bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of the Eye in Transmitting Human Coronavirus: What We Know and What We Do Not Know
Authors: Sun Chuan-bin , Wang Yue-ye , Liu Geng-hao , Liu Zhe
Published: March 2020

The outbreak of recently identified 2019 novel coronavirus (2019-nCOV) infection has become a world-wide health threat. Currently, more information is needed for further understanding the transmission, clinical characteristics, and infection control of 2019-nCOV. Recently, the role of the eye in transmitting 2019-nCOV has been intensively discussed. Previous investigations about other high infectious human COVs, that is, severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), may provide helpful information. In this review, we describe the genomics and morphology of human CoVs, the epidemiology, systemic and ophthalmic manifestations, mechanisms of human CoVs infection, and infection control procedures. The role of the eye in the transmission of SARS-CoV and 2019-nCOV is discussed. Although the conjunctiva is directly exposed to extraocular pathogens, and the mucosa of ocular surface and upper respiratory tract is connected by nasolacrimal duct and share same receptors for some respiratory viruses. The eye is rarely involved by human CoVs infection, conjunctivitis is quite rare in patients with SARS-CoV and 2019-nCoV infection, and COV RNA positive rate in tears and conjunctival scrapings tested by RT-PCR from patients with SARS-CoV and 2019-nCoV infection is also very low, which imply that the eye is neither a preferred organ of human COVs infection, nor is a preferred gateway of entry for human COVs to infect respiratory tract. However, considering close doctor-patient contact is quite common in ophthalmic practice which are apt to transmit human COVs by droplets and fomites, hand hygiene and personal protection are still highly recommended for health care workers to avoid hospital-related viral transmission during ophthalmic practice.
New Classification of Collective Animal Behaviour as an Autonomous System
Authors: Niizato Takayuki , Sakamoto Kotaro , Mototake Yoh-ichi , Murakami Hisashi , Tomaru Takanori , Hoshika Tomotaro , Fukushima Toshiki
Published: March 2020

Integrated information theory (IIT) was initially proposed to describe human consciousness in terms of intrinsic-causal brain network structures. This theory could potentially be used for conceptualising complex living systems. In a previous study, we analysed collective behaviour in {\it Plecoglossus altivelis}. We found that IIT 3.0 exhibits qualitative discontinuity between three and four schools of fish in terms of $\Phi$ values (i.e., group integrity). Other measures, such as mutual information, did not show such characteristics. In this study, we follow up on our previous findings and introduce two new factors. First, we define the global parameter settings to determine a different kind of group integrity. Second, we set several timescales (from $\Delta t =5/120$ s to $\Delta t =120/120$ s). The results showed that we succeeded in classifying fish school according to their group size in terms of the degree of group integrity, despite the small group size. The concrete classification includes the followership for a two-fish school, fission--fusion for a three-fish school, emergence of leadership for a four-fish school, and emergence of Boid-like behaviour for a five-fish school. These minute classifications have never been revealed before. Finally, we discuss one of the longstanding paradoxes in collective behaviour, known as the heap paradox, for which two tentative answers could be provided through our IIT analysis.
Flexural Deflection Prediction of Piezo-Composite Unimorph Actuator Using Material Orthotropy and Nonlinearity of Piezoelectric Material Layer
Authors: Lee Jae Hoon , Yoon Bum Soo , Park Ji-Won , Song Gunho , Yoon Kwang Joon
Published: March 2020

Research on piezo-composite actuators has been actively conducted over the past two decades as a response to strong demand for light, compact actuators to replace electro-magnetic motor actuators in micro robots, small flying drones, and compact missile systems. Layered piezo-composite unimorph actuators have been studied to provide active vibration control of thin-walled aerospace structures, control the shapes of aircraft wing airfoils, and control the fins of small missiles, because they require less space and provide better frequency responses than conventional electro-magnetic motor actuator systems. However, based on the limited actuation strains of conventional piezo-composite unimorph actuators with poly-crystalline piezoelectric ceramic layers, they have not been implemented effectively as actuators for small aerospace vehicles. In this study, a lightweight piezo-composite unimorph actuator (LIPCA-S2) was manufactured and analyzed to predict its flexural actuation displacement. It was found that the actuated tip displacement of a piezo-composite cantilever could be predicted accurately using the proposed prediction model based on the nonlinear properties of the piezoelectric strain coefficient and elastic modulus of a piezoelectric single crystal.
A Novel Approach of CT Images Feature Analysis and Prediction to Screen for Corona Virus Disease (COVID-19)
Authors: Abdullah Farid Ahmed , Selim Gamal Ibrahim , Khater Hatem Awad A.
Published: March 2020

The paper demonstrates the analysis of Corona Virus Disease based on a probabilistic model. It involves a technique for classification and prediction by recognizing typical and diagnostically most important CT images features relating to Corona Virus. The main contributions of the research include predicting the probability of recurrences in no recurrence (first time detection) cases at applying our proposed approach for feature extraction. The combination of the conventional statistical and machine learning tools is applied for feature extraction from CT images through four images filters in combination with proposed composite hybrid feature extraction (CHFS). The selected features were classified by the stack hybrid classification system(SHC). Experimental study with real data demonstrates the feasibility and potential of the proposed approach for the said cause.
Structural Equations Modeling of the Relationship between Human Resource Strategies and Talent Management with the role of Educating Workers in Governmental Organizations of Kerman Province
Authors: Ahmadiyeh Sedigheh Hasani , Tavakoli Alireza Manzari , Salajegheh Sanjar , Sheykhi Ayob , Pourkiani Masoud
Published: March 2020

This study aimed to model the structural equations of the relationship between HR strategies and talent management with respect to the educating workers. The current research is applied and developmental in terms of purpose and with regard to the research method it is a descriptive and correlational one. The statistical population of this study included all employees of government agencies in Kerman province in 2019 (n=8675), and the sample size was 367 using Cochran formula, which were selected by stratified random sampling. Data collection instrument consisted of three researcher-made questionnaires including 50-item queastionaire of HR strategies with validity of 0.82 and reliability of 0.87, 50-item questionaire of talent management with validity of 0.77 and reliability of 0.79 and 98 questionnaires of knowledge worker employees with validity of 0.84 and reliability of 0.74. Structural equation modeling using amos22 software was used for data analysis. The results revealed that the relationship between human resource strategies to educate the foals of this study to the workers in Kerman province government agencies was well-fitted. Strategies Human resources, which involves commitment, free agent, paternalistic, secondary strategies, can have a significant relationship with talent management, including the components of hire, evaluate, develop and maintain, and knowledge workers have mediating role with knowledge and technical reasoning, individual skills and attitudes, professional skills and attitudes, interpersonal skills and attitudes, and system, product, and process development skills in line with HR strategies and talent management, and free agent strategy is the best and most effective HR strategy that affects talent management.
Persistent Racial Disparities in Utilization Rates and Perioperative Metrics in Total Joint Arthroplasty in the U.S.
Authors: Amen Troy B. , Varady Nathan H. , Rajaee Sean , Chen Antonia F.
Published: March 2020

Background:

Trends in racial disparities in total joint arthroplasty (TJA) care have been documented from 1991 to 2008. However, it remains unknown whether numerous national and orthopaedic-specific efforts to reduce these disparities have been successful. The purpose of this study was to investigate trends in racial disparities in TJA utilization and perioperative metrics between black and white patients in the U.S. from 2006 to 2015.

Methods:

The National Inpatient Sample (NIS) was queried to identify black and white patients who underwent primary total knee arthroplasty (TKA) or primary total hip arthroplasty (THA) between 2006 to 2015. Utilization rates, length of stay in the hospital (LOS), discharge disposition, and inpatient complications and mortality were trended over time. Linear and logistic regression analyses were performed to assess changes in disparities over time.

Results:

From 2006 to 2015, there were persistent white-black disparities in standardized utilization rates and LOS for both TKA and THA (p < 0.001 for all; ptrend > 0.05 for all). Moreover, there were worsening disparities in the rates of discharge to a facility (rather than home) after both TKA (white compared with black: 40.3% compared with 47.2% in 2006 and 25.7% compared with 34.2% in 2015, ptrend < 0.001) and THA (white compared with black: 42.6% compared with 41.7% in 2006 and 23.4% compared with 29.2% in 2015, ptrend < 0.001) and worsening disparities in complication rates after TKA (white compared with black: 5.1% compared 6.1% in 2006 and 3.9% compared with 6.0% in 2015, ptrend < 0.001).

Conclusions:

There were persistent, and in many cases worsening, racial disparities in TJA utilization and perioperative care between black and white patients from 2006 to 2015 in the U.S. These results were despite national efforts to reduce racial disparities and highlight the need for continued focus on this issue. Although recent work has shown that elimination of racial disparities in TJA care is possible, the present study demonstrates that renewed efforts are still needed on a national level.
Global Forum: Orthopaedic Physicians in the Winter and Summer Olympic Games
Authors: Kennedy Mitchell i. , Moatshe Gilbert , Engebretsen Lars
Published: March 2020

In training for and performing in the sporting competitions of the Olympic Games, athletes endure a variety of injuries that can lead to the development of a chronic musculoskeletal condition. Injury surveillance studies are in place for each event to collect epidemiological data in an attempt to enhance injury prevention for future Winter and Summer Olympic Games. Periodic health evaluations also are used to screen for injuries and monitor athletes’ health in order to take measures to reduce the risk of reinjury. Orthopaedic physicians work to improve sport-specific injury prevention protocols to create a safe environment for competition and ultimately reduce the occurrence of injuries throughout the Olympic Games.
My Day as an Orthopedic Physician Assistant
Authors: Creamer Samantha
Published: March 2020

A personal account of a day in the life of an orthopedic physician assistant surrounding professional duties and the person beyond the career.
Physician-Review Websites in Orthopaedic Surgery
Authors: Bernstein David N. , Mesfin Addisu
Published: March 2020

» As consumerism in health care increases, physician-review websites (PRWs) are becoming a common online resource for patients to seek out information.

» The vast majority of ratings and comments are positive across all orthopaedic subspecialties.

» Surgeon-related factors that tend to be associated with higher ratings are younger age, having an active presence on social media, demonstrating trustworthiness, spending time with patients, and answering questions.

» Non-surgeon-related factors that tend to impact ratings include staff courtesy and ease of scheduling.
Interventions for Obesity and Nutritional Status in Arthroplasty Patients
Authors: Rahman Tahsin M. , Fleifel Dominik , Padela Muhammad T. , Anoushiravani Afshin , Rizvi Syed Ahmad , El-Othmani Mouhanad M. , Sayeed Zain
Published: March 2020

» Nutritional risk in patients undergoing total joint arthroplasty has been well-studied with regard to diagnostic criteria; however, therapeutic management of abnormal body mass index (BMI) values and serum markers remains to be studied in patients undergoing joint replacement surgery.

» Patients with a BMI value of >40 kg/m2 are at increased risk for postoperative complications; weight loss programs and bariatric surgery are therapeutic modalities that can be used in the prehabilitation and long-term rehabilitation of patients undergoing total joint arthroplasty.

» Management of patients with abnormal nutritional status should be multidisciplinary and allow for the incorporation of dietitians and nutritionists in therapeutic planning.

» Hypoalbuminemia correction can be completed intravenously or orally; however, arthroplasty studies remain lacking with regard to the preferred modalities of correction.
Exploring the Transitory Experiences of Immigrants in Rural Ontario
Authors: Pallak Arora
Published: March 2020

Immigration has been an important characteristic of the Canadian society for hundreds of years as it has often been used as a tool to maintain the demographic trends in the country. Historically, most immigrants have chosen to migrate to urban areas, especially the three metropolitan cities: Toronto, Montreal and Vancouver. Immigrants make this choice due to a variety of reasons including job opportunities, social networks, family etc., all of which are perceived as abundant in urban centres. However, the current state of rural areas in Canada has created a need for attracting and retaining immigrants. I would like to focus in rural Ontario which, like most rural areas in the country, is experiencing a relative decline in population due to out-migration of youth and an ageing cohort of baby-boomers. With continuing low birth rates, rural Ontario will have to rely on transforming communities to become more attractive for immigrants. Through my research I present an exploratory case of immigrants who are currently living in Bruce and Grey county. The research delves into unique stories of individuals- their successes and challenges by painting a picture of the life of an immigrant in a rural Canadian town.
Rural Space and Social Enterprise
Authors: Scott Brown
Published: March 2020

Geography and the spatial have been pushed to the periphery in terms of how we think about and imagine change; we are more likely to rely on history and time as the great theatres of change. However, there has been a slow “turning” toward a re-recognition of the spatial, and this unleashing of spatial thinking and the 'spatial turn' is quite profound for rural research and rural policy building in general. My presentation will push off from this premise and hone in on my own research focus more specifically, an investigation of the spaces of rural social enterprise. Utilizing the “spatial dialectics” of Henri Lefebvre, I would like to unpack briefly what a spatial understanding of social enterprise might look like and what this understanding means for rural policy.
Factors associated with malnutrition in children <5 years in western Kenya: A hospital-based unmatched case control study
Authors: Gudu Edwin , Obonyo Mark , Omballa Victor , Oyugi Elvis , Kiilu Cecilia , Githuku Jane , Gura Zeinab , Ransom James Anthony
Published: March 2020

Background: Globally, under-nutrition accounts for >3 million deaths annually among children <5 years, with Kenya having ~35,000 deaths. This study aimed to identify factors associated with malnutrition in children aged <5 years in western Kenya. Methods: We conducted a hospital-based unmatched case-control study between May and June 2017. Cases were defined as children aged 6-59 months with either z-score for weight-for-height ≤-2SD or ≥+2SD; weight-for-age ≤-2SD or ≥+2SD; or height-for-age ≤-2SD. Controls were children aged 6-59 months with age-appropriate anthropometric measurements. Cases were consecutively recruited while systematic random sampling was used to select controls. Data from interviews and clinical records were collected and entered into Epi-Info, which was used to run unconditional logistic regression analyses. Results: A total of 94 cases and 281 controls were recruited. Of the cases, 84% (79/94) were under-nourished. Mother not having attended ante-natal clinic (OR=7.9; 95% CI: 1.5-41.2), deworming (OR=0.8; 95% CI: 0.4-1.2), and pre-lacteal feeding (OR=1.8; 95% CI: 1.1-3.0) were associated with under-nutrition. Delayed developmental milestones (AOR=13.9; 95% CI: 2.8-68.6); low birth weight (AOR=3.3; 95% CI: 1.4-7.6), and paternal lack of formal education (AOR=4.9; 95% CI: 1.3-18.9) were independently associated with under-nutrition. Conclusion: Proper pre-natal care, child feeding practices and deworming programs should be enhanced to reduce pediatric malnutrition.
Successes and Challenges of Using a Peer Mentor Model for Nutrition Education within a Food Pantry: A Qualitative Study
Authors: Oliver Tracy Lynn , McKeever Amy , Shenkman Rebecca , Diewald Lisa K.
Published: March 2020

Background: Delivering nutrition education within an emergency food pantry (EFP) is a valuable and sustainable approach to target food insecure and underserved populations. However, little is known about using a peer mentor model, “ Community Cooks,” as a modality to deliver nutrition education within this setting. This research aimed to identify the successes and challenges of using a peer mentor model within an EFP to better understand the best approaches to deliver nutrition education among community residents. Methods: In spring 2018, semi-structured interviews were conducted with eleven peer mentors after they delivered a series of nutrition workshops to community members of the EFP. Interviews were audio-recorded and transcribed verbatim. Qualitative content analysis was used to analyze the data. Results: All peer mentors were women over 40 years-of-age, were recruited from the EFP community; most were high school graduates and currently received some form of federal nutrition assistance. All peer mentors reported that the “Community Cooks” nutrition education program offered many benefits. Key successes of the program included serving in the role as a peer mentor was an empowering experience which gave them a sense of community, purpose, and camaraderie; 2) the nutrition education was appropriately tailored towards those living with food insecurity; 3) the recipes required minimal cooking skills and included low-cost easily accessible foods available at the EFP. Key challenges of the program were the lack of community member engagement in the nutrition education workshops. Conclusion: Challenges continue to exist when delivering nutrition education within a community EFP setting. While the use of peer mentors to deliver nutrition education messages is promising, more research is needed to quantify the impact of using a peer mentor model in underserved and food insecure communities.
Which interactions matter in economic evaluations? A systematic review and simulation study
Authors: Dakin Helen A , Gray Alastair
Published: March 2020

Background: We aimed to assess the magnitude of interactions in costs, quality-adjusted life-years (QALYs) and net benefits within a sample of published economic evaluations of factorial randomised controlled trials (RCTs), evaluate the impact that different analytical methods would have had on the results and compare the performance of different criteria for identifying which interactions should be taken into account. Methods: We conducted a systematic review of full economic evaluations conducted alongside factorial RCTs and reviewed the methods used in different studies, as well as the incidence, magnitude, statistical significance, and type of interactions observed within the trials. We developed the interaction-effect ratio as a measure of the magnitude of interactions relative to main effects. For those studies reporting sufficient data, we assessed whether changing the form of analysis to ignore or include interactions would have changed the conclusions. We evaluated how well different criteria for identifying which interactions should be taken into account in the analysis would perform in practice, using simulated data generated to match the summary statistics of the studies identified in the review. Results and conclusions: Large interactions for economic endpoints occurred frequently within the 40 studies identified in the review, although interactions rarely changed the conclusions. Simulation work demonstrated that in analyses of factorial RCTs, taking account of all interactions or including interactions above a certain size (regardless of statistical significance) minimised the opportunity cost from adopting treatments that do not in fact have the highest true net benefit.
LncRNA regulates tomato fruit cracking by coordinating gene expression via a hormone-redox-cell wall network
Authors: Xue Lingzi , Sun Mintao , Wu Zhen , Yu Lu , Yu Qinghui , Tang Yaping , Jiang Fangling
Published: March 2020

Background
Fruit cracking occurs easily under unsuitable environmental conditions and is one of the main types of damage that occurs in fruit production. It is widely accepted that plants have developed defence mechanisms and regulatory networks that respond to abiotic stress, which involves perceiving, integrating and responding to stress signals by modulating the expression of related genes. Fruit cracking is also a physiological disease caused by abiotic stress. It has been reported that a single or several genes may regulate fruit cracking. However, almost none of these reports have involved cracking regulatory networks.
Results
Here, RNA expression in 0 h, 8 h and 30 h saturated irrigation-treated fruits from two contrasting tomato genotypes, ‘LA1698’ (cracking-resistant, CR) and ‘LA2683’ (cracking-susceptible, CS), was analysed by mRNA and lncRNA sequencing. The GO pathways of the differentially expressed mRNAs were mainly enriched in the ‘hormone metabolic process’, ‘cell wall organization’, ‘oxidoreductase activity’ and ‘catalytic activity’ categories. According to the gene expression analysis, significantly differentially expressed genes included Solyc02g080530.3 ( Peroxide, POD ), Solyc01g008710.3 ( Mannan endo-1,4-beta-mannosidase, MAN ), Solyc08g077910.3 ( Expanded, EXP ), Solyc09g075330.3 ( Pectinesterase , PE ), Solyc07g055990.3 ( Xyloglucan endotransglucosylase-hydrolase 7, XTH7 ), Solyc12g011030.2 ( X yloglucan endotransglucosylase-hydrolase 9 , XTH9 ), Solyc10g080210.2 ( Polygalacturonase-2, PG2 ), Solyc08g081010.2 ( Gamma-glutamylcysteine synthetase, gamma-GCS ), Solyc09g008720.2 ( Ethylene receptor , ER ), Solyc11g042560.2 ( Ethylene-responsive transcription factor 4, ERF4 ) etc. In addition, the lncRNAs (XLOC_134491 and XLOC_036966) regulated the expression of their neighbouring genes, and genes related to tomato cracking were selected to construct a lncRNA-mRNA network influencing tomato cracking.
Conclusions
This study provides insight into the responsive network for water-induced cracking in tomato fruit. Specifically, lncRNAs regulate the hormone-redox-cell wall network, including plant hormone (auxin, ethylene) and ROS (H 2 O 2 ) signal transduction and many cell wall-related mRNAs (EXP, PG, XTH), as well as some lncRNAs ( XLOC_134491 and XLOC_104931, etc.).
Keywords
Tomato, LncRNA, mRNA, Transcriptome, Network, Fruit cracking
Knowledge-based analyses reveal new candidate genes associated with risk of hepatitis B virus related hepatocellular carcinoma
Authors: Jiang Deke , Deng Jiaen , Dong Changzheng , Ma Xiaopin , Xiao Qianyi , Zhou Bin , Yang Chou , Wei Lin , Conran Carly , Zheng S. Lilly , Ng Irene Oi-lin , Yu Long , Xu Jianfeng , Sham Pak C. , Qi Xiaolong , Hou Jinlin , Ji Yuan , Cao Guangwen , Li Miaoxin
Published: March 2020

Background : Recent genome-wide association studies (GWASs) have suggested several susceptibility loci of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) by statistical analysis at individual single-nucleotide polymorphisms (SNPs). However, these loci only explain a small fraction of HBV-related HCC heritability. In the present study, we aimed to identify additional susceptibility loci of HBV-related HCC using advanced knowledge-based analysis.Methods: We performed knowledge-based analysis (including gene- and gene-set-based association tests) on variant-level association p-values from two existing GWASs of HBV-related HCC. Five different types of gene-sets were collected for the association analysis. A number of SNPs within the gene prioritized by the knowledge-based association tests were selected to replicate genetic associations in an independent sample of 965 cases and 923 controls.Results: The gene-based association analysis detected four genes significantly or suggestively associated with HBV-related HCC risk: SLC39A8, GOLGA8M, SMIM31, and WHAMMP2. The gene-set-based association analysis prioritized two promising gene set for HCC, cell cycle G1/S transition and NOTCH1 intracellular domain regulates transcription. Within the gene sets, three promising candidate genes (CDC45, NCOR1 and KAT2A) were further prioritized for HCC. Among genes of liver-specific expression, multiple genes previously implicated in HCC were also highlighted. However, probably due to small sample size, none of the genes prioritized by the knowledge-based association analyses are successfully replicated in the independent sample. Conclusions: This comprehensive knowledge-based association mining study suggested several promising genes and gene-sets associated with HBV-related HCC risks, which facilitate follow-up functional studies on the pathogenic mechanism of HCC.
The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry: a descriptive study from single-center hospital registry of adult congenital heart disease and pulmonary hypertension in Indonesia
Authors: Dinarti Lucia Kris , Hartopo Anggoro Budi , Kusuma Arditya Damar , Satwiko Muhammad Gahan , Hadwiono Muhammad Reyhan , Pradana Aditya Doni , Anggrahini Dyah Wulan
Published: March 2020

Backgrounds: The COngenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry is the first registry for congenital heart disease (CHD) andCHD-related pulmonary hypertension (PH) in adults in Indonesia.The study aims to describethe demographics, clinical presentation, and hemodynamics data of adult CHD and CHD-related PH in Indonesia.
Methods: The COHARD-PH registry is a hospital-based, single-center, and prospective registry which includes adult patients with CHD and CHD-related PH. The patients were enrolled consecutively. For this study, we evaluatedthe registry patients from July 2012 until July 2019. The enrolled patients underwent clinical examination, electrocardiography, chest x-ray, 6-minute walking test, laboratory measurement, and transthoracic and transesophageal echocardiography. Right heart catheterization was performed to measure hemodynamics and confirmthe diagnosis of pulmonary artery hypertension (PAH).
Results: We registered 1012 patients during the study.The majority were young, adult females.The majority of CHD was secundum ASD (73.4%). The main symptom was dyspnea on effort. The majority of patients (77.1%)had already developed signs of PH assessed by echocardiography. The Eisenmenger syndrome was encountered in 18.7% of the patients. Based on the right heart catheterization, 66.9% of patients had developed PAH. Patients with PAH were significantly older,had lower peripheral oxygen saturation, had lower 6-minute walking distance, and higher NTproBNP. The NTproBNP level independently predicted the development of PAH among CHD.
Conclusions: The COHARD-PH registry is the first Indonesian adult-CHD and CHD-related PH registry. The demographics, clinical presentation, and hemodynamics dataof this registry reflect the situation in developing countries which needs to be compared with similar registries from developed countries.
Are we doing enough? Improved breastfeeding practices at 14weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa
Authors: Horwood Christiane , Haskins Lyn , Engebretsen Ingunn Marie , Connolly Catherine , Coutsoudis Anna , Spies Lenore
Published: March 2020

Background: KwaZulu-Natal (KZN) Initiative for breastfeeding support (KIBS) was a multipronged intervention to support the initiation and sustaining of breastfeeding, implemented between 2014 and 2017. We present results of two surveys conducted before and after KIBS implementation to assess changes in infant feeding practices in KZN over this time period.Methods: Two cross-sectional surveys were conducted in primary health care clinics. Multistage stratified random sampling was used to select clinics and participants. Sample size was calculated to provide district estimates of 14-week exclusive breastfeeding (EBF) rates at baseline (KIBS1), and provincial estimates at endpoint (KIBS2). At KIBS1 the sample required was nine participating clinics in each of 11 districts (99 clinics) with 369 participants per district (N=4059), and at KIBS2 was 30 clinics in KZN with 30 participants per clinic (N=900). All caregivers aged ≥ 15 years attending the clinic with infants aged 13- <16 weeks were eligible to participate. Data was collected using structured interviews on android devices. Multi-variable logistic regression was used to adjust odds ratios for differences between time points. Results: At KIBS1 (May2014- March2015), 4172 interviews were conducted with carers, of whom 3659 (87.6%) were mothers. At KIBS2 (January-August 2017), 929 interviews were conducted which included 788 (84.8%) mothers. Among all carers the proportion exclusively breastfeeding was 44.6% and 50.5% (p= 0.1) at KIBS1 and KIBS2 respectively, but greater improvements in EBF were shown among mothers (49.9 vs 59.1: p=0.02). There were reductions in mixed feeding among all infants (23.2% vs 16.3%; p=0.016). Although there was no change in the proportion of carers who reported not breastfeeding (31.9% vs 32.8%; p= 0.2), the duration of breastfeeding among mothers who had stopped breastfeeding was longer at KIBS2 compared to KIBS1 (p=0.0015). Mothers who had returned to work or school were less likely to be breastfeeding (AOR 3.76; 95% CI 3.1-4.6), as were HIV positive mothers (AOR 2.1; 95% CI 1.7-2.6). Conclusion: Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.
Efficacy of high dose versus low dose vitamin D supplementation on serum levels of inflammatory factors and mortality rate in severe traumatic brain injury patients: study protocol for a randomized placebo-controlled trial
Authors: Arabi Seyed Mostafa , Sedaghat Alireza , Ehsaei Mohammadreza , Safarian Mohammad , Ranjbar Golnaz , Rezaee Hamid , Rezvani Reza , Tabesh Hamed , Norouzy Abdolreza
Published: March 2020

Background

Traumatic Brain Injury (TBI) is the most common trauma worldwide and is a leading cause of injury-related death and disability. Inflammation is a major problem among TBL patients which is in association with severity of illness and mortality in brain trauma patients, especially in subdural hemorrhage and epidural hemorrhage cases. A high percentage of adults admitted to the intensive care unit with critical conditions are diagnosed with vitamin D-deficiency, this deficiency may induce impaired immune responses and increase the risk of infections. Vitamin D intervention has been shown to modulate pro- and anti-inflammatory cytokines in non-critically ill patients, but to date, there is no substantial data on the effectiveness of vitamin D for the improvement of immune function in traumatic brain injury patients.

Methods/design

A randomized clinical trial (RCT) will be performed on 74 Iranian adults 18-65 years old with brain trauma, and will be treated daily by vitamin D supplements (100000 IU oral drop) or a similar placebo (1000 IU) for 5 days.

Discussion

If this randomized clinical trial elucidates reduction in inflammatory cytokines, it would provide the evidence for multi-central clinical trials to evaluate the efficacy of vitamin D supplementation in neuro -critically ill patients. Since vitamin D supplements are inexpensive and safe, this clinical trial could have the potential to improve clinical outcomes in traumatic brain injury patients through reduction of inflammation and infection associated morbidity and mortality rates.
Physical activity types and risk of dementia in community-dwelling older people: the Three-City cohort.
Authors: Dupré Caroline , Bongue Bienvenue , Helmer Catherine , Dartigues Jean François , Hupin David , Roche Frédéric , Berr Claudine , Carriere Isabelle
Published: March 2020

Background Physical activity may decrease the risk of dementia; however, previous cohort studies seldom investigated the different types of physical activity and household activities. Our objective was to analyze the links between two physical activity types and dementia in older people. Methods The study used data from the prospective observational Three-city cohort and included 1550 community-dwelling individuals aged 72 to 87 without dementia at baseline. Physical activity was assessed with the Voorrips questionnaire. Two sub-scores were calculated to assess household/transportation activities and leisure/sport activities. Restricted cubic spline and proportional hazard Cox models were used to estimate the non-linear exposure-response curve for the dementia risk and the appropriate activity level thresholds. Models were adjusted for possible confounders, including socio-demographic variables, comorbidities, depressive symptoms and APOE genotype. Results The median age was 80 years, and 63.6% of participants were women. After a median follow-up of 4.6 years, dementia was diagnosed in 117 participants (7.6%). An inverse J-shaped association was found between household/transportation physical activity sub-score and dementia risk, which means that the risk is lowest for the moderately high values and then re-increases slightly for the highest values. The results remained significant when this sub-score was categorized in three classes (low, moderate, and high), with hazard ratios (95% confidence interval) of 0.55 (0.35-0.87) and 0.62 (0.38-1.01) for moderate and high activity levels, respectively. No significant effect was found for leisure/sport activities. Conclusions The 5-year risk of dementia was significantly and negatively associated with the household/transportation activity level, but not with the leisure and sport activity sub-score. This highlights the importance of considering all physical activity types in 72 years or older people.
Active and latent tuberculosis in refugees and asylum seekers: a systematic review and meta-analysis
Authors: Proenca Raquel , Souza Fernanda Mattos , Bastos Mayara Lisboa , Caetano Rosangela , Braga Jose Ueleres , Faerstein Eduardo , Trajman Anete
Published: March 2020

Background: In 2018, there were 70.8 million refugees, asylum seekers and persons displaced by wars and conflicts worldwide. Many of these individuals face a high risk for tuberculosis in their country of origin, which may be accentuated by adverse conditions endured during their journey. Objective: We summarised the prevalence of active and latent tuberculosis infection in refugees and asylum seekers through a systematic literature review and meta-analyses by country of origin and host continent. Methods: Articles published in Medline, EMBASE, Web of Science and LILACS from January 2000 to August 2017 were searched for, without language restriction. Two independent authors performed the study selection, data extraction and quality assessment. Random effect models were used to estimate average measures of active and latent tuberculosis prevalence. Sub-group meta-analyses were performed according to country of origin and host continent. Results: Sixty-seven out of 767 identified articles were included, of which 16 entered the meta-analyses. Average prevalence of active and latent tuberculosis was 1331 per 100 thousand inhabitants [95% confidence interval (CI) = 542-2384] and 37% (95% CI = 23-52%), respectively, both with high level of heterogeneity (variation in estimative attributable to heterogeneity [I 2 ] = 98.2% and 99.8%). Prevalence varied more according to countries of origin than host continent. Ninety-one per cent of studies reported routine screening of recently arrived immigrants in the host country; two-thirds confirmed tuberculosis bacteriologically. Many studies failed to provide relevant information. Conclusion: Tuberculosis is a major health problem among refugees and asylum seekers and should be given special attention in any host continent. To protect this vulnerable population, ensuring access to healthcare for early detection for prevention and treatment of the disease is essential.
Optimization of parasite DNA enrichment approaches to generate whole genome sequencing data for Plasmodium falciparum from low-parasitaemia samples
Authors: Shah Zalak , Adams Matthew , Moser Kara A , Shrestha Biraj , Stucke Emily M , Laufer Miriam K , Serre David , Silva Joana C , Takala-Harrison Shannon
Published: March 2020

Background
Owing to the large amount of host DNA in clinical samples, generation of high-quality Plasmodium falciparum whole genome sequencing (WGS) data requires enrichment for parasite DNA. Enrichment is often achieved by leukocyte depletion of infected blood prior to storage. However, leukocyte depletion is difficult in low-resource settings and limits analysis to prospectively-collected samples. As a result, approaches such as selective whole genome amplification (sWGA) are being used to enrich for parasite DNA. However, sWGA has had limited success in generating reliable sequencing data from low parasitaemia samples. In this study, enzymatic digestion with MspJI prior to sWGA and whole genome sequencing was evaluated to determine whether this approach improved genome coverage compared to sWGA alone. The potential of sWGA to cause amplification bias in polyclonal infections was also examined.
Methods
DNA extracted from laboratory-created dried blood spots was treated with a modification-dependent restriction endonuclease, MspJI, and filtered via vacuum filtration. Samples were then selectively amplified using a previously reported sWGA protocol and subjected to WGS. Genome coverage statistics were compared between the optimized sWGA approach and the previously reported sWGA approach performed in parallel. Differential amplification by sWGA was assessed by comparing WGS data generated from lab-created mixtures of parasite isolates, from the same geographical region, generated with or without sWGA.
Results
MspJI digestion did not enrich for parasite DNA. Samples that underwent vacuum filtration (without MspJI digestion) prior to sWGA had the highest parasite DNA concentration and displayed greater genome coverage compared to MspJI+sWGA and sWGA alone, particularly for low parasitaemia samples. The optimized sWGA (filtration + sWGA) approach was successfully used to generate WGS data from 218 non-leukocyte depleted field samples from Malawi. Sequences from lab-created mixtures of parasites did not show evidence of differential amplification of parasite strains compared to directly sequenced samples.
Conclusion
This optimized sWGA approach is a reliable method to obtain WGS data from non-leukocyte depleted, low parasitaemia samples. The absence of amplification bias in data generated from mixtures of isolates from the same geographic region suggests that this approach can be appropriately used for molecular epidemiological studies.
Keywords Plasmodium falciparum , malaria, whole genome sequencing, selective whole genome amplification, vacuum filtration
Integrative expression network analysis of microRNA and gene isoforms in sacred lotus
Authors: Zhang Yue , Rahmani Razgar Seyed , Yang Xingyu , Chen Jinming , Shi Tao
Published: March 2020

Background
Gene expression is complex and regulated by multiple molecular mechanisms, such as miRNA-mediated gene inhibition and alternative-splicing of pre-mRNAs. However, the coordination of interaction between miRNAs with different splicing isoforms, and the change of splicing isoform in response to different cellular environments are largely unexplored in plants. In this study, we analyzed the miRNA and mRNA transcriptome from lotus ( Nelumbo nucifera ), an economically important flowering plant.
Results
Through RNA-seq analyses on miRNAs and their target genes (isoforms) among six lotus tissues, expression of most miRNAs seem to be negatively correlated with their targets, and tend to be tissue-specific. Further, our results showed that frequent interactions between miRNAs and hub gene isoforms highlight the critical roles of miRNAs in the gene network. Intriguingly, for many genes, their corresponding isoforms were assigned to different co-expressed modules, and they exhibited more divergent mRNA structures including presence and absence of miRNA binding sites, suggesting functional divergence for many isoforms is escalated by both structural and expression divergence. Further detailed functional enrichment analysis of miRNA targets revealed that miRNAs are involved in the regulation of lotus growth and development by regulating plant hormone-related pathway genes.
Conclusions
Taken together, our comprehensive analyses of miRNA and mRNA transcriptome elucidate the coordination of interaction between miRNAs and different splicing isoforms, and highlight the functional divergence of many transcript isoforms from the same locus in lotus.
Ethylene glycol and glycolic acid production from xylonic acid by Enterobacter cloacae
Authors: Zhang Zhongxi , Yang Yang , Wang Yike , Gu Jinjie , Lu Xiyang , Liao Xianyan , Shi Jiping , Kim Chulho , Lye Gary , Baganz Frank , Hao Jian
Published: March 2020

Background: Biological routes for ethylene glycol production have been developed in recent years by constructing the synthesis pathways in different microorganisms. However, no microorganisms have been reported yet to produce ethylene glycol naturally. Results: Xylonic acid utilizing microorganisms were screened from natural environments, and an Enterobacter cloacae strain was isolated. The major metabolites of this strain were ethylene glycol and glycolic acid. However, the metabolites were switched to 2,3-butanediol, acetoin or acetic acid when this strain was cultured with other carbon sources. The metabolic pathway of ethylene glycol and glycolic acid synthesis from xylonic acid in this bacterium was identified. Xylonic acid was converted to 2-dehydro-3-deoxy-D-pentonate catalyzed by D-xylonic acid dehydratase. 2-Dehydro-3-deoxy-D-pentonate was converted to form pyruvate and glycolaldehyde, and this reaction was catalyzed by an aldolase. D-xylonic acid dehydratase and 2-dehydro-3-deoxy-D-pentonate aldolase were encoded by yjhG and yjhH, respectively. The two genes are part of the same operon and are located adjacent on the chromosome. Besides yjhG and yjhH, this operon contains four other genes. However, individually inactivation of these four genes had no effect on either ethylene glycol or glycolic acid production; both formed from glycolaldehyde. YqhD exhibits ethylene glycol dehydrogenase activity in vitro. However, a low level of ethylene glycol was still synthesized by E. cloacae ΔyqhD. Fermentation parameters for ethylene glycol and glycolic acid production by the E. cloacae strain were optimized, and aerobic cultivation at neutral pH were found to be optimal. In fed batch culture, 34 g/L of ethylene glycol and 13 g/L of glycolic acid were produced in 46 hours, with a total conversion ratio of 0.99 mol/mol xylonic acid.Conclusions: A novel route of xylose biorefinery via xylonic acid as an intermediate has been established.
No evidence for amyloid pathology as a key mediator of neurodegeneration post-stroke - a seven year follow-up study
Authors: Hagberg Guri , Ihle-Hansen Hege , Fure Brynjar , Thommessen Bente , Ihle-Hansen Håkon , Øksengård Anne Rita , Beyer Mona K. , Wyller  , Müller Ebba Gløersen , Pendlebury Sarah T. , Selnes Per
Published: March 2020

Background Cognitive impairment (CI) with mixed vascular and neurodegenerative pathologies after stroke is common. The role of amyloid pathology in post-stroke CI is unclear. We hypothesize that amyloid deposition, measured with Flutemetamol ( 18 F-Flut) positron emission tomography (PET), is common in 7-year stroke survivors diagnosed with CI and, further, that quantitatively assessed 18 F-Flut-PET uptake after seven years correlates with amyloid-β peptide (Aβ 42 ) levels in cerebrospinal fluid (CSF) at one year, and with measures of neurodegeneration and cognition at seven years post-stroke. Methods 208 patients with first-ever stroke or TIA without pre-existing CI were included during 2007 and 2008. At one- and seven-years post-stroke, cognitive status was assessed, and categorized into dementia, mild cognitive impairment or none. Etiologic sub-classification was based on magnetic resonance imaging (MRI) findings, CSF biomarkers and clinical cognitive profile. At seven years, patients were offered 18 F-Flut-PET, and amyloid-positivity was assessed visually and semi-quantitatively. The associations between 18 F-Flut-PET standardized uptake value ratios (SUVr) and measures of neurodegeneration (medial temporal lobe atrophy (MTLA), global cortical atrophy (GCA)) and cognition (Mini-Mental State Exam (MMSE), Trail-making test A (TMT-A)) and CSF Aβ 42 levels were assessed using linear regression. Results In all, 111 patients completed 7-year follow-up, and 26 patients agreed to PET imaging, of whom 13 had CSF biomarkers from one year. Thirteen out of 26 patients were diagnosed with CI seven years post-stroke, but only one had visually assessed amyloid positivity. CSF Aβ 42 levels at one year, MTA grade, GCA scale, MMSE score or TMT-A at seven years did not correlate with 18 F-Flut-PET SUVr in this cohort. Conclusions Amyloid binding were not common in 7-year stroke survivors diagnosed with CI. Quantitatively assessed amyloid did not correlate with other measures related to neurodegeneration and cognition. Therefore amyloid pathology may not be a key mediator of neurodegeneration seven years post-stroke.