bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnitude of Enteropathogens and Associated Factors Among Apparently Health Food Handlers at Wolkite University Student’s Cafeteria, Wolkite, Southern Ethiopia
Authors: Bafa Temesgen Abera , Muktar Ebrahim , Haile Adimasu , Garedew Gashaw
Published: October 2019

Abstract
Objective : The study aimed to assess enteropathogens carriage rate and risk factors among apparently healthy food handlers at Wolkite University cafeteria, Southern Ethiopia.
Results : Cross-sectional study was conducted among 170 food handlers to collect socio-demographic and related data by using structured questionnaires. Stool samples were collected and subjected to microscopic examination and cultured to determine intestinal parasites. Among the total study participants, 66% of them were found to be carriers of enteropathogens: bacteria ( Salmonella typhi , Shigella species), and intestinal parasites ( Ascaris lumbricoides , Taenia species, Giardia lamblia , Entameoba histolytica/dispar , Enterobius vermicularis , Hook worm and Trichuris trichiura) . All Salmonella and Shigella isolates were sensitive to ceftriaxone, ciprofloxacin, and gentamicin. A significant association was found between hand washing practice before food preparation and isolated pathogens [p = 0.013]. A significant proportion of food handlers were found to be carriers of pathogens which require a periodic screening and antibiotic therapy monitoring.
Keywords : Food handlers, Intestinal parasites, Salmonella, Shigella
An automated high throughput solution for DNA extraction and bisulfite-conversion from high volume liquid biopsy specimens – sample preparation for epigenetic analysis
Authors: Rausch Sebastian , Hasinger Oliver , König Thomas , Schlegel Anne , Weiss Gunter
Published: October 2019

Objective: DNA methylation analysis via real-time PCR or other analytical techniques requires purified bisulfite converted DNA. We report on an automated high throughput solution for DNA extraction, bisulfite-conversion, and purification of 96 samples with an input volume of up to 3.5mL of plasma or urine, using reagents from the commercially available Epi BisKit. Results: Magnetic bead-based DNA extraction, bisulfite conversion at high temperature, and efficient DNA purification was conducted on a customized commercially available liquid-handling platform. A highly interlaced 4x24 sample protocol was implemented for DNA extraction, elution in a 96-well plate, efficient bisulfite-conversion and extensive purification. The resulting bisulfite-converted DNA was stored in a 96-well format, ready for PCR set-up or other down-stream applications. The automated method is a walk-away solution for processing 96 samples in 7h30min. Performance of the method was validated by comparison with the standard manual method of the Epi BiSKit using technical and biological samples. Overall DNA yield was assessed with a standardized ß-actin assay. The automated workflow demonstrated equivalent performance to the manual method for technical, plasma and urine samples. It may provide a new standard for effective high-throughput preparation of bisulfite-converted DNA from a variety of high volume liquid biopsy specimens.
Analysis of erroneous data entries in paper based and electronic data collection
Authors: Ley Benedikt , Rijal Komal Raj , Marfurt Jutta , Adhikari Nabaraj , Banjara Megha , Shrestha Upendra Thapa , Thriemer Kamala , Price Ric N. , Ghimire Prakash
Published: October 2019

Objective: Electronic data collection (EDC) has become a suitable alternative to paper based data collection (PBDC) in biomedical research even in resource poor settings. During a survey in Nepal, data were collected using both systems and data entry errors compared between both methods.
Collected data were checked for completeness, values outside of realistic ranges, internal logic and date variables for reasonable time frames. Variables were grouped into 5 categories and the number of discordant entries were compared between both systems, overall and per variable category.
Results: Data from 52 variables collected from 358 participants were available. Discrepancies between both data sets were found in 12.6% of all entries (2352/18,616). Differences between data points were identified in 18.0% (643/3,580) of continuous variables, 15.8% of time variables (113/716), 13.0% of date variables (140/1,074), 12.0% of text variables (86/716), and 10.9% of categorical variables (1,370/12,530). Overall 64% (1,499/2,352) of all discrepancies were due to data omissions, 76.6% (1,148/1,499) of missing entries were among categorical data. Omissions in PBDC (n=1002) were twice as frequent as in EDC (n=497, p<0.001).
Data omissions, specifically among categorical variables were identified as the greatest source of error. If designed accordingly, EDC can address this short fall effectively.
Reducing underreporting of stigmatized pregnancy outcomes: results from a mixed-methods study of self-managed abortion in Texas using the list-experiment method
Authors: Moseson Heidi , Filippa Sofia , Baum Sarah E. , Gerdts Caitlin , Grossman Daniel
Published: October 2019

Background Accurately measuring stigmatized experiences is a challenge across reproductive health research. In this study, we tested a novel method – the list experiment – that aims to reduce underreporting of sensitive events by asking participants to report how many of a list of experiences they have had, not which ones. We applied the list experiment to measure “self-managed abortion” - any attempt by a person to end a pregnancy on one’s own, outside of a clinical setting – a phenomenon that may be underreported in surveys due to a desire to avoid judgement. Methods We administered a double list experiment on self-managed abortion to a Texas-wide representative sample of 790 women of reproductive age in 2015. Participants were asked how many of a list of health experiences they had experienced; self-managed abortion was randomly added as an item to half of the lists. A difference in the average number of items reported by participants between lists with and without self-managed abortion provided a population level estimate of self-managed abortion. In 2017, we conducted cognitive interviews with women of reproductive age in four states to understand how women (1) interpreted the list experiment question format, and (2) interpreted the list item on prior experiences attempting to self-manage an abortion. Results Results from this list experiment estimated that 8% of women of reproductive age in Texas have ever self-managed an abortion. This number was higher than expected, thus, the researchers conducted cognitive interviews to better understand how people interpreted the list experiment on self-managed abortion. Some women interpreted “on your own” to mean “without the knowledge of friends or family”, as opposed to “without medical assistance”, as intended. Conclusion The list experiment may have reduced under-reporting of self-managed abortion; however, the specific phrasing of the list item may also have unintentionally increased reporting of abortion experiences not considered “self-managed.” High participation in and comprehension of the list experiment, however, suggests that this method is worthy of further exploration as tool for measuring stigmatized experiences.
Fibrin-Associated Large B-Cell Lymphoma: First Case Report Within A Cerebral Artery Aneurysm And Literature Review
Authors: Zanelli Magda , Zizzo Maurizio , Montanaro Marco , Gomes Vito , Martino Giovanni , De Marco Loredana , Orcioni Giulio Fraternali , Martelli Maria Paola , Ascani Stefano
Published: October 2019

Background: Fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) is a rare Epstein-Barr virus (EBV) positive lymphoproliferative disorder included in the current World Health Organization (WHO) classification. It arises within fibrinous material in the context of hematomas, pseudocysts, cardiac myxoma or in relation with prosthetic devices. In these clinical settings the diagnosis requires an high index of suspicion, because it does not form a mass itself, being composed of small foci of neoplastic cells. Despite overlapping features with diffuse large B-cell lymphoma associated with chronic inflammation, it deserves a separate classification, being not mass-forming and often following an indolent course. Case presentation: A 64-year-old immunocompetent woman required medical care for cerebral hemorrhage. Computed Tomography (CT) angiography identified an aneurysm in the left middle cerebral artery. A FA-DLBCL was incidentally identified within thrombotic material in the context of the arterial aneurysm. After surgical removal, it followed a benign course with no further treatment. Conclusions: The current case represents the first report of FA-DLBCL identified in a cerebral artery aneurysm, expanding the clinicopathologic spectrum of this rare entity. A complete literature review is additionally made.
A Cross Sectional Analysis Of Dietary Practices And Nutrition Status Of Female Undergratuate Students At Kenyatta University, Kenya
Authors: Waweru Grace , Chege Peter , Njogu Eunice
Published: October 2019

Background

The rapid changes in eating habits and lifestyles in Kenya have resulted to the overweight/obesity transition. Students are likely to make poor food choices which may affect their nutrition status during the beginning of college and this may continue throughout their life. This study aimed to establish the dietary practices, assess nutrition status based on body mass index and the relationship between selected dietary practices and nutrition status of female undergraduate students at Kenyatta University, Kenya.Method

s: The study adopted a cross-sectional analytical design involving sample of 422 female undergraduate students randomly selected from Kenyatta University. Food Frequency Questionnaire and the Minimum Dietary Diversity – Women were used to assess dietary practices. Weight and height were measured to assess the nutrition status of the female students.Results

The results showed that 64.0% of the participants had consumed ≥ 5 food groups while 36% had consumed <5 food groups over a period of 24 hours. In terms of nutrition status, 68.4% of the participants had normal BMI while 23.9% were overweight, 5.55% were underweight and 2.3% were obese MDDS-W was significantly associated with nutrition status (p=0.044).Conclusion

The results illustrated unhealthy eating habits and sub-optimal nutrition status among a significant number of the female students. Policy makers should scale up interventions that would help improve dietary practices of women of reproductive age particularly university students.
Energy Balance-Related Factors Associating with Adolescent Weight Loss Intent: Evidence from the 2017 National Youth Risk Behavior Survey
Authors: Burns Ryan Donald
Published: October 2019

Background: The purpose of this study was to examine specific energy balance-related behaviors (sedentary behaviors, physical activity, and dietary) associating with adolescent weight loss intent using data from the 2017 US Youth Risk Behavior Survey (YRBS).
Methods: This was a cross-sectional study that employeda multi-stage cluster sampling procedure to obtain a representative sample of US adolescents. The target population consisted of public and private high schoolers from grades 9 through 12. The number of sampled adolescents was 18,324 with 14,765 of the 18,324 sampled students (Mean age = 15.9 (1.3) years) submitting questionnaires with usable data (81% response rate). The outcome was intent to lose weight with specific energy-balance related behaviors examined as predictor variables. A weighted logistic regression model was employed to examine the associations between sedentary behaviors, physical activity, and dietary-related variables with weight loss intent controlling for age, sex, BMI percentile, and race/ethnicity.
Results: Variables associating with adolescent intent to lose weight included 3 or more hours of video game playing (OR=1.15, 95%CI: 1.01-1.31, p =0.028), achieving 60 minutes of physical activity daily (OR=0.66, 95%CI: 0.59-0.73, p <0.001), daily breakfast consumption (OR=0.76, 95%CI: 0.67-0.87, p <0.001) and weekly salad consumption (OR=1.30, 95%CI: 1.12-1.52, p =0.001).
Conclusions: Meeting physical activity guidelines and regular breakfast consumption associated with lower odds of weight loss intent and video game playing and salad consumption associated with higher odds of weight loss intent in a representative sample of US adolescents.Therefore, there is a discordance between adolescent weight loss intent and the engagement in specific energy balance-related health behaviors, particularly physical activity.
Psychometric Assessment of the Post-Secondary Student Stressors Index (PSSI)
Authors: Linden Brooke , Stuart Heather
Published: October 2019

Background: Previous research has linked excessive stress among post-secondary students to poor academic performance and poor mental health. Despite attempts to ameliorate mental health challenges at post-secondary institutions, there exists a gap in the evaluation of the specific sources of stress for students within the post-secondary setting. Methods: The goal of this study was to develop a new instrument to better assess the sources of post-secondary student stress. Over the course of two years, the Post-Secondary Student Stressors Index (PSSI) was created in collaboration with post-secondary students as co-developers and subject matter experts. In this study, we used a combination of individual cognitive interviews (n = 11), an online consensus survey modeled after a traditional Delphi method (n = 65), and an online pre- (n = 535) and post-test (n = 350) survey to psychometrically evaluate the PSSI using samples of students from Ontario, Canada. We collected four types of evidence for validity, including: content evidence, response processes evidence, internal structure evidence, and relations to other variables. The test-retest reliability of the instrument was also evaluated. Results: The PSSI demonstrated strong psychometric properties. Content validation and response processes evidence was derived from active student involvement throughout the development and refinement of the tool. Exploratory factor analysis suggested that the structure of the PSSI reflects the internal structure of an index, rather than a scale, as expected. Test-retest reliability of the instrument was comparable to existing, established instruments. Finally, the PSSI demonstrated good relationships with like measures of stress, distress, and resilience, in the hypothesized directions. Conclusions: The PSSI is a 46-item inventory that will allow post-secondary institutions to pinpoint the most severe and frequently occurring stressors on their campus. This knowledge will facilitate appropriate targeting of priority areas, and help institutions to better align their mental health promotion and mental illness prevention programming with the needs of their campus.
Protocol for a Randomized Controlled Trial Examining Multi-level Prediction of Response to Behavioral Activation and Exposure-based Therapy for Generalized Anxiety Disorder
Authors: Santiago Jessica , Akeman Elisabeth , Kirlic Namik , Clausen Ashley , Cosgrove Kelly , McDermott Timothy , Mathis Bailey , Paulus Martin , Craske Michelle , Abelson James , Martell Christopher , Wolitzky-Taylor Kate , Bodurka Jerzy , Thompson Westley , Aupperle Robin
Published: October 2019

Background: Only 40 to 60% of patients with generalized anxiety disorder experience long-lasting improvement with gold-standard psychosocial interventions. Identifying neurobehavioral factors that predict treatment success might provide specific targets for more individualized interventions, fostering more optimal outcomes and bringing us closer to the goal of “personalized medicine.” Research suggests that reward and threat processing (approach/avoidance behavior) and cognitive control may be important for understanding anxiety and comorbid depressive disorders and have relevance to treatment outcomes. This study was designed to determine whether approach-avoidance behaviors and associated neural responses moderate treatment response to exposure-based versus behavioral activation therapy for generalized anxiety disorder. Methods: We are conducting a randomized, controlled trial involving two ten-week, group-based interventions – exposure-based therapy or behavioral activation therapy. These interventions focus on specific and unique aspects of threat and reward processing, respectively. Prior to and after treatment, participants are interviewed and undergo behavioral, biomarker and neuroimaging assessments, with a focus on approach and avoidance processing and decision-making. Primary analyses will utilize mixed models to examine whether hypothesized approach, avoidance, and conflict arbitration behaviors and associated neural responses at baseline moderate symptom change with treatment, as assessed using the GAD-7. Exploratory analyses will examine additional potential treatment moderators and utilize data reduction and machine learning methods. Discussion: This protocol provides a framework for how studies may be designed to move the field towards neuroscience-informed and personalized psychosocial treatments. Results will have implications for approach-avoidance processing in generalized anxiety disorder, relationships between levels of analysis (i.e., behavioral, neural), and predictors of behavioral therapy outcome. Trial registration: The study was retrospectively registered within 21 days of first participant enrollment in accordance with FDAAA 801 at the US National Institutes of Health (ClinicalTrials.gov) #NCT02807480 (registration date: June 21, 2016), pre-results.
Adverse events associated with continuous interscalene block administered using the catheter-over-needle method: a retrospective analysis
Authors: Tanizima Meishu , Takechi Kenichi , Nakanishi Kazuo , Yorozuya Toshihiro
Published: October 2019

Background: Continuous interscalene block is widely used for pain management in shoulder surgery. However, continuous interscalene block performed using the catheter-through-needle method is reportedly associated with adverse events such as pericatheter leakage of the local anesthetic, phrenic nerve paralysis, and hoarseness. Because we expected that the catheter-over-needle method would reduce these adverse events, we examined cases in which continuous interscalene block was performed using the catheter-over-needle method to determine what adverse events occurred and when.
Methods: We retrospectively reviewed the anesthesia and medical records of adult patients who underwent catheter insertion to receive a continuous interscalene block performed using the catheter-over-needle method at our hospital from July 2015 to July 2017.
Results: During the surveillance period, 122 adult patients underwent catheter insertion to receive a continuous interscalene block administered using the catheter-over-needle method. No case of pericatheter local anesthetic leakage was observed. Adverse events, such as dyspnea, hoarseness, insufficient anesthetic effect, dizziness, cough reflex during drinking, or ptosis, were observed in 42 patients (34.4%; 95% confidence interval 26–42.7). Most of the adverse events occurred on postoperative day 2. The median time between surgery and the onset of adverse events was 28.5 h.
Conclusions: The catheter-over-needle method may prevent the pericatheter leakage of the local anesthetic. However, adverse events occurred in more than one-third of the patients. During continuous interscalene block, patients must be carefully observed for adverse events, especially on postoperative day 2.
Trial registration: This study was registered with the UMIN Clinical Trials Registry (UMIN000037673).
Regulatory Roles of Differentially Expressed MicroRNAs in Metabolic Processes in Negative Lens-Induced Myopia Guinea Pigs
Authors: Guo Dadong , Ding Meihua , Song Xiaoli , Sun Yuanyuan , Li Guoping , Li Zonghong , Wei Huixia , Wu Jianfeng , Jiang Wenjun , Bi Hongsheng
Published: October 2019

Myopia is one of the most common vision defects worldwide. microRNAs can regulate the target gene expressions, influencing the development of diseases. In order to investigate the alterations of microRNAs profiling in negative lens-induced myopia (NLIM) guinea pigs and to explore the regulatory role of microRNAs in the occurrence and the development of myopia, we first established the NLIM guinea pig model after induction for 2 weeks. Further, we isolated sclera to purify total messenger RNA (mRNA) in both NLIM and NLIM fellow sclera. Using next generation sequencing technique and bioinformatics analysis, we identified the differentially expressed microRNAs in NLIM guinea pigs, performed the bioinformatics annotation for the differentially expressed microRNAs, and validated the expressions of differentially expressed microRNAs. We successfully established a negative NLIM model in guinea pigs, identified 27 differentially expressed microRNAs in NLIM guinea pig sclera, including 10 up-regulated and 17 down-regulated microRNAs. The KEGG annotation showed the main signaling pathways were closely associated with PPAR signaling, pyruvate and propanoate metabolisms, and TGF-beta signaling pathways. In summary, we found the development of myopia is mainly involved in the disorder of metabolic processes in NLIM guinea pigs. The PPAR signaling, pyruvate and propanoate metabolism pathways may play roles in the development of myopia.
Validation of a New Risk Score System for Non-variceal Upper Gastrointestinal Bleeding
Authors: Kim Min Seong , Moon Hee Seok , Kwon In Sun , Park Jae Ho , Kim Ju Seok , Kang Sun Hyung , Sung Jae Kyu , Lee Eaum Seok , Kim Seok Hyun , Lee Byung Seok , Jeong Hyun Yong
Published: October 2019

Background Recently, a new international bleeding score was developed to predict 30-day hospital mortality in patients with upper gastrointestinal bleeding (UGIB). However, the efficacy of this newly developed scoring system has not been extensively investigated. We aimed to validate a new scoring system for predicting 30-day mortality in patients with non-variceal UGIB and determine whether a higher score is associated with re-bleeding, length of hospital stay and endoscopic failure.Methods A retrospective study was performed on 905 cases with acute non-varieal UGIB who were examined in our hospital between January 2013 and December 2017. Baseline characteristics, endoscopic findings, re-bleeding, admission, and mortality were reviewed. The 30-day mortality rate of the new international bleeding risk score was calculated using the receiver operating characteristic curves and compared to the pre-endoscopy Rockall score, AIMS65, Glasgow Blatchford score, and Progetto Nazionale Emorragia Digestiva score. To verify the variable for the 30-day mortality of the new scoring system, we performed multivariate logistic regression using our data and further analyzed the score items.Results Compared with other scoring systems, the new international bleeding scoring system showed higher receiver operating characteristic (ROC) curve values in predicting mortality. (area under ROC curve 0.832; [95% confidence interval (CI)]) Multivariate analysis was performed using our data, the 30-day mortality rate was related to multiple comorbidities, BUN, creatinine, albumin, syncope at first visit, and endoscopic failure at first admission within 24 hours. In addition, in the new high score group, relatively long hospital stays, re-bleeding, and endoscopic failure were observed.Conclusion The new international bleeding score could predict 30-day mortality better than the other scoring systems. High-risk patients can be screened using this new scoring system to predict 30-day mortality. The use of this scoring system seems to improve the outcomes of non-variceal UGIB patients through proper management and intervention.
Risk factors of pulmonary complications after minimally invasive surgery for elderly patients with vertebral compression fractures
Authors: Zhang Hua-Xing , Shen Yong , Chen Jia , Zhang Long , Lin Wei
Published: October 2019

Purpose: To determine the risk factors for pulmonary complications after minimally invasive surgery in elderly patients with vertebral compression fractures (VCFs). Methods: We retrospectively analyzed 233 elderly patients (age ≥ 65 years) with VCFs who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) surgery at Hebei General Hospital from January 2011 to December 2016 . Risk factors and the effects of the model were determined by univariate logistic regression analyses and the receiver operating characteristic (ROC) curve, respectively. A risk assessment scale was established based on the risk factors and physiological and surgical scores for mortality and morbidity. The risk assessment scale prospectively evaluated risk factors of pulmonary complications after minimally invasive surgery for elderly patients with VCFs from January to June 2017. Results: A total of 27 patients diagnosed with pulmonary complications (11.59%) among 233 detected patients. There were statistically significant differences in age, body mass index (BMI), smoking, cardiovascular diseases and old fractures between patients with and without pulmonary complications (P<0.05). Logistic regression analysis showed that smoking, cardiovascular diseases and old fractures were risk factors of pulmonary complications after PVP or PKP for elderly patients with VCFs (P<0.05) and area under the curve was 0.738 (95% confidence intervals (CI): 0.648-0.828). We assessed 53 elderly patients with VCFs, 5 of whom occurred pulmonary complications after PVP or PKP. Areas under the curve of preoperative and total risk assessment values were all 0.925. Conclusions: Significant risk factors of pulmonary complications were BMI, cardiovascular diseases and old fractures for patients aged 65 years or elderly with VCFs after minimally invasive surgery. The risk assessment scale established by us gaining high accuracy.
Information needs and information seeking behaviour of dementia patients and their caregivers: a scoping review
Authors: Soong Aijia , Au Shu Ting , Kyaw Bhone Myint , Theng Yin Leng , Car Lorainne Tudor
Published: October 2019

Background Patients with dementia often require full-time caregivers especially in the later stages of their condition. Patients and caregivers’ access to reliable information on dementia is essential as it may have an important impact on patient care and quality of life. This study aims to provide an overview of the information needs and information seeking behaviour of dementia patients and their caregivers.Methods We conducted a scoping review of the literature and searched four electronic databases for eligible studies published up to August 2018. Two reviewers independently screened studies and extracted data. Information needs were classified according to emerging themes in the literature, and information seeking behaviour was categorized using Wilson’s model of information behaviour.Results Twenty studies with a total of 4,140 participants, were included in this review. Reported information needs focused on: (i) disease; (ii) patient care provision; (iii) healthcare services; and (iv) caregiver self-care. The most commonly reported information need was on healthcare service-related information. Characteristics found to influence information needs were the severity of dementia as well as patient and caregiver status. Dementia patients and caregivers mainly displayed active searching information seeking behaviour and preferred using electronic sources to obtain health information.Conclusion Current dementia information sources available in English are extensive in the information they offer, but more emphasis needs to be placed on healthcare service-related information. All studies originated from high income countries and focused on information needs of caregiver only. The only variable found to significantly influence information needs was severity of dementia condition. The information needs identified in this review can be used to inform development and design of future dementia resources for patients and their caregivers.
Comparison of Outcomes Postoperation between Straight Leg Raising Test Negative and Positive Patients Who Underwent Percutaneous Transforaminal Endoscopic Discectomy for Lumbar Disc Herniation
Authors: Wei Feilong , Gao Haoran , Yuan Yifang , Qian Shu , Guo Quanyou , Guo Shikong , Xue Weigao , Zhou Chengpei , Qian Jixian
Published: October 2019

Background: Percutaneous Transforaminal Endoscopic Discectomy is used increasingly in patients with Lumbar Disc Herniation. There is little knowledge on the related factors including SLR test influencing the operation. Therefore, we designed this prospective study to explore the relevant factors influencing postoperative effect of PTED surgery.Methods: Consecutive patients with LDH who came to our hospital from August 2015 to September 2016 and received PTED surgery. 4 kinds of scales including VAS (lumbar/leg), ODI and JOA were measured and reassessed at 1 day, 3 months, 6 months, 12months and 36 months after the PTED to assess their surgical outcomes. Results: All the patients had successful surgery. ODI and VAS (lumbar/leg) decreased in all patients and groups. And there was a statistically significant difference in each postoperative follow-up compared with that before surgery in every visit. In addition, the increase of JOA in postoperation was statistically significant compared with that before surgery. And, there is statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°-) in the changes of the scores of VAS(leg), ODI and JOA. However, there is no statistically significant difference between the three subpopulations (patients with SLR Positive (0°-30°), SLR Positive (31°-60°) and SLR Negative (61°--RRB- in the changes of the score of VAS(lumbar). Conclusions: PTED showed great effect on treating patients with lumbar disc herniation. And the main scale score such as VAS(leg). ODI and JOA showed that there is a statistically significant difference between the three subpopulations treated by PTED. Patients with SLR negative may get greater benefit from PTED.
Prevalence and contributing factors of Birth asphyxia among the neonates delivered at Negest Eleni Mohammed memorial teaching hospital, Southern Ethiopia: A cross-sectional study
Authors: Abdo Ritbano Ahmed , Halil Hassen Mosa , Kebede Biruk Assefa , Anshebo Abebe Alemu , Gejo Negeso Gebeyehu
Published: October 2019

Background: Birth asphyxia is a major contributor to neonatal mortality worldwide. In Ethiopia, birth asphyxia remains a severe condition that leads to significant mortality and morbidity. This study aimed to assess the prevalence and contributing factors of birth asphyxia among the neonates delivered at the Negest Eleni Mohammed Memorial Teaching Hospital, Southern Ethiopia.
Methods: A hospital based cross-sectional study design was employed from June 1- 30, 2019. Two hundred seventy nine study participants were selected using the systematic sampling method. Data were collected using a pretested structured interviewer administered questionnaire, check list and chart review. Data were entered into Epi-data (version 3.1) and analyzed using statistical package for social sciences (version 24). Descriptive and binary logistic regression analysis were made and P value of < 0.05 was considered significant.
Result: The overall prevalence of birth asphyxia among newborns was found to be 15.1%. Factors that were significantly associated with birth asphyxia included mothers aged ≥ 35 [AOR=6.4, 95% CI (2.0, 20.5)], primigravida [AOR=5.1, 95% CI (2.0, 13.3)], prolonged second stage of labor [AOR=4.6, 95%CI (1.6, 13.3)], preterm birth [AOR=4.7, 95% CI (1.5, 14.1)], meconium stained amniotic fluid[AOR=7.5, 95% CI (2.5, 21.4)]and tight nuchal[AOR=3.1, 95% CI (1.2, 9.3)].
Conclusion: Birth asphyxia is still prevalent in the study setting. The results of this study show the need for better maternal care, creating awareness about contributing factors of birth asphyxia to the maternity health professionals, careful monitoring of labor, and identifying and taking proper measures that could help in reducing the occurrence of birth asphyxia.
Proteome Profile Changes During Poly-hydroxybutyrate Intracellular Mobilization in Gram Positive Bacillus cereus tsu1
Authors: LI HUI , O’Hair Joshua , Thapa Santosh , Bhatti Sarabjit , Zhou Suping , Yang Yong , Fish Tara , Thannhauser Theodore W.
Published: October 2019

Background Bacillus cereus is a bacterium species can grow efficiently on a wide range of carbon sources and accumulate biopolymer poly-hydroxybutyrate (PHB) up to 80% cell dry weight. PHB is an aliphatic polymer produced and stored intracellularly as a reservoir of carbon and energy, its mobilization is a key biological process for the spore forming Bacillus spp . Our lab previously isolated and identified a bacterial strain Bacillus cereus tsu1. The bacterium was cultured on rapeseed cake substrate (RCS) and the maxima of PHB accumulation reached within 12 h, and depleted after 48 h; fore-spore and spore structure were observed after 24 h culture.Results Quantitative proteomic analysis of ‘ tsu1’ identified 3,215 proteins in total, out of which 2,952 got quantified. 244 were identified as significantly changed proteins (SCPs) in the 12-24-hour pair of samples, and 325 in the12-48-hour pair of samples. Gene Ontology classification revealed that enriched biological processes only found in the 12-24h pair SCPs include purine nucleotide metabolism, protein folding, metal ion homeostasis, response to stress, carboxylic acid catabolism, cellular amino acid catabolism; and those only found in the 12-48h pair SCPs were carbohydrate metabolism, protein metabolism, oxidative phosphorylation, formation of translation ternary structure. Based on statistical analysis, key enzymes poly(R)-hydroxyalkanoic acid synthase (PhaC, KGT44864) is significantly higher in 12h-culture; SigF, SpoEII related with sporulation were significantly higher in the 24h-samples; enzymes for nitrate respiration and fermentation were significantly induced in 48h-culture.Conclusions Proteome profile changes during PHB intracellular mobilization in B. cereus tsu1 were characterized in this study. The key enzyme PhaC for PHB synthesis is significantly higher in 12h-culture which supports the highest PHB accumulation at this time point; protein abundance of SpoIIE and σF were significantly increased to induce sporulation in 24h-culture; enzymes for nitrate respiration and fermentation were significantly induced in 48h-culture which implied the depletion of oxygen at this stage and carbon flow towards fermentative growth. The results from this study provide insights into proteome profile changes during PHB accumulation and reuse, which can be applied to achieve a higher PHB yield and to improve bacterial growth performance and stress resistance.
Assessment of Care Provision for Hypertension at Emergency Department of an Urban Hospital in Mozambique
Authors: Bay Neusa Vanessa Amad , JUGA Edna , MACUACUA Carlos , JOAO Jose , ANIBAL Maria , STEWART Simon , MOCUMBI Ana Olga
Published: October 2019

Background: Management of hypertension in Mozambique is poor, and rates of control are amongst the lowest in the world. Health system related factors contribute at least partially to this situation, particularly in settings where there is scarcity of resources to address the double burden of infectious and non-communicable diseases. This study aimed to assess the management of hypertension in an emergency department (ED). Methods: During a pragmatic and prospective 30-day snapshot study (with 24 hour surveillance) and random profiling of one-in-five presentations to the ED of Hospital Geral De Mavalane, Maputo, we assessed patient’s flow, infrastructure and resources through direct observation, and reports from pharmacy and laboratory stocks were used to assess availability of diagnostics and medicines needed for hypertension management. Results: Hypertensive patients had several stops during their journey inside the health facility, and followed a non-standardized flow. No clinical protocols or algorithms for risk stratification of hypertension were available. Stock-outs of basic diagnostic tools for risk stratification and medicines were registered. The availability of medicines was 28% on average. Conclusions: Critical gaps in health facility readiness to address arterial hypertension seen in ED were uncovered, including lack of clinical protocols, insufficient availability of diagnostics and essential medicines, as well as low affordability of the families to guaranty continuum of care. Innovative financing mechanisms are needed to support the health system to address hypertension.
Epidemic Ribotypes Of Clostridium (Now Clostridioides) Difficile Are Likely To Be More Virulent Than Non-epidemic Ribotypes In Animal Models
Authors: Vitucci John C. , Pulse Mark , Tabor-Simecka Leslie , Simecka Jerry W.
Published: October 2019

Background. Clostridium difficile infections have become more frequently diagnosed and associated with greater disease severity, which has resulted in an increase burden on the healthcare system. These increases are attributed to the increased prevalence of hypervirulent strains encompassing select ribotypes. These epidemic ribotypes were characterized as hypervirulent due to higher in vitro spore and toxin production, as well as increased incidence, severity and mortality within patients. However, it is unclear whether epidemic ribotypes are truly more virulent than non-epidemic ribotypes in vivo. Furthermore, there is conflicting evidence about the ability of a strain’s in vitro phenotype to be predictive of their in vivo virulence. The goals of the current studies were to determine if epidemic ribotypes are more virulent than other ribotypes in animal models, and whether the in vitro virulence phenotype of an isolate or ribotype predict in vivo virulence. Results. To determine if epidemic strains were truly more virulent than other non-epidemic strains, the in vivo virulence of thirteen C. difficile isolates (7 non-epidemic and 6 epidemic ribotype isolates) were determined in murine (C57BL/6 mice) and hamster (golden Syrian hamster) models of C. difficile infections. The isolates of epidemic ribotype of C. difficile were found to be more virulent in both the murine and hamster models than non-epidemic isolates. In particular, the group of epidemic ribotypes of C. difficile had lower LD50 values in hamsters. The increased severity of disease was associated with higher levels of Toxin A and Toxin B production found in fecal samples, but not numbers of organisms recovered. The isolates were further characterized for their in vitro virulence phenotypes, e.g. toxin production, growth rates, spore formation and adherence of spores to intestinal epithelial cell lines. Although there were higher levels of toxins produced and greater adherence for the group of epidemic ribotypes, the in vitro profiles of individual isolates were not always predictive of their in vivo virulence. Conclusions. Overall, the group of epidemic ribotypes of C. difficile were more virulent in vivo despite individual isolates having similar phenotypes to the non-epidemic isolates in vitro.
A Comparison of Two DNA Metagenomic Bioinformatic Pipelines while evaluating the Microbial Diversity in feces of Tanzanian small holder dairy cattle
Authors: Kibegwa Felix , Francesca Stomeo , Rawlynce Bett C. , Charles Gachuiri K. , Fidalis Mujibi D.
Published: October 2019

Background: Analysis of shotgun metagenomic data generated from next generation sequencing platforms can be done through a variety of bioinformatic pipelines. These pipelines employ different sets of sophisticated bioinformatics algorithms which may affect the results of this analysis. Furthermore, no conventional assessment technique for estimating the precision of each pipeline exists and few studies have been carried out to compare the characteristics, benefits and disadvantages of each pipeline. In this study we compared two commonly used pipelines for shotgun metagenomic analysis: MetaGenome Rapid Annotation using Subsystem Technology (MG-RAST) and Kraken, in terms of taxonomic classification, diversity analysis and usability using their primarily default parametersResults: Overall, the two pipelines detected similar abundance distributions in the three most abundant taxa Proteobacteria, Firmicutes and Bacteroidetes. Within bacterial domain, 497 genera were identified by both pipelines, while an additional 694 and 98 genera were solely identified by Kraken and MG-RAST respectively. 933 species were detected by the two algorithms. Kraken solely detected 3550 species, while MG-RAST identified 557 species uniquely. For archaea, Kraken generated 105 and 236 genera and species respectively while MG-RAST detected 60 genera and 88 species. 54 genera and 72 species were commonly detected by the two methods. Kraken had a quicker analysis time (~4 hours) while MG-RAST took approximately 2 days per sample.Conclusions: This study revealed that Kraken and MG-RAST generate comparable results and that a reliable high-level overview of sample is generated irrespective of the pipeline selected. The observed variations at the genus level show that a main restriction is using different databases for classification of the metagenomic data. Specifically, the pipelines could have been limited because some rumen microbes lack reference genomes. The results of this research indicate that a more inclusive and representative classification of microbiomes may be achieved through creation of combined pipelines.
Awareness and Attitudes toward Corneal Donations among Applicants and Staff of a Driver, Vehicle and Licensing Authority (DVLA) in Ghana
Authors: Lartey Seth , ANTWI-ADJEI ELLEN KONADU , Agyapong Solomon , Mohammed Abdul-Kabir , Mensah Derrick N.O. , Genego Edward S
Published: October 2019

Background: Corneal transplantations are surgeries performed for irreparable corneal diseases and damage. However, there is a gap between the number of potential recipients and the number of donor corneas available. The main aim of the study was to determine the awareness and attitudes toward corneal donation among applicants and staff of DVLA, Kumasi-Ghana.
Methods: A descriptive cross-sectional study was conducted. 100 participants were selected using convenient sampling method. A structured questionnaire was used to elicit responses from participants concerning awareness and attitudes toward corneal transplant.
Results: The mean ± SD age of the participants was 32.05 ± 11.48years and age range, 18-67years. Males were 66% whilst females constituted 34%. 32.7% of the participants were aware of corneal donation. Majority of the participants were Christians (83.1%) and Singles (63%). Television was the source of information with the highest preponderance (49.4%). 67.3% were willing to donate their corneas after death. 63.9% were willing to indicate their donor statuses on drivers’ license form which had a significant association with willingness to donate cornea after death (p<0.05, ᵪ 2 = 12.187).
Conclusion: There is a poor level of awareness (32.7%) of transplant and donation amongst the study population but a good level of willingness to donate organs (67%). Consent via driving license would seem to be a good potential mode of obtaining consent to supplement the harvesting of adequate tissues for transplant if adequate awareness is created.
Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016
Authors: Guo Xiaorong , Yang Dong , Liu Ruchun , Li Yaman , Hu Qingqing , Ma Xinrui , Li Yelan , Zhang Heng , Zhang Xixing , Zhao Benhua , Chen Tianmu
Published: October 2019

BACKGROUND: Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease.
METHODS: The HIS (hospital information system) modified influenza surveillance system (ISS) and a newly built pneumonia surveillance system (PSS) were used to monitor the influenza viruses in Changsha City, China. The ISS was used to monitor outpatients in two sentinel hospitals and to detect mild influenza and avian influenza cases, and PSS was used to monitor inpatients in 49 hospitals and to detect severe and death influenza cases.
RESULTS: From 2005 to 2016, there were 3,551,917 outpatients monitored by the ISS system, among whom 126,076 were influenza-like illness (ILI) cases, with the ILI proportion (ILI%) of 3.55%. After the HIS was used, the reported incident cases of ILI and ILI% were increased significantly. From March, 2009 to September, 2016, there were 5,491,560 inpatient cases monitored by the PSS system, among which 362,743 were pneumonia cases, with a proportion of 6.61%. Among pneumonia cases, about 10.55% (38,260/362,743) of cases were severe or death cases. The pneumonia incidence increased each year in the city. Among 15 avian influenza cases reported from January, 2005 to September, 2016, there were 26.7% (4/15) mild cases detected by the HIS-modified ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available.
CONCLUSIONS: The HIS was able to improve the efficiency of the ISS for monitoring ILI and emerging avian influenza virus. However, the efficiency of the system needs to be verified in a wider area for a longer time span in China.
Supervised exercise protocol for lower limbs in subjects with chronic venous disease: an evaluator-blinded randomized clinical trial
Authors: Volpe Esther Tinoco , Resqueti Vanessa Regiane , Silva Ana Aline Marcelino , Gualdi Lucien Peroni , Fregonezi Guilherme Augusto de Freitas
Published: October 2019

ABSTRACT
Background : Chronic venous insufficiency (CVI) causes pathophysiological changes in lower limb muscles, particularly calf muscles, and limits ankle range of motion (ROM). These changes reduce functional activities and decreases the quality of life (QOL). Although several studies have shown benefits of exercise (strengthening the calf muscles to improve calf muscle pumping and QOL in patients with CVI), only a few randomized clinical trials are based on exercise programs. This has led to a weak indication of exercise for the treatment of patients with CVI. The aim of this study is to analyze the effects of a supervised exercise program to improve calf muscle strength and endurance besides QOL in patients with CVI. Methods : This is an evaluator-blind, randomized clinical trial with an 8-week duration and 16-week follow-up period. This study is planned to include 26 participants with CVI diagnosis. The participants will be randomly allocated (1:1) into a treatment or control group (usual care/no intervention). The treatment intervention consists of a bi-weekly supervised exercise program of the lower limbs that will include aerobic training, strengthening, and cardiovascular exercises. The participants from both groups will participate in a health education lecture. Primary outcomes are change of calf muscle endurance, strength, and QOL score and secondary outcomes are change of exercise capacity and ankle ROM. Discussion : Patients with CVI may have an impaired calf muscle pump. Strengthening calf muscles and increasing resistance can significantly improve exercise capacity and health in patients with CVI. A supervised exercise program will provide much needed information on the management of CVI to promote health and independence.

Trial registration: This study was registered on the Brazilian Clinical Trials Database (REBEC) (RBR-57xtk7). The results will be disseminated at scientific events, presentations, and publications in peer reviewed journals.