bluuebunny/crossref_metadata_2025 huggingface dataset:
Sciatic obturator femoral technique versus spinal anaesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixator. A randomised trial
Authors: Shokri Hoda , Kasem Amr
Published: December 2019

Background
Peripheral nerve block is preferable for lower extremity surgery because it sufficiently blocks pain pathways at different levels providing excellent anaesthesia at the site of surgery. We designed this study to compare the efficacy and safety of SOFT block (sciatic-obturator-femoral technique) compared with spinal anaesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixator

Methods
One hundred and seven patients ASA I, II scheduled for fixation of open tibial fractures using Ilizarov external fixator. The patients were randomly allocated to receive either spinal anaesthesia or SOFT block. In spinal anaesthesia group, patients received spinal anaesthesia with hyperbaric bupivacaine 0.5% (7.5-10mg). In SOFT group, patients received SOFT block with bupivacaine 0.25%. Primary endpoint included the duration of analgesia. The secondary endpointsincluded patient satisfaction scores, visual analogue scores, incidence of adverse events as vomiting, systemic toxicity from local anaesthetic drug and time to first effect of the techniques.

Results
The duration of SOFT block and time to first analgesic dose in SOFT group was significantly longer (p<0.001). There was no significant difference between the study groups regarding satisfaction scores, the incidence of cardiovascular collapse, seizures and paraesthesia. Pain scores were significantly lower in SOFT group at 3,6,12 hours postoperative (p<0.001). The time to the first effect was significantly longer in SOFT group (p<0.001).
Conclusion:
SOFT is a feasible technique of local anaesthesia for control of postoperative pain with unremarkable adverse events compared with spinal anaesthesia, in patients undergoing fixation of tibial fractures using Ilizarov external fixator.
SIP SMART: A parallel group randomised feasibility trial of a tailored pre-treatment Swallowing Intervention Package compared with usual care for patients with head and neck cancer
Authors: Govender Roganie , Smith Christina H , Barratt Helen , Gardner Benjamin , Taylor Stuart
Published: December 2019

Background: Dysphagia or difficulty in swallowing affects quality of life for most patients with head and neck cancer. SIP SMART – [Swallowing Intervention Package: Self-Monitoring, Assessment, Rehabilitation Training] aims to improve post-treatment swallowing outcomes through a targeted and tailored pre-treatment intervention. This feasibility study assessed 1) recruitment and retention, 2) patient acceptability of randomisation and participation, 3) patient adherence, and 4) sought to identify a suitable primary outcome for a definitive trial, including sample size estimation. Methods: This two-arm parallel group non-blinded randomised feasibility trial took place within a head and neck centre at a teaching hospital in London, UK. Patients newly diagnosed with stage III/IV head and neck cancer were recruited and underwent 6-month follow-up. Patients were randomised to SIP-SMART or usual care via an online web-based system. SIP SMART comprised two 45-minute consultations including a baseline clinical and instrumental swallowing assessment, relevant educational information, targeted swallowing exercises, and specific behaviour change strategies to increase exercise adherence. Usual care comprised a single session including a baseline clinical assessment and generic information about the likely impact of treatment on swallowing. Results: A total of 106 patients were identified at pre-screening, 70 were assessed for eligibility. Twenty-six patients did not meet eligibility criteria [0.37, 95% CI 0.27 to 0.49]. Five of 44 [0.11, 95% CI 0.05 to 0.24] eligible patients were not approached by researchers during clinic. Seven [0.18, 95% CI 0.08 to 0.33] of the 39 approached declined participation. Target recruitment (32 consented patients) was achieved within the timeframe. At 6-months 29/32 [0.91, 95% CI 0.76 to 0.97] patients remained in the trial. Acceptability of randomisation and participation in the intervention was favourable, and adherence to the exercises exceeded the pre-defined 35% minimum criterion. The MD Anderson Dysphagia Inventory swallow related quality of life measure was selected as the most suitable primary outcome for sample size estimation. No adverse effects arose from the intervention, or study participation. Conclusions: A definitive trial of the SIP SMART intervention compared to usual care is feasible and can be undertaken with patients with head and neck cancer treated within the NHS. Trial Registration: ISRCTN40215425
High-throughput sequencing analysis of intestinal flora changes in ESRD and CKD patients
Authors: liu yan , Hu Jianguang , Zhong Xiaoshi , Yan Jing , Zhou Daoyuan , Qin Danping , Xiao Xiao , Zheng Yuanyuan
Published: December 2019

Background Chronic kidney disease (CKD) disease affects gut flora by causing dysbiosis and lead to systemic inflammatory conditions. Here, we provide intestinal flora changes of CKD patients undertook different hemodialysis therapy.Methods Patients were recruited during 2017-2019 and divided into healthy control group (CT), CKD non-dialysis group (CKD), hemodialysis group (HD) and peritoneal dialysis group (PD). Intestinal flora genome 16S rDNA sequencing and further bio-informatic analysis were performed.Results Decreased diversity and altered communities of intestinal flora in PD patients, in which microbial diversity was positive correlated with the albumin level were observed. A total of 20 intestinal flora phyla were detected in 166 fecal samples, divided into 3 dominant intestinal types including Bacteroides-dominant gut type, Firmicutes-dominant type and Proteobacteria-dominant gut type. Further analyses found 198 genera, the abundance of 86 genera were significantly different. Butyrate-producing taxa as Faecalibacterium in genera level and Bifidobacteriaceae and Prevotellaceae in family level were dominant genus in CT, CKD, and HD groups, while urease containing-, indole- and p-cresol-forming taxa as Escherichia in genera and Enterobacteriaceae , Enterococcaceae in family level was dominated genus in PD group. Number of differential expressed genes in KEGG enrichment pathways were significantly different in PD group in carbohydrate metabolism, amino acid metabolism, energy metabolism, translation, and membrane transport.Conclusion Our results suggest peritoneal dialysis therapy could result in reduced diversity and altered microbial communities, with reduced probiotic butyrate-producing taxa and increased urease containing-, indole- and p-cresol-forming taxa. The disordered intestinal flora can seriously affect the nutrition level in CKD patients with PD therapy.
Integrated Care Search: Development and validation of a PubMed search filter for retrieving the integrated care research evidence
Authors: Damarell Raechel A. , Lewis Suzanne , Trenerry Camilla , Tieman Jennifer J.
Published: December 2019

Background Integrated care is an increasingly important principle for organising healthcare. Integrated care models show promise in reducing resource wastage and service fragmentation whilst improving the accessibility, patient-centredness and quality of care for patients. Those needing reliable access to the growing research evidence base for integrated care can be frustrated by search challenges reflective of the topic's complexity. The aim of this study is to report the empirical development and validation of two search filters for rapid and effective retrieval of integrated care evidence in PubMed. One filter is optimised for recall and the other for precision.Methods An Expert Advisory Group comprising international integrated care experts guided the study. A gold standard test set of citations was formed from screening Handbook Integrated Care chapter references for relevance. This set was divided into a Term Identification Set (20%) for determining candidate terms using frequency analysis; a Filter Development Set (40%) for testing performance of term combinations; and a Filter Validation Set (40%) reserved for confirming final filter performance. In developing the high recall filter, recall was steadily increased while maintaining precision at ≥ 50%. Similarly, the high precision filter sought to maximise precision while keeping recall ≥ 50%. For each term combination tested, an approximation of precision was obtained by reviewing the first 100 citations retrieved in Medline for relevance.Results The gold standard set comprised 534 citations. The search filter optimised for recall ('Broad Integrated Care Search') achieved 86.0%-88.3% recall with corresponding low precision (47%-53%). The search filter optimised for precise searching ('Narrow Integrated Care Search') demonstrated precision of 73%-95% with recall reduced to between 55.9% and 59.8%. These filters are now available as one-click URL hyperlinks in the website of International Foundation for Integrated Care.Conclusions The Broad and Narrow Integrated Care Search filters provide potential users, such as policy makers and researchers, seamless, reliable and ongoing access to integrated care evidence for decision making. These filters were developed according to a rigorous and transparent methodology designed to circumvent the challenges of information retrieval posed by this complex, multifaceted topic.
Clinical characterstics, precipitating factors and glycemic control among diabetic ketoacidosis patients admitted to university hopsital in Northwest Ethiopia: A hospital based observational study.
Authors: Alemnew Gizework Mekonnen , Abegaz Tadesse Melaku
Published: December 2019

Aims: The aim of the study was to determine the clinical characteristics, precipitating factors and the level of glycemic control of diabetic ketoacidosis patients admitted to Debretabor General Hospital, northwest Ethiopia.Methods: A retrospective, cross-sectional study was conducted at Debretabor General Hospital and data was collected from June 1 to 30, 2018.Participants included in the study were all diabetic patients with diabetic ketoacidosis admitted to the General Hospital during the study period. The primary outcome was to determine precipitating factors for DKA and the level of glycemic control of diabetic ketoacidosis patients. All the statistical data was carried out using Statistical Package for Social Sciences (SPSS).Result: A total of 387 patients’ medical records contained pertinent complete information included in this study. The mean age of the patients was 33.30± 14.96 years. The majority of patients were females 244 (63.0%). The most common clinical presentation was polyuria and polydipsia in (n=379, 97.9%) of patients. The most common precipitating factor was newly diagnosed diabetics mellitus 150(38.8%). Binary logistic regression showed that for every increase in the duration of the disease(DM) by 1 year, the likelihood of controlling hyperglycemia would increases nearly 1.5 times AOR:1.497 [1.203-1.814].Conclusions: In this study, newly onset type 1 diabetes mellitus was the major precipitating factor for DKA. Polyuria and polydipsia were the most common presenting clinical characteristic of diabetic ketoacidosis. Long standing DM was found to be associated with good glycemic control among DKA patients.
Clinically useful prediction of hospital admissions in an older population
Authors: Marcusson Jan , Nord Magnus , Dong Huan-Ji , Lyth Johan
Published: December 2019

Background The health care for older adults is insufficient in many countries, not designed to meet their needs and is often described as disorganized and reactive. Prediction of older persons at risk of admission to hospital may be one important way for the future health-care system to act proactively when meeting increasing needs for care. Therefore, we wanted to develop and test a clinically useful model for predicting hospital admissions of older persons based on routine health-care data.Methods We used the health-care data on 40,728 persons, 75-109 years of age to predict hospital in-ward care in a prospective cohort. Multivariable logistic regression was used to identify significant factors predictive of unplanned hospital admission. Model fitting was accomplished using forward selection. The accuracy of the prediction model was expressed as area under the receiver operating characteristic (ROC) curve, AUC.Results The prediction model consisting of 38 variables exhibited a good discriminative accuracy for unplanned hospital admissions over the following 12 months (AUC 0·69 [95% confidence interval, CI 0·68–0·70]) and was validated on external datasets. Clinically relevant proportions of predicted cases of 40 or 45% resulted in sensitivities of 62 and 66%, respectively. The corresponding positive predicted values (PPV) was 31% and 29%, respectively.Conclusion A prediction model based on routine administrative health-care data from older persons can be used to find patients at risk of admission to hospital. Identifying the risk population can enable proactive intervention for older patients with as-yet unknown needs for health care.
KLF4 alleviates cerebral vascular injury by ameliorating vascular endothelial inflammation and regulating tight junction protein expression following ischemic stroke
Authors: Zhang Xinyu , Wang Lu , Han Zhenxiang , Dong Jing , Pang Defang , Fu Yuan , Li Longxuan
Published: December 2019

Background: Although inflammatory cell adhesion molecules (CAMs) and anti-inflammation factor- kruppel-like transcription factor (KLF) 4 have all been reported to be induced after cerebral ischemic stroke (CIS), the close temporal and spatial relationship between expressions of CAMs and KLF4 following CIS, and whether and how CAMs and KLF-4 contribute to development of CIS-induced vascular injury are still unclear.Methods: Here, we first examined the correlation between serum levels of CAMs/KLF4 and infarct volume in acute CIS patients. Then, we determined relationship between CAMs and KLF4 in mice after focal cerebral ischemia. Finally, we investigated the mechanism of KLF4 in protecting against oxygen-glucose deprivation-induced brain endothelial cell injury.Results Our results demonstrated that patients with moderate to severe CIS had higher serum levels of three CAMs (E-selectin, inter-cellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1)) but lower levels of KLF4 at 48 hours after acute event as compared to patients with minor CIS. The expression levels of three CAMs as well as KLF4 all correlated well with the infarct volume in all the CIS subjects at that time. Although the expressions of three CAMs and KLF4 were all induced in the ischemic hemisphere following focal cerebral ischemia, but the peak timing and distribution patterns of their expression were different: the induction of KLF4 lagged behind that of the CAMs in the ischemic penumbra, furthermore, the dual immunofluorescent studies displayed that high expression of KLF4 was always associated with relatively less cerebral vascular endothelial inflammation response in the ischemic hemisphere, and vice versa. Mechanistic analyses revealed that KLF4 alleviated CIS-induced cerebral vascular injury by regulating endothelial expressions of CAMs, nuclear factor-kB and tight junction proteins.Conclusions These data indicate that KLF4 confers vascular protection against cerebral ischemic injury, suggesting that circulating CAMs and KLF4 might be used as potential biomarkers for predicting the prognosis of acute ischemic stroke, and also providing a new proof of concept and potential targets for future prevention and treatment of CIS.
Oral Nystatin Prophylaxis to Prevent Systemic Fungal Infection in Very Low Birth Weight Preterm Infants : A Randomized Controlled Trial
Authors: Rundjan Lily , Wahyuningsih Retno , Oeswadi Chrissela Anindita , Marsogi Miske , Purnamasari Ayu
Published: December 2019

Background Systemic fungal infection (SFI) is one of leading causes of morbidity and mortality in very low birth weight (VLBW) preterm infants. Because early diagnosis of SFI is challenging due to nonspecific manifestations, prophylaxis becomes crucial. This study aimed to assess effectiveness of oral nystatin as an antifungal prophylaxis to prevent SFI in VLBW preterm infants.Methods A prospective, open-labelled, randomized controlled trial was performed in a neonatal intensive care unit (NICU) of an academic hospital in Indonesia. Infants with a gestational age < 32 weeks and/or birth weight of < 1500 grams with risk factors of fungal infection were assessed for eligibility and randomized to either an intervention group (nystatin) or control group. The intervention group received 1 ml of oral nystatin three times a day, and the control group received a dose of 1ml of sterile water three times a day. The incidence of fungal colonization and SFI were observed and evaluated during the six-week study period. Overall, mortality rates and nystatin-related adverse drug reactions during the study period were also documented.Results A total of 95 patients were enrolled. The incidence of fungal colonization was lower among infants in nystatin group compared to those in control group (29.79% and 56.25%, respectively; relative risk 0.559; 95% confidence interval 0.357-0.899; p-value=0.009). There were five cases of SFI, all of which were found in the control group (p-value=0.056). There was no difference in overall mortality between the two groups. No adverse drug reactions were noted during the study period.Conclusions Nystatin is effective and safe as an antifungal prophylactic medication in reducing colonization rates in the study population. Whilst the use of nystatin showed a potential protective effect against SFI among VLBW preterm infants, there was no statistical significant difference in SFI rates between groups.
A novel all-in-one strategy for purification and immobilization of β-1,3-xylanase directly from cell lysate as active and recyclable nanobiocatalyst
Authors: Cai Lixi , Chu Yunmeng , Liu Xin , Qiu Yue , Ge Zhongqi , Zhang Guangya
Published: December 2019

Background: Exploring a simple and versatile technique for direct immobilization of target enzymes from cell lysate without prior purification is urgently needed. Thus, a novel all-in-one strategy for purification and immobilization of β-1, 3-xylanase was proposed, the target enzymes were covalently immobilized on silica nanoparticles via ELP-based biomimetic silicification and SpyTag/SpyCatcher spontaneous reaction. Thus, the functional carriers that did not require the time-consuming surface modification step were quickly and efficiently prepared. These carriers could specifically immobilize the SpyTag-fused target enzymes from the cell lysate without pre-purification. Results: The ELPs-SpyCatcher hardly leaked from the carriers (0.5%), and the immobilization yield of enzyme was up to 96%. Immobilized enzyme retained 85.6% of the initial activity and showed 88.6% of the activity recovery. Compared with free ones, the immobilized β-1, 3-xylanase showed improved thermal stability, elevated storage stability and good pH tolerance. It also retained more than 70.6% of initial activity after12 reaction cycles, demonstrating its excellent reusability. Conclusions: The results clearly highlighted the effectiveness of the novel enzyme immobilization method proposed here due to the improvement of overall performance of immobilized enzyme in respect to free form for the hydrolysis of macromolecular substrates. Thus, it may have great potential in the conversion of algae biomass as well as other related fields.
Cone Beam Computed Tomography (CBCT) in Periodontal Diseases: A Systematic Review Based on the Efficacy Model
Authors: Assiri Hassan , Dwasaz Ali
Published: December 2019

Objectives: The aim of this study was to address the diagnostic efficacy of cone beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model.Methods: A systematic search of the electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted until February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on a diagnostic imaging modality. Two examiners performed the eligibility and quality assessment of relevant studies, and consensus was reached where disagreement was found.Results: The search resulted in 64 studies. Of these, 35 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy studies showed the risk of bias and applicability concerns in the use of CBCT to be low to moderate. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of the outcomes after the treatment of periodontal defects.Conclusion: CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.
Strategies For Strengthening High Risk Pregnancy Care In Primary Healthcare Services
Authors: Aratani Nathan , Tanaka Oswaldo Yoshimi
Published: December 2019

Background: In the Brazilian Public healthcare system (The Unified Healthcare System - Sistema Único de Saúde), Primary Healthcare has expanded from implementing healthcare networks, an organization form of services with centrality to primary care services. Due to the extension and heterogeneity of Brazilian municipalities, several organization forms of primary care services existed. In the city of São Paulo they were organized by three modalities of Basic Health Units. Thus, this study aimed to evaluate the care continuity in high-risk pregnancy care in different models of the basic health units. Methods:Data analysis defined performing prenatal care in primary care even after referral to the high-risk pregnancy service as the dependent variable. The independent variables were the sociodemographic and organizational aspects of health services. Logistic regression was used as the statistical technique. Results:Care is provided in a similar way in all basic health unit models, without prioritizing pregnant women with greater vulnerabilities (under 15 years and over 35 years, with education less than 7 years). Regarding women of black or brown color, it was observed that they were more likely (OR 1.997) to have care continuity in family health units. Home visiting and knowing the community health agent proved to be tools for organizing health services which are capable of producing better care. Conclusion: Primary healthcare services in Brazil for high-risk pregnancy care are organized without considering individual vulnerabilities. The home visits and the presence of the community health agent need to be strengthened in organizing the services, as they are able to modify the process of producing healthcare.
Acute effects of systemic inflammation upon the neuro-glial-vascular unit and cerebrovascular function.
Authors: Brezzo Gaia , Simpson Julie , Ameen-Ali Kamar E. , Berwick Jason , Martin Chris
Published: December 2019

Background Brain health relies on a tightly regulated system known as neurovascular function whereby the cellular constituents of the neuro-glial-vascular unit (NGVU) regulate cerebral haemodynamics in accordance with neuronal metabolic demand. Disruption of neurovascular function impairs brain health and is associated with the development of disease, including Alzheimer’s disease. The NGVU is also a key site of action for neuroinflammatory responses and contributes to the transition of systemic inflammation to neuroinflammatory processes. Thus, systemic inflammatory challenges may cause a shift in NGVU operation towards neuroimmune over neurovascular actions, leading to altered neurovascular function. Methods To investigate this, rats were injected with lipopolysaccharide (LPS) (2mg/kg) to induce a systemic inflammatory response, or vehicle, and brain haemodynamic responses to sensory and non-sensory (hypercapnia) stimuli were assessed in vivo using optical imaging techniques. Following imaging, animals were perfused and their brains extracted to histologically characterise components of the NGVU to determine the association between altered underlying pathology and in vivo blood flow regulation. Results LPS-treated animals showed altered haemodynamic function and cerebrovascular dynamics six hours after LPS administration. Histological assessment identified a significant increase in astrogliosis, microgliosis and endothelial activation in LPS-treated animals. Conclusions Our data shows that an acutely induced systemic inflammatory response is able to rapidly alter in-vivo haemodynamic function and is associated with significant changes in the cellular constituents of the NGVU. We suggest that these effects are initially mediated by endothelial cells, which are directly exposed to the circulating inflammatory stimulus and have been implicated in regulating functional hyperaemia.
Investigating Psychometric Properties of the Thai Version of Zarit Burden Interview using Rasch Model
Authors: Pinyopornpanish Kanokporn , Pinyopornpanish Manee , Wongpakaran Nahathai , Wongpakaran Tinakon , Soontornpun Atiwat , Kuntawong Pimolpun
Published: December 2019

Objective: The Zarit Burden Interview (ZBI) has been widely used to assess caregiver’s burden. Research investigating the Thai version of the ZBI is few. The study aimed to examine the psychometric properties of both the full length (ZBI-22) and short versions (ZBI-12) using Rasch analysis among a sample of Alzheimer’s disease caregivers. Results: The ZBI-22 fitted the Rasch measurement model regarding unidimensionality but not for ZBI-12. Five items from ZBI-22, and two items from ZBI-12 were shown to be misfitting items. The model of ZBI-12 was improved when item “should do more” and “could do a better job caring” were removed. Reliability was good for both forms of the ZBI (a = 0.86 - 0.92). Significant correlations were found with caregiver’s perceived stress and caregiver's depression. Significant correlation with subscales of anxiety/depression, pain and mobility were indicative of discriminant validity but not with self-care and usual activity (p > 0.05). To conclude, the Thai version ZBI was supported for the reliability and validity in both the full length and 12 short forms among Alzheimer’s disease caregivers; however, some misfitting items of the ZBI undermined the unidimensionality of the scale, and need revision.
Ethnomedicine investigation of the medicinal plants and animals in Daur, Inner Mongolia, China
Authors: Bi Ya-Qiong , Yi Le-Tai , Zhang Lei , Sun Ya-Hong , Li Minhui
Published: December 2019

Background: The classification and application of Daur medicine is an essential part of Chinese ethnomedicinal knowledge. However, the cataloging of traditional Daur medicine is still limited. As Daur medicine is gradually being replaced by traditional Chinese and modern medicine, further research is urgently needed.Methods: We collected ethnobotany and ethnozoology data via semi-structured interviews, focus group discussions, and extensive literature reviews. Medicinal samples and specimens were collected during field investigations from June 2015 to October 2018. Attending diseases and ailments were classified according to the International Classification of Diseases 11th (ICD-11). The expression correlation of medicine classification, medicine and disease was assessed using Cytoscape 3.6.1 software. Use values were calculated to determine the importance of tradition medicinal plants and animals.Results: We documented 30 plant species (from 19 families) and 21 animal species (from 11 families). The majority of the species were previously collected from natural habitats but they have gradually become cultivated. The most widely utilized plants were herbs (21 species), followed by shrubs (4), trees (3), and fungus (2). The most utilized groups of animals were mammals (14 species), followed by birds (5), amphibians (1), and reptiles (1). Medicines were mostly administered orally (39), but were also externally applied (11), or via both routes (9). Informants indicated that medicines were prepared via decoction (21), grinding (11), boiling (10), extraction (8), and burning (7). Most medicines are taken/consumed as a drink (37), eaten (16), or made into pills and powders (7), but also used as an anointment/wash (6), wrap/dressing (5), in the nose, eyes, and mouth (4), or as a fumigate (2). The reported traditional Daur medicines treated 76 human diseases or ailments classified under 13 disease categories, based on the ICD-11. The most commonly used medicinal species were Cervus elaphus, Cervus nippon, Capreolus capreolus, Gallus gallus, Canis lupus familiaris, Betula platyphylla, and Artemisia integrifolia.Conclusions: A wealth of ethnobiological and ethnozoological knowledge exists, which may lead to the development of new drugs; thus, such knowledge urgently requires documentation. The information documented in the present study will be useful for future studies on the ethnopharmacological and traditional knowledge of the Daur region.
Higher prevalence of multi-antimicrobial resistant Bacteroides spp. strains isolated at a tertiary teaching hospital, China
Authors: Wang Yanyan , Han Yanqiu , Shen Huimin , Lv Yingying , Zheng Wenqi , Wang Junrui
Published: December 2019

Background: The antimicrobial resistance of Bacteroides spp. isolates is reported to be increasing among different districts around the world, and few reports found that multi-antimicrobial resistant strains emerged. However, less is known about the prevalence of multi-antimicrobial resistant isolates in China, especially for carbapenem resistance. Methods: Bacteroides spp. clinical strains were isolated from inpatients at a 3000 bed tertiary teaching hospital , and were identified by MALDI-TOF MS and VITEK-2 anaerobes and corynebacterium (ANC) card. Broth microdilution method was employed to detect the antimicrobial sensitivities of Bacteroides spp. isolates and PCR method was used to detect the resistance genes, including cfxA, cepA, cfiA, ermF and nim. The upstream insertion sequence (IS) element of cfiA gene was further detected and verified. Results: Among 115 Bacteroides spp. strains enrolled in this study, 80 isolates were Bacteroides fragilis and 35 isolates were non-Bacteroides fragilis. The total resistance rates of 115 Bacteroides spp. isolates to ampicillin/sulbactam, amoxicillin/clavulanic, cefoxitin, piperacillin, piperacillin/tazobactam, moxifloxacin, clindamycin, metronidazole, imipenem and meropenem were 22.6%, 19.6%, 3.5%, 27.8%, 8.7%, 16.5%, 80.0%, 5.2%, 13.9% and 13.9% , respectively. Except cefoxitin and moxifloxacin, the resistance rates of B. fragilis isolates to the above antibiotics were all higher than those of non-B. fragilis isolates. The positive rates of carbapenem resistance gene cfiA were 38.9% and 8.6% for B. fragilis and non-B. fragilis isolates, respectively. For 15 carbapenem resistant B. fragilis isolates, the co-carrying rates of carbapenem resistance gene cfiA and its upstream IS element were 86.7% (13/15). Conclusions: The overall resistance rates of Bacteroides spp. isolates toward multiple antibiotics were at a higher level, especially for B. fragilis. CfiA gene carrying rate among B. fragilis isolates was high up to 38.9% and its mediated carbapenem resistance was a major resistance mechanism for B. fragilis. The findings of this study imply that the actual resistance tendency of Bacteroides spp. may be underestimated and need to be given more attention to.
Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China
Authors: Wang Yingying , Lin Jialing , Zhou Junli , Han Zhigang , Yao Zhenjiang
Published: December 2019

Background: Staphylococcus aureus (S. aureus), particularly methicillin-resistant Staphylococcus aureus (MRSA), remains the predominant cause of infections in drug users. The cross-sectional study aims to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus carriage among community-based drug users.Methods: All eligible drug users, both intravenous and oral drug users, were asked to complete questionnaires and collect nasal swabs during the period between May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus. Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus carriage.Results: Overall, 353 drug users were included in the study and the prevalence of S. aureus carriage was 15.01% (53/353). The prevalence of MRSA carriage was 6.80% (24/353). Cohabitation was a risk factor for S. aureus (adjusted OR=8.80, 95% CI: 1.89-40.99). The proportion of multidrug resistance was 54.72% for S. aureus isolates and most of these isolates were resistant to penicillin, erythromycin and clindamycin. Seventeen MRSA isolates were multidrug resistant. The results of clonal complexes (CCs) and sequence types (STs) for S. aureus were diverse. The three predominant types for CCs were CC5 (64.15%, 34/53), CC59 (11.32%, 6/53), and CC7 (7.55%, 4/53); and for STs were ST188 (20.75%, 11/53), ST5 (11.32%, 6/53), and ST59 (11.32%, 6/53). Conclusion: The prevalence of S. aureus nasal carriage was lower when the prevalence of MRSA carriage was moderate. Phenotypic and molecular characteristics of S. aureus isolates, particularly MRSA isolates, revealed serious antibiotic resistance, indicating the existence of cross-circulation, and implying high opportunity of virulence-related diseases. Decolonization might be considered for drug users with MRSA carriage.
Circulating sex hormone levels in relation to male sperm quality
Authors: Zhao Wei , Jing Jun , Shao Yong , Zeng Rong , Wang Cencen , Hang Dong , Yao Bing
Published: December 2019

Background Although sex hormones play critical roles in spermatogenesis and sperm maturation, it remains inconclusive whether circulating sex hormones can serve as non-invasive biomarkers to determine sperm quality. Methods We systematically evaluated the association of various sex hormones in serum with sperm quality among 338 subfertile males. Concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), total estradiol (E2), and sex hormone-binding globulin (SHBG) were detected by chemiluminescent immunoassay. Free testosterone and estradiol were calculated using a validated algorithm. A generalized liner regression model controlling for lifestyle factors was used to assess the associations with sperm count, concentration, motility, and morphology. Results After adjusting for age, body mass index, current smoking and alcohol drinking, LH, FSH, and TT levels were all inversely associated with sperm motility (all P for trend < 0.05); however, in mutual adjustment analysis, only LH remained an inverse association with sperm motility after adjusting for FSH and TT levels ( P for trend = 0.04 ). Higher concentrations of LH were also associated with lower sperm progressive motility ( P for trend = 0.04 ). Moreover, LH and FSH levels were both inversely associated with normal sperm morphology ( P for trend = 0.04 and 0.02, respectively ). Conclusions Increased levels of LH are associated with poor sperm motility and morphology. Our findings suggest that LH might play a central role in sperm maturation, which represents a potential biomarker to improve clinical evaluation of male infertility.
Distribution of Parkinson’s disease associated RAB39B in mouse brain tissue
Authors: Gao Yujing , Wilson Gabrielle R. , Stephenson Sarah E.M. , Oulad-Abdelghani Mustapha , Charlet-Berguerand Nicolas , Bozaoglu Kiymet , McLean Catriona A. , Thomas Paul Q. , Finkelstein David I. , Lockhart Paul
Published: December 2019

Pathogenic variants in the gene encoding the small GTPase Ras analogue in Brain 39b (RAB39B) are associated with early-onset parkinsonism. In this study we investigated the expression and localization of RAB39B (RNA and protein) in mouse brain tissue to gain a better understanding of its normal physiological function(s) and role in disease. We developed novel resources, including monoclonal antibodies directed against RAB39B and mice with Rab39b knockout, and performed real-time PCR and western blot analysis on whole brain lysates. To determine the spatial localization of Rab39b RNA and protein, we performed in-situ hybridization and immunohistochemistry on fresh frozen and fixed brain tissue. Our results show that RAB39B is localized throughout the cortex, hippocampus and substantia nigra of mice throughout postnatal life. We found high levels of RAB39B within MAP2 positive cortical and hippocampal neurons, and TH positive dopaminergic neurons in the substantia nigra pars compacta. Our studies support and extend current knowledge of the localization of RAB39B. We validate RAB39B as a neuronally-enriched protein and demonstrate that is present throughout the mouse cortex and hippocampus. Further, we observe high levels in the substantia nigra pars compacta, the brain region most affected in Parkinson’s disease pathology. The distribution of Rab39b is consistent with human disease associations with parkinsonism and cognitive impairment. We also describe and validate novel resources, including monoclonal antibodies directed against RAB39B and mice with Rab39b knockout, both of which are valuable tools for future studies of the molecular function of RAB39B.
A pilot case-control study using a one health approach to evaluate behavioral, environmental, and occupational risk factors for chronic kidney disease of unknown etiology in Sri Lanka
Authors: Pry Jesse , Jackson Wendi , Rupasinghe Ruwini , Lishanthe Guneratne , Badurdeen Zied , Abeysekara Tilak , Chandrajith Rohana , Smith Woutrina , Wickramasinghe Saumya
Published: December 2019

Chronic kidney disease of unknown etiology (CKDu) was first recognized in Sri Lanka in the early 1990s, and since then it has reached epidemic levels in the North Central Province of the country. The prevalence of CKDu is reportedly highest among communities that engage in chena and paddy farming, which is most often practiced in the dry zone including the North Central and East Central Provinces of Sri Lanka. Previous studies have suggested varied hypotheses for the etiology of CKDu; however, there is not yet a consensus on the primary risk factors, possibly due to disparate study designs, sample populations, and methodologies. The goal of this pilot case-control study was to evaluate the relationships between key demographic, cultural, and occupational variables as risk factors for CKDu, with a primary interest in pesticide exposure both occupationally and through its potential use as an ingredient in brewed kasippu alcohol. A total of 56 CKDu cases and 54 control individuals were surveyed using a proctored, self-reported questionnaire. Occupational pesticide exposure and alcohol consumption were not found to be significant risk factors for CKDu. However, a statistically significant association with CKDu was observed with chewing betel (OR: 6.11, 95% CI: 1.93, 19.35), age (OR: 1.07, 95% CI: 1.02, 1.13), owning a pet dog (OR: 3.74, 95% CI: 1.38, 10.11), water treatment (OR: 3.68, 95% CI: 1.09, 12.43) and pests in the house (OR: 5.81, 95% CI: 1.56, 21.60). The findings of this study suggest future research should focus on practices associated with chewing betel, potential animal interactions including pests in the home and pets, and risk factors associated with water.
Study on the measurement method of environmental pollution loss based on shadow price model of waste gases emission from energy consumption in China's industrial parks
Authors: Han Xiuyan , Sun Tao , Cao Taiyi
Published: December 2019

Background: China's industrial parks are areas where energy consumption is relatively concentrated and air pollution is relatively serious. Air pollution threatens the living environment, health and even life of the residents around the industrial park. Therefore, the measurement of air pollution loss and its application have been raised, and gradually become an important problem to be solved.Results: In order to explore the measurement method of environmental pollution loss from energy consumption waste gas emission in industrial parks, this paper, based on literature review, draws lessons from the latest research results at home and abroad, fully considers the actual situation of energy consumption waste gas emission and environmental pollution control in China's industrial parks, and constructs the shadow price measurement model of environmental pollution loss from energy consumption waste gas emission. Taking Nanjing MV industrial park as an example, the application test of environmental pollution loss of energy consumption waste gas emission is carried out by using the relevant statistical data of the park, and the validity of the model is verified.Conclusions: The results show that the shadow price model is more effective for the Measurement of environmental pollution loss of exhaust gas emissions from energy consumption in industrial parks. The research results are of great significance to guide exhaust emission enterprises to strengthen environmental pollution loss control and support local governments to formulate energy consumption and exhaust emission standards and relevant policies for industrial parks
Carbonaceous composite materials from calcination of azo dye-adsorbed layered doubled hydroxide with enhanced photocatalytic efficiency for removal of Ibuprofen in water
Authors: Shen Xiaolin , Zhiliang ZHU , Zhang Hua , Di Guanglan , Chen Ting , Qiu Yanling , Yin Daqiang
Published: December 2019

Background: The discard of used adsorbents may pose a great threat to human health and ecological environment. This work herein reported a facile and feasible method, with aims of (i) reusing the calcined layered double hydroxide (CLDH) adsorbent after azo dye adsorption, and (ii) being further used as a photocatalyst to enhance the degradation of typical pharmaceuticals. Calcination under inner gas flow has been utilized to carbonize adsorbed azo dye and a kind of novel carbonaceous CLDH composite material (CM-CLDH) was synthesized. This fabricated material was used as a catalyst for Ibuprofen removal in water samples under simulated sunlight irradiation.Results: According to our experimental results, combination of carbonaceous material with CLDH showed an enhanced photocatalytic performance compared to original CLDH materials. More than 90% of Ibuprofen could be removed in less than 180 min. Photoluminescent spectra and transient photocurrent examination confirmed that suppressed recombination of photo-induced electrons and holes led to higher photocatalytic activities. Furthermore, conduct band potential (E CB ) of the CM-CLDH became lower (-1.31 V), manifesting higher oxidation ability of accumulated electrons, leading to better photocatalytic activity. Under experimental conditions, the removal efficiency of Ibuprofen by CM-CLDH composite kept above 90% during five cycles.Conclusion: Calcination under inner gas flow can transform organic pollutant-adsorbed CLDH to CM-CLDH composite with higher photocatalytic performance. A feasible way to reuse spent LDH adsorbents was proposed, which is benefit to reduce second pollution of spent adsorbents in environment.
Fate simulation and risk assessment of TBT and TPhT considering water level fluctuations in the TGR before and after AFS Convention implementation in China
Authors: Gao Jun-min , Fu Ping-ting , Chen Xiao-ling , Guo Jin-song , Hou Xian-yu , Zeng Jie , Chen Zhu-man
Published: December 2019

Background: The Three Gorges Reservoir (TGR) is the largest freshwater reservoir in China. Previous studies showed that organotin pollution is present in the TGR. In June 2011, the AFS Convention went into effect in China. In order to explore the pollution evolution processes of tributyltin (TBT) and triphenyltin (TPhT) before and after implementation of the AFS Convention and their variations with water level fluctuations in the TGR, the characteristic parameters of the TGR and the physicochemical parameters of TBT and TPhT were used to develop a level IV multimedia fugacity model considering water level fluctuations to simulate the fate, transfer, and transport of TBT and TPhT in the TGR. Based on the simulation results, exposure concentrations of TBT and TPhT were then used to assess the ecological and health risks in the TGR region (TGRR). Results: The simulation results showed that the average concentrations of both TBT and TPhT decreased in all compartments except the sediment, whereas the total content of the system continued to increase after the AFS Convention was implemented. The concentration of TBT in the sediment was higher than that in fish, while the concentration of TPhT in fish was much greater than that in the sediment. The total contents of both TBT and TPhT were highest in the sediment phase. In addition, variations in water level of the TGR significantly affected the distribution and transport of TBT and TPhT in the TGR. Conclusions: Sediment is an important source and sink of TBT and TPhT, and the water level regulation of the TGR strengthened the two roles of sediment. Both TBT and TPhT in surface water, but especially TBT, carried significant chronic exposure risks to the aquatic community of the TGR. Intake of TPhT, mainly through eating fish, posed a potential health risk to the population in the TGRR.
Early cognitive function changes after dexmedetomidine added to propofol-based sedation for gastrointestinal endoscopy
Authors: Chen Lei , Lin Bi , Wu Fangyuan , Zhao Xiyue , Jin Lida , Lin Lina
Published: December 2019

Background: Propofol usually used for sedation for gastrointestinal endoscopy, result in short-term, reversible decline in cognitive function. This prospective cohort trial aimed to propofol plus dexmedetomidine can improve cognitive function for elective outpatient gastrointestinal endoscopy. Methods: Patients undergoing gastrointestinal endoscopy were included. Patients were randomized allocation into group C (groupC30 and groupC60), and group D. The group D was The group D was a continuous intravenous pumping of dexmedetomidine at a dose of 0.3μg/kg within 10min before anaesthesia; the group C were given an equal volume of normal saline instead. Patients underwent a MoCA test before sedation and at discharge. Results: The MoCA scores were similar at baseline in each group. Compared to baseline before gastrointestinal endoscopy, the MoCA scores were decreased each group ( group C30: p<0.001; group C60: p<0.001; group D: p=0.002). Compared to group C30, the MoCA scores were better in group C60 (p=0.03) and group D (p<0.001), and those in group D were higher than those in group C60 (p<0.001). Incidence of cognitive impairment in group C30 is 56.6% which ranks the highest among the three groups, and those in group D is 7.8% which ranks the lowest among the three groups, the difference is significant statistically (p<0.001). The MoCA scores were similar between the genders in each group (p>0.05). Conclusions: Dexmedetomidine added to sedation for gastrointestinal endoscopy can improve early cognitive function and reduce incidence of cognitive impairment.