bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Mental and Physical Fatigue Risk Factors in Utility Unit of Petrochemical Company
Authors: Irwanto Bian Shabri Putri
Published: May 2020

Introduction: Work exhaustion defined as a tired feeling felt by workers with different symptoms in each individual. In this study work fatigue was divided into two types, namely physical work fatigue and mental work fatigue. This study aims to determine risk factors of physical and mental fatigue on utility unit PT. Trans Pacific Petrochemical Indotama (TPPI) which produces petroleum or gas, as well as the chemical BTX. Methods: This research was an observational study with a cross-sectional method. Based on the problem characteristic and data analysis, this study belongs to analytical research. Data were collected by interview, questionnaires, measurement, and observations. The population is 36 workers and the sample size of this study is 33 respondents from utility unit workers. The sampling technique used simple random sampling. The variables in this study were age, years of service, work duration, workload, heat stress index, responsibility, and support from company’s head. Results: Showed that factors associated with physical and mental fatigue are the age, workloads, work duration, and heat stress index. Conclusion: Physical fatigue and mental fatigue had correlation with age, workloads, work time, and heat stress index. The higher age, workload, work duration, and heat stress index, it will increasingly cause physical and mental fatigue faster and harder.Keywords: fatigue risk factors, mental fatigue work, physical fatigue work
Determinants of Elderly Behavior Follow the Posyandu in the Working Area of Kebonsari Primary Healthcare Surabaya
Authors: Ariani Made
Published: May 2020

Background: Indonesia is ranked 4th in the World with the largest population in 2017 of 261,890,882 million. According to the 2017 Central Bureau of Statistics, the elderly population is 23.4 million (8.97%) of the Indonesian population. The habit of the elderly attending the Integrated Health Center (Posyandu) can have a good impact on the health of the elderly in the future. Objective: The aims of this study was to analyze the factors associated with the participation of the elderly following the Posyandu. Method: This study used Cross Sectional design with a sample of 210 respondents aged 45-59 years; 60-74 years; 75-84 years; and >84 years old. The technique used in sampling is simple random sampling with its independent variables namely intention, social support, information access, personal autonomy, and action situations in the elderly. The dependent variable is the activity of the elderly following the Posyandu. The data collection technique used primary data and secondary data. Data were analyzed by the chi square test through the SPSS application to see factors related to the activity of the elderly following the Posyandu. Result: From the results of the analysis, all independent variables showed a relationship between the independent variables on the activity of the elderly in attending the Elderly Posyandu (P<a (a = 0.05)). The P value for each variable, namely the intention P value= 0.015 (RP 3.619: 95% CI 1.599-8.188); social support P value =0.008 (RP 2.374: 95% CI 1.285-4.385); access to information P value= 0.007 (RP 2,714: 95%CI 1.356-5.429); personal autonomy P value= 0.012 (RP 2.876: 95% CI 1.316-6.289); and the action situation P value= 0.0001 (RP 5.575: 95% CI 2.913-10672). Elderly people with supportive action situations tend to actively participate in Posyandu 5 times greater than the elderly with non-supportive action situations. Conclusion: there is a significant relationship between intention, social support, information access, personal autonomy, and the situation of the elderly's actions towards the active participation of the elderly in the Posyandu.
Levels of transparency and county service delivery in Kenya
Authors: Kiambati Kellen k
Published: May 2020

In order to push development to the grassroots and ensure citizens contribute meaningfully to development, many African countries have adopted the devolved governance system.  However, it has been observed that the devolution of political powers has not translated equally to envisioned overall development. In Kenya County governments have achieved various milestones towards development demonstrated through the infrastructure, social amenities, and standards of living. However, corruption has been increasing mainly due to a lack of transparency. This paper sought to examine the contribution of transparency levels in County government service delivery.  The study adopted mixed method approach using survey and in-depth interviews concurrently.  Stratified multi stage cluster sampling was deployed. Quantitative data was collected using questionnaires and qualitative data using interview schedules. Data was analyzed using descriptive and inferential statistics and a typological theory developed to explain the study results. The study findings showed that the level of transparency in the counties was low which affected service delivery.  The study concluded that county governments should ensure that public participation and sharing of information is bidirectional to involve both users and management so as to improve service delivery.
The role of relationship marketing to building loyalty on bank customers
Authors: Zaid Sudirman
Published: May 2020

This study aims to test the role of relationship marketing on customer loyalty. The research used a quantitative approach with the survey method. The population of the research is all customers of BRI Bank in Kendari City Indonesia, where the respondent in this research is 77 customer. The cross-sectional data were collected to measure each variable research. Analysis research used Partial Least Squared (PLS) to test the role of each relationship marketing variable in building customer loyalty. The results explained that;(a) communication has a significant role on trust; (b) handling problem has a non-significant role on trust; (c) communication has a significant role on commitment; (d) handling problem has a non-significant role to commitment; (e)trust has a significant role on commitment; (f) communication has a non-significant role on loyalty; (g) handling problem has a non-significant role on loyalty; (h)trust has a significant role to customer loyalty; and (i) commitment has a significant role on loyalty. This study also found that the problem handling variable has no role in building customer loyalty. This study concludes that the BRI Bank is still not good at handling problems with its customers and the variables of trust and commitment play a significant role in mediating the role of communication in building customer loyalty.
Sensitivity and Performances Analysis of a Dynamic Pressure Narrow-Band Electrodynamic Micro-Sensor
Authors: Said Mohamed Hadj , Tounsi Fares , Rufer Libor , Mezghani Brahim , Francis Laurent A.
Published: May 2020

This paper presents analytic and numerical modelling of a MEMS electrodynamic micro-sensor of dynamic pressure. Two coaxial planar inductors of different diameters are used in the proposed micro-sensor design. Using finite element analysis, the diaphragm resonant frequency and dynamic displacements are evaluated for different diaphragm thicknesses. Then, the total sensitivity is deduced by coupling different physical domains which contribute in the micro-sensor operation. A lumped element model is built in order to study the micro-sensor sensitivity and define the dynamic performance for different resonant frequencies. This model shows that the best sensitivity, within the mV/Pa range, is obtained around the resonant frequency when operation in the audible frequency range, and decreases to the uV/Pa range for ultrasonic frequencies. The obtained sensitivity curves prove that the undamped inductive micro-sensor can offer high pressure sensitivity within a narrow frequency bandwidth.
Gestion optimisée de la parenté et de la consanguinité dans les programmes de sélection des bovins laitiers
Authors: COLLEAU J.J. , MOUREAUX S.
Published: May 2020

On décrit l’approche adoptée pour gérer la variabilité génétique au moment de la procréation des jeunes taureaux, (phase amont), la mise en testage, de l’utilisation des taureaux de service (phase aval) et du choix des taureaux à l’issue du testage (phase agrément). L’objectif est de minimiser la parenté moyenne deux à deux dans la population existante augmentée des produits à naître des accouplements programmés, tout en fixant le niveau génétique moyen de ceux-ci à une valeur souhaitée. Des tests a posteriori en vraie grandeur sont effectués sur les races Holstein, Montbéliarde, Normande. Par rapport aux accouplements effectivement réalisés, l’optimisation permet de réduire les parentés moyennes de l’ordre de 20 à 30 % (phases amont et aval), en gardant le niveau génétique moyen observé. L’agrément optimisé rejette une fraction importante des taureaux déjà agréés et par contre admet des taureaux qui n’ont pas reçu l’agrément. On analyse également les possibilités offertes par l’utilisation d’un index de synthèse pénalisé pour la parenté.
Physiologie de la production de colostrum chez la truie
Authors: DEVILLERS N. , LE DIVIDICH J. , PRUNIER A.
Published: May 2020

Le colostrum joue un rôle indispensable dans la survie du porcelet nouveau-né en lui apportant de l’énergie et une protection immunitaire. La production de colostrum par la truie est très variable et les facteurs l’influençant n’ont pas encore été clairement identifiés. La sécrétion du colostrum intervient autour de la parturition et est susceptible d’être contrôlée par les différentes hormones régulant la gestation, la parturition et l’initiation de la lactation. Chez d’autres espèces, l’influence prépondérante de la prolactine, de la progestérone et du cortisol dans l’initiation de la lactation a déjà été démontrée. L’avancement des connaissances sur la régulation hormonale de la colostrogenèse est une voie prometteuse pour trouver des solutions concrètes en terme de conduite d’élevage qui permettront d’augmenter la production de colostrum de la truie et de réduire la mortalité précoce du porcelet.
Les activités biologiques de l’œuf
Authors: REHAULT S. , ANTON M. , NAU F. , GAUTRON J. , NYS Y.
Published: May 2020

L’œuf se compose d’une grande diversité de nutriments et de molécules actives «programmés» pour permettre le développement autonome d’un embryon dans un milieu confiné. Ces molécules d’intérêt sont réparties de manière équilibrée entre les différents compartiments de l’œuf (coquille, blanc, jaune, membranes) qui assurent chacun une fonction bien déterminée. Outre les éléments nutritifs essentiels à l’embryogenèse, on y trouve de multiples molécules participant au développement et à la protection de l’embryon qu’elle soit physique (coquille, membranes) ou chimique (molécules antibactériennes, antivirales, antioxydantes). Pour l’homme, l’œuf constitue un aliment de haute valeur nutritionnelle mais de plus en plus, il apparaît comme riche de nombreuses molécules actives d’intérêt majeur pour différents secteurs industriels tels que l’agroalimentaire, les biotechnologies, la cosmétique ou la santé humaine et animale. Les propriétés antibactériennes des protéines du blanc d’œuf sont connues depuis longtemps, mais il émerge depuis plusieurs années des activités particulièrement prometteuses en médecine humaine telles que des propriétés anti-adhésives, immuno-modulatrices, anti-hypertensives, anti-cancéreuses, anti-inflammatoires ou cryoprotectrices. Certaines de ces activités ne sont pas portées par les protéines natives mais par des peptides dérivés, générés in vitro par protéolyse ménagée des protéines de l’œuf. Ces peptides et protéines bioactifs présentent un intérêt grandissant depuis quelques années et de nombreux efforts sont actuellement menés pour tenter de mieux caractériser leurs applications potentielles.
Расчет эволюции турбулентных следов под воздействием неблагоприятного градиента давления с помощью метода моделирования крупных вихрей
Authors: Гусева Екатерина Константиновна , Guseva Ekaterina Konstantinovna , Стрелец Михаил Хаимович , Strelets Mikhail Khaimovich , Травин Андрей Константинович , Travin Andrei Konstantinivich , Шур Михаил Львович , Shur Mikhail L'vovich
Published: May 2020

Представлены результаты вихреразрешающих расчетов осредненных и пульсационных (включая скорость диссипации кинетической энергии турбулентности) характеристик турбулентного следа за плоской пластиной при наличии Неблагоприятного Градиента Давления (НГД). Расчеты выполнены в рамках зонной RANSLES модели для двух конфигураций, в первой из которых НГД создается симметричным плоским диффузором, а во второй - специально сконструированной для этой цели системой, состоящей из двух пар тонких аэродинамических профилей. В обоих случаях для создания турбулентного контента в LES подобласти используется объемный источник синтетической турбулентности. Высокая точность результатов расчетов подтверждается их слабой чувствительностью к измельчению сетки. Полученные детальные данные по характеристикам следов могут использоваться для усовершенствования и тестирования RANS моделей турбулентности применительно к рассматриваемому классу течений.
Pengaruh Kecepatan, Kelincahan, Dan Motivasi Terhadap Kemampuan Menggiring Bola Pada Permainan Sepakbola Murid SD Inpres Bontomanai Makassar
Authors: Nurwirhanuddin  , Suprianto
Published: May 2020

The study aims at examining the speed, agility, and motivation on ball dribbling abilities in football game of students at SD Inpres Bontomanai Makassar. The populations of the study were all students class 4, 5 and 6 at SD Inpres Bontomanai. The samples were taken by purposive sampling technique. The study is descriptive research with path analysis research. Data were analyzed by employing statistics descriptive analysis and inferential analysis with SPSS 22 program. The results of the study are: (1) there is direct influence significantly of speed on motivation in football game of students at SD Inpres Bontomanai Makassar by 34%, (2) there is direct influence significantly of agility on motivation in football game of students at SD Inpres Bontomanai Makassar by 61%, (3) there is direct influence significantly of speed on ball dribbling abilities in football game of students at SD Inpres Bontomanai Makassar by 33%, (4) there is direct influence significantly of agility on ball dribbling abilities in football game of students at SD Inpres Bontomanai Makassar by 37%, (5) there is direct influence significantly of motivation on ball dribbling abilities in football game of students at SD Inpres Bontoimanai Makassar by 33%, (6) there is direct influence significantly of speed on motivation in football game of students at SD Inpres Bontomanai Makassar by 11%, and (7) there is direct influence significantly of agility on motivation in football game of students at SD Inpres Bontomanai Makassar by 20%.
Sumbangan Kecepatan dan Daya Ledak Otot Tungkai Terhadap Keterampilan Lompat Jauh Gaya Menggantung
Authors: Setiawan Hepi , Hutomo Pramudito
Published: May 2020

Penelitian ini bertujuan untuk menguji tingkat hubungan kepercayaan diri dengan prestasi belajar pendidikan jasmani di Sekolah Dasar se Kecamatan Tawang, Kota Tasikmalaya. Metode penelitian menggunakan deskriptif-korelasional. Sampel dalam penelitian ini adalah siswa kelas VI yang dipilih mewakili beberapa sekolah yang ada di Kecamatan Tawang sebanyak 60 orang siswa dengan cara teknik purposive sampling. Instrument yang digunakan adalah berupa angket kepercayaan diri. Prosedur pengolahan data untuk memperoleh jawaban mengenai diterima tidaknya hipotesis sesuai dengan signifikansi yang diajukan adalah: (1) mencari rata-rata, (2) mencari simpangan baku, (3) menguji normalitas melalui uji Lillefors (4) menguji korelasi dua variabel. Berdasakan hasil penelitian dan perhitungan statistik terhadap uji hipotesis hubungan tingkat kepercayaan diri dengan prestasi belajar pendidikan jasmani, maka penulis dapat menyimpulkan sebagai berikut; terdapat hubungan yang signifikan antara kepercayaan diri dengan prestasi belajar siswa kelas VI di Kecamatan Tawang, Kota Tasikmalaya. Karena nilai signifikansi yang diperoleh lebih besar dari 0,05, dan nilai Yxy (0,90) > (0,250) rtabel (0,05)(60) maka H0 ditolak dan Ha diterima, sehingga terdapat hubungan yang signifikan antara kepercayaan diri dengan prestasi belajar (signifikan).
Treatment of Locked Pubic Symphysis by Distraction Osteotomy of the Superior Pubic Ramus
Authors: Pushpasekaran Narendran , Thampy Sujith , Khaleel Veliyaveettil Muhamed , Joseph Sachin
Published: May 2020

Case:

An 18-year-old adolescent sustained a lateral compression injury to the pelvis that featured a locked pubic symphysis with plastic deformation of the sacrum. The pubic bone was entrapped in the opposite obturator foramen and required a novel distraction osteotomy of the superior ramus to restore the symphysis. The patient developed a urethral stricture 3 months after injury that required urethroplasty. The symphysis remained in alignment without any morbidity at the osteotomy site over 13 months of follow-up.

Conclusion:

Locked pubic symphysis is frequently associated with urethral injuries. The distraction osteotomy of the superior pubic ramus described is a viable reduction maneuver that neutralizes the plastic deformation forces.
Preoperative Angiography Can Guide Treatment of Post–Femoral Neck Fracture Capital Femoral Physeal Separation and Displacement
Authors: McGraw Jessica , Beaver Cody , Douthit Christian , Diab Michel
Published: May 2020

Case:

A 13-year, 6-month-old boy sustained a Delbet type III femoral neck fracture with postoperative femoral head avascular necrosis (AVN) and subsequent capital femoral physeal separation (CFPS). Preoperative angiography revealed a patent artery of the ligamentum teres to the femoral head epiphysis, allowing our patient to undergo a modified Dunn procedure to maintain this artery and preserve his native hip.

Conclusion:

Preoperative angiography allows for real-time identification of femoral head epiphyseal blood supply in patients with femoral head AVN complicated by CFPS and guides surgical treatment for hip preservation.
Lack of synsedimentary chemical alteration in polar carbonates (Ross Sea, Antarctica): Resolution of a conundrum
Authors: Frank Tracy D. , James Noel P. , Shultis Aaron I.
Published: May 2020

Although rare in space and time, skeletal carbonates deposited on polar shelves hold great potential for improving understanding of the oceanography of the high latitudes. Low temperatures, low carbonate saturation states, and strong seasonality govern not only the nature of carbonate communities, but also how their deposits translate into the rock record. To understand the effects of early seafloor processes on preservation, we investigated late Quaternary carbonates recovered in piston cores from the Ross Sea, Antarctica. Sediments are unconsolidated skeletal gravels and sands that mantle areas of the outer shelf swept by strong bottom currents. Deposits are dominated locally by either stylasterine hydrocorals, barnacles, or bryozoans, which comprise assemblages with strong similarities to modern benthic communities. Radiocarbon ages indicate that carbonate factories were most prolific during the lead-up to the Last Glacial Maximum (Tartanian), when sediment input was minimized, and have been mostly dormant since. Results show that synsedimentary alteration is not substantially different in the temperate and polar realms with the significant exception of chemical diagenesis. As is common in temperate deposits, skeletal grains undergo disarticulation, fracturing, abrasion, and intense bioerosion. By contrast, cementation is absent and rare aragonite grains are preserved, indicating that taphonomic loss is not as prevalent as in temperate deposits. Primary skeletal microstructures and stable-isotope compositions are preserved, indicating that chemical alteration of grains is negligible. The preservation of aragonite in polar settings is herein attributed to low rates of organic-matter burial and very low temperatures, which strongly limit microbial activity. These factors allow interstitial waters to remain weakly supersaturated with respect to aragonite. Comparison with Permian analogs indicates that lithification is delayed until deposits reach burial depths at which chemical compaction proceeds. The ultimate end product is limestone with prominent compaction features and a tightly packed fabric. Calcitic skeletal material can retain primary geochemical compositions through the lithification process, although growth of burial cement in intraparticle porosity complicates selective sampling of unaltered material. In providing a cold-water end member for the spectrum of synsedimentary diagenetic processes, results highlight specific differences that should be accounted for when interpreting the deposits of polar, cold-water carbonate systems.
Tumor-associated Tissue Eosinophilia Predicts Favorable Clinical Outcome in Solid Tumors: A Meta-analysis
Authors: Hu Guoming , Wang Shimin , Zhong Kefang , Xu Feng , Huang Liming , Chen Wei , Cheng Pu
Published: May 2020

Background: Activated eosinophils have been deemed to affect carcinogenesis and tumor progression via various mechanisms in tumor microenvironment. However, the prognostic role of tumor-associated tissue eosinophilia (TATE) in human cancers remains controversial. Therefore, we performed the meta-analysis to better understand the role of TATE in prognosis prediction for cancer patients.Methods: We searched PubMed, Embase and EBSCO to identify the studies evaluating the association between TATE and overall survival (OS) and/or disease-free survival (DFS) in cancer patients, then computed extracted data into hazard ratios (HRs) for OS, DFS and clinicopathological features such as lymph node metastasis etc with STATA 12.0.Results: A total of 6384 patients from 26 published studies were incorporated into this meta-analysis. We found that the presence of TATE was significantly associated with improved OS, but not with DFS in all types of cancers. In stratified analyses based on cancer types, pooled results indicated that the infiltration of eosinophils was significantly associated with better OS in esophageal carcinoma and colorectal cancer. In addition, TATE significantly inversely correlated with lymph node metastasis, tumor stage and lymphatic invasion of cancer.Conclusion: TATE leads to a favorable clinical outcome in cancer patients, implicating that it is a valuable biomarker for prognostic prediction for human cancers and clinical application of biological response modifiers or agonists promoting TATE may be the novel therapeutic strategy for patients.
Disease-free survival as a surrogate endpoint for overall survival in adjuvant trials of pancreatic cancer: evidence from 20 randomized controlled trials
Authors: Nie Run-Cong , Zou Xue-Bin , Yuan Shu-Qiang , Chen Ying-Bo , Chen Shi , Chen Yong-Ming , Chen Guo-Ming , Chen Xiao-Jiang , Luo Tian-Qi , Li Shu-Man , Duan Jin-Ling , Wang Yun , Li Yuan-Fang
Published: May 2020

Background: We aimed to assess whether disease-free survival (DFS) could serve as a reliable surrogate endpoint for overall survival (OS) in adjuvant trials of pancreatic cancer. Methods: We systematically reviewed adjuvant randomized trials for non-metastatic pancreatic cancer after curative resection that reported a hazard ratio (HR) for DFS and OS. We assessed the correlation between treatment effect (HR) on DFS and OS, weighted by sample size or precision of hazard ratio estimate, assuming fixed and random effects, and calculated the surrogate threshold effect (STE). We also performed sensitivity analyses and a leave-one-out cross validation approach to evaluate the robustness of our findings. Results: After screening 450 relevant articles, we identified a total of 20 qualifying trails comprising 5170 patients for quantitative analysis. We noted a strong correlation between the treatment effects for DFS and OS, with coefficient of determination of 0.82 in the random effect model, 0.82 in the fixed effect model, and 0.80 in the sample size weighting; the robustness of this finding was further verified by the leave-one-out cross-validation approach. Sensitivity analyses with restriction to phase 3 trials, large trials, trials with mature follow-up periods, and trials with adjuvant therapy versus adjuvant therapy strengthened the correlation (0.75 to 0.88) between DFS and OS. The STE was 0.96 for DFS. Conclusions: Therefore, DFS could be regarded as a surrogate endpoint for OS in adjuvant trials of pancreatic cancer. In future similar adjuvant trials, a hazard ratio for DFS of 0.96 or less would predict a treatment impact on OS.
Prioritization of risk factors of gingival hyperplasia during orthodontic treatment: the role of biofilm.
Authors: VINCENT-BUGNAS Séverine , BORSA Leslie , GRUSS Apolline , LUPI Laurence
Published: May 2020

Background The mechanism of gingival growth that may occur during fixed orthodontic treatment is not yet fully understood and the amount of dental plaque is often incriminated. The objective of this study was to evaluate the prevalence of gingival growth during multi-attachment orthodontic treatment and to prioritize its associated factors. Methods: This comprehensive cross-sectional descriptive study was conducted on orthodontic patients aged 9 to 30 years, in good general health, treated by a fixed appliance. Periodontal clinical parameters such as plaque index, gingival index, probing pocket depth, periodontal phenotype and gingival enhancement index were recorded. Likewise, the brushing habits and the date of the last scaling were noted. The orthodontic parameters studied were the duration of the treatment, the type of attachment, the alloys used for the arches and the type of ligatures. Descriptive statistics were carried out, and variables presenting p value < 0.05 were included in a multivariate analysis to calculate the Odds Ratio (OR) of gingival enlargement". Results: A total of 193 patients were included (16.38 ± 4.89 years). Gingival growth occurred for 49.7% of patients included. The associated factors for this pathology during fixed orthodontic treatment were conventional metal brackets (OR = 3.5), mouth breathing (OR = 3), male gender (OR = 2.2), thick periodontal phenotype (OR = 2) and elastomeric ligations (OR = 2). After achievement of the logistic regression, the amount of plaque would not be directly related to the development of this gingival increase. Conclusions Among the associated factors that underlie gingival growth during multi-attachment therapy, the amount of plaque is not found. The qualitative assessment of the plaque and its evolution during treatment could clarify the role of the biofilm in the occurrence of gingival overgrowth.
Involvement of ABC-transporters and acyltransferase 1 in intracellular cholesterol-mediated autophagy in bovine alveolar macrophages in response to the Bacillus Calmette-Guerin (BCG) infection
Authors: Xu Jinrui , Zhou Yanbing , Yang Yi , Lv Cuiping , Liu Xiaoming , Wang Yujiong
Published: May 2020

Background: Understanding pathogenic mechanisms is imperative for developing novel treatment to the tuberculosis, an important public health burden worldwide. Recent studies demonstrated that host cholesterol levels have implications in the establishment of Mycobacterium tuberculosis ( M. tuberculosis , Mtb ) i nfection in host cells, in which the intracellular cholesterol-mediated ATP-binding cassette transporters (ABC-transporters) and cholesterol acyltransferase1 (ACAT1) exhibited abilities to regulate macrophage autophagy induced by Mycobacterium bovis Bacillus Calmette–Guérin (BCG). Methods: In the present report, the involvements of ABC-transporters and ACAT1-mediated intracellular cholesterol in autophagy of bovine alveolar macrophages induced by Mycobacterium bovis BCG were interrogated by enzymatic and biochemistry assays in vitro, including quantitative RT-PCR and immunoblotting assays. Results: The results showed that a down-regulated expression of the ABC-transporters and ACAT1 in primary bovine alveolar macrophages (AMs) and murine RAW264.7 cells in response to BCG infection. The inhibited expression of ABC-transporters and ACAT1 was associated with the reduction of intracellular free cholesterol, which in turn induced autophagy in macrophages upon to the Mycobacterial infection. These results strongly suggest an involvement of ABC-transporters and ACAT1 in intracellular cholesterol-mediated autophagy in AMs in response to BCG infection. Conclusion: This study thus provides an insight into into a mechanism by which the cholesterol metabolism regulated the autophagy in macrophages in response to mycobacterial infections .
Why women chose unassisted home birth in Malaysia: A qualitative study
Authors: Tajuddin Nur Amani @ Natasha Ahmad , Suhaimi Julia , Ramdzan Siti Nurkamilla , Malek Khasnur Abd , Ismail Ilham Ameera , Shamsuddin Nurainul Hana , Bakar Ahmad Ihsan Abu , Othman Sajaratulnisah
Published: May 2020

Background: Incidences of unassisted home birthing practices have been increasing in Malaysia despite the accessibility to safe and affordable child birthing facilities. We aimed to explore the reasons for women to make such decisions. Methods: Twelve women participated in in-depth interviews. They were recruited using a snowballing approach. The interviews were supported by a topic guide which was developed based on the Theory of Planned Behaviour and previous literature. The interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.Results: Women in this study described a range of birthing experiences and personal beliefs as to why they chose unassisted home birth. Four themes emerged from the interviews; i) preferred birthing experience, ii) birth is a natural process, iii) expressing autonomy and iv) faith. Such decision to birth at home unassisted was firm and steadfast despite the possible risks and complications that can occur. Giving birth is perceived to occur naturally regardless of assistance, and unassisted home birth provides the preferred environment which health facilities in Malaysia may lack. They believed that they were in control of the birth processes apart from fulfilling the spiritual beliefs.Conclusions: Women may choose unassisted home birth to express their personal views and values, at the expense of the health risks. Apart from increasing mothers' awareness of the possible complications arising from unassisted home births, urgent efforts are needed to provide better birth experiences in healthcare facilities that resonate with the mothers’ beliefs and values.
Baseline Low ALT Activity, a Marker of Sarcopenia and Frailty, is Associated with Increased Long-Term Mortality after COPD Exacerbations. Historic Prospective Cohort Study.
Authors: Lasman Nir , Shalom Matan , Turpashvili Natia , Goldhaber Gal , Lifshitz Yulia , Leibowitz Eyal , Berger Gideon , Zalzman-Shenhav Gilat , Brom Adi , Cohen Dor , Avaki Chen , Segal Gad
Published: May 2020

Background. COPD exacerbations have negative impact on patients' survival. Several risk factors for grave outcomes of such exacerbations have been descried. Muscle dysfunction and mass loss were shown to impact negatively on prognosis and survival. Low activity of the enzyme ALT (Alanine amino-transferase) in the blood is a known indicator for sarcopenia and frailty, however, no previous studies addressed the association of low ALT amongst patients hospitalized due to COPD exacerbation and long-term survival. Methods. This is a historic prospective cohort study of patients hospitalized due to acute COPD exacerbation. Results. Included were 232 consecutive COPD exacerbation patients. The median time of follow-up was 34.9 months (IQR 23.13 – 41.73 months). During this period 104 (44.8%) patients died. All patients were grouped to quartiles according to blood ALT levels (after exclusion of cases considered to have hepatic tissue damage (ALT > 40 IU)). The risk of long-term mortality increased, in a statistically significant manner, amongst patients with low ALT values: the median survival of patients with ALT < 11 IU was 18.5 months only while the median survival for the rest of the study group was not reached. For ALT < 11IU; 12-16IU; 17-20IU and >21IU the mortality rates were 69%; 40.9%; 36.3% and 25% respectively (p < 0.001 for comparison of lower quartile with upper three quartiles). The crude hazard ratio for mortality amongst patients with ALT levels lower than 11IU was 2.37 (95% CI; 1.6 – 3.5). This increased risk of mortality remained significant after adjustment for age, weight, creatinine, albumin concentration and cardiovascular diseases (HR = 1.83; 95% CI 1.08 – 3.1, p < 0.05). Conclusions. Low ALT values, a biomarker of sarcopenia and frailty, are associated with poor long-term survival amongst patients hospitalized due to COPD exacerbation.
Pertussis outbreak in Southern Ethiopia: challenges of detection, management and response
Authors: Mitiku Aychiluhim Damtew , Argaw Mesele Damte , Desta Binyam Fekadu , Tsegaye Zergu Taffesse , Atsa Afework Ayele , Tefera Bekele Belayihun , Teferi Ephreme , Rogers Deirdre , Ali Ismael , Gebeyehu Asrat , Anjulo Desta , Abate Derebe Tadesse , Sendeku Agegnehu Gebru , Mulowa Rudzani
Published: May 2020

Background: Despite the availability of effective vaccines, pertussis remains endemic with high fatality rates in low and middle-income countries (LMIC).This study aims to describe an outbreak of pertussis in a health district of Ethiopia. The study highlights the challenges faced by the health system in identifying pertussis cases and appropriately responding to the outbreak at district level. Method: a descriptive cross-sectional study was conducted using data sourced from the district Public Health Emergency and Management (PHEM) surveillance service and outbreak management field reports. Stratified attack rates and fatality rates for pertussis are described. Systemic problems leading to the outbreak are explored and narrated. A modified CDC pertussis case definition was employed with polymerase chain reaction used to confirm cases. Results: From September 2018 to January 2019, 1840 suspected, probable and confirmed pertussis cases and six deaths were identified. Pertussis cases ranged from 1 month to 51 years in age and outbreak occurred in 14 out of the 24 villages of Dara Malo district. The overall attack rate was 1708 per 100,000 population with a fatality rate of 3.3 per 1,000 pertussis cases. The highest attack rate of 12,689/100,000 was seen in infants. Only 41.1% had completed the three-dose pertussis vaccine primary schedule. Investigations suggested the existence of poor cold chain management system in the study area. Conclusion: There is an urgent need to build capacity to strengthen routine vaccination services and improving the maintenance of vaccine cold chain. Other Low-and Middle -Income Countries (LMICs), are urged to take lessons learnt from this outbreak and strengthen their own vaccination programs and capacitate health workers to manage local outbreaks.
Intracranial-to-Central Venous Pressure Gap Predicts the Responsiveness of Intracranial Pressure to PEEP in Patients with Traumatic Brain Injury: a Prospective Cohort Study
Authors: Peng Li Hong , Ning Lin Ying , Hui Cheng Zhi , Wei Qu , Liu Zhang , Yun Li Qing
Published: May 2020

Background: Mechanical ventilation (MV) with positive end-expiratory pressure (PEEP) is commonly applied in patients with severe traumatic brain injury (sTBI). However, the individual responsiveness of intracranial pressure (ICP) to PEEP varies. Thus, identifying an indicator detecting ICP responsiveness to PEEP is of great significance. As central venous pressure (CVP) could act as an intermediary to transduce pressure from PEEP to ICP, we developed a new indicator, PICGap, representing the gap between baseline ICP and baseline CVP. The aim of the current study was to explore the relationship between PICGap and ICP responsiveness to PEEP. Methods: A total of 112 patients with sTBI undergoing MV were enrolled in this prospective cohort study. ICP, CVP, cerebral perfusion pressure (CPP), static compliance of the respiratory system (Cst), and end-tidal carbon dioxide pressure (PetCO2) were recorded at the initial (3 cmH2O) and adjusted (15 cmH2O) levels of PEEP. PICGap was assessed as baseline ICP - baseline CVP (when PEEP=3 cmH2O). The patients were classified into the ICP responder and non-responder groups based on whether ICP increment with PEEP adjusted from 3 cmH2O to 15 cmH2O was greater than 20% of baseline ICP. The above parameters were compared between the two groups, and prediction of ICP responsiveness to PEEP adjustment was evaluated by receiver operating characteristic (ROC) curve analysis. Results: Compared with the non-responder group, the responder group had lower PICGap (1.63±1.33 versus 6.56±2.46 mmHg; p<0.001), lower baseline ICP, and higher baseline CVP. ROC curve analysis suggested that PICGap was a stronger predictive indicator of ICP responsiveness to PEEP (AUC=0.957, 95%CI 0.918-0.996; p<0.001) compared with baseline ICP and baseline CVP, with favorable sensitivity (95.24%, 95%CI 86.91%-98.70%) and specificity (87.6%, 95%CI 75.76%-94.27%), at a cut off value of 2.5 mmHg. Conclusion: The impact of PEEP on ICP depends on the gap between baseline ICP and baseline CVP, i.e. PICGap. In addition, PICGap is a potential predictor of ICP responsiveness to PEEP adjustment in patients with sTBI.
Adherence to ready-to-use food and acceptability of outpatient nutritional therapy in HIV-infected undernourished Senegalese adolescents: research-based recommendations for routine care.
Authors: Niasse Fatou , Varloteaux Marie , Diop Karim , Ndiaye Sidy Mokhtar , Diouf François Niokhor , Mbodj Pape Birane , Niang Babacar , Diack Aminata , Cames Cecile
Published: May 2020

Background: Ready-to-use food (RUF) is increasingly used for nutritional therapy in HIV-infected individuals. However, practical guidance advising nutrition care to HIV-infected adolescents is lacking, so that little is known about the acceptability of such therapy in this vulnerable population. This study assesses the overall acceptability and perception of a RUF-based therapy and risk factors associated with sub-optimal RUF intake in HIV-infected undernourished adolescents in Senegal.Methods: Participants 5 to 18 years of age with acute malnutrition were enrolled in 12 HIV clinics in Senegal. Participants were provided with imported RUF, according to WHO prescription weight- and age-bands (2009), until recovery or for a maximum of 9-12 months. Malnutrition and recovery were defined according to WHO growth standards. Adherence was assessed fortnightly by self-reported RUF intake over the period. Sub-optimal RUF intake was defined as when consumption of the RUF provision was < 50%. RUF therapy acceptability and perceptions were assessed using a structured questionnaire at week 2 and focus group discussions (FGDs) at the end of the study. Factors associated with sub-optimal RUF intake at week 2 were identified using a stepwise logistic regression model. Results: We enrolled 173 participants, with a median age of 12.5 years (Interquartile range: 9.5 – 14.9), of whom 61% recovered from malnutrition within the study period. Median follow-up duration was 66 days (21 – 224). RUF consumption was stable, varying between 64% and 57% of the RUF provided, throughout the follow-up. At week 2, sub-optimal RUF intake was observed in 31% of participants. Dislike of the taste of RUF (aOR=5.0, 95% CI: 2.0 – 12.3), HIV non-disclosure (5.1, 1.9 – 13.9) and food insecurity (2.8, 1.1 – 7.2) were the major risk factors associated with sub-optimal RUF intake at week 2. FGDs showed that the need to hide from others to avoid sharing and undesirable effects were other constraints on RUF feeding. Conclusions: This study revealed several factors reducing the acceptability and adherence to RUF therapy based on WHO guidelines in HIV-infected adolescents. Tailoring prescription guidance and empowering young patients in their care are crucial levers for improving the acceptability of RUF-based therapy in routine care. ClinicalTrials.gov identifier: NCT03101852, 04/04/2017
The development of a questionnaire to assess leisure time screen-based media use and its proximal correlates in children (SCREENS-Q)
Authors: Klakk Heidi , Wester Christian Tolstrup , Olesen Line Grønholt , Rasmussen Martin Gillies , Kristensen Peter Lund , Pedersen Jesper , Grøntved Anders
Published: May 2020

Background: The screen-media landscape has changed drastically during the last decade with wide-scale ownership and use of new portable touchscreen-based devices plausibly causing changes in the volume of screen media use and the way children and young people entertain themselves and communicate with friends and family members. This rapid development is not sufficiently mirrored in available tools for measuring children’s screen media use. The aim of this study was to develop and evaluate a parent-reported standardized questionnaire to assess 6-10-year old children’s multiple screen media use and habits, their screen media environment, and its plausible proximal correlates based on a suggested socio-ecological model. Methods: An iterative process was conducted developing the SCREENS questionnaire. Informed by the literature, media experts and end-users, a conceptual framework was made to guide the development of the questionnaire. Parents and media experts evaluated face and content validity. Pilot and field testing in the target group was conducted to assess test-retest reliability using Kappa statistics and intraclass correlation coefficients (ICC). Construct validity of relevant items was assessed using pairwise non-parametric correlations (Spearman’s). The SCREENS questionnaire is based on a multidimensional and formative model. Results: The SCREENS questionnaire covers six domains validated to be important factors of screen media use in children and comprises 19 questions and 92 items. Test-retest reliability (n=37 parents) for continuous variables was moderate to substantial with ICC’s ranging from 0.67 to 0.90. For relevant nominal and ordinal data, kappa values were all above 0.50 with more than 80 percent of the values above 0.61 indicating good test-retest reliability. Internal consistency between two different time use variables (from n=243) showed good correlations with rho ranging from 0.59 to 0.66. Response-time was within 15 min for all participants. Conclusions: SCREENS-Q is a comprehensive tool to assess children’s screen media habits, the screen media environment and possible related correlates. It is a feasible questionnaire with multiple validated constructs and moderate to substantial test-retest reliability of all evaluated items. The SCREENS-Q is a promising tool to investigate children screen media use.
The influence of dietary supplementation with the leucine metabolite β-hydroxy-β-methylbutyrate (HMB) on chemotaxis, phagocytosis and respiratory burst of peripheral blood granulocytes and monocytes in calves
Authors: Wójcik Roman , Małaczewska Joanna , Zwierzchowski Grzegorz , Miciński Jan , Kaczorek-Łukowska Edyta
Published: May 2020

Background A healthy immune system plays a particularly important role in newborns, including in calves that are far more susceptible to infections (viral, bacterial and other) than adult individuals. Therefore the objective of this study was to evaluate the effect of HMB on the chemotactic activity (MIGRATEST® kit), phagocytic activity (PHAGOTEST® kit) and respiratory burst (BURSTTEST® kit) of peripheral blood granulocytes and monocytes in calves by flow cytometry. Results An analysis of granulocyte and monocyte chemotactic activity and phagocytic activity revealed significantly higher levels of phagocytic activity in calves administered HMB than in the control group, expressed in terms of the percentage of phagocytising cells and mean fluorescence intensity (MFI). HMB also had a positive effect on the oxidative metabolism of both granulocytes and monocytes after stimulation with Escherichia coli bacteria and with PMA (4-phorbol-12-β-myristate-13-acetate), expressed in terms of the percentage of oxidative metabolism and MFI. Conclusion HMB stimulates non-specific cell-mediated immunity, which is a very important consideration in newborn calves that are exposed to adverse environmental factors in the first weeks of their life. The supplementation of animal diets with HMB for both preventive and therapeutic purposes can also reduce the use of antibiotics in animal production.
MiR-9-5p promotes rabbit preadipocyte differentiation by suppressing leptin gene expression
Authors: Luo Gang , Hu Shenqiang , Lai Tianfu , Wang Jie , Wang Li , Lai Songjia
Published: May 2020

Background: MicroRNAs (miRNAs) are a class of small non-coding RNAs, which participate in the regulation of cell differentiation. Previous studies have demonstrated that miR-9-5p plays a key role in cancer cell development, but the mechanisms by which miR-9-5p regulates adipogenesis remain poorly understood. The present study intended to investigate its significance in producing rabbits with high-quality meat by observing the regulatory effect of miR-9-5p in preadipocytes and finding the related targets. Methods: In this study, a dual-luciferase reporter assay was employed to validate the targeting relationship between miR-9-5p and leptin gene. We also utilized quantitative reverse transcription PCR (qRT-PCR), western blot, oil red-O staining assay, and determination of triglyceride content to analyze the regulation of miR-9-5p and leptin gene during adipocyte differentiation. Results: The analysis demonstrated that during preadipocyte differentiation, miR-9-5p was up-regulated and the fat formation related biomarkers, i.e., fatty acid-binding protein 4 (FABP4), CCAAT-enhancer binding protein α (C/EBPα), and peroxisome proliferator activated receptor γ (PPARγ) were also up-regulated. Meanwhile, the oil red-O staining assay revealed that the accumulation of lipid droplets increased. We also explored the expression pattern and role of miR-9-5p in adipogenesis using white pre-adipocytes. The results showed that miR-9-5p was up-regulated during preadipocyte differentiation, and overexpression of miR-9-5p enhanced lipid accumulation. Furthermore, we found that the overexpression of miR-9-5p significantly up- regulated the expression of marker genes, PPARγ, C/EBPα and FABP4, and increased the protein levels of PPARγ and triglyceride content. The results suggest that miR-9-5p might be involved in the regulation of rabbit preadipocyte differentiation. We predicted that leptin is the target gene of miR-9-5p, by using bioinformatics tools and the conclusion was validated by a luciferase reporter assay. Finally, we verified that the knock-down of leptin by si-leptin promoted preadipocyte differentiation in rabbits. Conclusion: The results of the present study indicate that miR-9-5p regulates white preadipocyte differentiation in rabbits by targeting the leptin gene.