bluuebunny/crossref_metadata_2025 huggingface dataset:
Group B Streptococcus detection in pregnant women: comparison of real-time PCR assay, culture, and the Xpert GBS rapid test
Authors: Vieira Laura , Perez Amanda Vilaverde , Machado Monique M , Kayser Michele L , Vettori Daniela V , Alegretti Ana Paula , Ferreira Charles Francisco , Vettorazzi Janete , Valério Edimárlei G
Published: November 2019

Background Group B Streptococcus (GBS) is one of the most important causative agents of neonatal sepsis. As administration of prophylactic antibiotics during labor can prevent GBS infection, routine screening for this bacterium in prenatal care before the onset of labor is recommended. However, many women present in labor without having undergone such testing during antenatal care, and the turnaround time of detection methods is insufficient for results to be obtained before delivery. Methods Vaginal and anorectal specimens were collected from 270 pregnant women. Each sample was tested by Xpert GBS, PCR, and culture for GBS detection. Results The overall prevalence of maternal GBS colonization was 30.7% according to Xpert GBS, 51.1% according to PCR, and 14.3% according to cultures. Considering the PCR method as the reference, the Xpert GBS had a sensitivity of 53% and specificity of 93%. Positive Xpert GBS results were associated with marital status (married or cohabitating) and with prematurity as a cause of neonatal hospitalization. Positive cultures were associated with ischemic–hypoxic encephalopathy requiring therapeutic hypothermia. Conclusions Combined enrichment/PCR and the Xpert GBS rapid test found a high prevalence of GBS colonization. The Xpert GBS technique gives faster results and could be useful for evaluating mothers who present without antenatal GBS screening results and are at risk of preterm labor, thus allowing institution of prophylactic antibiotic therapy. Trial Registration: The study was approved by the institutional Research Ethics Committee (CAAE: 59688316.0.0000.5327)
The phylogenetic significance of the morphology of the syrinx, hyoid and larynx, of the Southern Cassowary, Casuarius casuarius (Aves, Palaeognathae)
Authors: McInerney Phoebe Louise , Lee Michael S. Y. , Clement Alice M. , Worthy Trevor H.
Published: November 2019

Background: The Palaeognathae are a basal clade within Aves and include the large and flightless ratites and the smaller, volant tinamous. Although much research has been conducted on various aspects of palaeognath morphology, ecology, and evolutionary history, there are still areas which require investigation. This study aimed to fill gaps in our knowledge of the Southern Cassowary, Casuarius casuarius, for which information on the skeletal systems of the syrinx, hyoid and larynx is lacking - despite these structures having been recognised as performing key functional roles associated with vocalisation, respiration and feeding. Previous research into the syrinx and hyoid have also indicated these structures to be valuable for determining evolutionary relationships among neognath taxa, and thus suggest they would also be informative for palaeognath phylogenetic analyses, which still exhibits strong conflict between morphological and molecular trees.
Results: The morphology of the syrinx, hyoid and larynx of C. casuarius is described from CT scans. The syrinx is of the simple tracheo-bronchial syrinx type, lacking specialised elements such as the pessulus; the hyoid is relatively short with longer ceratobranchials compared to epibranchials; and the larynx is comprised of entirely cartilaginous, standard avian anatomical elements including a concave, basin-like cricoid and fused cricoid wings. As in the larynx, both the syrinx and hyoid lack ossification and all three structures were most similar to Dromaius. We documented substantial variation across palaeognaths in the skeletal character states of the syrinx, hyoid, and larynx, using both the literature and novel observations (e.g. of C. casuarius). Notably, new synapomorphies linking Dinornithiformes and Tinamidae are identified, consistent with the molecular evidence for this clade. These shared morphological character traits include the ossification of the cricoid and arytenoid cartilages, and an additional cranial character, the articulation between the maxillary process of the nasal and the maxilla.
Conclusion: Syrinx, hyoid and larynx characters of palaeognaths display greater concordance with molecular trees than do other morphological traits. These structures might therefore be less prone to homoplasy related to flightlessness and gigantism, compared to typical morphological traits emphasised in previous phylogenetic studies.
Key Words: Palaeognathae, Cassowary, Syrinx, Hyoid, Larynx, Morphology, Phylogenetics, Optimisation
Tooth Extraction as a Risk Factor for Maxillary Sinus Pneumatization: A Case-control Study
Authors: Ocak Hakan , Çolpak Halis Ali , Demetoğlu Umut , Soydan Damla , Kılıç Erdem , Canger Murat E , Alkan Alper
Published: November 2019

Purpose Maxillary sinus pneumatization following teeth extraction may require various treatment plans such as sinus lifting and alveolar grafting procedures to obtain sufficient alveolar bone height for implant surgery. The aim of this study was to identify sinus pneumatization and to help in determining the proper time for preprosthetic surgery following extraction of maxillary sinus related teeth. Methods We evaluated 75 teeth extraction related to maxillary sinus floor. The panoramic radiographs were evaluated before and after extraction of the posterior maxillary teeth. The radiographs were divided into 5 groups according to duration after extraction. Two reference points (the first point corresponds to the nasal spine while the second point corresponds to the most inferior point of the floor of the maxillary sinus wall) were determined on digital panoramic radiographs before and after teeth extraction and the distance between both aforementioned points was measured. Results The amount of pneumatization was found to be increased with time. The pneumatization within the first 6 months was limited. However, a sudden increase of pneumatization after 6th month, especially the highest between 18th and 24th months, was observed. The mean pneumatization amount was found to be highest in the 1st molar group. Conclusion According to the results of the present study, surgeons should not be waited any more than 6 months after tooth extraction for preprosthetic surgery in the posterior maxillary region as long as physiological healing of extraction socket is allowed.
Understanding factors influencing care seeking for sick children in Ebonyi and Kogi states, Nigeria
Authors: Dougherty Leanne , Gilroy Kate , Olayemi Abimbola , Ogesanmola Omitayo , Ogaga Felix , Nweze Chinwe , Banerjee Joya , Oduenyi Chioma , Pacqué Michel
Published: November 2019

Background Nigeria has one of the highest child mortality rates in the world, with an estimated 750,000 deaths annually among children under age five. The majority of these deaths are due to pneumonia, malaria, or diarrhea. Many parents do not seek sick-child care from trained, biomedical providers, contributing to this high rate of mortality. Methods This qualitative study explores factors enabling or preventing parents from seeking care for sick under-five children in Nigeria’s Kogi and Ebonyi states, including gender-related roles and social norms. Interviews were conducted with parents of sick under-five children and service providers, and focus group discussions were held with community leaders to assess how care-seeking behavior was influenced by four modes from the Colvin et al conceptual framework for household decision-making and pathways to care. These include (1) caregivers’ recognition and response to illness, (2) seeking advice and negotiating access within the family, (3) making use of community-based treatment options, and (4) accessing biomedical services. Results Parents were found to have a general understanding of illness symptoms but did not always attribute illness to biomedical causes. Intra-household decision-making processes were shaped by gender dynamics between men and women, and were found to have great effects on decisions to seek care. Use of traditional medicine and self-treatment were found to be common first steps in treatment before turning to the biomedical care system. Once the decision to seek biomedical care was taken, the route of seeking care varied between seeking care at chemists and then continuing to health facilities or starting with a health facility and then accessing prescriptions from a chemist. Conclusion We conclude that care-seeking decisions do not follow a linear process; that intra-household decision-making processes particularly among parents should not be underestimated in addressing sick-child care seeking; and that, given the role of mothers as primary caregivers, their knowledge in illness recognition and agency in care-seeking decision-making, and seeking biomedical care, is deserving of future study.
Dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia
Authors: Mulugeta Yeshalem , Alem Getu Degu , Belachew Tefera
Published: November 2019

Background: The optimal dietary practice is critical requisite for maternal nutrition. However, the majority of Ethiopian pregnant women have inadequate nutrient intakes. This may be due to their poor dietary habit. Identifying factors affecting dietary practices of pregnant women is crucial to design appropriate interventions. In this country, the dietary practices of pregnant women and determinants are not well studied. Therefore, the purpose of this study was to assess the dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia. Methods: A community-based cross-sectional study was carried out among 712 pregnant women from May to August 2018. Quantitative data complemented with qualitative method. Pregnant women were selected using a cluster sampling technique. Structured questionnaires were utilized for data collection. Data were entered into Epi-Info version 7.2.2 and exported to SPSS version 23 software for analysis. Data were described using frequencies and mean. Logistic regression analysis was done. For qualitative data, three focus group discussions and 17 key-informant interviews were conducted. . Focus group discussion participants were mother-in-lows, husbands and health professionals. Typical case and homogeneous sampling techniques were used for the key-informant interviews and focus group discussions, respectively. The tape-recorded interviews and FGDs were transcribed verbatim into Amharic language and then translated from Amharic to English. Thematic analysis was used for the qualitative data. Results: Only 19.9% of respondents had appropriate dietary practices. On the multivariable logistic regression analyses, being food secure [AOR=2.25, 95% CI: (1.1, 4.5)], having high edible crop production [AOR=2.00, 95% CI: (1.2, 3.2)] and favorable attitude [AOR=1.69, 95% CI: (1.1, 2.6)] were significantly associated with the appropriate dietary practices of pregnant women. In the qualitative study lack of knowledge on maternal diet, cultural prohibition and knowledge gap of professionals were barriers that interfere with dietary practices during pregnancy. Conclusion: Pregnant women in the study area are found to have suboptimal dietary practices. Therefore, health professionals should give regular nutrition counseling using cards and role models for promoting diversified food production and consumption to meet the nutrient requirements during pregnancy. Keywords: pregnant women, dietary practice, dietary diversity, food variety score
Association of Cleft Lip and Palate on Mother-to-Infant Bonding: a Cross-Sectional Study in the Japan Environment and Children's Study (JECS).
Authors: Tsuchiya Shinobu , Tsuchiya Masahiro , Momma Haruki , Koseki Takeyoshi , Igarashi Kaoru , Nagatomi Ryoichi , Arima Takahiro , Yaegashi Nobuo
Published: November 2019

Background: Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of childbirths of infant with cleft lip and/or palate with maternal emotional involvement still remains unclear. We examined the association between childbirths of infant with cleft lip and/or palate and mother-to-infant bonding, using data from the Japan Environment and Children's Study, a nationwide birth cohort study.
Methods: A cross-sectional study using the jecs-an-20180131 dataset was performed. A total 104,065 foetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at one year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers of infants with cleft lip and/or palate were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirths with cleft lip and/or palate.
Results: No increased risk of bonding disorders was observed among all the mothers of infants with cleft lip and/or palate (odds ratio [95% confidence interval]; 0.97 [0.63-1.48], p = 0.880), however, advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and/or palate, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and/or palate with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval] = 2.51 [1.17-5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression.
Conclusions: Childbirths of infant with cleft lip and/or palate may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.
Genome-wide characterization of the rose (Rosa chinensis) WRKY family and role of RcWRKY41 in gray mold resistance
Authors: Liu Xintong , Li Dandan , Zhang Shiya , Xu Yaling , Zhang Zhao
Published: November 2019

Background The WRKYs are a major family of plant transcription factors that play roles in the responses to biotic and abiotic stresses; however, a comprehensive study of the WRKY family in roses ( Rosa sp.) has not previously been performed.Results In the present study, we performed a genome-wide analysis of the WRKY genes in the rose ( Rosa chinensis ), including their phylogenetic relationships, gene structure, chromosomal locations, and collinearity. Using a phylogenetic analysis, we divided the 56 RcWRKY genes into three subgroups. The RcWRKY s were unevenly distributed across all seven rose chromosomes, and a study of their collinearity suggested that genome duplication may have played a major role in RcWRKY gene duplication. A Ka/Ks analysis indicated that they mainly underwent purifying selection. Botrytis cinerea infection induced the expression of 19 RcWRKY s, most of which had undergone gene duplication during evolution. These RcWRKY s may regulate rose resistance against B. cinerea . Based on our phylogenetic and expression analyses, RcWRKY41 was identified as a candidate regulatory gene in the response to B. cinerea infection, which was confirmed using virus-induced gene silencing.Conclusions This study provides useful information to facilitate the further study of the function of the rose WRKY gene family.
Endoscopic treatment of early leaks and strictures after laparoscopic one anastomosis gastric bypass
Authors: Younis Fadi , Shnell Mati , Gluck Nathan , Abu-Abeid Subhi , Eldar Shai , Fishman Sigal
Published: November 2019

Background: Laparoscopic one anastomosis gastric bypass has become a prominent bariatric procedure. Yet, early and late complications, primarily leaks and strictures, are not uncommon. This study summarizes our experience with endoscopic treatment of laparoscopic one anastomosis gastric bypass complications. Methods: This is a retrospective study of consecutive patients referred to our hospital from 2015 to 2017 with post laparoscopic one anastomosis gastric bypass complications. Therapy was tailored to each case, including fully covered self-expandable metal stents, fibrin glue, septotomy, internal drainage with pigtail stents, through-the-scope and pneumatic dilation. Success was defined as resuming oral nutrition without enteral or parenteral support or further surgical intervention. Results : Nine patients presented with acute or early leaks: 5 (56%) had staple-line leaks, 3 (33%) had anastomotic leaks and 1 (11%) had both. All were treated with stents. Adjunctive endoscopic drainage was applied in 4 patients (44%). Overall 5 patients (56%) with acute/ early leaks recovered completely, including all 3 patients with anastomotic leak and the patient with both leaks but only 1/5 with staple line leak (20%). Complication rate in the leak group reached 22%. Eight patients presented with strictures, 7 at the anastomosis and one due to remnant stomach misalignment. All anastomotic strictures were dilated successfully. However, the patient with the pouch stricture required conversion to Roux-en-Y gastric bypass after 3 failed attempts of dilatation. Conclusion: Endoscopic treatments of laparoscopic one anastomosis gastric bypass complications are relatively effective and safe. Anastomosis-related complications are more amenable to endoscopic treatment compared to staple line leaks.
The effect of Liv-52 on liver ischemia reperfusion damage in rats
Authors: Cimen Orhan , Eken Huseyin , Cİmen Ferda Keskin , Cekic Arif Burak , Kurt Nezahat , Bilgin Asli Ozbek , Suleyman Bahadir , Suleyman Halis , Mammadov Renad , Pehlivanoglu Kamil , Kurnaz Eray
Published: November 2019

Background: Liver ischemia reperfusion (I/R) damage is frequently seen in clinical hepatobiliary surgeries and there is no effective treatment for it. Liv-52, known to have hepatoprotective effects, is a natural antioxidant drug licensed by Ministry of Health of India. Therefore, the aim of our study is to investigate the effect of Liv-52 on liver damage induced by I/R in rats.
Methods: Albino Wistar male rats were divided into three groups; liver I/R (IR), 20 mg/kg Liv-52 + liver ischemia reperfusion (LIR) and sham operation applied to control group (HG). Liv-52 was administered to the LIR group (n-6) one hour prior to I/R application and distilled water was given orally to IR (n-6) and HG (n-6) groups as a solvent. In animals, ischemia was determined as one hour, and reperfusion was identified as six hours.
Results: Increased levels of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase, malondialdehyde, myeloperoxidase, and decreased levels of superoxide dismutase, and glutathione related enzymes caused by I/R application have been converged to healthy group level with Liv-52 treatment and the damage occurred in liver tissue has been improved histopathologically.
Conclusions: Liv-52 may be beneficial for preventing liver I/R damage in pre-surgery application.
Three Easily-Implementable Changes Reduce Median Door-To-Needle Time for Intravenous Thrombolysis by 23 Minutes
Authors: Tran Demi , Zhu Zhu , Shafie Mohammad , Abcede Hermelinda , Stradling Dana , Yu Wengui
Published: November 2019

Background: The benefit of intravenous thrombolysis (IVT) for acute ischemic stroke is time dependent. Despite great effort, the median door-to-needle time (DNT) was 60 minutes at the United States stroke centers. We investigated the effect of a simple quality improvement initiative on DNT for IVT.
Methods: This is a single-center study of patients treated with IVT between 2013 and 2017. A simple quality improvement initiative was implemented in January 2015 to allow the Stroke team to manage hypertension in the emergency room, to make decision for IVT before getting blood test results unless patients were taking oral anticoagulants, and to give IVT in the CT suite. Baseline characteristics, DNT and outcomes at hospital discharge were compared between pre- and post-intervention groups.
Results: Ninety and 136 patients were treated with IVT in pre- and post-intervention groups, respectively. The rate of IVT was significantly higher in the post-intervention group (20% vs. 14.4%, p=0.007). The median DNT with interquartile range (IQR) was reduced significantly by 23 minutes (63[53-81] vs. 40[29-53], p<0.001) with more patients in the post-intervention group receiving IVT within 60 minutes (81.6% vs. 46.7%) and 45 minutes (64.0% vs.17.8%). There was no significant difference in symptomatic intracerebral hemorrhage rate (1.5% vs. 1.1%), modified Rankin Scale 0-1 (29.4% vs. 23.3%), and hospital mortality (7.4% vs. 6.7%) between the 2 groups.
Conclusions: Three easily-implementable quality improvement initiative increases IVT rate and reduces DNT significantly without increasing the rate of IVT-related complications in our comprehensive stroke center.
Gross Motor Developmental Dysfunctional Outcomes in Infantile and Toddler Pediatric Intensive Care Unit Survivors
Authors: Yang Chun-Feng , Xue Yang , Feng Jun-Yan , Jia Fei-Yong , Zhang Yu , Li Yu-Mei
Published: November 2019

Background: Increasing studies have focused on motor function/dysfunction in PICU survivors; however, most studies have focused on adults and older children. This study investigated gross motor developmental function outcomes in infantile and toddler pediatric intensive care unit (PICU) survivors and the factors associated with gross motor developmental functions. Methods: This observational study was conducted in the PICU of the First Hospital of Jilin University between January 2019 and March 2019. Thirty-five eligible patients were divided into the dysfunctional (n=24) or non-dysfunctional (n=11) group according to the results of the Peabody Developmental Motor Scales, Second Edition (PDMS-2). Baseline gross motor function for all participants before PICU admission was measured via the Age and Stages Questionnaires, Third Edition (ASQ-3). The PDMS-2 was used to evaluate gross motor development function before PICU discharge. Results: The gross motor developmental dysfunction incidence was 68.6%. Linear correlation analysis showed that the gross motor quotient (GMQ) was positively correlated with the pediatric critical illness score (PCIS, r=0.621, P<0.001), and negatively correlated with length of PICU stay (r=-0.556, P=0.001), days sedated (r=-0.602, P<0.001), days on invasive mechanical ventilation (IMV; r=-0.686, P<0.001), and days on continuous renal replacement therapy (CRRT; r=-0.538, P=0.001). Linear regression analysis showed that IMV days (β=-0.736, P=0.001), sepsis (β=-18.111, P=0.003) and PCIS (β=0.550, P=0.021) were independent risk factors for gross motor developmental dysfunction Conclusions: Gross motor developmental dysfunction in infantile and toddler PICU survivors is more common and may be exacerbated by experiences associated with longer IMV days and increasing illness severity combined with sepsis.
Treatment Patterns and Sequences of Pharmacotherapy for Patients Diagnosed with Depression in the United States: 2014 through 2019
Authors: Kern David M. , Cepeda M. Soledad , Defalco Frank , Etropolski Mila
Published: November 2019

Background: Understanding how patients are treated in the real-world is vital to identifying potential gaps in care. We describe the current pharmacologic treatment patterns for the treatment of depression.
Methods: Patients with depression were identified from four large national claims databases during 1/1/2014-1/31/2019. Patients had ≥2 diagnoses for depression or an inpatient hospitalization with a diagnosis of depression. Patients were required to have enrollment in the database ≥1 year prior to and three years following their first depression diagnosis. Treatment patterns were captured at the class level and included selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, anxiolytics, hypnotics/sedatives, and antipsychotics. Treatment patterns were captured during all available follow-up.
Results: We identified 269,668 patients diagnosed with depression. The proportion not receiving any pharmacological treatment during follow-up ranged from 29% to 52%. Of the treated, approximately half received ≥2 different classes of therapy, a quarter received ≥3 classes and more than 10% received 4 or more. SSRIs were the most common first-line treatment; however, many patients received an anxiolytic, hypnotic/sedative, or antipsychotic prior to any antidepressive treatment. Treatment with a combination of classes ranged from approximately 20% of first-line therapies to 40% of fourth-line.
Conclusions: Many patients diagnosed with depression go untreated and many others receive a non-antidepressant medication class as their first treatment. More than half of patients received more than one type of treatment class during the study follow up, suggesting that the first treatment received may not be optimal for most patients.
Vaccine uptake and associated factors in an irregular urban settlement in northeastern Brazil: a cross-sectional study
Authors: Veras Ana Amélia Corrêa de Araújo , Lima Eduardo Jorge da Fonseca , Caminha Maria de Fátima Costa , Silva Suzana Lins da , de Castro Amanda Alves Moreira , Bernardo Andressa Lílian Bezerra , Ventura Maria Lídia Amaral Barbosa , de Lira Pedro Israel Cabral , Filho Malaquias Batista
Published: November 2019

Background: Childhood immunization saves the lives of 2-3 million children annually by protecting them against vaccine-preventable diseases. In 2017, 116.2 million children were vaccinated worldwide according to the World Health Organization. Nevertheless, figures suggest that 19.5 million children around the world fail to receive the benefits of complete immunization. Methods: This cross-sectional study analyzed vaccine uptake and the factors associated with compliance in all the children of up to 36 months of age receiving care within the family health strategy program in an irregular settlement located in a state capital city in northeastern Brazil. This study was nested within a larger study entitled “Health, nutrition and healthcare services in an urban slum population in Recife, Pernambuco”, conducted in 2015. A census sample of 309 children was included, with vaccination data being obtained from their personal child health records. An ad hoc database was constructed, with absolute and relative values being calculated for the socioeconomic, demographic, obstetric and biological data collected. To identify possible factors associated with vaccine compliance, univariate and multivariate regression analyses were performed, and the 95% confidence intervals calculated. Variables with p-values <0.20 in the univariate stage were included in the multivariate analysis. The statistical significance of the variables was evaluated using the Wald test, with p-values <0.05 being considered statistically significant. Results: Compliance with the vaccination schedule was 52.1%. In the final model, the factors associated with inadequate compliance with the vaccination schedule were age 12-36 months and the mother not having completed high school. Conclusion: The percentage of vaccine uptake found was well below the figure recommended by the national immunization program and was associated with the child’s age and the mother’s education level. Based on these findings, the family healthcare teams may elaborate vaccination strategies aimed at reaching the coverage rates established by the national immunization program. Optimizing coverage will ultimately prevent the resurgence, at epidemic level, of infectious diseases that are already under control in this country. Keywords: children’s health; vaccination schedule; maternal education level; Family Health Strategy.
Effects of menarche,parity,primiparous age,and reproductive diseases on uterine fibroids of rural women in China
Authors: Wu Bing-Jie , Shao Chun-Yan , Zhu Yun , Huang Kai , Wei Wu , Zhang Xiu-Jun , Hu Cheng-Yang , Zhong Fei
Published: November 2019

Objectives With the increasing prevalence of hysteromyoma among Chinese rural women at childbearing age, it has become a priority to identify the risk factors that predispose to corporeity and promote early prevention. The aim of the study is to explore the relationship between menarche age, female reproductive health and uterine fibroids.Methods Study participants included 2,200 rural women of reproductive age who were screened for a cross-sectional study in the Anhui province. Data collected by questionnaire survey, gynecological and laboratory examinations were analyzed by Univariate and multivariate analysis to evaluate the risk factors for uterine fibroids.Results Of the 2,200 women, 440 had uterine fibroids. In general, women with endometriosis, ovarian cysts and early menarche were more likely to suffer from hysteromyoma. Factors including more parity, appropriate late primiparous age and normal menstrual cycle were protective of uterine fibroids.Conclusions Our findings indicate that a variety of modifiable factors may increase the risk of uterine fibroids and that relevant health departments should develop effective prevention and intervention measures to improve the reproductive health of rural women.
The Wide Distribution and Horizontal Transfers of Beta Satellite DNA in Eukaryotes
Authors: Guo Yabin , Yang Jiawen , Yuan Bin , Wu Yu , Li Meiyu , Li Jian , Xu Donglin , Gao Zeng-hong , Ma Guangwei , Zhou Yiting , Zuo Yachao , Wang Jin
Published: November 2019

Beta satellite DNA (satDNA) sequences, also known as Sau3A sequences, are repeated DNA elements reported in human and primate genomes. Beta satDNAs may play roles in genome stability and chromosome segregation during mitosis. It is previously thought that beta satDNAs originated in old world monkeys and bursted in great apes. However, global and high-throughput studies on beta satDNAs are still absent.Results: In this study, we searched 7,821 genome assemblies of 3,767 eukaryotic species and found that beta satDNAs actually are widely distributed across eukaryotes. The four major branches of eukaryotes, animals, fungi, plants and Harosa/SAR, all have multiple clades containing beta satDNAs. These results were also confirmed by searching whole genome sequencing data (SRA) and PCR assay. Beta satDNA might have originated during the early evolution of eukaryotes. The widely patchy distribution of beta satDNAs across eukaryotes presents a typical scenario of multiple horizontal transfers (HT). In contrast, beta satDNA sequences were found in all the primate clades, Primatomorpha and Euarchonta, indicating an origin in the common ancestor and vertical transfers thereafter. Besides in eukaryotes, beta satDNAs were even found in some archaea and bacteria, which should have been acquired from eukaryotes via HTs.Conclusion:Beta satDNAs widely exist in eukaryotes. The current distribution landscape of beta satDNA is the result of countless HTs. Our study shows for the first time that satellite DNAs can also undergo HT, and will provide new ideas for the future investigations in HT/HGT field.Keywords: Beta satellite DNA, Sau3A sequences, Eukaryotes, Horizontal gene transfer, Primates
Serum Amyloid A Protein as a Potential Biomarker in predicting acute onset and association with in-hospital death in acute aortic dissection
Authors: He Yuchen , Ma Changcheng , Xing Jia , Wang Shiyue , Chao Ji , Han Yanshuo , Zhang Jian
Published: November 2019

Background: Acute aortic dissection (AAD) is a life-threatening disorder in vascular surgery with a high early mortality. Serum amyloid A (SAA) is a kind of acute-phase protein with a rapid diagnostic value in other diseases. However, the researches on the performance of SAA for the diagnosis of AAD is still lacking. This retrospective study aimed to evaluate the SAA levels and further explore its potential diagnostic role in AAD patients. Methods: SAA levels were measured by enzyme-linked immunosorbent assay (ELISA) in 63 controls and 87 AAD patients. Laboratory examinations were also performed. And relative clinical information was collected from participants included in this study. Results: SAA levels were significantly higher in AAD patients than those in healthy controls. SAA levels were independently associated with the risk of AAD. There was a positive significant correlation between SAA and C reactive protein (R=0.442, and P=0.001). Based on receiver-operating characteristic (ROC) analysis, the area under the curve (AUC) of SAA for the diagnosis of AAD were 0.942 with optimal cut-off points of 0.427mg/L. For in-hospital mortality, the AUC of SAA were 0.732 with optimal cut-off points of 0.500mg/L. According to logistic regression analysis, higher SAA levels represent a higher risk of in-hospital mortality (OR=1.25; 95%CI: 1.07-1.47; P=0.005). Conclusion: Our findings demonstrated that SAA levels were significantly enhanced in AAD. SAA was closely correlated with inflammatory parameters and coagulation-related parameters in AAD. Furthermore, SAA could be a potential bio-marker for identifying AAD in the early diagnosis. Finally, SAA >5.0 mg/L are independently related to AAD in-hospital mortality.
Development of a model on factors affecting instrumental activities of daily living in people with mild cognitive impairment – a Delphi study
Authors: Bruderer-Hofstetter Marina , Sikkes Sietske A.M. , Münzer Thomas , Niedermann Karin
Published: November 2019

The level of functioning in instrumental activities of daily living (IADL) is crucial for a person’s autonomy. A clear understanding of the nature of IADL and its limitations in people with mild cognitive impairment (MCI) is lacking. Literature suggests numerous possible influencing factors, e.g. cognitive function, however, without considering other domains of human functioning, e.g. environmental factors. Therefore, we aimed to propose a comprehensive model for IADL functioning that pictures relevant influencing factors. Methods We conducted a four-round online Delphi study in a sample of international IADL experts (N=69). In the first round, panelists were asked to mention all possible relevant cognitive and physical function factors as well as environmental and personal factors influencing IADL functioning. In the subsequent rounds panelists rated the relevance of these factors. Consensus was defined as: 1) ≥70% agreement between panelists on a factor and 2) stability between two succeeding rounds. Results Response rates of the four rounds were high (83% to 100%). In the first round, 229 influencing factors were mentioned, whereof thirteen factors reached consensus in the subsequent rounds and were used to build a model for IADL functioning. The final model includes five cognitive function factors (i.e. memory, attention, executive function, executive function subdomains (problem solving / reasoning and organization / planning), five physical function factors (i.e. seeing functions, hearing functions, balance, gait / mobility functions and functional mobility functions), two environmental factors (i.e. social network / environment and support of social network / environment) and one personal factor (i.e. education). Conclusions This study proposes a comprehensive model on IADL functioning in people with MCI. The results from this Delphi suggest that IADL functioning is not merely affected by cognitive function factors, but also by physical function, environmental and personal factors. The numerousness of mentioned factors in the first round also underlines the individuality of IADL functioning in people with MCI. The model may serve as ground for future research in IADL functioning in people with MCI.
Pneumocystis pneumonia occurrence and prophylaxis duration in kidney transplant recipients according to perioperative treatment with rituximab: a single-center, retrospective study
Authors: Kim Young Hoon , Kim Jee Yeon , Kim Dong Hyun , Ko Youngmin , Choi Ji Yoon , Shin Sung , Jung Joo Hee , Park Su-Kil , Kim Sung-Han , Kwon Hyunwook , Han Duck Jong
Published: November 2019

Background Pneumocystis pneumonia (PCP) is a life-threatening fungal infection that can occur in kidney transplantation (KT) recipients. A growing number of KT recipients are receiving perioperative treatment with rituximab, which is associated with prolonged B-cell depletion and possible risk of PCP occurrence; however, the optimal prophylaxis duration according to rituximab treatment is yet unknown. We compared the occurrence of PCP and the duration of prophylaxis in KT recipients according to rituximab treatment. Method We retrospectively analyzed 2110 patients who underwent KT between January 2009 and December 2016. The study cohort was divided into non-rituximab group (n = 1588, 75.3%) and rituximab group (n = 522, 24.7%), the latter of which was defined as recipients who had been treated with rituximab due to pre-operative desensitization or rejection treatment within 6 months after transplant. Results In the rituximab group, the estimated number needed to treat (NNT) for prophylaxis prolongation from 6 to 12 months was 29.0 with a relative risk reduction of 90.0%. In the non-rituximab group, the estimated NNT value was 133.3 and the relative risk reduction was 66.4%. Rituximab treatment (hazard ratio (HR) = 3.09; P < 0.01) and acute rejection (HR = 2.19; P = 0.03) were significant risk factors for PCP in multivariate analysis. Conclusion Our results suggest that maintaining PCP prophylaxis for 12 months may be beneficial in KT recipients treated with rituximab for desensitization or acute rejection treatment.
Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – A time series analysis over 10 years
Authors: Damlin Anna , Sharma Megha , Marrone Gaetano , Lundborg Cecilia Stålsby
Published: November 2019

Antibiotic resistance is an emerging problem, particularly in low- and middle-income countries, where mortality rates due to infectious diseases are highly associated with antibiotic resistance. Analyses of antibiotic prescribing practices is needed to develop strategies for improvement. The aim was to analyze antibiotic prescribing among patients with severe infections admitted to two Indian hospitals during 2007-2018. Methods Data from patients (>18 years-of-age), admitted to a teaching (TH) and a non-teaching hospital (NTH) in Ujjain, India, from 2008-2017 registered with one of the infectious diagnoses; epiglottitis, pneumonia, peritonitis, pyelonephritis, cellulitis, erysipelas, septic arthritis, endocarditis, meningitis or sepsis, were included. Antibiotic prescription data was analyzed using the 2019 Anatomical Therapeutic Chemical classification system and the Defined Daily Doses (DDD). Prescribing of antibiotics was calculated for DDD/1000 patient days. To compare data between the hospitals and patient groups, chi-square tests and t-tests were used. Time series analyses were conducted using linear regression. P-values <0.05 were considered significant. Results In total, 2571 patients were included (NTH: 1610, TH: 96, of which 92% respectively 89% were prescribed antibiotics). Antibiotics included in the World Health Organization’s (WHO) access category; antibiotics that should be prescribed as first-choice treatment comprised 61% of the total antibiotic prescribing at the TH and 40% at the NTH (P<0.05). Prescribing of antibiotics categorized as the WHO’s watch antibiotics (second-choice antibiotics) comprised 29% of the antibiotic prescribing at the TH and 40% at the NTH. Prescribing of fixed dose combinations (FDCs) of antibiotics comprised 8% of the antibiotic prescribing at the TH and 18% at the NTH (P<0.05). At the NTH, overall antibiotic prescribing as well as prescribing of access, watch and FDCs of antibiotics increased between 2008-2017 among all included patients and for patients with pneumonia, sepsis, cellulitis and peritonitis (P<0.05). At TH, prescribing of watch, reserve and FDCs of antibiotics increased among all included patients well as among patients with pneumonia, cellulitis and peritonitis (P<0.05). Conclusions High percentage of patients were prescribed antibiotics at both hospitals. Between 2008-2017, overall antibiotic prescribing increased at NTH and prescribing of watch, reserve and FDCs of antibiotics increased at both NTH and TH.
Prevalence of perinatal asphyxia and its associated factors in Ethiopia; A systematic review and meta-Analysis
Authors: Assemie Moges Agazhe , Tizazu Getaye , Labata Busha Gamachu , Simegn Alemu
Published: November 2019

Background: Perinatal asphyxia(PNA) is a severe health problem and main cause of neonatal mortality and morbidity worldwide. In Ethiopia, there are many studies conducted on PNA characterized by replete of inconsistent; unavailability of nation wide study to determines the prevalence of PNA and its determinants is an important gap. The aim of this study is to develop national consensus on pooled prevalence and associated factor key reports to enhance the quality and consistency of the evidence on perinatal asphyxia. Method: Systematic review and meta-analysis using computerized databases; searches were performed to locate all articles on the prevalence of perinatal asphyxia. Databases included were Pub Med, Cochran library, Google Scholar, Scopus and Science Direct systematically between 2014 and April 2019. All identified studies reporting the prevalence of PNA in Ethiopia were pooled. Two independent authors extracted the data using a standardized data extraction tool. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the studies. Random-effects model was used to calculate pooled estimates and determinant factor of PNA in Stata/se version-14. Result: The prevalence of PNA reported from fifteen studies was in the range of 3.1 to 47.5%. The pooled occurrence of PNA in Ethiopia based on 15 articles with a sample size of 17,091 was 21.1% (95% CI: 14, 28). There was high heterogeneity observed (I2 = 99.4%, p <0.001). Thus, Subgroup analysis in the study area was computed .Thus, the highest prevalence (40.4%) was observed from Oromia region and the lowest 8% noted from Dire Dawa city administration. Pooled odd ratio estimates from included studies revealed prolonged labour (OR=3.7, 95% CI 2.4, 5.7), low birth weight (OR=6.5, 95% CI 4.0, 10.3), and Meconium stained liquor (OR=6.6, 95% CI: 4.4, 10.1) are significant risk factors of perinatal asphyxia. Conclusion: In this review, prolonged labour, meconium stained liquor and low birth weight are significantly associated with perinatal asphyxia. Therefore, improve facility-based intra partum care and quality neonatal resuscitation service through capacity building for health professionals is needed.
Relationship between Air Pollution and Lung Cancer in Fujian Province: A Case-control study
Authors: Chen Guang-Min , He Fei , Wu Jiasheng , Yang Huimin , Su Jin , Lin Jianbo , Liu Zhiqiang , Xie Jianfeng , Bai Liang , Cai Lin , Zheng Kuicheng
Published: November 2019

Background: Outdoor air pollutants, especially particulate matters, are defined as a type of carcinogen by the International Agency for Research on Cancer. Studies have shown that air pollution is associated with lung cancer morbidity or mortality . This study is aimed at exploring the relationship between air pollutants and primary lung cancer in Fujian Province, China. Methods: We conducted a hospital-based, retrospective, case–control epidemiological study on three different populations to assess the occurrence of lung cancer caused by exposure to various levels of air pollution. Results: The total study population comprised 885 lung cancer patients and 1,220 healthy controls. The following parameters were identified as risk factors for lung cancer among the total population: smoking; exposure to cooking oil fumes; passive smoking; medical history of lung disease; family history of lung cancer; and exposure to PM10, PM2.5, and O3. Fruit intake and physical exercise were protective against lung cancer. For smokers, medical history of lung disease, family history of lung cancer, and exposure to PM10, and PM2.5 were risk factors for lung cancer, while fruit intake and physical exercise were protective factors. Among non-smokers, exposure to cooking oil fumes; medical history of lung disease; family history of lung cancer; and exposure to PM10, PM2.5, and O3 were factors increasing the risk of lung cancer, while fruit intake, physical exercise, and tea drinking were protective. Conclusions: Long-term exposure to PM10, PM2.5, and O3 was found to be significantly associated with increased risk of lung cancer, with the risk being greater for non-smokers and persons exposed to cooking oil fumes.
Improving the information technology competency of nurses in critical care units: an interventional study
Authors: Jouparinejad Somayeh , Foroughameri Golnaz , Khajouei Reza , Farokhzadian Jamileh
Published: November 2019

Introduction To convert nurses of the critical care units into active users of evidence-based practices, their IT competency should be improved by appropriate planning. This study aimed to evaluate the impact of a training program on nurses' IT competency in critical care units.Methods In this interventional study, 60 nurses working in critical care units of hospitals were randomly assigned into the control and intervention groups. The three-day workshop on IT skills training was conducted for the intervention group. Data were collected using demographic questionnaire and Nursing Informatics Competency Assessment Tool (NICAT) before and one month after the intervention.Results In the pretest stage, both groups were at the competent level with regard to the competency level and no significant difference was observed between them in the pretest. However, in the posttest, the IT competency of the intervention group significantly increased compared to the control group. This showed that the intervention group was at the proficient level.Conclusions Education enhanced the nurses' IT competency in critical care units. So, in order to provide nurses with the latest scientific information and to promote high quality evidence-based practices, related educational programs should be added to continuous educational programs for all clinical nurses.