bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal abscesses refractory to treatment: Have you thought of tuberculosis?
Authors: Abdalla Omer , Phan Yih Chyn , Ismail Mohamed
Published: January 2020

Urogenital tuberculosis is the commonest extrapulmonary tuberculosis after lymphadenitis, with the kidneys being the most frequently affected organ. The clinical manifestation of renal tuberculosis is frequently nonspecific, leading to many overlooked cases especially in a developed country. Herein, we report a case of renal tuberculosis in a 79-year-old Caucasian lady who presented with recurrent renal abscess refractory to antibiotics.

Level of evidence: Level 5
The destiny of replaced technological products: The influence of perceived residual value
Authors: Kréziak Dominique , Prim-Allaz Isabelle , Robinot Elisabeth
Published: January 2020

Technological products are being replaced at an increased rate, inducing the disposition of still functioning devices and generating a growing flow of electronic waste. Following the perspective of the circular economy, this research uses perceived residual value (PRV) to shed new light on the destiny of replaced products. Considering simultaneously consumers’ evaluation of a product in a specific situation, PRV is the value consumers ascribe to post-use possession. A measurement tool of PRV is developed and used to measure its effects on a sample of 1,302 respondents representative of the French population. Results show that the three dimensions of PRV (utilitarian, financial, and affective) influence whether or not a replaced technological product is kept. PRV has a major impact on disposition channels when the replaced product is not kept. These results lead to managerial recommendations, as PRV can be used to foster product recirculation and contribute to reducing the wastage of natural resources.
Negotiating a Shared Interpretation During Piano Duo Performance
Authors: Bishop Laura , Goebl Werner
Published: January 2020

Most notated forms of music require interpretation of loosely-defined score instructions. For music ensembles, coordinating a shared interpretation in which each performer plays a complementary role can be challenging, especially if performers have already established their own individual interpretations. This study aimed to identify the patterns of behavior that distinguish performance in collaborative and solo conditions. We tested the hypothesis that highly skilled pianists would be motivated to create more expressively variable and divergent interpretations in the collaborative duet setting than when performing solo. Pianists recorded solo and duet performances of a new piece following individual rehearsal. MIDI and head motion data were assessed. Contrary to expectations, duet performances were less expressively variable than solo performances and no more or less prototypical; indeed, prototypicality increased with years of training. Leader–follower relationships in note timing emerged, with primos tending to take the lead. Pianists moved less during duet performances, and more smoothly. Coordination in head acceleration patterns also emerged during duet performances. Our findings show how performers’ intent to collaborate encourages more communicative styles of head movement and a conservative or protective style of playing that prioritizes coordination over creativity.
One issue, different stories: The construction of GMO issues on Chinese, American and British mainstream media portals
Authors: Ruan Yiqin , Yang Jing , Jin Jianbin
Published: January 2020

Biotechnology, as an emerging technology, has drawn much attention from the public and elicited hot debates in countries around the world and among various stakeholders. Due to the public's limited access to front-line scientific information and scientists, as well as the difficulty of processing complex scientific knowledge, the media have become one of the most important channels for the public to get news about scientific issues such as genetically modified organisms (GMOs). According to framing theory, how the media portray GMO issues may influence audiences’ perceptions of those issues. Moreover, different countries and societies have various GMO regulations, policies and public opinion, which also affect the way media cover GMO issues. Thus, it is necessary to investigate how GMO issues are covered in different media outlets across different countries. We conducted a comparative content analysis of media coverage of GMO issues in China, the US and the UK. One mainstream news portal in each of the three countries was chosen ( People's Daily for China, The New York Times for the US, and The Guardian for the UK). We collected coverage over eight years, from 2008 to 2015, which yielded 749 pieces of news in total. We examined the sentiments expressed and the generic frames used in coverage of GMO issues. We found that the factual, human interest, conflict and regulation frames were the most common frames used on the three portals, while the sentiments expressed under those frames varied across the media outlets, indicating differences in the state of GMO development, promotion and regulation among the three countries.
Misinformation and disinformation in science: Examining the social diffusion of rumours about GMOs
Authors: Jiang Sujia , Fang Wei
Published: January 2020

Genetically modified organisms (GMOs) have caused considerable controversy in China in recent years. Uncertainty about the technology, ineffective channels for releasing official information and a lack of sufficient public trust in the government and scientists have led to rampant rumours about genetic modification technology, making it hard for the public to acquire scientific knowledge about it and a rational attitude towards it. In this paper, by using as an example the rumour that genetically modified (GM) soybeans cause cancer, we discuss the content and diffusion of rumours related to genetic modification technology in the new media environment. Based on an analysis of content on the social media platform Weibo one week after the rumour began, we discovered that the ensuing cyber discussions reflected reality, that netizens expressed anxiety and panic while stressing social injustice and reflecting conflict between social classes, and that they exhibited little trust in scientists and the government. On the mechanism of diffusion of rumours on Weibo, we observed that ‘evidence’ that directly or indirectly purported to show that GM soybeans cause cancer was added to the rumours and that the rumours were ‘assimilated’ into people's perception through the stigmatization of GMOs and through conspiracy theories.
Learning Engagements and the Role of Religion
Authors: Khalid Fatima , Mirza Sultan Sikandar , Bin-Feng Chai , Saeed Nighat
Published: January 2020

The objective of this study is to determine the relationship between learning engagement, academic motivation, and academic performance in undergraduate students and the importance of religion in determining the academic motivation and academic performance. A sample of 840 university students from different regions (provinces) of Pakistan is pooled through a convenient sampling technique. Engagement Versus Disaffection (EVD) and the Academic Motivation Scale (AMS) are administered for learning engagement and academic motivation, respectively. After applying analysis of variance (ANOVA), Pearson product-moment correlation analysis, and hierarchical regression, the findings of this research reveal that learning engagement and academic motivation have significant relationships with academic performance. Furthermore, it is also found that, in religiosity, academic motivation for both Muslims and non-Muslims do not induce learning engagement, but Muslim students have shown better academic performance than non-Muslims. This study can be beneficial for policymakers and practitioners to analyze the determinants of learning engagements and improve the academic performance of university students.
Operative Treatment of Traumatic Spinal Injuries in Tanzania: Surgical Management, Neurologic Outcomes, and Time to Surgery
Authors: Magogo Juma , Lazaro Albert , Mango Mechris , Zuckerman Scott L. , Leidinger Andreas , Msuya Salim , Rutabasibwa Nicephorus , Shabani Hamisi K. , Härtl Roger
Published: January 2020

Study Design:

Retrospective case series.

Objective:

Little is known about operative management of traumatic spinal injuries (TSI) in low- and middle-income countries (LMIC). In patients undergoing surgery for TSI in Tanzania, we sought to (1) determine factors involved in the operative decision-making process, specifically implant availability and surgical judgment; (2) report neurologic outcomes; and (3) evaluate time to surgery.

Methods:

All patients from October 2016 to June 2019 who presented with TSI and underwent surgical stabilization. Fracture type, operation, neurologic status, and time-to-care was collected.

Results:

Ninety-seven patients underwent operative stabilization, 23 (24%) cervical and 74 (77%) thoracic/lumbar. Cervical operations included 4 (17%) anterior cervical discectomy and fusion with plate, 7 (30%) anterior cervical corpectomy with tricortical iliac crest graft and plate, and 12 (52%) posterior cervical laminectomy and fusion with lateral mass screws. All 74 (100%) of thoracic/lumbar fractures were treated with posterolateral pedicle screws. Short-segment fixation was used in 86%, and constructs often ended at an injured (61%) or junctional (62%) level. Sixteen (17%) patients improved at least 1 ASIA grade. The sole predictor of neurologic improvement was faster time from admission to surgery (odds ratio = 1.04, P = .011, 95%CI = 1.01-1.07). Median (range) time in days included: injury to admission 2 (0-29), admission to operating room 23 (0-81), and operating room to discharge 8 (2-31).

Conclusions:

In a cohort of LMIC patients with TSI undergoing stabilization, the principle driver of operative decision making was cost of implants. Faster time from admission to surgery was associated with neurologic improvement, yet significant delays to surgery were seen due to patients’ inability to pay for implants. Several themes for improvement emerged: early surgery, implant availability, prehospital transfer, and long-term follow-up.
Pushed or Pulled Out? The Racialization of School Choice in Black and White Mothers’ (Home) Schooling Decisions for Their Children
Authors: Stewart Mahala Dyer
Published: January 2020

Homeschooling is an increasingly common schooling option for middle-class black families yet is often overlooked in research on race and education. Drawing on interviews with 67 middle-class black and white mothers living in one northeastern metropolitan area—half of whom homeschool, while the other half enroll their children in conventional school—the author examines how race influences mothers’ decisions to homeschool or conventional school. The findings show that mothers’ schooling explanations reflect their experiences as shaped by the racial hierarchy constituted in schools. Black mothers respond to a push out of conventional schools on the basis of their children’s experiences of racial discrimination. In contrast, white mothers respond to a pull out of conventional schools to individualize their children’s academic programs. Building on racialized organizations and critical race theory, these findings elucidate how the formal structure of schools is racialized in ways that constrain black mothers’ agency, while enabling the agency of white mothers to activate school choice. The findings underscore how homeschooling, often assumed to be race neutral, is racialized in ways that reproduce inequalities under school choice and appears to redress discrimination in schools.
The Memory of the Civil War in Algeria: Lessons from the Past with Reference to the Algerian Hirak
Authors: Zeraoulia Faouzia
Published: January 2020

The Algerian Civil War during the 1990s is considered to be one of the violent wars in the Arab world. For one decade, isolated from the international community, the country and its civilians suffered from extremism, radicalism, torture, and assassinations. Today, it is arguable that the memory of the Algerian Civil War played a pivotal role in producing the legitimacy of the political system and framing the citizens’ perceptions of the postwar regime before the current manifestations. Nevertheless, no field research has explored how that memory is represented and recalled by the people. Through analyzing the public narrative, surveying and examining the public platforms, and conversations dealing with the past civil war in Algeria, this article seeks to demonstrate how that violent past is remembered in the public arena, the emotions that have been accumulated from such experience and the lessons that have been learned by the people. In doing so, we use many examples from the Algerian manifestations after 22 February 2019, or what is called “the Algerian Hirak.”
The Discharge Process—From a Patient’s Perspective
Authors: Krook Maura , Iwarzon Marie , Siouta Eleni
Published: January 2020

Inadequacy in discharge planning, preparation of readiness, and unplanned readmissions are closely linked and could cause misutilization of hospital services, creating higher costs to the health-care system. The information given before discharge is vital and of great importance for the well-being of the patient. The study’s objective was to describe the patient’s experience of their discharge process. A descriptive study was designed. Fifteen ( n = 15) interviews with patients at one University Swedish hospital were held, and a qualitative content analysis was made from the collected data. The results show that accessibility, information, communication, confidence, and participation are pivotal in future development in the discharge process. The findings of this study indicate that in affirmation with the patient’s experiences and desires, there is a great urgency for improvement in the discharge process. There is a need to focus on information and communication at discharge by initiating interaction from the nurses together with the doctors at a specific time in the discharge process. The discharge process needs to be more individualized and person-centered which could lead to better patient governance. Both accessibility and continuity need to be improved. The information given needs to be met with the patient’s level of understanding.
Periorbital Subcutaneous Perfluoron Is Well Tolerated Following Intravitreal Surgery
Authors: Larochelle Ryan D. , Shields Ryan A. , Erickson Benjamin P. , Silva A. Ruwan
Published: January 2020

Purpose:

Perfluorocarbon liquids (PFCLs) are well tolerated in intraocular surgery, but chronic exposure can cause inflammation. PFCL leakage into the orbit without significant sequelae has been reported, but PFCL leakage into the preseptal subcutaneous tissues has not been described.

Methods:

A case report is presented.

Results:

A 46-year-old man presented with hand motion vision from a ruptured globe and retained intraocular foreign body. Intraoperatively, the foreign body could not be removed, and PFCL extravasated from the posterior globe rupture. Postoperative imaging revealed hyperdense material in the orbit, lids, and superficial adnexal tissues. The patient tolerated the retained PFCL, and imaging 10 months later demonstrated interval resorption. The patient eventually developed ocular siderosis and underwent transconjunctival orbitotomy with foreign body extraction. Two years following the initial injury, his vision remained stable at 20/40 without further sequelae.

Conclusions:

PFCL is well tolerated in the extraocular space and may resorb with conservative management.
Impact of a Pharmacy-Driven Transitions of Care Medication Reconciliation Following Hospitalization
Authors: Stauffer Rebecca L. , Yancey Abigail
Published: January 2020

Background: Medication changes are common after hospitalizations, and medication reconciliations are one tool to help identify potential medication discrepancies. Objective: To determine the impact of a pharmacy-driven medication reconciliation service on number of medication discrepancies identified. Methods: This was a retrospective cohort, chart-review study conducted at an internal medicine outpatient clinic. Patients at least 18 years of age were eligible for inclusion if they presented for a hospital follow-up appointment within 14 days of discharge between September 1, 2015, and May 31, 2016, from a system hospital. The 2 cohorts were patients with a pharmacist-completed medication reconciliation note written in the electronic health record on the date of their hospital follow-up appointment and those without. The primary outcome was number of medication discrepancies identified during medication reconciliation. Secondary outcomes included types of discrepancies, 30-day hospital readmission, and 30-day emergency department visits. This study was approved by the facility institutional review board. Results: Seventy-nine patients were included, and 38 patients had a pharmacist-completed medication reconciliation (48%). A total of 64 medication discrepancies were identified in 26 patients; of these, 49 discrepancies were resolved during the appointment (77%). There was an average of 2.46 medication discrepancies (±2.34) per patient. The most common discrepancy was missing medications. Thirty-day readmission rate was 5.3% in the intervention group and 19.5% in the control group ( P = .054). Conclusions: A pharmacist-completed medication reconciliation identified many medication discrepancies that were then resolved. From this study, pharmacist-led medication reconciliations following hospital discharge appear valuable.
How I treat measurable (minimal) residual disease in acute leukemia after allogeneic hematopoietic cell transplantation
Authors: Spyridonidis Alexandros
Published: January 2020

Although allogeneic hematopoietic cell transplantation (allo-HCT) is currently the standard curative treatment of acute leukemia, relapse remains unacceptably high. Measurable (minimal) residual disease (MRD) after allo-HCT may be used as a predictor of impending relapse and should be part of routine follow-up for transplanted patients. Patients with MRD may respond to therapies aiming to unleash or enhance the graft-versus-leukemia effect. However, evidence-based recommendations on how to best implement MRD testing and MRD-directed therapy after allo-HCT are lacking. Here, I describe our institutional approach to MRD monitoring for preemptive MRD-triggered intervention, using patient scenarios to illustrate the discussion.
Heavy chain dimers stabilized by disulfide bonds are required to promote in vitro assembly of trastuzumab
Authors: Farràs Mercè , Román Ramón , Camps Marc , Miret Joan , Martínez Óscar , Pujol Xavier , Casablancas Antoni , Cairó Jordi Joan
Published: January 2020

Background

Monoclonal antibodies (mAbs) and their derivatives have become one of the most important classes of therapeutic drugs. Their multiple applications increased the interest for understanding their complex structure. In vivo, animal cells are able to fold mAbs correctly (Song et al, J Biosci Bioeng 110:135-40, 2010), whereas previous in vitro approaches were scarce and mostly unsuccessful.

Results

In this work, we compared in vitro assembly characteristics of trastuzumab, produced either by A) physical separation and refolding of its sub-units or B) direct joining of individually produced heavy and light chains. Native and denatured structures of trastuzumab were determined by SEC-HPLC, HIC-HPLC and SDS-PAGE.

Conclusions

Our results demonstrate the requirement of correctly folded HC, forming disulfide-bonded dimers, in order to form a fully functional mAb. Otherwise, the unfolded HC tend to precipitate. We were able to assemble trastuzumab in this fashion by only mixing them to LC in pH-buffered conditions, while monomeric HC structure was too unstable to render a functional mAb. This approach has been used in the generation of homogeneous ADC, with results pending to be published.
Integrated genome-wide investigations of the housefly, a global vector of diseases reveal unique dispersal patterns and bacterial communities across farms
Authors: Bahrndorff Simon , Ruiz-González Aritz , de Jonge Nadieh , Nielsen Jeppe Lund , Skovgård Henrik , Pertoldi Cino
Published: January 2020

Background

Houseflies (Musca domesticaL.) live in intimate association with numerous microorganisms and is a vector of human pathogens. In temperate areas, houseflies will overwinter in environments constructed by humans and recolonize surrounding areas in early summer. However, the dispersal patterns and associated bacteria across season and location are unclear. We used genotyping-by-sequencing (GBS) for the simultaneous identification and genotyping of thousands of Single Nucleotide Polymorphisms (SNPs) to establish dispersal patterns of houseflies across farms. Secondly, we used 16S rRNA gene amplicon sequencing to establish the variation and association between bacterial communities and the housefly across farms.

Results

Using GBS we identified 18,000 SNPs across 400 individuals sampled within and between 11 dairy farms in Denmark. There was evidence for sub-structuring of Danish housefly populations and with genetic structure that differed across season and sex. Further, there was a strong isolation by distance (IBD) effect, but with large variation suggesting that other hidden geographic barriers are important. Large individual variations were observed in the community structure of the microbiome and it was found to be dependent on location, sex, and collection time. Furthermore, the relative prevalence of putative pathogens was highly dependent on location and collection time.

Conclusion

We were able to identify SNPs for the determination of the spatiotemporal housefly genetic structure, and to establish the variation and association between bacterial communities and the housefly across farms using novel next-generation sequencing (NGS) techniques. These results are important for disease prevention given the fine-scale population structure and IBD for the housefly, and that individual houseflies carry location specific bacteria including putative pathogens.
Efficacy of companion-integrated childbirth preparation for childbirth fear, self-efficacy, and maternal support in primigravid women in Malawi
Authors: Munkhondya Berlington M. J. , Munkhondya Tiwonge Ethel , Chirwa Ellen , Wang Honghong
Published: January 2020

Background

In resource-limited settings, childbirth remains a matter of life and death. High levels of childbirth fear in primigravid women are inevitable. To date, few studies have explored interventions to reduce childbirth fear in primigravid women. This study aimed to evaluate the efficacy of companion-integrated childbirth preparation (C-ICP) during late pregnancy for reducing childbirth fear and improving childbirth self-efficacy, birth companion support, and other selected pregnancy outcomes in primigravid women.

Methods

A quasi-experimental study was carried out using a non-equivalent control group design to recruit a sample of 70 primigravid women in hospital maternity waiting homes in the intervention and control groups, with 35 in each group. The primigravid women and their birth companions in the intervention group received two sessions of companion-integrated childbirth preparation, whereas the control group received routine care. A questionnaire that incorporated the childbirth attitude questionnaire (CAQ), the childbirth self-efficacy inventory (CBSEI), the birth companion support questionnaire (BCSQ), and a review checklist of selected pregnancy outcomes was used to collect data. Pretest and post-test data were analyzed using simple linear regression. Beta coefficients were adjusted at a 95% confidence interval with statistical significance set at aP-value of < 0.05 using Statistical Package for the Social Sciences version 25.

Results

At pretest, mean scores were similar in the intervention and control groups. At post-test, being in the intervention group significantly decreased childbirth fears (β:= − .866,t(68) = − 14.27,p < .001) and significantly increased childbirth self-efficacy (β:= .903,t(68) = 17.30,p < .001). In addition, being in the intervention group significantly increased birth companion support (β: = − 0.781,t(68) = 10.32,p < .001).However, no statistically significant differences regarding pregnancy outcomes were observed between the study groups (Mann–Whiney U test,p > .05).

Conclusion

The findings of our study suggest that C-ICP is a promising intervention to reduce childbirth fear while increasing childbirth self-efficacy and maternal support. We recommend the inclusion of C-ICP for primigravid women during late pregnancy in resource-limited settings.
The efficacy of superior oblique posterior tenectomy in the treatment of A-pattern exotropia without ocular intorsion: A retrospective study
Authors: Wei Yan , Dong Ling-Yan , Zhao Pei-quan , Kang Xiao-li
Published: January 2020

Background

Superior oblique weakening is a common method to treat A-pattern strabismus. This study aims to evaluate the surgical results of the bilateral superior oblique posterior tenectomy procedure to treat A-pattern strabismus patients who had bilateral superior oblique overaction without objective ocular intorsion.

Methods

The records of 18 consecutive patients who underwent surgery of superior oblique posterior tenectomy close to its insertion with superior oblique overaction (SOOA)-associated A-pattern strabismus between September 1, 2015 and August 31, 2018 were retrospectively reviewed. Ocular alignment, objective torsion, A-pattern and ocular motility were assessed. Ocular alignment was measured in the primary position, 25° upgaze, and 25° downgaze using the prism bar cover test, and torsion was measured using fundus photographs.

Results

A total of 18 patients (mean age: 15 years; 6 female, 12 male) underwent bilateral superior oblique posterior tenectomy and simultaneous horizontal rectus muscle surgery were included. The mean preoperative A-pattern deviation was 15 PD and the mean postoperative A-pattern deviation was 2.25 PD with a mean reduction of 12.75 PD. The mean preoperative superior oblique overaction was 2.28 and the mean postoperative superior oblique overaction was 0.43 with a mean reduction of 1.85. There was no significant correlation between the ocular torsional, vertical alignment change and the superior oblique posterior tenectomy procedure.

Conclusions

Superior oblique posterior tenectomy surgery selectively improved the A-pattern and superior oblique overaction but not affect the primary position vertical deviation, as well as the ocular torsion. It is an effective procedure to treat the mild to moderate superior oblique overaction associated A pattern strabismus without ocular intorsion.
Development and psychometric evaluation of a questionnaire to measure cancer patients’ perception of care coordination
Authors: Okado Izumi , Cassel Kevin , Pagano Ian , Holcombe Randall F.
Published: January 2020

Background

Although the importance of care coordination (CC) is well-recognized, cancer patients often receive poorly coordinated care across varied care settings and different oncology providers. Efforts to improve cancer care are hampered by lack of adequate measures. In this two-part, mixed-method study, we describe the development, refinement, and validation of a new care coordination instrument (CCI) designed to assess cancer patients’ perception of CC.

Methods

In Study 1, an initial CCI was developed incorporating questions based on literature review. The items were then modified following four field tests conducted in a large academic hospital with oncology nurses (n = 20) and cancer patients (n = 120). This modified instrument was used to determine whether the CCI was able to distinguish CC between two practices (30 GI and 30 myeloma patients) within the same hospital setting. In Study 2, 68 patients receiving community-based care participated in seven focus groups. Based on these discussions, the CCI items were again refined, and psychometric evaluation was conducted to assess the quality of the instrument.

Results

Based on field tests, 3 domains of the CCI, Communication, Navigation, and Operational, were defined as critical components of CC. The Operational domain evaluates efficiency of care and is unique to this CCI. The field test demonstrated that GI patients reported significantly better CC Overall and for the Communication and Navigation domains (all p < .05). In Study 2, patients expressed concordance with the CCI items and their CC experiences, establishing validity of the CCI. Qualitative analysis of the focus group discussions indicated that the items with the highest frequencies of participants’ comments were related to the concepts of Navigator, Team, Survey, and Communication. Quantitative analysis identified items with a limited response range or high rates of “neutral” responses; accordingly, those items were removed. The final CCI survey is a 29 item, multiple-choice questionnaire with excellent reliability, Cronbach’s α = .922.

Conclusions

We developed a novel, patient-centered tool with excellent psychometric properties that can be utilized across varied practice settings to assess patients’ perception of cancer care coordination.

Trial registration

Not required; retrospectively registered ClinicalTrials.gov NCT03594006 20 July 2018.
Clustering of asymptomatic Plasmodium falciparum infection and the effectiveness of targeted malaria control measures
Authors: Shaffer Jeffrey G. , Touré Mahamoudou B. , Sogoba Nafomon , Doumbia Seydou O. , Gomis Jules F. , Ndiaye Mouhamadou , Ndiaye Daouda , Diarra Ayouba , Abubakar Ismaela , Ahmad Abdullahi , Affara Muna , Nwakanma Davis , Lukowski Mary , Welty James C. , Mather Frances J. , Keating Joseph , Krogstad Donald J.
Published: January 2020

Background

Because clustering of Plasmodium falciparum infection had been noted previously, the clustering of infection was examined at four field sites in West Africa: Dangassa and Dioro in Mali, Gambissara in The Gambia and Madina Fall in Senegal.

Methods

Clustering of infection was defined by the percent of persons with positive slides for asexual P. falciparum sleeping in a house which had been geopositioned. Data from each site were then tested for spatial, temporal and spatio-temporal clustering in relation to the prevalence of infection from smear surveys.

Results

These studies suggest that clustering of P. falciparum infection also affects the effectiveness of control interventions. For example, the clustering of infection in Madina Fall disappeared in 2014–2016 after vector control eliminated the only breeding site in 2013. In contrast, the temporal clustering of infection in Dioro (rainy season of 2014, dry season of 2015) was consistent with the loss of funding for Dioro in the second quarter of 2014 and disappeared when funds again became available in late 2015. The clustering of infection in rural (western) areas of Gambissara was consistent with known rural–urban differences in the prevalence of infection and with the thatched roofs, open eaves and mud walls of houses in rural Gambissara. In contrast, the most intense transmission was in Dangassa, where the only encouraging observation was a lower prevalence of infection in the dry season. Taken together, these results suggest: (a) the transmission of infection was stopped in Madina Fall by eliminating the only known breeding site, (b) the prevalence of infection was reduced in Dioro after financial support became available again for malaria control in the second half of 2015, (c) improvements in housing should improve malaria control by reducing the number of vectors in rural communities such as western Gambissara, and (d) beginning malaria control during the dry season may reduce transmission in hyperendemic areas such as Dangassa.

Conclusions

From a conceptual perspective, testing for spatial, temporal and spatio-temporal clustering based on epidemiologic data permits the generation of hypotheses for the clustering observed and the testing of candidate interventions to confirm or refute those hypotheses.
Determinants of the persistence of malaria in Rwanda
Authors: Rudasingwa Guillaume , Cho Sung-Il
Published: January 2020

Background

Malaria has a considerable impact on the health of the populations of developing countries; indeed, the entire population of Rwanda is at risk of contracting the disease. Although various interventions to control malaria have been implemented in Rwanda, the incidence of malaria has increased since 2012. There is an interest in understanding factors driving its persistence in Rwanda. This study aims at evaluating the effect of socio-economic and environmental factors, seasonality and the use of insecticide-treated mosquito nets (ITNs) on malaria persistence in Rwanda.

Methods

This study analysed data from the 2014–2015 Rwanda Demographic and Health Survey of 11,202 household’s members composed of children under the age of 5 and women aged between 15 and 49. Bivariate analysis was performed between the outcome and each covariate including wealth, altitude, education level, place of residence, and use of ITNs generating percentages. Chi square test was performed to compare malaria negatives and positives on each covariate. Significant variables were subjected to logistic regression analysis to evaluate factors that are significantly associated with malaria at P < 0.05. The analysis was performed in R x64 3.6 and QGIS3.6 was used to map geographical distribution of malaria cases.

Results

The lowest wealth category was associated with the incidence of malaria [AOR] = 1.54, 95% CI (1.78–2.03). Having a place of residence < 1700 m above sea level (asl) and non-use of ITNs were significantly associated with the incidence of malaria (adjusted odds ratio [AOR] = 2.93, 95% confidence interval [95% CI] 1.94–4.42 and [AOR] = 1.29, 95% C.I (1.03–1.60), respectively). Season and type of residence were not significantly associated with malaria prevalence while women had lower risk of contracting malaria than children.

Conclusion

Increased malaria prevalence was associated with lower income, non-compliance with bed-net usage and living below 1700 m of altitude. In addition to current malaria control strategies, potential interventions in individuals with lower income and areas at low altitudes should be taken into consideration when formulating malaria-control strategies, Also use of ITNs to control the spread of malaria should be emphasized.
Late clinical failure associated with cytochrome b codon 268 mutation during treatment of falciparum malaria with atovaquone–proguanil in traveller returning from Congo
Authors: Massamba Laurencie , Madamet Marylin , Benoit Nicolas , Chevalier Alicia , Fonta Isabelle , Mondain Véronique , Jeandel Pierre-Yves , Amalvict Rémy , Delaunay Pascal , Mosnier Joel , Marty Pierre , Pomares Christelle , Pradines Bruno
Published: January 2020

Background

The drug combination atovaquone–proguanil, is recommended for treatment of uncomplicated falciparum malaria in France. Despite high efficacy, atovaquone–proguanil treatment failures have been reported. Resistance to cycloguanil, the active metabolite of proguanil, is conferred by multiple mutations in the Plasmodium falciparum dihydrofolate reductase (pfdhfr) and resistance to atovaquone by single mutation on codon 268 of the cytochrome b gene (pfcytb).

Case presentation

A 47-year-old female, native from Congo and resident in France, was admitted in hospital for uncomplicated falciparum malaria with parasitaemia of 0.5%, after travelling in Congo (Brazzaville and Pointe Noire). She was treated with atovaquone–proguanil (250 mg/100 mg) 4 tablets daily for 3 consecutive days. On day 5 after admission she was released home. However, many weeks after this episode, without having left France, she again experienced fever and intense weakness. On day 39 after the beginning of treatment, she consulted for fever, arthralgia, myalgia, photophobia, and blurred vision. She was hospitalized for uncomplicated falciparum malaria with a parasitaemia of 0.375% and treated effectively by piperaquine–artenimol (320 mg/40 mg) 3 tablets daily for 3 consecutive days. Resistance to atovaquone–proguanil was suspected. The Y268C mutation was detected in all of the isolates tested (D39, D42, D47). The genotyping of the pfdhfr gene showed a triple mutation (N51I, C59R, S108N) involved in cycloguanil resistance.

Conclusion

This is the first observation of a late clinical failure of atovaquone–proguanil treatment of P. falciparum uncomplicated malaria associated with pfcytb 268 mutation in a traveller returning from Congo. These data confirm that the Y268C mutation is associated with delayed recrudescence 4 weeks or more after initial treatment. Although atovaquone–proguanil treatment failures remain rare, an increased surveillance is required. It is essential to declare and publish all well-documented cases of treatment failures because it is the only way to evaluate the level of resistance to atovaquone.
Determinants of health, health behaviours and demographic profile of patients attending an Australian university student-led osteopathy clinic
Authors: Vaughan Brett , Fitzgerald Kylie , Fleischmann Michael , Mulcahy Jane
Published: January 2020

Background

Profiles of health professions practice can inform pre-professional education, provide evidence to assist with interprofessional practice, and inform policy development. An understanding of the profile of patients seeking osteopathy care is emerging. Current research suggests that musculoskeletal presentations predominate with approximately one-third of patients presenting with co-morbid diseases. There is little data on these presentations in Australian osteopathy practice. This study aimed to describe the patient demographics, clinical presentations, health behaviours and determinants of health, including health literacy, of those attending for care at an Australian student-led osteopathy clinic.

Methods

A convenience sample design was utilised where consecutive patients presenting for their initial consultation were invited to complete a health information questionnaire during 2016–2017. The questionnaire explored a range of health behaviours and the patient’s health status. Data from the clinical records were also extracted to establish the presenting complaint, duration of the complaint and pertinent demographics. Descriptive statistics were generated for each variable.

Results

Data were available for 1617 patients presenting for their initial consultation. The mean age of patients was 33.7 (±13.1) years with 55% (n = 887) identifying as female. Acute presentations predominated (n = 840, 52%), with presentations affecting the spine being the most common (57.8%). Most patients rated their health status as good to very good (75%). Approximately 7.5% of patients were identified as having low health literacy and 55.9% were currently suffering from one or more co-morbid presentations.

Conclusions

The demographic profile and presenting complaints of patients presenting to a student-led osteopathy clinic are largely consistent with other Australian private practice profiles. The current work also identified co-morbid presentations, and positive and negative health behaviours. Osteopaths may play a role in the management of, or referral for, these presentations where health behaviours require change, or management of co-morbid conditions is beyond the scope of practice. The increasing volume of patient profile literature globally suggests that osteopaths can play a substantial role in the management of musculoskeletal complaints. Further, osteopathy may play a role in screening determinants of health, and engage in multidisciplinary care to ensure those patients with co-morbid conditions or adverse health behaviours are managed appropriately.
Phenotypic zinc resistance does not correlate with antimicrobial multi-resistance in fecal E. coli isolates of piglets
Authors: Ghazisaeedi Fereshteh , Ciesinski L. , Bednorz C. , Johanns V. , Pieper L. , Tedin K. , Wieler L. H. , Günther Sebastian
Published: January 2020

Background

Following the ban on antimicrobial usage for growth promotion in animal husbandry in the EU, non-antimicrobial agents including heavy metal ions (e.g. zinc and copper), prebiotics or probiotics have been suggested as alternatives. Zinc has extensively been used in pig farming, particularly during weaning of piglets to improve animal health and growth rates. Recent studies, however, have suggested that high dietary zinc feeding during weaning of piglets increases the proportion of multi-drug resistant E. coli in the gut, contraindicating the appropriateness of zinc as an alternative. The underlying mechanisms of zinc effects on resistant bacteria remains unclear, but co-selection processes could be involved. In this study, we determined whether E. coli isolates from intestinal contents of piglets that had been supplemented with high concentrations of zinc acquired a higher tolerance towards zinc, and whether multi-drug resistant isolates tolerated higher zinc concentrations. In addition, we compared phenotypic zinc and copper resistance of E. coli isolates for possible correlation between phenotypic resistance/tolerance to different bivalent ionic metals.

Results

We screened phenotypic zinc/copper tolerance of 210 isolates (including antimicrobial resistant, multi-drug resistant, and non-resistant E. coli) selected from two, independent zinc-feeding animal trials by determining a zinc/copper minimal inhibitory concentration (Merlin, Bornheim-Hersel, Germany). In both trials, groups of piglets were supplemented either with high dietary zinc (> 2000 ppm) or control (50–70 ppm, background) concentrations. Our observations showed that high concentration zinc exposure did not have an effect on either zinc or copper phenotypic tolerance of E. coli isolates from the animals. No significant association was found between antimicrobial resistance and phenotypic zinc/copper tolerance of the same isolates.

Conclusion

Our findings argue against a co-selection mechanism of antimicrobial drug-resistance and zinc tolerance after dietary zinc supplementation in weaning piglets. An explanation for an increase in multi-drug resistant isolates from piglets with high zinc dietary feeding could be that resistant bacteria to antimicrobial agents are more persistent to stresses such as zinc or copper exposure.
5-Hydroxymethylcytosine signatures in circulating cell-free DNA as diagnostic and predictive biomarkers for coronary artery disease
Authors: Dong Chaoran , Chen Jiemei , Zheng Jilin , Liang Yiming , Yu Tao , Liu Yupeng , Gao Feng , Long Jie , Chen Hangyu , Zhu Qianhui , He Zilong , Hu Songnian , He Chuan , Lin Jian , Tang Yida , Zhu Haibo
Published: January 2020

Background

The 5-hydroxymethylcytosine (5hmC) DNA modification is an epigenetic marker involved in a range of biological processes. Its function has been studied extensively in tumors, neurodegenerative diseases, and atherosclerosis. Studies have reported that 5hmC modification is closely related to the phenotype transformation of vascular smooth muscle cells and endothelial dysfunction. However, its role in coronary artery disease (CAD) has not been fully studied.

Results

To investigate whether 5hmC modification correlates with CAD pathogenesis and whether 5hmC can be used as a biomarker, we used a low-input whole-genome sequencing technology based on selective chemical capture (hmC-Seal) to firstly generate the 5hmC profiles in the circulating cell-free DNA(cfDNA) of CAD patients, including stable coronary artery disease (sCAD) patients and acute myocardial infarction (AMI) patients. We detected a significant difference of 5hmC enrichment in gene bodies from CAD patients compared with normal coronary artery (NCA) individuals. Our results showed that CAD patients can be well separated from NCA individuals by 5hmC markers. The prediction performance of the model established by differentially regulated 5hmc modified genes were superior to common clinical indicators for the diagnosis of CAD (AUC = 0.93) and sCAD (AUC = 0.93). Specially, we found that 5hmC markers in cfDNA showed prediction potential for AMI (AUC = 0.95), which was superior to that of cardiac troponin I, muscle/brain creatine kinase, and myoglobin.

Conclusions

Our results suggest that 5hmC markers derived from cfDNA can serve as effective epigenetic biomarkers for minimally noninvasive diagnosis and prediction of CAD.
RETRACTED ARTICLE:Existence of global solutions for the
semilinear nonlocal fractional Cauchy problem of the Schrödinger equation
Authors: Liu Zhen
Published: January 2020

This paper is concerned with the global existence of solutions for the
semilinear nonlocal fractional Cauchy problem of the Schrödinger equation. Firstly,
based on the Schrödinger approximation technique and the theory of a family of
potential wells, the authors obtain the invariant sets and vacuum isolating of
global solutions including the critical case. Then, the global existence of
solutions and the stability of equilibrium points are discussed. Finally, the global
asymptotic stability of the unique positive equilibrium point of the system is
proved by applying the Leray–Schauder alternative fixed point theorem.
Bifurcation analysis and chaos control in discrete-time modified Leslie–Gower prey harvesting model
Authors: Bilal Ajaz Muhammad , Saeed Umer , Din Qamar , Ali Irfan , Israr Siddiqui Muhammad
Published: January 2020

We investigate the dynamical behavior of a modified Leslie–Gower prey–predator model with harvesting in prey population. In order to explore rich dynamics of the model, Euler approximation is implemented to obtain a discrete-time modified Leslie–Gower model. Existence of equilibria and their local asymptotic stabilities are carried out. Furthermore, with the help of bifurcation theory and center manifold theorem, existence and directions of period-doubling and Neimark–Sacker bifurcations are investigated at positive steady-state. In order to control chaos and bifurcations, the Ott–Grebogi–Yorke (OGY) method and the hybrid control strategy are introduced. Numerical simulations are also provided to illustrate the theoretical discussions.