bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of stress distribution and displacement of open subtalar dislocation in using titanium alloy and stainless steel mitkovic external fixator – a finite element analysis
Authors: Ramlee Muhammad Hanif Hanif , Abd Wahab Abdul Hadi , Abd Wahab Asnida , Mohd Latip Hadafi Fitri , Daud Siti Asmah , Abdul Kadir Mohammed Rafiq
Published: April 2018

An external fixator is normally used by medical surgeons in treating subtalar dislocation due to its biomechanical characteristics that can providing an adequate stability, preventing deformity (mal-union and non-union), reduce rate of infections, and promoting fast healing process as compared to coventional internal fixator. Apart from the configurations and fixation techniques, previous studies has mentioned that the stability of external fixator can be altered and manipulated by using different materials, e.g. stainless steel, titanium alloy and polymer. To be noted, the current available research works that have been investigated on different materials of external fixator are still lacking, therefore, the present study is aims to conduct related study. The main objective of the research work is to simulate finite element model of foot and ankle joint associated with open subtalar dislocation in which treated with Mitkovic external fixator by using two different material properties; titanium alloy (Model 1) and stainless steel (Model 2). The three-dimensional model of foot and ankle joint were reconstructed using images of CT dataset. For the soft tissues, cartilages at the ankle joint were developed by offsetting the bone surfaces with 1 mm thickness while ligaments were modelled with linear links. Homogeneous and isotropic properties were assigned to the bone, Mooney-Rivlin model for cartilage and specific stiffness value for ligaments. In order to simulate stance phase during walking condition, an axial load of 350 N was applied to the proximal tibia bone. The results of von Mises stress demonstrated that Model 2 has a low magnitude (127 MPa) at the pin-bone interface of tibia bone, compared with Model 1 (369 MPa). As for the local displacement at the bony segment of fibula, Model 2 (3.3 mm) indicated high stability of the external fixator than Model 1 (7.4 mm). In conclusion, the use of stainless steel material for Mitkovic external fixator can provide adequate stability and optimum stress distribution.
Evaluation of muscle fatigue using infrared thermal imaging technique with assisted electromyography
Authors: Ridzuan Nursyazana , Azaman Aizreena , K Soeed , Zulkapri Izwyn , Abd Wahab Asnida
Published: April 2018

Muscle fatigue in sports science is an established research area where various techniques and types of muscles have been studied in order to understand the fatigue condition. It can be used as an indicator for predicting muscle injury and other muscle problems which can decrease athletes’ performance. Muscle fatigue usually occurs after a long lasting or repeated muscular activity. Electromyography (EMG) assessment method is a standard tool used to evaluate muscle fatigue based on the signals from the neuromuscular activation during fatigue condition. However, additional time for equipment set up such as placement of the electrodes and the use of multiple wires make this overall setting a bit complicated. In addition, the signal from EMG which possessed some noise, need to be filtered and post processing time is also required to obtain a reliable measurement signal. Therefore, researchers have explored the application of thermal imaging technique as one of the alternative methods for muscle fatigue assessment. The objective of this study is to investigate the correlation of muscle fatigue condition measured using a non-invasive infrared thermal imaging technique and a standard evaluation method, EMG. Five healthy men were selected to run on a treadmill for 30 minutes with a constant speed setting. Temperature and EMG signals were registered from gastrocnemius muscle of the subjects' dominant leg simultaneously. Result obtained shows that the average temperature of gastrocnemius muscle decrease as subjects start to exercise. Further temperature decrease along with exercise and increase in temperature were observed during the recovery period. Statistical analysis was performed and analyzed using both temperature and EMG parameters. Result shows a significant strong correlation with r = 0.7707 and p < 0.05 between temperature difference and median frequency (MDF) for all subjects compared to average temperature. Therefore, it is concluded that temperature difference extracted from thermal images can be used as an ideal parameter for muscle fatigue evaluation.
Improvement of estimation based on small number of events per variable (EPV) using bootstrap logistics regression model
Authors: Lola Muhamad Safiih , Zainuddin Nurul Hila , Ramlee Mohd Noor Afiq , Abdul Rahman Muhamad Na’eim , Abdullah Mohd Tajuddin
Published: April 2018

In this research, a bootstrap approach model is proposed, namely as Bootstrap Logistics Regression Model (BLRM) that is specifically used to solve the small events per variable (EPV) problem. Considering a sample data from study case of endemic dengue at several localities in Kelantan, Malaysia, a simulation study is conducted.  We generated 5, 10, 20 and 25 mean samples with 500 times replacement, 1500 times bootstrap for each small EPV value (EPV= 2, 3, 4 and 5) according to the basic reproduction number, R0 for endemic dengue.  The performance of the propose BLRM revealed that the frequency distribution of estimated regression coefficient became less peaked and possessed thinner tails; the average percent relative bias consistently decreased and was closed to true parameter; the sample variance (MSE and RMSE) of the estimated regression coefficients of were smaller than original model.
Polycyclic transformations of crystallographic groups with quaternion point group of order eight
Authors: Mohammad Siti Afiqah , Sarmin Nor Haniza , Mat Hassim Hazzirah Izzati
Published: April 2018

Exploration of a group's properties is vital for better understanding about the group.  Amongst other properties, the homological invariants including the nonabelian tensor square of a group can be explicated by showing that the group is polycyclic.  In this paper, the polycyclic presentations of certain crystallographic groups with quaternion point group of order eight are shown to be consistent; which implies that these groups are polycyclic.
Polyethersulfone/polyvinyl acetate blend membrane incorporated with TiO2 nanoparticles for CO2/CH4 gas separation
Authors: Abdullah Mohd Afzan , Mukhtar Hilmi , Abdul Mannan Hafiz , Fong Yeong Yin , Shaharun Maizatul Shima
Published: April 2018

Development of polymer blend membranes is gaining much attention especially for gas separation processes. This paper is primarily focused on synthesizing polymer blend membranes incorporated with titanium dioxide (TiO2) nanoparticles as inorganic filler to enhance its performances. Polyethersulfone (PES) and polyvinyl acetate (PVAc) were blended at ratio of 90/10, together with 5 wt.% of TiO2 in dimethylformamide (DMF). The morphological structure of the membrane was analysed via FESEM. It shows that a rigid/non-porous membrane with slight nanoparticles agglomeration was formed. As interpreted from TGA, incorporating TiO2 nanoparticles into the polymer blend reduces the degradation temperature, increases wt.% of leftover residual thus proves an enhancement in thermal stability of the membrane. Moreover, the presence of TiO2 nanoparticles in the developed membrane possesses some effect on the spectral analysis as observed via FTIR spectroscopy. The permeability of CO2 gas is improved with addition of TiO2 nanoparticles within the blend membrane and better selectivity of CO2/CH4 is observed.
Isotherm studies of methylene blue adsorption onto waste tyre pyrolysis powder-based activated carbons
Authors: Mohd Shaid Mohd Shafiq Hakimi , Ahmad Zaini Muhammad Abbas , Nasri Noor Shawal
Published: April 2018

This study was aimed to investigate the adsorptive ability of activated carbons derived from waste tyre pyrolysis powder by CO2 activation and ZnCl2 activation. The derived activated carbons and char were characterized for yield and specific surface area. Methylene Blue dye was used as a model pollutant to probe the performance of activated carbons. Result shows that the CO2-activated waste tyre pyrolysis powder exhibits a higher surface area of 97.0 m2/g, hence a greater methylene blue removal capacity of 47.2 mg/g. The methylene blue adsorption data by activated carbons and char obeyed the Langmuir isotherm with R2 of more than 0.99, describing the monolayer adsorption onto homogeneous surface. Physical activation of waste tyre pyrolysis powder using CO2 yields activated carbon with a promising performance for dyes removal from water.
Attitudes of University Students Towards Sport
Authors: Yanik Mehmet
Published: April 2018

The aim of this study is to examine the attitude levels of students receiving education at university level towards sport with regard to certain variables. The research was designed with the scanning model. A “sport attitudes scale” was applied to a total of 547 students, selected by random sampling method, who were studying at Balikesir University.The research findings revealed that the participants’ attitude levels regarding sport were at a “high attitude” level, with an average of 3.70±058. It was determined that participants who did sport regularly had a higher attitude level. It was also determined that according to the education department variable, students receiving sports education together with those in the economics faculty had higher attitude levels. As for the grade level variable, it was revealed that the lowest attitude level belonged to third-grade students.Consequently, with the aim of increasing university students’ attitude levels regarding sport, it is recommended that they be given the opportunity to do more sport and that they be given guidance in this direction.
Determination of Bioethical Perceptions of Gifted Students
Authors: Ceylan Özge , Topsakal Ünsal Umdu
Published: April 2018

This research was carried out to reveal the bioethical values that special, talented students have about the socioscientific issues that they may encounter in everyday life. Scanning model was used in the research from quantitative research methods. The study's working group is composed of special talented fifth, sixth, seventh, eighth, ninth, and tenth-grade students (N = 100) who have already been diagnosed with a special talent individual in the 2017-2018 academic year and who continue to science and art centers. The Bioethics Value Inventory developed by Kurt (2011) was used as a data collection tool. The inventory consists of five scenarios and contains frequently encountered dilemmas. Scenario issues include active and passive euthanasia, organ donation, GMO products, embryology technologies. In the analysis of the data, descriptive statistics were used for the answers given by the students to the script. Besides, Chi-square test was applied by SPSS package program to determine whether there is a difference in bioethical value and main decision options according to gender, grade level, mother education level and father education level. According to the scenario in the inventory, the students' ethical values (The Utilitarian, The rights, The justice, The virtue, The normative, The theological, preference for natural, The science and technology-based, Belief in Humans' Superiority to Other Living Beings) were calculated by calculating percentages. There are various outcomes in the Chi-square test for each scenario. Despite the fact that private/gifted individuals are few in the society, they need to develop their ethical values, especially when considering the contribution each country can make. For this reason, the ethical values of special, talented individuals should first be identified in their current bioethics, and then the bioethical value education should be given to the privatized programs directed to them. Nowadays, with the emphasis on bioethics education, it is expected that the study will be a source of many kinds of researchers on bioethics education of specially talented children. The study is becoming important in these aspects.
Alterations of Metabolic and Lipid Profiles in Polymyxin-Resistant Pseudomonas aeruginosa
Authors: Han Mei-Ling , Zhu Yan , Creek Darren J. , Lin Yu-Wei , Anderson Dovile , Shen Hsin-Hui , Tsuji Brian , Gutu Alina D. , Moskowitz Samuel M. , Velkov Tony , Li Jian
Published: April 2018

Multidrug-resistant
Pseudomonas aeruginosa
presents a global medical challenge, and polymyxins are a key last-resort therapeutic option. Unfortunately, polymyxin resistance in
P. aeruginosa
has been increasingly reported. The present study was designed to define metabolic differences between paired polymyxin-susceptible and -resistant
P. aeruginosa
strains using untargeted metabolomics and lipidomics analyses. The metabolomes of wild-type
P. aeruginosa
strain K ([PAK] polymyxin B MIC, 1 mg/liter) and its paired
pmrB
mutant strains, PAK
pmrB6
and PAK
pmrB12
(polymyxin B MICs of 16 mg/liter and 64 mg/liter, respectively) were characterized using liquid chromatography-mass spectrometry, and metabolic differences were identified through multivariate and univariate statistics. PAK
pmrB6
and PAK
pmrB12
, which displayed lipid A modifications with 4-amino-4-deoxy-
l
-arabinose, showed significant perturbations in amino acid and carbohydrate metabolism, particularly the intermediate metabolites from 4-amino-4-deoxy-
l
-arabinose synthesis and the methionine salvage cycle pathways. The genomics result showed a premature termination (Y275stop) in
speE
(encoding spermidine synthase) in PAK
pmrB6
, and metabolomics data revealed a decreased intracellular level of spermidine in PAK
pmrB6
compared to that in PAK
pmrB12
. Our results indicate that spermidine may play an important role in high-level polymyxin resistance in
P. aeruginosa
. Interestingly, both
pmrB
mutants had decreased levels of phospholipids, fatty acids, and acyl-coenzyme A compared to those in the wild-type PAK. Moreover, the more resistant PAK
pmrB12
mutant exhibited much lower levels of phospholipids than the PAK
pmrB6
mutant, suggesting that the decreased phospholipid level was associated with polymyxin resistance. In summary, this study provides novel mechanistic information on polymyxin resistance in
P. aeruginosa
and highlights its impacts on bacterial metabolism.
Are Sphingolipids and Serine Dipeptide Lipids Underestimated Virulence Factors of Porphyromonas gingivalis?
Authors: Olsen Ingar , Nichols Frank C.
Published: April 2018

The keystone periodontal pathogen
Porphyromonas gingivalis
produces phosphorylated dihydroceramide lipids (sphingolipids) such as phosphoethanolamine dihydroceramide (PE DHC) and phosphoglycerol dihydroceramide (PG DHC) lipids. Phosphorylated DHCs (PDHCs) from
P. gingivalis
can affect a number of mammalian cellular functions, such as potentiation of prostaglandin secretion from gingival fibroblasts, promotion of RANKL-induced osteoclastogenesis, promotion of apoptosis, and enhancement of autoimmunity. In
P. gingivalis
, these lipids affect anchoring of surface polysaccharides, resistance to oxidative stress, and presentation of surface polysaccharides (anionic polysaccharides and K-antigen capsule). In addition to phosphorylated dihydroceramide lipids, serine dipeptide lipids of
P. gingivalis
are implicated in alveolar bone loss in chronic periodontitis through interference with osteoblast differentiation and function and promotion of osteoclast activity. As a prerequisite for designation as bacterial virulence factors, bacterial sphingolipids and serine dipeptide lipids are recovered in gingival/periodontal tissues, tooth calculus, human blood, vascular tissues, and brain. In addition to
P. gingivalis
, other bacteria of the genera
Bacteroides
,
Parabacteroides
,
Porphyromonas
,
Tannerella
, and
Prevotella
produce sphingolipids and serine dipeptide lipids. The contribution of PDHCs and serine dipeptide lipids to the pathogenesis of periodontal and extraoral diseases may be an underappreciated area in microbe-host interaction and should be more intensively investigated.
Use of Automated Urine Microscopy Analysis in Clinical Diagnosis of Urinary Tract Infection: Defining an Optimal Diagnostic Score in an Academic Medical Center Population
Authors: Foudraine Dimard E. , Bauer Martijn P. , Russcher Anne , Kusters Elske , Cobbaert Christa M. , van der Beek Martha T. , Stalenhoef Janneke E.
Published: April 2018

A retrospective case record study was conducted that established a scoring tool based on clinical and iQ200 parameters, able to predict or rule out the clinical diagnosis of UTI in the majority of adult patients in an academic hospital. Automated standardized quantitative urine analysis, such as iQ200 analysis, is on the rise because of its high accuracy and efficiency compared to those of traditional urine analysis. Previous research on automated urinalysis focused mainly on predicting culture results but not on the clinical diagnosis of urinary tract infection (UTI). A retrospective analysis was conducted of consecutive urine samples sent in for culture because of suspected UTI. UTI was defined by expert opinion, based on reported symptoms, conventional urine sediment analysis, and urine cultures. Parameters of iQ200 analysis and clinical symptoms and signs were compared between cases and controls. Optimal cutoff values were determined for iQ200 parameters, and multivariate logistic regression analysis was used to identify the set of variables that best predicts the clinical diagnosis of UTI for development of a scoring tool. A total of 382 patients were included. Optimal cutoff values of iQ200 analysis were 74 white blood cells (WBC)/μl, 6,250 “all small particles” (ASP)/μl, and a bacterial score of 2 on an ordinal scale of 0 to 5. The scoring tool attributed 1 point for frequent micturition or increased urge, 2 points for dysuria, 1 point for a bacterial score of ≥2, 2 points for WBC/μl of ≥50, and an additional point for WBC/μl of ≥150. This score had a sensitivity of 86% and a specificity of 92% when using a threshold of <4 points. The combination of iQ200 analysis and a simple survey could predict or rule out UTIs in a majority of patients in an academic medical center.
Kaposi's Sarcoma-Associated Herpesvirus mRNA Accumulation in Nuclear Foci Is Influenced by Viral DNA Replication and Viral Noncoding Polyadenylated Nuclear RNA
Authors: Vallery Tenaya K. , Withers Johanna B. , Andoh Joana A. , Steitz Joan A.
Published: April 2018

Kaposi's sarcoma-associated herpesvirus (KSHV), like other herpesviruses, replicates within the nuclei of its human cell host and hijacks host machinery for expression of its genes. The activities that culminate in viral DNA synthesis and assembly of viral proteins into capsids physically concentrate in nuclear areas termed viral replication compartments. We sought to better understand the spatiotemporal regulation of viral RNAs during the KSHV lytic phase by examining and quantifying the subcellular localization of select viral transcripts. We found that viral mRNAs, as expected, localized to the cytoplasm throughout the lytic phase. However, dependent on active viral DNA replication, viral transcripts also accumulated in the nucleus, often in foci in and around replication compartments, independent of the host shutoff effect. Our data point to involvement of the viral long noncoding polyadenylated nuclear (PAN) RNA in the localization of an early, intronless viral mRNA encoding ORF59-58 to nuclear foci that are associated with replication compartments.

IMPORTANCE
Late in the lytic phase, mRNAs from Kaposi's sarcoma-associated herpesvirus accumulate in the host cell nucleus near viral replication compartments, centers of viral DNA synthesis and virion production. This work contributes spatiotemporal data on herpesviral mRNAs within the lytic host cell and suggests a mechanism for viral RNA accumulation. Our findings indicate that the mechanism is independent of the host shutoff effect and splicing but dependent on active viral DNA synthesis and in part on the viral noncoding RNA, PAN RNA. PAN RNA is essential for the viral life cycle, and its contribution to the nuclear accumulation of viral messages may facilitate propagation of the virus.
Hospitalized Premature Infants Are Colonized by Related Bacterial Strains with Distinct Proteomic Profiles
Authors: Brown Christopher T. , Xiong Weili , Olm Matthew R. , Thomas Brian C. , Baker Robyn , Firek Brian , Morowitz Michael J. , Hettich Robert L. , Banfield Jillian F.
Published: April 2018

During the first weeks of life, microbial colonization of the gut impacts human immune system maturation and other developmental processes. In premature infants, aberrant colonization has been implicated in the onset of necrotizing enterocolitis (NEC), a life-threatening intestinal disease. To study the premature infant gut colonization process, genome-resolved metagenomics was conducted on 343 fecal samples collected during the first 3 months of life from 35 premature infants housed in a neonatal intensive care unit, 14 of whom developed NEC, and metaproteomic measurements were made on 87 samples. Microbial community composition and proteomic profiles remained relatively stable on the time scale of a week, but the proteome was more variable. Although genetically similar organisms colonized many infants, most infants were colonized by distinct strains with metabolic profiles that could be distinguished using metaproteomics. Microbiome composition correlated with infant, antibiotics administration, and NEC diagnosis. Communities were found to cluster into seven primary types, and community type switched within infants, sometimes multiple times. Interestingly, some communities sampled from the same infant at subsequent time points clustered with those of other infants. In some cases, switches preceded onset of NEC; however, no species or community type could account for NEC across the majority of infants. In addition to a correlation of protein abundances with organism replication rates, we found that organism proteomes correlated with overall community composition. Thus, this genome-resolved proteomics study demonstrated that the contributions of individual organisms to microbiome development depend on microbial community context.

IMPORTANCE
Humans are colonized by microbes at birth, a process that is important to health and development. However, much remains to be known about the fine-scale microbial dynamics that occur during the colonization period. We conducted a genome-resolved study of microbial community composition, replication rates, and proteomes during the first 3 months of life of both healthy and sick premature infants. Infants were found to be colonized by similar microbes, but each underwent a distinct colonization trajectory. Interestingly, related microbes colonizing different infants were found to have distinct proteomes, indicating that microbiome function is not only driven by which organisms are present, but also largely depends on microbial responses to the unique set of physiological conditions in the infant gut.
Robust Mercury Methylation across Diverse Methanogenic Archaea
Authors: Gilmour Cynthia C. , Bullock Allyson L. , McBurney Alyssa , Podar Mircea , Elias Dwayne A.
Published: April 2018

Methylmercury (MeHg) production was compared among nine cultured methanogenic archaea that contain
hgcAB
, a gene pair that codes for mercury (Hg) methylation. The methanogens tested produced MeHg at inherently different rates, even when normalized to growth rate and Hg availability. Eight of the nine tested were capable of MeHg production greater than that of spent- and uninoculated-medium controls during batch culture growth.
Methanococcoides methylutens
, an
hgcAB

+

strain with a fused gene pair, was unable to produce more MeHg than controls. Maximal conversion of Hg to MeHg through a full batch culture growth cycle for each species (except
M. methylutens
) ranged from 2 to >50% of the added Hg(II) or between 0.2 and 17 pmol of MeHg/mg of protein. Three of the species produced >10% MeHg. The ability to produce MeHg was confirmed in several
hgcAB

+

methanogens that had not previously been tested (
Methanocella paludicola
SANAE,
Methanocorpusculum bavaricum
,
Methanofollis liminatans
GKZPZ, and
Methanosphaerula palustris
E1-9c). Maximal methylation was observed at low sulfide concentrations (<100 μM) and in the presence of 0.5 to 5 mM cysteine. For
M. hollandica
, the addition of up to 5 mM cysteine enhanced MeHg production and cell growth in a concentration-dependent manner. As observed for bacterial Hg methylators, sulfide inhibited MeHg production. An initial evaluation of sulfide and thiol impacts on bioavailability showed methanogens responding to Hg complexation in the same way as do
Deltaproteobacteria
. The mercury methylation rates of several methanogens rival those of the better-studied Hg-methylating sulfate- and iron-reducing
Deltaproteobacteria
.

IMPORTANCE
Archaea
, specifically methanogenic organisms, play a role in mercury methylation in nature, but their global importance to MeHg production and the subsequent risk to ecosystems are not known. Methanogenesis has been linked to Hg methylation in several natural habitats where methylmercury production incurs risk to people and ecosystems, including rice paddies and permafrost. In this study, we confirm that most methanogens carrying the
hgcAB
gene pair are capable of Hg methylation. We found that methylation rates vary inherently among
hgcAB

+

methanogens but that several species are capable of MeHg production at rates that rival those of the better-know Hg-methylating sulfate- and iron-reducing bacteria. Methanogens may need to be considered equally with sulfate and iron reducers in evaluations of MeHg production in nature.
At the Nexus of History, Ecology, and Hydrobiogeochemistry: Improved Predictions across Scales through Integration
Authors: Stegen James C.
Published: April 2018

To improve predictions of ecosystem function in future environments, we need to integrate the ecological and environmental histories experienced by microbial communities with hydrobiogeochemistry across scales. A key issue is whether we can derive generalizable scaling relationships that describe this multiscale integration.
Geographic coverage of demographic surveillance systems for characterising the drivers of childhood mortality in sub-Saharan Africa
Authors: Utazi C Edson , Sahu Sujit K , Atkinson Peter M , Tejedor-Garavito Natalia , Lloyd Christopher T , Tatem Andrew J
Published: April 2018

A major focus of international health and development goals is the reduction of mortality rates in children under 5 years of age. Achieving this requires understanding the drivers of mortality and how they vary geographically to facilitate the targeting and prioritisation of appropriate interventions. Much of our knowledge on the causes of, and trends in, childhood mortality come from longitudinal demographic surveillance sites, with a renewed focus recently on the establishment and growth of networks of sites from which standardised outputs can facilitate broader understanding of processes. To ensure that the collective outputs from surveillance sites can be used to derive a comprehensive understanding and monitoring system for driving policy on tackling childhood mortality, confidence is needed that existing and planned networks of sites are providing a reliable and representative picture of the geographical variation in factors associated with mortality. Here, we assembled subnational data on childhood mortality as well as key factors known to be associated with it from household surveys in 27 sub-Saharan African countries. We then mapped the locations of existing longitudinal demographic surveillance sites to assess the extent of current coverage of the range of factors, identifying where gaps exist. The results highlight regions with unique combinations of factors associated with childhood mortality that are poorly represented by the current distribution of sites, such as southern Mali, central Nigeria and southern Zambia. Finally, we determined where the establishment of new surveillance systems could improve coverage.
Poverty reduction and equity benefits of introducing or scaling up measles, rotavirus and pneumococcal vaccines in low-income and middle-income countries: a modelling study
Authors: Riumallo-Herl Carlos , Chang Angela Y , Clark Samantha , Constenla Dagna , Clark Andrew , Brenzel Logan , Verguet Stéphane
Published: April 2018

Introduction

Beyond their impact on health, vaccines can lead to large economic benefits. While most economic evaluations of vaccines have focused on the health impact of vaccines at a national scale, it is critical to understand how their impact is distributed along population subgroups.

Methods

We build a financial risk protection model to evaluate the impact of immunisation against measles, severe pneumococcal disease and severe rotavirus for birth cohorts vaccinated over 2016–2030 for three scenarios in 41 Gavi-eligible countries: no immunisation, current immunisation coverage forecasts and the current immunisation coverage enhanced with funding support. We distribute modelled disease cases per socioeconomic group and derive the number of cases of: (1) catastrophic health costs (CHCs) and (2) medical impoverishment.

Results

In the absence of any vaccine coverage, the number of CHC cases attributable to measles, severe pneumococcal disease and severe rotavirus would be approximately 18.9 million, 6.6 million and 2.2 million, respectively. Expanding vaccine coverage would reduce this number by up to 90%, 30% and 40% in each case. More importantly, we find a higher share of CHC incidence among the poorest quintiles who consequently benefit more from vaccine expansion.

Conclusion

Our findings contribute to the understanding of how vaccines can have a broad economic impact. In particular, we find that immunisation programmes can reduce the proportion of households facing catastrophic payments from out-of-pocket health expenses, mainly in lower socioeconomic groups. Thus, vaccines could have an important role in poverty reduction.
Impact of a health system strengthening intervention on maternal and child health outputs and outcomes in rural Rwanda 2005–2010
Authors: Thomson Dana R , Amoroso Cheryl , Atwood Sidney , Bonds Matthew H , Rwabukwisi Felix Cyamatare , Drobac Peter , Finnegan Karen E , Farmer Didi Bertrand , Farmer Paul E , Habinshuti Antoinette , Hirschhorn Lisa R , Manzi Anatole , Niyigena Peter , Rich Michael L , Stulac Sara , Murray Megan B , Binagwaho Agnes
Published: April 2018

Introduction

Although Rwanda’s health system underwent major reforms and improvements after the 1994 Genocide, the health system and population health in the southeast lagged behind other areas. In 2005, Partners In Health and the Rwandan Ministry of Health began a health system strengthening intervention in this region. We evaluate potential impacts of the intervention on maternal and child health indicators.

Methods

Combining results from the 2005 and 2010 Demographic and Health Surveys with those from a supplemental 2010 survey, we compared changes in health system output indicators and population health outcomes between 2005 and 2010 as reported by women living in the intervention area with those reported by the pooled population of women from all other rural areas of the country, controlling for potential confounding by economic and demographic variables.

Results

Overall health system coverage improved similarly in the comparison groups between 2005 and 2010, with an indicator of composite coverage of child health interventions increasing from 57.9% to 75.0% in the intervention area and from 58.7% to 73.8% in the other rural areas. Under-five mortality declined by an annual rate of 12.8% in the intervention area, from 229.8 to 83.2 deaths per 1000 live births, and by 8.9% in other rural areas, from 157.7 to 75.8 deaths per 1000 live births. Improvements were most marked among the poorest households.

Conclusion

We observed dramatic improvements in population health outcomes including under-five mortality between 2005 and 2010 in rural Rwanda generally and in the intervention area specifically.
ACL reconstruction with hamstring tendon autograft and accelerated brace-free rehabilitation: a systematic review of clinical outcomes
Authors: Janssen Rob P A , van Melick Nicky , van Mourik Jan B A , Reijman Max , van Rhijn Lodewijk W
Published: April 2018

Objective

To investigate the clinical outcomes after hamstring tendon autograft ACL reconstruction (ACLR) with accelerated, brace-free rehabilitation.

Design

Systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Data sources

Embase, MEDLINE Ovid, Web of Science, Cochrane CENTRAL and Google scholar from 1 January 1974 to 31 January 2017.

Eligibility criteria for selecting studies

Study designs reporting outcomes in adults after arthroscopic, primary ACLR with hamstring autograft and accelerated, brace-free rehabilitation.

Results

Twenty-four studies were included in the review. The clinical outcomes after hamstring tendon autograft ACLR with accelerated brace-free rehabilitation were the following: (1) early start of open kinetic exercises at 4 weeks in a limited range of motion (ROM, 90°−45°) and progressive concentric and eccentric exercises from 12 weeks did not alter outcomes, (2) gender and age did not influence clinical outcomes, (3) anatomical reconstructions showed better results than non-anatomical reconstructions, (4) there was no difference between single-bundle and double-bundle reconstructions, (5) femoral and tibial tunnel widening occurred, (6) hamstring tendons regenerated after harvest and (7) biological knowledge did not support return to sports at 4–6 months.

Conclusions

After hamstring tendon autograft ACLR with accelerated brace-free rehabilitation, clinical outcome is similar after single-bundle and double-bundle ACLR. Early start of open kinetic exercises at 4 weeks in a limited ROM (90°−45°) and progressive concentric and eccentric exercises from 12 weeks postsurgery do not alter clinical outcome. Further research should focus on achievement of best balance between graft loading and graft healing in the various rehabilitation phases after ACLR as well as on validated, criterion-based assessments for safe return to sports.

Level of evidence

Level 2b; therapeutic outcome studies.
Analysis of Circulating Tumor Cells in Patients with Hepatocellular Carcinoma Recurrence following Liver Transplantation
Authors: Wang Shaoping , Zheng Yujian , Liu Jun , Huo Feng , Zhou Jie
Published: April 2018

Although studies have shown that detection of peripheral circulating tumor cells (CTCs) is an important tool for monitoring prognosis and therapeutic response in patients with cancer, few studies have analyzed their role in patients with hepatocellular carcinoma (HCC) following liver transplantation (LTx). The present study examined whether CTC levels were associated with HCC recurrence in patients with HCC after LTx. This prospective study included 47 patients who received LTx between October 2014 and May 2016 and who underwent analysis for peripheral CTCs at least twice using the CanPatrol system. Baseline Edmondson stage, T stage, accumulated tumor diameter, microvascular cancer embolus, and alpha-fetoprotein (AFP) levels were greater in patients with recurrence (all p<0.05). In addition, 70.2% of patients with HCC were CTC-positive. Although the proportion of CTC subtypes changes following LTx and over the follow-up period with increased epithelial and interstitial CTC levels, no significant associations were observed between change in total CTCs or CTC subtype and HCC recurrence (all p>0.05). In conclusion, baseline Edmondson stage, T stage, accumulated tumor diameter, microvascular cancer embolus, and AFP levels may be predictive of HCC recurrence following LTx; however, CTC levels and subtypes were not. Further large, multicenter studies are necessary to confirm these results.
Severe rhabdomyolysis induced by quetiapine and mirtazapine in a French military soldier
Authors: Saguin Emeric , Keou S , Ratnam C , Mennessier C , Delacour H , Lahutte B
Published: April 2018

Rhabdomyolysis is a potential complication of psychotropic drugs use and may potentially lead to life-threatening complications, such as an acute renal failure. We describe the case of a 40-year-old military soldier suffering from post-traumatic stress disorder was admitted for an adaptation of his treatment. Mirtazapine was introduced and quetiapine increased. Two days later, the patient presented with severe rhabdomyolysis syndrome. Mirtazapine administration was paused and intravenous hydration commenced. Shortly after the creatine kinase levels decreased enabling mirtazapine to be reintroduced without complication. It is our opinion that 5-hydroxytryptamine 2a serotonergic receptors inhibition (related to mirtazapine and quetiapine) associated with muscle training was responsible for inducing rhabdomyolysis. This must be kept in mind when psychotropic medications are adjusted, especially in an athletic population such as military.
Methodological aspects of serosurveillance in resource‐poor settings
Authors: Sternberg Lewerin Susanna , Wolff Cecilia , Masembe Charles , Ståhl Karl , Boqvist Sofia , Franko Mikael Andersson
Published: April 2018

Animal production is important for the agricultural economy in low‐income countries, but is threatened by infectious diseases. Serosurveys are conducted for different reasons such as disease detection, risk factor studies, disease monitoring and establishing disease‐free status. Most reports on such serosurveys include some discussion about methodological constraints but still, by necessity, rely on serological results for case definition. This study uses a cross‐sectional serosurvey for foot‐and‐mouth disease (FMD), Rift Valley fever (RVF) and contagious bovine pleuropneumonia (CBPP) in cattle in three districts in Western Uganda to illustrate the limitations of this approach, addressing the questions of what flaws can be expected in sampling and diagnostics and how these influence the results. The target was to collect blood samples from 60 cattle herds per district. To reflect the recent infection history of the herd, young animals (two to five years) were prioritised. The farmers were interviewed about management, cattle trade, cattle health and vaccination. Commercial ELISAs were used for serological analyses: for CBPP the IDEXX CBPP Mycoplasma mycoides subspecies mycoides antibody test kit, for RVF the ID Screen Rift Valley Fever competitive ELISA, and for FMD the PrioCHECK FMDV NS. Apparent prevalence, true prevalence and associations with herd characteristics were assessed. The sampling plans could not be entirely fulfilled, nor the number of tests run in the laboratory. There were reactors to all three diseases with an apparent prevalence of approximately 30 per cent for CBPP, 6 per cent for RVF and 7 per cent for FMD. Calculation of true prevalence based on test sensitivity and specificity resulted in a slightly higher prevalence figure for CBPP and lower figures for RVF and FMD. The study illustrates the importance of considering diagnostic test performance when interpreting results from serosurveys, and the challenge of representative sampling and laboratory work in low‐income countries.
Phenology of hatching and food in low Arctic passerines and shorebirds: is there a mismatch?
Authors: Leung Maria C.-Y. , Bolduc Elise , Doyle Frank I. , Reid Donald G. , Gilbert B. Scott , Kenney Alice J. , Krebs Charles J. , Bêty Joël
Published: April 2018

The warming climate is driving earlier spring snow melt and longer growing seasons in tundra regions of northwestern North America, thereby changing the timing of ecological processes. On Herschel Island, Yukon, Canada, we investigated changes in the migratory bird community, and the potential for phenological mismatch of egg hatching with the pulses in abundance of arthropod prey on which young birds depend for growth. We found an apparent reduction in abundance or loss of some species dependent on freshwater ponds or sparsely vegetated upland tundra. Tracking hatch dates of passerines and shorebirds along with the changes in biomass of mobile life history stages of arthropods (principally Araneae, Tipulidae, Carabidae, Muscidae, Chironomidae, Mycetophilidae, and Ichneumonidae), we found no evidence for phenological mismatch in the 2007–2009 time period. Most nests hatched, and the period of most rapid chick growth occurred, in advance of the highest availability of arthropod biomass. Shorebirds hatched significantly later than passerines, less in advance of the peak abundances of arthropods. They are most at risk of future mismatch, given likely trend to earlier onset of arthropod availability and longer migration routes. Herschel Island is a well-studied site warranting further monitoring to assess changes in the Arctic tundra ecosystem.
U–Pb (zircon) ages and provenance of the White Rock Formation of the Rockville Notch Group, Meguma terrane, Nova Scotia, Canada: evidence for the “Sardian gap” and West African origin
Authors: White Chris E. , Barr Sandra M. , Linnemann Ulf
Published: April 2018

The White Rock Formation is the lowermost formation of the Rockville Notch Group, an assemblage of Silurian–Devonian rocks preserved in five areas along the northwestern margin of the Meguma terrane of Nova Scotia. The formation consists mainly of mafic and felsic metavolcanic rocks, interlayered with and overlain by marine metasedimentary rocks. Felsic metatuff has now been dated from four locations near both the bottom and top of the volcanic pile and yielded a narrow age range (with errors) of about 446–434 Ma. These dates confirm a 30 Ma hiatus after deposition of the Early Ordovician Hellgate Formation in the underlying Halifax Group. This hiatus is coeval with the “Sardian gap” in the Lower Palaeozoic of peri-Gondwanan Europe. The metavolcanic–metasedimentary assemblage is overlain by mainly metasiltstone with abundant quartzite and metaconglomerate lenses; some of the latter were previously interpreted to be Ordovician tillite, an interpretation no longer viable. New detrital zircon data from metasedimentary samples indicate that the major sediment sources for the White Rock Formation have ages of ca. 670–550 and ca. 2050 Ma, similar to ages from the underlying Goldenville and Halifax groups. A smaller population of Mesoproterozoic zircon grains indicates that the Meguma terrane interacted with a terrane composed mainly of Mesoproterozoic crust during the Silurian and Devonian. The occurrence of the “Sardian gap” and the detrital zircon record constrain the palaeoposition of the Meguma terrane to have been close to Cadomia and West Africa in the Early Cambrian to Early Silurian.
Condition-dependent skipped spawning in anadromous brown trout (Salmo trutta)
Authors: Haraldstad Tormod , Höglund Erik , Kroglund Frode , Lamberg Anders , Olsen Esben Moland , Haugen Thrond Oddvar
Published: April 2018

Repeat spawners of anadromous salmonids may contribute significantly to population resilience by providing multiple cohorts to both seawater and freshwater life stages. In this study, winter survival of sea trout (Salmo trutta Linnaeus, 1758) post spawners (kelts) was 89%. Sea survival increased linearly with female length with a return probability between 30% and 50%, whereas males attained a maximum return probability of 60% at 520 mm. Of the returning sea trout, 40% skipped spawning and they had significantly lower condition factor as kelts compared with those who returned after one summer. These results suggest that sex-specific differences in individual post-spawning growth–survival trade-off exist and that energetic status of descending kelts may influence the probability to skip spawning. We discuss to what extent hydropower may reduce post-spawning survival due to blocking of river descent opportunities, potentially altering the fitness landscape and favouring new life-history adaptations. From a management perspective, it is concluded that it is crucial to maintain connectivity in regulated rivers, allowing fish to complete repetitive spawning and feeding migrations, thus contributing to population productivity.
Life history variation across four decades in a diverse population complex of Atlantic salmon in a large subarctic river
Authors: Erkinaro Jaakko , Czorlich Yann , Orell Panu , Kuusela Jorma , Falkegård Morten , Länsman Maija , Pulkkinen Henni , Primmer Craig R. , Niemelä Eero
Published: April 2018

We used over 154 000 scale samples collected from salmon fisheries in the large River Teno system over a 40-year period to quantify life history diversity and long-term trends. We identified 120 different life history strategies, including combinations of smolt (2–8) and sea ages (1–5) and previous spawning events. Most strategies were rare; 60% of individuals matured after 1 year at sea following 3–5 years in fresh water. Age at maturity changed with an increase in two-sea-winter salmon and previous spawners and a decline in three-sea-winter fish. Smolt age distribution showed a decreasing proportion of age-3 smolts, while that of age-5 smolts increased. Fishing gear and fishing season times selected for fish differing in life history strategies. Temporal variation in life histories reflected changes in both fisheries and the changing environment. There was an inverse relationship between years spent in fresh water and sea age. Biocomplexity was manifested by the multiple year classes (6–11) present in annual runs, which increased with years, reflecting an increase both in previous spawners and sampling effort. The high number of cohorts spawning simultaneously each year indicates strong generational overlap, which has been suggested to maintain genetic diversity and thereby resilience via the portfolio effect.
Phylogenetic and expression analysis of protein disulfide isomerase unravels good reference genes for gene expression studies in pear and peach fruits
Authors: Ke Ya-Qi , Cheng Hai-Yan , Liu Xing , Zhang Ming-Yue , Gu Chao , Zhang Shao-Ling
Published: April 2018

Protein disulfide isomerase (PDI) is an important enzyme for protein folding in endoplasmic reticulum. The PDI gene family has been systematically studied in Arabidopsis, barley, rice, and bread wheat; however, little is known about this gene family and their roles during fruit development and ripening in fruit trees. In this study, 63 PDI genes were isolated from 8 fruit trees. Phylogenetic trees showed that these genes were clustered into six different groups, designated as A to F. In the groups, the PDI genes had significant differences in gene structure and conserved regions. The chromosome location of each PDI gene was determined in complete genome-assembly fruit trees and the synteny of chromosome segments was detected among peach, pear, and strawberry. Expression profiles of PDI genes in peach, pear, and strawberry showed that nearly all genes in group D and E were more highly expressed in developmental and ripening fruit tissues than those in other groups, while all genes in group A and B presented the lowest levels of expression in fruits of each stage. Moreover, qRT-PCR analyses revealed that these expressed genes were stable expressed in pear and peach fruits, as well as the reported reference genes. Eventually, PbPDI.F1 presented the highest expression stability in pear fruit while PpPDI.F displayed stronger stability than other genes in peach fruit. Thus, these two genes, which were clustered in group F, are good reference genes for gene expression studies during fruit development and ripening.
Do phosphorus and nitrogen contents in young corn leaves represent contents in shoots?
Authors: Pedersen Ingeborg Frøsig , Sørensen Peter , Christensen Bent T. , Rubæk Gitte Holton
Published: April 2018

For corn grown on two light-textured soils, leaf P and N concentrations at the six-leaf stage represented their respective concentrations in shoots. At the seven/eight-leaf stage, the P concentration was higher in leaves than in shoots. Biomass at the seven/eight-leaf stage is linked to the N to P ratio in leaves and shoots at the six-leaf stage.