bluuebunny/crossref_metadata_2025 huggingface dataset:
New Long-Term Opioid Prescription-Filling Behavior Arising in the 15 Months After Orthopaedic Surgery
Authors: Orfield Noah J. , Gaddis Andrew , Russell Kyle B. , Hartman David W. , Apel Peter J. , Mierisch Cassandra
Published: December 2019

Background:

The opioid crisis is a well-known public health issue. The risk of new long-term opioid prescription-filling behavior has been investigated after certain spinal procedures and total knee and hip arthroplasty. However, this has not been examined after many other common orthopaedic procedures. The purpose of this study was to determine the rates of long-term opioid prescription-filling behavior after common orthopaedic surgical procedures in patients who were not taking opioids preoperatively.

Methods:

This study utilized the Virginia All-Payer Claims Database (APCD), an insurance claims database with data from 3.7 to 4 million patients per year. Patients who underwent orthopaedic procedures and who had not filled an opioid prescription in the time period from 2 weeks to 1 year preceding the surgical procedure were selected for evaluation in our study. The percentage of these patients who then filled at least 10 prescriptions or a 120-day supply of opioids in the time period from 90 to 455 days following the surgical procedure was calculated for the 50 most commonly billed orthopaedic surgical procedures.

Results:

The rate of long-term opioid prescription-filling behavior in patients who were not taking opioids preoperatively for the 50 most common orthopaedic procedures was 5.3% (95% confidence interval, 5.1% to 5.5%). The highest rates were observed after spinal procedures. The lowest rates were seen after anterior cruciate ligament (ACL) reconstruction. Revision surgical procedures were found to have a significantly higher rate than primary procedures (p < 0.05). The rate was also related to increasing case complexity.

Conclusions:

New long-term opioid prescription-filling behavior is common after orthopaedic surgical procedures in patients who were not taking opioids preoperatively. Risk factors include spine surgery, revision surgery, and cases with increased complexity. Orthopaedic surgeons need to be aware of this risk.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Cerclage Wiring Fixation for the Treatment of Long Oblique Fractures of the Distal Clavicle
Authors: Matsumura Noboru , Takada Yuhei , Seto Takayuki , Suzuki Taku , Iwamoto Takuji , Sato Kazuki
Published: December 2019

Case:

A 49-year-old man and a 37-year-old man with long oblique fractures of the distal clavicle were successfully treated with cerclage wiring fixation without detachment of the trapezius and deltoid muscles and exposure of the fracture site.

Conclusions:

Long oblique fractures with the acromioclavicular and coracoclavicular ligaments being intact and attached to the distal fragment are relatively rare among distal clavicle fractures. Cerclage wiring fixation is a viable treatment option for the fixation of long oblique fractures of the distal clavicle, with good clinical results and rapid recovery of shoulder function.
The Calculation and Analysis of the Total Electron Content Over Different Latitudes and Seasons Using the Numerical Trapezoidal and Simpson Methods
Authors: Ni'ma Ali Hussein
Published: December 2019

It has been shown in ionospheric research that calculation of the total electron content (TEC) is an important factor in global navigation system. In this study, TEC calculation was performed over Baghdad city, Iraq, using a combination of two numerical methods called composite Simpson and composite Trapezoidal methods. TEC was calculated using the line integral of the electron density derived from the International reference ionosphere IRI2012 and NeQuick2 models from 70 to 2000 km above the earth surface. The hour of the day and the day number of the year, R12, were chosen as inputs for the calculation techniques to take into account latitudinal, diurnal and seasonal variation of TEC. The results of latitudinal variation of TEC show anomally called equatorial ionization anomally which presents two crests about the geomagnetic equators. The mean absolute percent errors MAPE for two numerical methods using the electron density profiles shown above were 0.0253, 0.02273 and 0.0213, 0.0124 respectively. The results of seasonal variation of TEC show a larger values for spring and autumn equinoxes other than for summer and winter seasons. The MAPE for autumn equinox has the smallest value than for summer, winter seasons and spring equinox. The MAPE for spring equinox equals to 0.01093 and 0.01015 for Simpson and Trapezoidal methods respectively. For autumn, summer and winter, the MAPE equals to 0.005825 and 0.006629 and 0.04682 and 0.0454, 0.01253 and 0.01231 for Simpson and Trapezoidal methods respectively.
Modeling Human Capital Impact on the Development of the Iraqi Oil Industry
Authors: Et al. Ali
Published: December 2019

Iraq has the second largest proven oil reserves in the world. According to oil experts, it is expected that the Iraq's reserves to rise to 200+ billion barrels of high-grade crude.

Oil is a strategic commodity for producing and exporting countries in general, and Iraq in particular, as demonstrated by the international experience that oil is an important means to achieve economic growth, an important tool in the overall economic, social and political development. It is also an important source of hard currency for any national economy and a means to connect the local economy and the global economy. In this paper we focus our attention on selecting the best regression model that explain the effect of human capital represented by different levels of human cadres on the development of the Iraqi oil industry by employing the data of a time series consisting of 21years period. Two popular classical procedures were applied to select such model, specifically, all possible regression procedure and the stepwise regression procedures. The statistical program SPSS was employed to perform the required calculations.
Compact MIMO Slots Antenna Design with Different Bands and High Isolation for 5G Smartphone Applications
Authors: Ibrahim Ayman mohammed
Published: December 2019

In this paper, two elements of the multi-input multi-output (MIMO) antenna had been used to study the five (3.1-3.55GHz and 3.7-4.2GHz), (3.4-4.7 GHz), (3.4-3.8GHz) and (3.6-4.2GHz) 5G bands of smartphone applications that is to be introduced to the respective US, Korea, (Europe and China) and Japan markets. With a proposed dimension of 26 × 46 × 0.8 mm3, the medium-structured and small-sized MIMO antenna was not only found to have demonstrated a high degree of isolation and efficiency, it had also exhibited a lower level of envelope correlation coefficient and return loss, which are well-suited for the 5G bands application. From the fabrication of an inexpensive FR4 substrate with a 0.8 mm thickness level, a loss tangent of 0.035 and a dielectric constant of 4.3, the proposed MIMO antennas that had been simulated under the five different band coverage were discovered to have demonstrated a respective isolation level of about 14dB, 12dB, 21.5dB, 19dB and 20dB under a -10dB impendence bandwidth. In the measurement and fabrication outcomes that were derived from the use of the prototype MIMO in the (3.4-3.8) band of the Europe and Chinese markets, the proposed MIMO was thus found to have produced a better performance in terms of efficiency, isolation, and envelope correlation coefficient (ECC).
Geomechanical Characterization of Unconventional Source Rocks Using Rebound-Hardness Test and Mineral Mapping
Authors: Lee Ji Soo , Jacobi David , Alnajar Zainab
Published: December 2019

Rock strength is seldom considered important by the hydrocarbon industry to help monitor the drilling progress, evaluate wellbore stability, guide well completions, or predict the success of hydraulic fracturing in unconventional reservoirs. With respect to hydraulic fracturing, rock-elastic moduli are routinely used to evaluate stress anisotropy. However, rock strength may also be a crucial parameter to evaluate when designing hydraulic-fracturing strategies to stimulate production from the rock volume. However, because of the density of horizontal laminae comprising the rock structure within a vertical whole core, the true geomechanical anisotropy for both properties is difficult to measure from extracted core plugs. Often, core-plug drilling and extraction techniques do not produce intact core plugs to measure these parameters consistently because of the laminated rock fabric. The integrity of the rock makes it is difficult to interpret both elastic moduli and rock-strength measurements using the recovered plugs extracted from horizontal, vertical, and diagonal azimuths. To address that challenge, a new, nondestructive method is demonstrated in which rebound-hardness measurements taken across a specifically gridded, slabbed rock surface can provide an estimate of the rock strength. The collected rebound-hardness numbers (RHNs) are converted into unconfined-compressive strengths (UCSs) using an empirical algorithm. The empirical algorithm was developed using UCSs measured from core plugs correlated to RHNs measured from the face of those same core plugs. The derived UCSs are then used to represent the source rock's mechanical characteristics, which can be presented as a contour map across the surface. These results have been correlated to the mineralogy of the rock surface, quantified, and mapped using micro-X-ray-fluorescence (µ-XRF) elemental maps. Differences in UCS can then be correlated to the changing mineral content of the rock surface. This nondestructive estimation of rock strength was conducted to address the challenge of relating core-scale measurements to reservoir-scaled analysis to improve hydraulic-fracturing designs in unconventional source rocks.
The Influx-Management Envelope Considering Real-Fluid Behavior
Authors: Berg Christian , Evjen Geir Arne , Velmurugan Naveen , Culen Martin
Published: December 2019

The influx-management envelope (IME), Culen et al. (2016), is a decision-making tool for how to deal with an influx during managed-pressure-drilling (MPD) operations that offers a substantial improvement over the traditional MPD well-control matrix (WCM). However, in the case study by Gabaldon et al. (2017), it has been found that the simplified analytical solution introduced by Culen et al. (2016) makes the IME inaccurate for many real-world applications. This paper extends the original IME that considers the gas migration in the annulus as a single bubble, without making the simplifying assumptions that are required to make the equations explicit and analytically solvable. The underlying equations that are required to develop the IME are derived from first principles, and it is shown that using realistic equations of state (EOSs) for gas, and a single-bubble-type model, the equations for the IME can be numerically solved yielding less conservative limits. The proposed approach is significantly faster than constructing the IME through high-fidelity simulations. The proposed method allows for the calculation of a peak circulating pressure at the surface and the maximum weak-point pressure for a given kick size and initial shut-in pressure, as well as a kick envelope with respect to formation limits. This makes the contributions of this paper also relevant for traditional well-control situations. The effect of considering various simplifying assumptions on the resulting IME is studied, and different scenarios that compare the results of the proposed approach with that of the original single-bubble equation for the IME (Culen et al. 2016) are presented.
Is radiographic lumbar spondylolisthesis associated with occupational exposures? Findings from a nested case control study within the Wakayama spine study
Authors: Ishimoto Yuyu , Cooper Cyrus , Ntani Georgia , Yamada Hiroshi , Hashizume Hiroshi , Nagata Keiji , Muraki Shigeyuki , Tanaka Sakae , Yoshida Munehito , Yoshimura Noriko , Walker-Bone Karen
Published: December 2019

Background: To explore the relationship between radiographic spondylolisthesis and occupational factors in a case-control study nested within the Wakayama Spine Study (WSS). Methods: The WSS is a cross-sectional observational study amongst Japanese adults. All participants completed a lifetime occupational history and underwent X-rays of the lumbar spine (L1-S1) according to a pre-defined protocol. One trained surgeon graded the presence of a spondylolisthesis based upon ≥5% anterior or posterior slip at one or more levels. Cases, with lumbar spondylolisthesis, were compared with controls without, for their principal occupation and occupational exposures. Results: In total, data were available for 722 adults (245 men and 477 women), mean age 70.1 (range 53-93) years. According to the pre-defined radiographic criteria, 117 were defined with spondylolisthesis (cases), leaving 605 controls. Cases were not significantly different from controls for age, gender, BMI, smoking or alcohol intake. However, cases were more than twice as likely to report occupational driving ≥ 4 hours/day (OR 2.39, 95% CI 1.08-5.27) after adjustment for age, gender and BMI. Additionally, after stratification by age using 75 years as a cut-point, cases were more than 3-fold more likely to report having worked in the agricultural/ fishing industries (OR 3.47, 95% CI 1.29-9.29) among those aged <75 years. A reduced risk of being a case was associated with climbing slopes/steps and walking. Conclusions: A history of occupational driving and working in the agricultural/fishing industry were associated with radiographic spondylolisthesis in this cross-sectional population study. This finding requires further evaluation in longitudinal studies.
Patency of conduits in patients who received internal mammary artery, radial artery and saphenous vein grafts
Authors: Royse Alistair , Pamment William , Pawanis Zulfayandi , Clarke-Errey Sandy , Eccleston David , Ajani Andrew , Wilson William , Canty David , Royse Colin
Published: December 2019

Background
Where each patient has all three conduits of internal mammary artery (IMA), saphenous vein graft (SVG) and radial artery (RA), most confounders affecting comparison between conduits can be mitigated. Additionally, since SVG progressively fails over time, restricting patient angiography to the late period only can mitigate against early SVG patency that may have occluded in the late period.

Objectives
The primary analysis was perfect patency and secondary analysis was overall patency including angiographic evidence of conduit lumen irregularity from conduit atheroma.

Methods
Research protocol driven conventional angiography was performed for patients with at least one of each conduit of IMA, RA and SVG and a minimum of 7 years postoperative. Multivariable generalized linear mixed model (GLMM) was used. Patency excluded occluded or “string sign” conduits. Perfect patency was present in patent grafts if there was no lumen irregularity.

Results
50 patients underwent coronary angiography at overall duration postoperative 13.1±2.9, and age 74.3±7.0 years. Of 196 anastomoses, IMA 62, RA 77 and SVG 57. Most IMA were to the left anterior descending territory and most RA and SVG were to the circumflex and right coronary territories. Perfect patency RA 92.2% was not different to IMA 96.8%, P=0.309; and both were significantly better than SVG 17.5%, P<0.001. Patency RA 93.5% was also not different to IMA 96.8%, P=0.169, and both arterial conduits were significantly higher than SVG 82.5%, P=0.029. Grafting according to coronary territory was not significant for perfect patency, P=0.997 and patency P=0.289. Coronary stenosis predicted perfect patency for RA only, P=0.030 and for patency, RA, P=0.007, and SVG, P=0.032.

When both arterial conduits were combined, perfect patency, P<0.001, and patency, P=0.017, were superior to SVG.

Conclusions
All but one patent internal mammary artery or radial artery grafts had perfect patency and had superior perfect patency and overall patency compared to saphenous vein grafts.
Transcriptome analysis of the fungal pathogen Rosellinia necatrix during infection of a susceptible avocado rootstock identifies potential mechanisms of pathogenesis
Authors: Zumaquero Adela , Kanematsu Satoko , Nakayashiki Hitoshi , Matas Antonio , Martínez-Ferri Elsa , Barceló-Muñóz Araceli , Alfaro Fernando Pliego , Lopez-Herrera Carlos , Cazorla Francisco , Prieto Clara Pliego
Published: December 2019

Background
White root rot disease caused by Rosellinia necatrix is one of the most important threats affecting avocado productivity in tropical and subtropical climates. Control of this disease is complex and nowadays, lies in the use of physical and chemical methods, although none have proven to be fully effective. Detailed understanding of the molecular mechanisms underlying white root rot disease has the potential of aiding future developments in disease resistance and management. In this regard, this study used RNA-Seq technology to compare the transcriptomic profiles of R. necatrix during infection of susceptible avocado `Dusa´ roots with that obtained from the fungus cultured in rich medium.

Results
The transcriptomes from three biological replicates of R. necatrix colonizing avocado roots (RGA) and R. necatrix growing on potato dextrose agar media (RGPDA) were analyzed using Illumina sequencing. A total of 12,104 transcripts were obtained, among which 1,937 were differentially expressed genes (DEG), 137 exclusively expressed in RGA and 160 in RGPDA. During the root infection process, genes involved in the production of fungal toxins, detoxification and transport of toxic compounds, hormone biosynthesis, gene silencing and plant cell wall degradation were overexpressed. Interestingly, 24 out of the 137 contigs expressed only during R. necatrix growth on avocado roots, were predicted as candidate effector proteins (CEP) with a probability above 60%. The PHI (Pathogen Host Interaction) database revealed that three of the R. necatrix CEP showed homology with previously annotated effectors, already proven experimentally via pathogen-host interaction.

Conclusions
The analysis of the full-length transcriptome of R. necatrix during the infection process is suggesting that the success of this fungus to infect roots of diverse crops might be attributed to the production of different compounds which, singly or in combination, interfere with defense or signaling mechanisms shared among distinct plant families. The transcriptome analysis of R. necatrix during the infection process provides useful information and facilitates further research to a more in -depth understanding of the biology and virulence of this emergent pathogen. In turn, this will make possible to evolve novel strategies for white root rot management in avocado.
Enterococcal periprosthetic joint infection: clinical and microbiological findings from a 8-year retrospective cohort study
Authors: Renz Nora , Trebse Rihard , Akgün Doruk , Perka Carsten , Trampuz Andrej
Published: December 2019

Background: Treatment of enterococcal periprosthetic joint infections (PJI) is challenging due to non-standardized management strategies and lack of biofilm-active antibiotics. The optimal surgical and antimicrobial therapy are unknown. Therefore, we evaluated characteristics and outcome of enterococcal PJI. Methods: Consecutive patients with enterococcal PJI from two specialized orthopedic institutions were retrospectively analyzed. Both institutions are following the same diagnostic and treatment concepts. The probability of relapse-free survival was estimated using Kaplan-Meier survival curves and compared by log-rank test. Treatment success was defined by absence of relapse or persistence of PJI due to enterococci or death related to enterococcal PJI. Clinical success was defined by the infection-free status, no subsequent surgical intervention for persistent or perioperative infection after re-implantation and no PJI-related death within 3 months. Results: Included were 75 enterococcal PJI episodes, involving 41 hip, 30 knee, 2 elbow and 2 shoulder prostheses. PJI occurred postoperatively in 61 episodes (81%), hematogenously in 13 (17%) and by contiguous spread in one. E. faecalis grew in 64 episodes, E. faecium in 10 and E. casseliflavus in one. Additional microorganism(s) were isolated in 38 patients (51%). Enterococci were susceptible to vancomycin in 73 of 75 isolates (97%), daptomycin in all 75 isolates, and fosfomycin in 21 of 22 isolates (96%). The outcome data was available for 66 patients (88%). The treatment success after 3 years was 83.7% (95% confidence interval [CI]; 76.1-96.7%) and the clinical success was 67.5% (95% CI; 57.3-80.8%). In 11 patients (17%), a new PJI episode caused by a different pathogen occurred. All failures occurred within the three years of surgery. Conclusion: About half of enterococcal PJI were polymicrobial infections. The treatment success was high (84%). All treatment failures occurred within the first three years after revision surgery. Interestingly, 17% of patients experienced a new PJI caused by another pathogen at a later stage. Trial registration: The study was retrospectively registered with the public clinical trial identification NCT0253022 at https://www.clinicaltrials.gov on 15 July 2015.
Predictive factors for the presence of invasive components in patients diagnosed with ductal carcinoma in situ based on preoperative biopsy
Authors: Lee Kwan Ho , Han Jeong Woo , Kim Eun Young , Yun Ji Sup , Park Yong Lai , Park Chan Heun
Published: December 2019

Background In patients diagnosed with ductal carcinoma in situ (DCIS) with needle biopsy before surgery, invasive component (IC) is often found in the postoperative tissue, which results in altered post-surgical care. However, there are no clinically available factors to predict IC, and few MRI studies are available for the detection of IC in DCIS patients. The purpose of this study was to evaluate which risk factors can predict IC preoperatively.Methods Patients with a DCIS diagnosis based on preoperative biopsy, who underwent breast surgery Kangbuk Samsung Hospital between Jan 2005 and June 2018, were retrospectively evaluated. Clinico-pathological and breast MRI factors were compared between DCIS and DCIS with IC in postsurgical specimens.Results Of the 431 patients with a preoperative diagnosis of DCIS, 34 (7.9%) showed IC during the postoperative pathological investigations, and 217 (50.3%) underwent breast MRI. Among MRI-related factors, Mass-like enhancement on MRI was the sole but significant predictor of IC (HR=0.26, C.I.=0.07-0.93, p=0.038), while nipple-areolar complex invasion, enhancement peak and pattern were not statistically significant. Nuclear grade was the only significant predictor of IC in the analysis of other clinico-pathological factors (HR=2.39, C.I.=1.05-5.42, p=0.038 in univariate analysis, HR=2.86, C.I.=1.14-7.14, p=0.025 in multivariate analysis).Conclusions Mass-like enhancement on MRI and high nuclear grade were associated with IC in patients with preoperative diagnosis of DCIS. Considering the high sensitivity of breast MRI for IC, further evaluation of the predictive value of MRI in preoperative DCIS patients is desirable.
Factors Affecting HBV Vaccination in a Medical Training College in Kenya: A Mixed Methods Study
Authors: Maina Anne , Bii Leah
Published: December 2019

Background : Hepatitis B Virus (HBV) is highly endemic in Sub-Saharan Africa with 70 to 90% of the population becoming infected before the age of 40 years. Healthcare workers (HCWs) including healthcare students (HCSs) are at an increased risk of contracting HBV due to occupational exposure. HCSs are especially at a high risk because of their inexperience with infection control procedures and insufficient knowledge about the level of risk when dealing with patients. Despite the availability of an effective vaccine, and its recommendation by Kenya’s Ministry of Health, few HCW and students are vaccinated. The aim of this study was to evaluate the influence of awareness, attitude, practices, and access factors on hepatitis B vaccination uptake by HCSs at Kenya Medical Training College (KMTC). Methods : This was a concurrent mixed methods study. For the quantitative arm, a structured questionnaire was used to assess the awareness, knowledge, attitudes and practices towards HBV disease and vaccination. Accessibility of the HBV vaccine in the participating campuses was also assessed. Two FGDs were carried out: one comprised of student representatives of the participating campuses while the second comprised of members of staff. Quantitative data was analysed using STATA (version 15) while NVIVO (version 11) was used for qualitative data. Results: Out of 634 students invited to participate in the study, 487 participated (response rate 76.8%). Majority of the respondents were from Nairobi Campus (44.2%) and from the Department of Nursing (31.2%). HBV vaccine uptake rate was 85.8% while the non-vaccination rate was 14.3%. Full vaccination was reported by only 20.2% of respondents. The major reason for not receiving the recommended doses was the unavailability of the vaccine when students went for it. The qualitative study revealed challenges in the implementation of the vaccination program at KMTC. Conclusions Full vaccination rates remained low despite good knowledge of HBV infection and positive attitude towards vaccination. There is therefore need to streamline vaccination programs in medical colleges to ensure availability and accessibility of the vaccine to healthcare students. Key words: HBV vaccination, Vaccine Uptake, Health Care Students, Kenya
Explaining the successes and failures of tuberculosis treatment programs; a tale of two regions in rural Eastern Uganda
Authors: Izudi Jonathan , Tamwesigire Imelda K , Bajunirwe Francis
Published: December 2019

Background. Optimally performing tuberculosis (TB) programs are characterized by treatment success rate (TSR) of at least 90%. In rural eastern Uganda, and elsewhere in sub Saharan Africa, TSR varies considerably across district TB programs and the reasons for the differences are unclear. This study explored factors associated with the low and high TSR across four districts in rural eastern Uganda.
Methods. We interviewed District TB and Leprosy Supervisors, Laboratory focal persons, and health facility TB focal persons from four districts in Eastern Uganda as key informants. Interviews were audio recorded, transcribed verbatim, and imported into ATLAs.ti where thematic content analysis was performed and results were summarized into themes.
Results . The emerging themes were categorized as either facilitators of or barriers to treatment success. The emerging facilitators prevailing in the districts with high rates of treatment success were using data to make decisions and design interventions, continuous quality improvement, capacity building, and prioritization of better management of people with TB. The barriers common in districts with low rates of treatment success included lack of motivated and dedicated TB focal persons, scarce or no funding for implementing TB activities , and a poor implementation of community-based directly observed therapy short course.
Conclusion. This study shows that several factors are associated with the differing rates of treatment success in rural eastern Uganda. These factors should be the focus for TB control programs in Uganda and similar settings in order to improve rates of treatment success.
Whole grain food diet slightly reduces cardiovascular risks in obese/overweight adults: a systematic review and meta-analysis
Authors: Wang Weihao , Li Jianan , Chen Xiaoxi , Yu Miao , Pan Qi , Guo Lixin
Published: December 2019

Background: The effects of whole grain diet on cardiovascular risks in obese and overweight adults is not well established. Our goal was to conduct a systematic review and meta-analysis on the effect of whole grain diet on cardiovascular risks in obese/overweight adults. Methods: PubMed, Embase and Cochrane were systematically scanned for randomized controlled trials (RCTs), and studies were selected based on certain inclusion and exclusion criteria. The primary outcome was the effectiveness of whole grain food consumption in reducing body weight. The secondary outcomes were the effect of whole grain food consumption on cardiovascular disease (CVD) risk factors including plasma low-density lipoprotein cholesterol (LDL-C), insulin resistance index, blood pressure, body mass index (BMI), C-reactive protein (CRP), and waist circumference in obese/overweight adults. Results: Our results showed that whole grain consumption was associated with lower body weight (mean difference (MD) =-0.5, 95% confidence intervals (CI) [-0.74, 0.25], I2 = 35%, P < 0.0001) and lower CRP (MD =-0.36, 95% CI [-0.54, -0.18], I2=69%, P<0.0001), compared with the control group. However, there were no significant differences in LDL-C (MD =-0.08, 95% CI [-0.16, 0.00], I2 = 27%, P = 0.05), waist circumference (MD=-0.12, 95% CI [-0.92, 0.68], I2=44%, P=0.76), systolic blood pressure (MD=-0.11, 95% CI [-1.55, 1.33], I2=3%, P=0.88), diastolic blood pressure (MD=-0.44, 95% CI [-1.44, 0.57], I2=15%, P=0.39), and fasting glucose (MD=-0.05, 95% CI [-0.12, 0.01], I2=31%, P=0.11) between the two groups. Conclusion: This study suggests that whole grain food consumption can slightly reduce body weight and CRP in obese/overweight population.
Autism spectrum disorder is associated with gut microbiota disorder in children
Authors: Sun Hairong , You Zhong , Jia Libo , Wang Fang
Published: December 2019

Background: The aim of this study was to evaluate the occurrence and clinical characteristics of autism spectrum disorder (ASD) associated to the stable state of the gut microbiota.
Methods: A total of 9 children with ASD and 6 healthy children used as control were selected and feces samples were collected from all of them. The 16S gene ribosomal RNA sequencing was used to analyze the difference in gut microbiota between healthy control children and ASD patients.
Results: The results of 16S sequencing based on operational taxonomic units (OTUs) analysis showed that the ASD group and the healthy control (HC) group had a large difference in the abundance of microbiota at the level of family, genus and species. The abundance of Bacteroidales and Selenomonadales was significantly lower in the ASD group than in the HC group (p=0.0110 and p=0.0076, respectively). The abundance of Ruminococcaceae in the ASD group was higher than that in the HC group (p=0.0285), while the amount of Prevotellaceae was significantly lower in the ASD group than in the HC group (p=0.0111). The Tax4Fun analysis based on Kyoto Encyclopaedia of Genes and Genomes (KEGG) data indicated differentially expressed functional pathway between the ASD group and healthy control group associated to the nervous system, environmental information processing and cellular processing.
Conclusions: The abundance of gut microbiota in the ASD group is different from that in the healthy control children. These differences affect the biological function of the host. These results suggest that a disorder in the gut microbiota may be associated, at least in part, with ASD in children.
Development and external validation of an online clinical prediction model for augmented renal clearance in adult mixed critically ill patients: the ARC predictor
Authors: Gijsen Matthias , Huang Chao-yuan , Flechet Marine , Daele Ruth Van , Declercq Peter , Debaveye Yves , Meersseman Philippe , Meyfroidt Geert , Wauters Joost , Spriet Isabel
Published: December 2019

BackgroundAugmented renal clearance (ARC) might lead to subtherapeutic plasma levels of drugs with predominant renal clearance. Early identification of ARC remains challenging for the intensive care unit (ICU) physician. We developed and validated the ARC predictor, a clinical prediction model for ARC on the next day during ICU stay, and made it available via an online calculator. Its predictive performance was compared with that of two existing models for ARC.MethodsA large multicenter database including medical, surgical and cardiac ICU patients (n = 33258 ICU days) from three Belgian tertiary care academic hospitals was used for the development of the prediction model. Development was based on clinical information available during ICU stay. We assessed performance by measuring discrimination, calibration and net benefit. The final model was externally validated (n = 10259 ICU days) in a single-center population.ResultsARC was found on 19.6% of all ICU days in the development cohort. Six clinical variables were retained in the ARC predictor: day from ICU admission, age, sex, serum creatinine, trauma and cardiac surgery. External validation confirmed good performance with an area under the curve of 0.88 (95% CI 0.87 – 0.88), and a sensitivity and specificity of 84.1 (95% CI 82.5 – 85.7) and 76.3 (95% CI 75.4 – 77.2) at the default threshold probability of 0.2, respectively.ConclusionARC on the next day can be predicted with good performance during ICU stay, using routinely collected clinical information that is readily available at bedside. The ARC predictor is available at www.arcpredictor.com.
Comparison of Inpatient Distribution among Different Medical Alliances in County Region: a Longitudinal Study on a healthcare reform in Rural China
Authors: Ran Yifan , Gao Hongxia , Han Dan , Hou Guilin , Chen Yingchun , Zhang Yan
Published: December 2019

Background: Three types of Medical Alliances (MAs) have been built in most county regions in China. These MAs are led by main three county hospitals to drive the development of township hospitals. This paper aims to evaluate the actual effect of China’s MAs reform in rural area on inpatient distribution especially among different categories of MAs. Methods：We obtained 2008-2015 claims data on enrolled residents from the New Cooperative Medical Scheme (NCMS) in Y County, Hubei Province of China. We considered January 2008–December 2010 as the pre-reform period and January 2011–December 2015 as the post-reform period. Independent sample t-test and single-group interrupted time series analysis (ITSA) were used to compare the number of inpatients per month in the three MAs including 3 county hospitals and 10 township hospitals before and after the reform. Paired t-test and multiple-group ITSA were used between township hospitals within MAs and outside MAs. Results：The MAs reform in Y County increased the number of inpatients and improved the service capacity of both county hospitals and township hospitals within MAs. After the reform, the number of inpatients per month in county hospitals had an upward trend, with a slope of 31.01 person/month (P < 0.000). Approximately 19.99 new inpatients were admitted to township hospitals monthly after the reform (P<0.000). Furthermore, township hospitals within MAs had a substantial increase in the number of inpatients (10.45 new inpatients monthly) compared with those outside MAs. Conclusion: The MAs reform in Y county effectively improved the capability of medical services in the county and decreased health inequality significantly. However, it also caused further imbalance in the county region in terms of the medical institutions among the three county hospitals and the different township hospitals, which contained the risk of new health inequality.
Abundant Taxa and Favorable Pathways in the Microbiome of Soda-Saline Lakes in Inner Mongolia
Authors: Zhao Dahe , Zhang Shengjie , Xue Qiong , Chen Junyu , Zhou Jian , Cheng Feiyue , Li Ming , Zhu Yaxin , Yu Haiying , Hu Songnian , Zheng Yanning , Liu Shuangjiang , Xiang Hua
Published: December 2019

Background: The chloride-carbonate-sulfate lakes (also called Soda-Saline lakes) are double-extreme ecological environments with high pH and high salinity values but can also exhibit high biodiversity and high productivity. The diversity of metabolic process that functioned well in such environments remains to be systematically investigated. Deep sequencing and species-level characterization of the microbiome in elemental cycling of carbon and sulfur will provide novel insights into the microbial adaptation in such saline-alkaline lakes. Results: In this study, we characterized environmental factors and performed deep metagenomic sequencing of the brine and sediment samples from nine ponds with different salinities of two chloride-carbonate-sulfate lakes in Inner Mongolia of China. The results showed that the concentration of chloride most significantly influenced the microbial community in both of the brine and sediment environments. Of 385 high-quality metagenome-assembled genomes (MAGs) belonging to archaea (56 Euryarchaeota, 12 Candidatus Nanohaloarchaeota, and 12 Candidatus Woesearchaeota) and bacteria (119 Proteobacteria and 186 other diverse bacterial phyla, including 18 from Candidate Phyla Radiation, CPR), 38 MAGs were observed to be abundant species at least in one of the eighteen niches. These abundant taxa represented most branches of a phylogenomic tree at phylum level. Interestingly, almost half of the abundant MAGs had the potential to drive dissimilatory sulfur cycling, including four autotrophic Ectothiorhodospiraceae MAGs, one Cyanobacteria MAG and nine heterotrophic MAGs with potential to oxidize sulfur, as well as four abundant MAGs containing genes for elemental sulfur respiration, which may increase the ability of environmental adaptation in such saline-alkaline environments. In addition, some subgroups in Ca. Nanohaloarchaeota and Ca. Woesearchaeota of the DPANN superphylum were also observed abundant. We found 1,4-alpha-glucans phosphorylation and complete glycolysis pathway in the abundant Nanohaloarchaeota MAG NHA-1, and this efficient energy regeneration pathway (compared with hydrolysis) may be a key factor for Ca. Nanohaloarchaeota in adaptation to hypersaline environments. Conclusions: The abundant taxa including carbon fixing microbes, versatile heterotrophs and the nanosized DPANN superphyla, and the superiority of energy production and thermodynamics of these abundant species were systematically investigated. This has provided novel insights into the microbial process in chloride-carbonate-sulfate lakes, and further understanding of the metabolic mechanism of adaptation to such extremely alkaline and saline conditions.
The effects of Bacillus spp. use as a dietary probiotic in weaning piglets
Authors: Dumitru Mihaela , Hăbeanu Mihaela , Sorescu Ionuț , Tabuc Cristina
Published: December 2019

Background: This study was conducted to evaluate the effects of supplementation with Bacillus-based probiotic (Bacillus subtilis ATCC 6051a, 1.6x109CFU/ml) on the performance of weaned piglets. Methods: A total of 60 piglets, 30 days±3 days of age, with an initial body weight (BW) of 8.41±0.92 kg were allotted randomly to 3 homogeneous groups (C, E1 and E2, 6 pens/10 piglets, 2 replicates/group) with a supplement of additive (Bs) based on 1% (E1), respectively 3% (E2)/kg feed. The feed was administered ad libitum in the flour form, 2 meals/day. Microbiological analysis and chemical composition of compound feed, the growth performances and diarrhoea incidence were assayed as well. Results: The addition of Bs didn’t influence significantly the BW or average daily gain (ADG). After 16 testing days, ADG was 1.13 times higher in E1 compared with C and with 1.04 times higher compared with E2. The feed intake (ADFI) increased with 1.08-fold in C diet compared with E1 diet. Feed efficiency diet was 1.22 times higher in E1 than C and with 1.05 higher than E2 diet. Conclusions: Addition of Bs-1% decreased diarrhoea incidence (P>0.05) by 7.6% vs. C and 3.8% vs. Bs-3%. 23.4% piglets had soft faeces, 43.75% score 2 (mild diarrhoea) and 32.81% score 3 (severe diarrhoea), no significant difference was noticed between the group (P˂0.05).
Spatial and Temporal Epidemiologic features analysis of pulmonary tuberculosis in Nanjing, China
Authors: Zhao Hongyu , Sun Changkui , Ma Wei , Yin Guoping , Zhang Xia , Yu Huiyan , Song Jinyun
Published: December 2019

Background This study aims to analyse the epidemiological features of tuberculosis in Nanjing and to identify possible risk factors associated with the spatial-temporal distribution.Methods Firstly, we used descriptive statistical method to study the epidemiologic features of confirmed PTB cases in 2017. Secondly, we explored Maxent method to construct the species distribution model with a high spatial resolution of 1km based on those confirmed cases and environmental features. Once again, we validated the performance of the species distribution model using ROC approach and spatial jackknife test, identified the key environmental factors associated with PTB occurrence. Finally, we created a prediction map under specific environmental factors by projecting the training model onto the research areas.Results The seasonal amount of PTB was not obvious. The key risk factors associated with PTB occurrence are monthly mean vapor pressure, solar radiation, monthly average temperature, and precipitation with suitable ranges. The economically developed central city is the high-burden area of tuberculosis with a high risk probability, and the economically backward Gaochun district is the high transmission area of tuberculosis with a high incidence. Epidemiologically, the farmers, the elderly, the floating population, and males are the focus groups for PTB prevention and control.Conclusion The combination of environmental factors with Maxent methods is an appropriate option to analyse and estimate the spatial and temporal distribution of PTB cases.
Genome-wide identification and expression analysis of rice NLR genes responsive to the infections of Xanthomonas oryzae pv. oryzae and Magnaporthe oryzae
Authors: Ding Li , Xu Xiameng , Kong Weiwen , Xia Xue , Zhang Shengwei , Liu Aixin , Zou Lifang
Published: December 2019

Background Nucleotide-binding site, leucine-rich repeat (NLR) genes play a critical role in rice disease resistance. However, the transcriptional activities of rice NLR genes during pathogen invasions are still unclear.Results To uncover the veil, we identified a total of 430 regular rice NLR genes with both NBS and LRR domains, consisting of 192 CNL and 238 XNL (without a CC motif) members. We performed individual and integrative analyses based on 69 samples from rice microarray after the infections of Xanthomonas oryzae pv. oryzae (Xoo) and Magnaporthe oryzae (Mor). 397 NLR genes were found to be expressed at low/medium level, while 10 NLR genes were observed to show high levels of expression. 400 NLR genes were discovered to be differentially expressed in at least one sample. Further, 46 NLR genes were identified to be differentially expressed in rice response to the two pathogens and 38 of them could be validated by RNA-seq data. Six cis-regulatory elements (MYC, STRE, MYB, ABRE, G-box, and AS-1) were observed to occur frequently in the promoter regions of rice NLR genes. Ten NLR genes were selected for in lab analysis, and qRT-PCR results of seven NLR genes verified the validity of the microarray and RNA-Seq data.Conclusions Our results would shed new light on revealing the roles of NLR genes in rice resistance to Xoo and Mor.
Identification of a new resistance locus against the rice gall midge, Orseolia oryzae (Wood-Mason), in Thai rice landrace MN62M
Authors: Leelagud Phikul , Kongsila Sakda , Vejchasarn Phanchita , Darwell Kulchana , Phansenee Yotwarit , Suthanthangjai Arissara , Uparang Chanita , Kawichai Rungnapa , Yajai Punnipa , Boonsa-nga Kunlayaa , Chamarerk Varapong , Jairin Jirapong
Published: December 2019

Background The rice gall midge (RGM), Orseolia oryzae (Wood-Mason), is one of the most destructive insect pests of rice, and it causes significant yield losses annually in Asian countries. The development of resistant rice varieties is considered as the most effective and economical approach for maintaining yield stability by controlling RGM. Identification of resistance genes will help in marker-assisted selection (MAS) to pyramid the resistance genes and develop a durable resistance variety against RGM in areas with frequent outbreaks.Results A mitochondrial gene, cytochrome C oxidase I (COI), was used to analyze the genetic diversity among Thai RGM populations. The phylogenetic tree indicated that the Thai RGM populations were homogeneously distributed throughout the country, except for some populations in central and northeast Thailand that probably became isolated from the main population. The reactions of the resistant rice varieties carrying different resistance genes revealed different RGM biotypes in Thailand. The Thai rice landrace MN62M showed resistance to all RGM populations used in this study. We identified a novel genetic locus for resistance to RGM, designated as GM12 , on the short arm of rice chromosome 2. The locus was identified using linkage analysis in 144 F 2 plants derived from a cross between susceptible cultivar KDML105 and RGM-resistant cultivar MN62M with single nucleotide polymorphism (SNP) markers and F 2:3 phenotype. The locus was confirmed and mapped using SNP and simple sequence repeat (SSR) markers surrounding the target chromosomal location. Finally, the locus was mapped between two flanking markers, RM6800 and S2_419160.Conclusions We identified a new RGM resistance gene, GM12 , on rice chromosome 2 in the Thai rice landrace MN62M. This finding yielded SNP and SSR markers that can be used in MAS to develop cultivars with broad-spectrum resistance to RGM. The new resistance gene provides important information for the identification of RGM biotypes in Thailand and Southeast Asia.
Cross-cultural Adaptation and Validation of the Polish Version of the Lower Limb Functional Index
Authors: Bejer Agnieszka , Podufały Agnieszka , Kyc Sylwia , Michałek Magdalena , Mataczyński Piotr , Domka-Jopek Elżbieta , Melloh Markus , Gabel Charles Philip
Published: December 2019

Background: Patient reported outcome measures (PROMs) are recommended to enable the standardization of collected data and provide accurate representation of the patients’ subjective opinions of their functional capabilities. The purpose of this study was to perform linguistic and cross-cultural adaptation to establish a Polish version of the Lower Limb Functional Index (LLFI), and to evaluate the psychometric properties of internal consistency, reliability, error score, validity, and factor structure with standardized criteria PROMs in a population with lower limb problems. Methods: Linguistic and cultural adaptation complied with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines to produce the Lower Limb Functional Index-Polish version (LLFI-PL). The study recruited subjects (n=125, age =52.86±19.53 years, range 20-87, 56% female, injury duration =17.69±18.39 weeks, range 5-71). Baseline reliability and criterion validity included the LLFI-PL, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Euroqol Health Questionnaire 5-Dimensions (EQ-5D-5L), and an 11-point pain Numerical Rating Scale, with retest at 3-7 days. Practicality for readability was considered within the face and content validity. Completion and scoring time were also calculated. Results: Statistical analysis showed excellent internal consistency ( α =0.94) and high test-retest reliability (ICC=0.96). The error score found the SEM=3.49% with MDC 90 =8.11%. Validity analysis showed strong correlations between the LLFI-PL with the WOMAC (r=-0.81) and moderate with the EQ-5D-5L (r=-0.63). Exploratory factor analysis confirmed a single-factor structure. Times for completion (172±33 seconds) and scoring (20±9 seconds) were determined. Conclusions: The LLFI-PL is a psychometrically sound questionnaire for Polish-speaking patients with lower limb musculoskeletal conditions. The results support the findings of previous original-English, Spanish, and Turkish versions for internal consistency, validity, reliability, error score, and factor structure.