’s an intelligent adaption strategy to use secondary metabolites as a cost-effective defense system. MiRNA- and degradome-sequencing results showed the involvement of a precise regulatory network in the miRNA-mediated transcriptional reprogramming of calli. MiRNAs act as direct regulators to enhance the metabolism of biological substances and repress defense activities. Given that only 17 genes of secondary metabolite biosynthesis were effectively regulated, miRNAs are likely to play intermediate roles in the biosynthesis of secondary metabolites by regulating transcriptional factors (TFs), such as ERF, WRKY, and SPL. Conclusion Our results suggest that increasing the biosynthesis of taxol and other secondary metabolites is an active regulatory measure of calli to adapt to heterotrophic culture, and this alteration mainly involved direct and indirect miRNA-induced transcriptional reprogramming. These results expand our understanding of the relationships among the metabolism of biological substances, the biosynthesis of secondary metabolites, and defense systems. They also provide a series of candidate miRNAs and transcription factors for taxol biosynthesis.
Comparative transcriptome combined with metabolome analyses revealed key factors involved in nitric oxide (NO)-regulated cadmium stress adaptation in tall fescue
Authors: Chen Liang , Zhu Huihui , Ai Honglian , Hu Zhengrong , Du Dongyun , Sun Jie , Chen Ke
Published: January 2020

Background It has been reported that nitric oxide (NO) could ameliorate cadmium (Cd) toxicity in tall fescue; however, the underlying mechanisms of NO mediated Cd detoxification are largely unknown. In this study, we investigated the possible molecular mechanisms of Cd detoxification process by comparative transcriptomic and metabolomic approaches. Results The application of Sodium nitroprusside (SNP) as NO donor decreased the Cd content of tall fescue by 11% under Cd stress (T1 treatment), but the Cd content was increased by 24% when treated with c-PTIO together with L-NAME (T2 treatment). RNA-seq analysis revealed that 904 (414 up- and 490 down-regulated) and 118 (74 up- and 44 down-regulated) DEGs were identified in the T1 vs Cd and T2 vs Cd comparisons, respectively. Moreover, metabolite profile analysis showed that 99 (65 up- and 34-down- regulated) and 131 (45 up- and 86 down-regulated) metabolites were altered in the T1 vs Cd and T2 vs Cd comparisons, respectively. The integrated analyses of transcriptomic and metabolic data showed that 81 DEGs and 15 differentially expressed metabolites were involved in 20 NO-induced pathways. The dominant pathways were involved in antioxidant activities such as glutathione metabolism, arginine and proline metabolism, secondary metabolites such as flavone and flavonol biosynthesis and phenylpropanoid biosynthesis, ABC transporters, and nitrogen metabolism. Conclusions In general, the results revealed that there are three major mechanisms regulated by NO in Cd stress response in tall fescue: (a) antioxidant capacity enhancement; (b) accumulation of secondary metabolites related to cadmium chelation and sequestration; and (c) regulation of cadmium ion transportation, such as ABC transporter activation. In conclusion, this study provides new insights into the NO-mediated cadmium stress response.
Stability of the effect of silencing genes involved in the midgut homeostasis on Anopheles arabiensis mosquito reared under different breeding site conditions
Authors: Debalke Serkadis , Habtewold Tibebu , Christophides George K. , Duchateau Luc
Published: January 2020

Background: Malaria vector mosquitoes acquire midgut microbiota primarily from their habitat. The homeostasis of these microbial communities plays an essential role in the mosquito longevity, the most essential factor in the mosquito vectorial capacity. Our recent study revealed that silencing genes involved in regulation of the midgut homeostasis including FN3D1, FN3D3, and GPRGr9 reduced the survival of female adult Anopheles arabiensis mosquito. In the present study, we investigate the stability of the gene silencing efficiency of mosquitoes reared in three different breeding conditions representing distinct larval habitat types: town brick pits in Jimma, flood pools in the rural land of Asendabo and roadside pools in Wolkite. Methods: First instar larvae of An. arabiensis mosquitoes were reared separately using water collected from the three breeding sites. The resulting adult females were micro-injected with dsRNA targeting the FN3D1 gene (AARA003032) and their survival was monitored. Control mosquitoes were injected with dsRNA Lacz. In addition, the load of midgut microbiota of these mosquitoes was determined using flow cytometry.Result: Survival of naïve adult female mosquitoes differed between the three sites. Mosquitoes reared using water collected from brick pits and flood pools survived longer than mosquitoes reared using water collected from roadside. However, the FN3D1 gene silencing effect on survival did not differ between the three sites. Conclusion: The present study revealed that the efficacy of FN3D1 gene silencing is not affected by variation in the larval habitat. Thus, silencing this gene using genetic engineering approaches can have a large potential for application throughout sub-Saharan Africa.
Geographically vary determinants of High-Risk Fertility Behavior among Reproductive age women in Ethiopia. Geographically Weighted Regression Analysis
Authors: Tadesse Zemenu Tessema , Azanaw Melkalem Mamuye , Asmare Yeaynmarnesh , Gelaye Kassahun Alemu
Published: January 2020

Background Maternal and child mortality is the main public health problem worldwide and it is the major health concern in developing countries such as Africa and Asia. Fertility behavior of women characterized in relation to maternal age, birth spacing, and order which has an impact on the health of women and children. The aim of this study was to assess the geographically vary Risk factors of High-Risk Fertility Behavior(HRFB) among reproductive-age women in Ethiopia. Methods A total of 11,022 reproductive-age women were included in this study. The data was cleaned and weighted by STATA 14.1 software. Bernoulli based spatial scan statistics were used to identify the presence of purely spatial clusters HRFB using Kulldorff’s SaTScan version 9.6 software. ArcGIS 10.7 was used to visualize spatial distribution for HRFB. Geographical weighted regression analysis was employed by Multiscale Geographical weighted regression version 2.0 software. A P-value of less than 0.05 was used to declare statistically significant predictors locally. Results Overall, 76% with 95% confidence interval of 75.60 to 77.20 of reproductive age women were faced with High-Risk Fertility problems in Ethiopia. High-Risk Fertility Behavior was highly clustered at the Somali, and Afar regions of Ethiopia. SaTScan identified 385 primary spatial clusters (RR= 1.13, P < 0.001) located at Somali, Afar, and some parts of Oromia Regional State of Ethiopia. Women live in primary clusters were 13% more likely venerable HRFB than outside the cluster. In geographically weighted regression not contraceptive use, and home delivery were statistically significant spatially vary risk factors affecting HRFB. Conclusion In Ethiopia, HRFB had to vary geographically across regions. Statistically, a significant-high hot spot of HRFB was identified at Somali and Afar. This study showed that predictor variables for HRFB were varied spatially in Ethiopia. Not use a contraceptive, and home delivery were statistically significant predictors locally in different regions of Ethiopia. Therefore, policymakers and health planners should design an effective intervention program at Somali, and Afar to reduce HRFB and Special attention needs about health education on the advantage of contraceptive utilization and health facility delivery to reduce HRFB.
The interrupted effect of autophagic flux and lysosomal function induced by graphene oxide in p62-dependent apoptosis of F98 cells
Authors: Zhang Chao , Feng Xiaoli , He Longwen , Zhang Yaqing , Shao Longquan
Published: January 2020

Background Graphene oxide (GO) nanoparticles (NPs) have been widely applied in various fields, especially in biomedical applications. Extensive studies have suggested that GO can pass through the blood-brain barrier (BBB) and induce abnormal autophagy and cytotoxicity in the central nervous system (CNS). However, the effect and specific mechanism of GO on astrocytes, the most abundant cells in the brain still has not been extensively investigated. Results In this study, we systematically explored the toxicity and mechanism of GO exposure in the rat astroglioma-derived F98 cell line using molecular biological techniques (immunofluorescence staining, flow cytometry and Western blot) at the subcellular level and the signaling pathway level. Cells exposed to GO exhibited decreased cell viability and increased lactate dehydrogenase (LDH) release in a concentration- and time-dependent manner. GO-induced autophagy was evidenced by transmission electron microscopy (TEM) and immunofluorescence staining. Western blots showed that LC3II/I and p62 were upregulated and PI3K/Akt/mTOR was downregulated. Detection of lysosomal acidity and cathepsin B activity assay indicated the impairment of lysosomal function. Annexin V-FITC-PI detection showed the occurrence of apoptosis after GO exposure. The decrease in mitochondrial membrane potential (MMP) with an accompanying upregulation of cleaved caspase-3 and Bax/Bcl-2 further suggested that endogenous signaling pathways were involved in GO-induced apoptosis. Conclusion GO-treated cells exhibited autophagy activation by inhibition of the PI3K/Akt/mTOR signaling pathway. Simultaneously, GO can induce the dysfunction of lysosomes via alkalization and then block autophagic flux, resulting in the abnormal accumulation of autophagic substrate p62 protein. Abnormal accumulation of p62 protein can induce capase-3-mediated apoptosis. The systematic exploration of GO in F98 cells in this study provides insight for the biocompatible application of graphene-family NPs in the CNS.
Mortality at the Pediatric Emergency Unit of the Mohammed VI Teaching Hospital of Marrakech
Authors: bourrous mounir , Lahmini Widad
Published: January 2020

Background : Pediatric mortality is still one of the developement indicators of a country. In our country the published data concerning the causes and the factors related to pediatric mortality especially in the pediatric emergency wards is very rare. This study aimed to determine the global rate of the pediatric mortality in the pediatric emergency departement (PED), to study its epidemiology and to identify its most frequent causes. Methods : It is a retrospective and descriptive study, over five years (1st january 2012 and 31st december 2016) including all children aged from 0 to 15 years old who died at the PED in the Mohamed VI Hospital in Marrakech. Results : During the period of the study a total of 172.691 patients were admitted, among which 628 died in the PED (global pediatric mortality rate : 3,63%). The masculine gender was predominant with a gender ratio of 1.59. Two-thirds of the patients died in the first 24 hours. The median of time from admission to death was around 12 hours. Majority of the deceased children (75%) were from a low socioeconomic status. The most frequent cause of admissions was respiratory distress (47%) followed by neurological disorders (11%). Neonatal mortality was predominant with (75,1%) followed by postnatal mortality (11,6%). No autopsy was performed during the study period. Conclusion : Our data once again underline the crucial importance of prevention. This requires correct follow-up of the pregnancies, an adequate assistance of births, and perfecting healthcare provision to newborns in order to attain proper assistance.
Comparing local ancestry inference models in populations of two- and three-way admixture
Authors: Schubert Ryan , Andaleon Angela , Wheeler Heather E.
Published: January 2020

Background: Local ancestry estimation infers the regional ancestral origin of chromosomal segments in admixed populations using reference populations and a variety of statistical models. Integrating local ancestry into complex trait genetics has the potential to increase detection of genetic associations and improve genetic prediction models in understudied admixed populations, including African Americans and Hispanics. Five methods for local ancestry estimation are LAMP-LD (2012), RFMix (2013), ELAI (2014), Loter (2018), and MOSAIC (2019), but direct comparisons of accuracy, runtime, and memory usage of all these software tools have not previously been reported across common patterns of human admixture. Results: We found that in cases of two-way admixture, RFMix and ELAI had the highest median accuracy depending on population structure, while in cases of three-way admixture, we found RFMix, MOSAIC, and LAMP-LD had the highest median accuracy. Additionally, we estimate the O(n) of both memory and runtime for each software and find that for both time and memory most software expand linearly with respect to sample size. The only exception is RFMix, which expands quadratically with respect to runtime and linearly with respect to memory. Conclusions: Effective local ancestry estimation tools are necessary to combat population disparities in human genetics studies. RFMix performs the best across methods, however, depending on application, other methods perform similarly well with the benefit of shorter runtimes. Scripts used to format data, run software, and estimate accuracy can be found at https://github.com/WheelerLab/LAI_benchmarking .
Evaluation of organic fractions of municipal solid waste as renewable feedstock for succinic acid production
Authors: Stylianou Eleni , Pateraki Chrysanthi , Ladakis Dimitrios , Fernández María Cruz , Latorre-Sánchez Marcos , Coll Caterina , Koutinas Apostolis
Published: January 2020

Background: Despite its high market potential, bio-based succinic acid production experienced recently a declining trend because the initial investments did not meet the expectations for rapid market growth. Thus, reducing the succinic acid production cost is imperative to ensure industrial implementation. Results: Succinic acid production has been evaluated using hydrolysates from the organic fraction of municipal solid waste (OFMSW) collected from MSW treatment plants. A tailor-made enzymatic cocktail was used for OFMSW hydrolysate production containing up to 107.3 g/L carbon sources and up to 638.7 mg/L free amino nitrogen. The bacterial strains Actinobacillus succinogenes and Basfia succiniciproducens were evaluated for succinic acid production with the latter strain being less efficient due to high lactic acid production. Batch A. succinogenes cultures supplemented with 5 g/L yeast extract and 5 g/L MgCO3 reached 29.4 g/L succinic acid with productivity of 0.89 g/L/h and yield of 0.56 g/g. Continuous cultures at dilution rate of 0.06 h-1 reached 21.2 g/L succinic acid with yield of 0.47 g/g and productivity of 1.27 g/L/h. Downstream separation and purification of succinic acid was achieved by centrifugation, treatment with activated carbon, acidification with cation exchange resins, evaporation and drying, reaching more than 99% purity. Preliminary techno-economic evaluation has been employed to evaluate the profitability potential of bio-based succinic acid production.Conclusions: The use of OFMSW hydrolysate in continuous cultures could reduce succinic acid production cost to 2.07 $/kg at annual production capacity of 40,000 t and OFMSW hydrolysate production cost of 25 $/kg sugars.
A novel ultrasound controlled paclitaxel releasing balloon catheter versus plain balloon catheter in the treatment of small coronary vessel stenosis: study protocol of a randomized controlled clinical trial (Vasoguard I Trial)
Authors: Pan Yueyi , Zhang Feng , Wang Jingpu , Yang Ji'e , Shen Li , Qian Juying , Zhang Haijun , Ge Junbo
Published: January 2020

Background The optimal intervention strategy remains controversial in small vessel disease which is a very common kind of coronary artery lesions. For now, balloon-only percutaneous coronary intervention is the major percutaneous revascularization method in these patients, but the restenosis rate is still at a high level. Drug coated balloon is designed to deliver paclitaxel to target vessel to inhibit the proliferation of vascular endothelial cells, it aims at restraining the stenosis process after intervention so as to reduce the rate of restenosis. Ultrasound controlled paclitaxel releasing balloon catheter (Vasoguard TM ) is a newly designed drug coated balloon, expected to promote the drug release process via external ultrasound intervention so as to improve drug bioavailability. The current trial was designed to assess the efficacy and safety of Vasoguard in the treatment of small vessel coronary disease.Methods A prospective, multicenter, randomized, controlled clinical trial has been designed to compare the safety and efficacy of Vasoguard with plain balloon angioplasty in the treatment of small vessel coronary disease. 230 patients will be included in this trial, the primary endpoint is late lumen loss of target lesion at 9 months post operation measured by quantitative coronary angiography. Secondary endpoints include angiographic findings such as device success rate, operation success rate, in-segment restenosis, clinical outcomes such as target lesion revascularization, target vessel revascularization, device oriented composite endpoint and thrombotic events.Discussion This trial will evaluate the efficacy and safety of Vasoguard in the treatment of small vessel coronary disease by comparing to plain balloon angioplasty. It will clarify the practicability of the newly designed balloon and may lend more credence to the role of drug coated balloon in the treatment of small vessel disease.
Protocol for a cluster randomised trial in Madhya Pradesh, India: Community health promotion and medical provision and impact on neonates (CHAMPION2); and support to rural India’s public education system and impact on numeracy and literacy scores (STRIPES2)
Authors: Agarwal Arjun , Banerji Rukmini , Boone Peter , Elbourne Diana , Fazzio Ila , Frost Chris , Gopal Madan , Karnati Sridevi , Nair Rakhi , Reddy Harshavardhan , Reddy Padmanabh , Sharma Dropti , Shekhawat Sajjan Singh , Shivalli Siddharudha
Published: January 2020

Background Rural areas of India exhibit high neonatal mortality, and low literacy and numeracy. We assess the effect of a complex package of health interventions on neonatal survival, and the effect of out-of-school-hours teaching on children’s literacy and numeracy, in rural Madhya Pradesh.Methods/Design This is a cluster-randomised controlled trial with villages (clusters) receiving either a health (CHAMPION2) or education (STRIPES2) intervention. Building on the design of the earlier CHAMPION/STRIPES trial villages receiving the health intervention are controls for the education intervention, and vice versa.Clusters 196 villages in Satna district, Madhya Pradesh, India: each at least five kilometres from a Community Health Centre, a population below 2,500, and at least 15 children eligible for the education intervention. Participants CHAMPION2 - resident married women under 50 without a family planning operation, provided they are enumerated pre-randomisation, or marry a man enumerated pre-randomisation. STRIPES2 - resident children born 16June 2010-15June 2013, not in school before the 2018-2019 school year and intending to enrol in first grade in 2018-2019 or 2019-2020.
Mechanisms of change in brief treatments for borderline personality disorder: a randomized controlled trial
Authors: Kramer Ueli , Grandjean Loris , Beuchat Hélène , Kolly Stéphane , Conus Philippe , de Roten Yves , Draganski Bogdan , Despland Jean-Nicolas
Published: January 2020

Background Borderline Personality Disorder (BPD) is one of the most frequent, most debilitating and lethal mental conditions and is associated with a serious burden of disease. Treatment for patients with BPD involves structured psychotherapy, and may involve brief psychiatric treatment as first-line intervention. No controlled study has assessed the effectiveness of such brief intervention. Whereas most psychotherapy studies with patients with BPD focus on the effectiveness of the intervention, we still lack an understanding of how and why these effects are produced from a patient process perspective. It is therefore of utmost importance to study the treatment-underlying mechanisms of change . The present study plans to apply novel measurement methods for assessing change in two central psychobiological processes in BPD: emotion and socio-cognitive processing. The study uses theory-driven and ecologically valid experimental tasks which take as anchor the patient’s individual experience, by integrating methodology from psychotherapy process and neurofunctional imagery research. Methods and study design The present two-arm randomized controlled study aims at testing the effects (i.e., symptom reduction) and the underlying mechanisms of change associated with a brief psychiatric treatment (10 sessions over 4 months), compared with treatment as usual. Participants ( N = 80 patients with BPD) undergo assessments at four points (intake, 2 months, discharge, and 12 month follow-up). In addition to symptom measures, individuals undergo a two-step assessment for the potential mechanisms of change (i.e., emotion and socio-cognitive processing): a) behavioural and b) (for a sub-sample) neurofunctional. We hypothesize that change in the mechanisms explains the treatment effects. Discussion The present study uses an easy-to-implement treatment of BPD, as well as a sophisticated assessment procedure to demonstrate the critical role of psychobiological change in emotion and socio-cognitive processing in brief treatments. It will help increase the effectiveness of brief treatment for BPD and help diminish the societal burden of disease related with BPD, in these early stages of treatment. Trial registration : Clinical Trials NCT0317818 (date of registration of Abstract October 24 th , 2018). Protocol version number 2 from February 9 th , 2018.
Determinants of High Fertility Rate among Married Women in Ethiopia
Authors: Muche Setegn Muche , Gebremichael Shewayiref Geremew
Published: January 2020

Background: Fertility is one the major components of changing the population size and structure over time. Hence, this study aims to identify the socioeconomic and demographic factors associated with the high fertility rate among married women in Ethiopia Method: Ethiopian demography and health survey of 2016 data were accessed and used for the analysis. A total of 9602 married women were included in the study. Poisson regression models were employed by considering the number of children ever born (count) as a response variable. Results: A total of 9602 married women were included and 907 (9.4%) of the mothers have not born a child in their life time and only 307 (3.2%) of them have born more than 9 children. Rich women (IRR =0.794; 95%CI: 0.685, 0.920, secondary and above education of women (IRR =0.602; 95%CI: 0.570, 0.635), secondary and above education level of husbands’ (IRR =0.917; 95%CI: 0.880, 0.955) and late marriage (IRR =0.853; 95%CI: 0.832, 0.873) were found significantly associated with low level of fertility rate. Small family size (IRR =2.23.; 95%CI: 2.168, 2.294) and being child death experience (IRR =1.636; 95%CI: 1.601, 1.672) were also showed statistically significant association with high level of fertility rate. Conclusion: The government should focus on providing better access to education, increasing the coverage of family planning service and improving sources of income. Furthermore, the society should be made aware on consequences of high fertility on the child and maternal health, household economy, human capital investment and environmental degradation.
Cardiovascular risk screening of patients with serious mental illness or using antipsychotics in family practice.
Authors: Jakobs Kirsti Marieke , Posthuma Anne , de Grauw Wim JC , Schalk Bianca WM , Akkermans Reinier P , Lucassen Peter , Schermer Tjard , Assendelft Willem JJ , Biermans Marion JC
Published: January 2020

Background Patients with a serious mental illness (SMI) and those using antipsychotics (AP) have an elevated risk for cardiovascular disease (CVD). In the Netherlands, the mental healthcare for these patients is increasingly provided by family practitioners (FPs), following a shift from secondary to primary care. It is therefore essential to better understand the characteristics of this patient group and the (somatic) care provided by their FPs. The aim of this study was to examine the rate of cardiovascular risk (CVR) screening in patients with SMI or those using APs in family practice. Methods We performed a retrospective cohort study of 151,238 patients registered with 24 family practices in the Netherlands. From electronic medical records, we extracted data concerning diagnoses, the measurement of CVR factors, medication, and the frequency of visits over a two-year year period. The primary outcome was the proportion of patients who were screened for CVR factors. We compared three groups: patients with SMI or using AP without diabetes or CVD (SMI/AP only), patients with SMI or using AP and diabetes mellitus (SMI/AP+DM), and patients with SMI or using AP and a history of CVD (SMI/AP+CVD). We explored the factors associated with adequate screening using a multilevel logistic regression. Results We identified 1705 patients with SMI or using AP, 834 of whom had a SMI diagnosis and 1150 of whom used AP. CVR was adequately screened in 8.5% of the SMI/AP-only group (117 of 1383 patients). Screening was much more commonly performed in the SMI/AP+DM (n=206, 68.4% adequate) and SMI/AP+CVD (n=116, 26.7% adequate) groups. (ORs for moderate and adequate screening 21.8 (95%CI, 15.4-30.8) and 4.3 (95%CI, 2.8-6.6) respectively). A high frequency of FP visits, age, the use of AP, and a diagnosis of chronic obstructive pulmonary disease were associated with a higher screening rate. In addition, we examined the differences between patients with SMI and patients using AP in the absence of a SMI. ConclusionsCVR screening in patients with SMI or using AP is often inadequate or lacking in Dutch family practices. Acceptable screening rates were found only among SMI/AP patients with diabetes mellitus as a comorbidity.
The Risk of Rheumatoid Arthritis among Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Authors: Chen Yi , Chen Lang , Xing Changsheng , Deng Guangtong , Zeng Furong , Xie Tingting , Gu Lei , Yang Hui Xiang
Published: January 2020

Background: Studies have suggested that patients with inflammatory bowel disease (IBD) have an increased risk of rheumatoid arthritis (RA). However, the available data on this association are inconsistent. This meta-analysis aimed to determine the association between IBD and the risk of RA. Methods: Observational studies investigating the RA risk among patients with IBD (Crohn disease (CD) and/or ulcerative colitis (UC)) were searched in PubMed, Embase, and Web of Science from the date of inception to December 2019. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. Relative risks (RRs) and corresponding 95% confidential intervals (CIs) were pooled with a random-effects model. Heterogeneity was evaluated using I2 statistics while publication bias was determined using Begg’s and Egger’s tests. Subgroup and sensitivity analyses were performed. Results: A total of three cohort studies, three cross-sectional studies, and two case-control study were included in the meta-analyses. Compared to the non-IBD control or general population, there was a significantly higher risk of RA among patients with IBD (RR=2.59; 95% CI: 1.93–3.48). Moreover, both CD (RR=3.14; 95% CI: 2.46–4.01) and UC (RR=2.29; 95% CI: 1.76–2.97) were associated with a significantly increased risk of RA. However, heterogeneity was substantial across studies and the subgroup analyses failed to identify the potential source of heterogeneity. Conclusions: Patients with IBD have a greater risk of developing RA. Rheumatologists should be consulted when patients with IBD present with undifferentiated joint complaints. However, more prospective cohort studies are needed to validate these results.
POSTMODERNISM VS POST-POSTMODERNISM: PHILOSOPHICAL DISTINCTIONS (ON THE MATERIAL OF THE CONTEMPORARY BRITISH NOVEL)
Authors: Drozdovskyi D.I.
Published: January 2020

In the paper, I spotlight the question about the determining the post-postmodern component in the novels that represent the contemporary literary process of the UK. The methodological conflicts that appear during the study of the contemporary literary process in the aspect of the attempts of literary scholars to extrapolate the key phenomena of postmodernism to the literature that has replaced this cultural and historical period is emphasized. It is determined that at the present stage of the functioning of literature it is expedient to outline first of all the changes concerning philosophical parameters of the novel; characteristics of post-postmodernism should be found not in the poetics but in the worldview of the protagonists by analyzing the motive and thematic units represented in the novels after 2000. The stylistic specificity of the post-postmodern novel determined by the intention of the characters to reach the level of comprehension of reality from rational positions, which makes possible the search for truth in the transcendental meanings, is emphasized. The emphasis relates to the semantic paradigm of the British post- postmodern novel. The strategies of positivistic thinking in the contemporary British novels, whose characters reveal a scientific approach to the perception of reality, their body, identity, thinking, etc., are determined. The principles of constructing a post-postmodern narrative are formed by spotlighting factual material (diary, encyclopedic records, notes, memoirs, etc.) oriented to intensify the search for characters in the plane of meaning and not only for the purpose of the postmodern game. The discussion with I. Kropyvko about the inappropriateness of considering the contemporary literary process in the categories of postmodernism was introduced. The newest philosophical studies («The Routledge companion to twenty-first century literary fiction», A. Pavlov’s dissertation) are outlined, in which an attempt was made to systematize different directions determining the epistemological basis of post-postmodernism. The necessity of the contemporary theory of literature to define the literary phenomena after the year 2000 in the categories of postmodernist paradigm has been explained. Keywords: post-postmodernism, postmodernism, contemporary British novel, naturalism, problem-thematic units of post-postmodernism, paradigm of meaning.