bluuebunny/crossref_metadata_2025 huggingface dataset:
Low level of awareness among Iranian women concerning cervical cancer and screening: the role of knowledge, risk perceptions and cues to action
Authors: Asl Rahim Taghizadeh , Osch Liesbeth Van , De Vries Nanne , Zendehdel Kazem , Shams Mohsen , Zarei Fatemeh , De Vries Hein
Published: February 2020

Background Iran has a low incidence of, but a higher rate of death from, cervical cancer (CC). The country is in the process of implementing an organized screening program including HPV testing and cytology. Studies show high drop-out in continued testing among eligible women. This qualitative study aimed to explore women’s awareness regarding CC and CC testing, and the role of knowledge, perceived risk and cues to action in this process. Methods We recruited 81 women aged between 25-65 years, who participated in 15 focus group discussions (FGDs) and two in-depth interviews in Tehran, the capital of Iran. Data were acquired through 11 open-ended questions and 32 related probe questions. All interviews were transcribed and independently analyzed by two researchers (Kappa and agreement testing respectively: 0.77, 97.11%). Results Coded texts were categorized under three themes and 13 subthemes. The three thematic areas referred to knowledge, cues to action and perceived risks regarding cervical cancer and screening. Results showed that women had inadequate and unspecified knowledge about cervical cancer and screening, compounded by misconceptions regarding infection and cancer prevention measures. Social and cultural barriers hindered proper communication between health system/providers and clients, and within communities on subjects related to cervical cancer and screening. Perceived risk of getting CC was low due to insufficient knowledge regarding the causes of cancer, difficulty in differentiating between cancer and sexually transmitted infections, and the absence of visible symptoms. Conclusions The results indicate a strong need to invest more efforts to improve health education and communication in the current national health program to promote awareness of the need to screen for CC, through, for example, establishing correct knowledge and risk perceptions among women. In addition, this intervention should address women’s social environment in order to prevent misconceptions being communicated to women.
Conditional cash transfers, uptake of maternal and child health services, and health outcomes in western rural China
Authors: Zhou Huan , Wu Yuju , Liu Chengfang , Sun Chang , Shi Yaojiang , Zhang Linxiu , Medina Alexis , Rozelle Scott
Published: February 2020

Background: Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that the low uptake of MCH services may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that conditional cash transfers (CCT) have on the uptake of MCH services and ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services, and health outcomes among children in poor rural areas of western China.Methods: We designated two different sets of comparison villages and households that were used as comparison against which outcomes of the treated households could be assessed. In 2014 we conducted a large-scale survey of 1,522 households at 75 villages (including 25 treatment and 50 comparison) from nine nationally-designated poverty counties in two provinces of China. In each village, 21 households were selected based on their eligibility status for the CCT program. Difference-in-difference analyses were used to assess the impact of CCT on outcomes in terms of both Intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT). Results: Overall, the uptake of MCH services in the sample households were low, especially in terms of post-partum care visits, early breast feeding, exclusive breast feeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages were significantly higher than that in the comparison villages. Results from both the ITT and ATT analyses showed the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers about MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes.Conclusions: The CCT program generated modest improvements in the uptake of MCH services and mothers' knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two possible reasons: poor CCT implementation and the low quality of rural health facilities.
Comparative genomics and association analysis identifies virulence genes of Cercospora sojina in soybean
Authors: Gu Xin , Ding Junjie , Liu Wei , Yang Xiaohe , Yao Liang liang , Gao Xuedong , Zhang Maoming , Yang Shuai , Wen Jingzhi
Published: February 2020

Background: Recently, a new strain of Cercospora sojina (Race15) has been identified, which has caused the breakdown of resistance in most soybean cultivars in China. Despite this serious yield reduction, little is known about why this strain is more virulent than others. Therefore, we sequenced the Race15 genome and compared it to the Race1 genome sequence, as its virulence is significantly lower. We then re-sequenced 30 isolates of C. sojina from different regions to identifying differential virulence genes using genome-wide association analysis (GWAS).Results: The 40.12-Mb Race15 genome encodes 12,607 predicated genes and contains large numbers of gene clusters that have annotations in 11 different common databases. Comparative genomics revealed that although these two genomes had a large number of homologous genes, their genome structures have evolved to introduce 245 specific genes. The most important 5 candidate virulence genes were located on Contig 3 and Contig 1 and were mainly related to the regulation of metabolic mechanisms and the biosynthesis of bioactive metabolites, thereby putatively affecting fungi self-toxicity and reducing host resistance. Our study provides insight into the genomic basis of C. sojina pathogenicity and its infection mechanism, enabling future studies of this disease.Conclusions: Via GWAS, we identified five candidate genes using three different methods, and these candidate genes are speculated to be related to metabolic mechanisms and the biosynthesis of bioactive metabolites. Meanwhile, Race15 specific genes may be linked with high virulence. The genes highly prevalent in virulent isolates should also be proposed as candidates, even though they were not found in our SNP analysis. Future work should focus on using a larger sample size to confirm and refine candidate gene identifications and should study the functional roles of these candidates, in order to investigate their potential roles in C. sojina pathogenicity.
Posterior only instrumented fusion provides incomplete curve control for early-onset scoliosis in type 1 neurofibromatosis
Authors: Cai Siyi , Li Zhenyao , Qiu Guixing , shen Jianxiong , Zhao Hong , Zhao Yu , Wang Yipeng , Zhang Jianguo
Published: February 2020

Background: The mid-long term outcomes of posterior spinal fusion in pediatric neurofibromatosis type 1 (NF-1) patients are rarely reported, so does the effectiveness of itsorthopeidc maintenance function. This study aims to evaluate the mid-long term surgical outcomes of posterior only instrumented spinal fusion for early-onset scoliosis (EOS) in NF-1 patients. Methods: A retrospective review was performed on a cohort of 10 NF-1 patients having EOS from 2008 to 2014 in our hospital, including four male and six female patients with an age averaged at 7.8 years old when they underwent posterior only instrumented spinal fusion for their EOS. Both general clinical data and surgical specific data of the patients were collected and reviewed, and the dystrophic progression of EOS was evaluated during the follow-up. Results: The average duration of follow-up was 54 months (24 to 88 months). All patients underwent posterior only instrumented spinal fusion at 1 stage. The primary curves of EOS were thoracic in 9 cases and 1 patient had lumbar scoliosis. Preoperative major curve was significantly corrected (from 66.1 to 31.1 degrees). However, the major curve deteriorated significantly to 40.1 degrees on average at the end of the follow-up. The T1-S1 distance increased 2.8 cm on average and kept increasing at a rate of 0.6cm/year during the follow-up. Conclusions: Posterior only fusion surgery was not a good option to treat the EOS in NF-1 patients despite the relatively short segments involvement in the disease. The maintenance of orthopedic effect after treatment was not satisfactory.
How does a targeted active labour market program impact on the well-being of the unemployed? A Concept Mapping study on Barcelona “Employment in the Neighbourhoods”
Authors: Puig-Barrachina Vanessa , Malmusi Davide , Artazcoz Lucía , Bartoll Xavier , Clotet Eva , Cortés-Franch Imma , Ventura Lorena , Daban Ferran , Díez Èlia , Borrell Carme
Published: February 2020

Background: The “Employment in the neighbourhoods” program is an innovative, tailor-made Active Labour Market Program that has been implemented in 12 neighbourhoods in Barcelona (Spain). Its goal is to get people from deprived, high-unemployment neighbourhoods back to work. The aim of this study was to describe the effects of the program on participants’ quality of life, and identify the mechanisms underlying these effects, according to their own perception and the perception of technical staff who assisted them. Methods: We used Concept Mapping, a mixed methods approach combining qualitative and quantitative analysis, to develop a conceptual map of the participants’ and technical staffs’ perceptions about changes in the participants’ quality of life. Data were collected during the generation and structuring steps, where participants brainstormed answers to a focus question, and then rate and sort the responses. To create maps, we used Concept Systems Incorporated software, which conducted two main forms of analysis, a multidimensional scaling analysis, and a hierarchical cluster analysis. Results: Study participants reported several positive effects on mental health and emotional wellbeing, including self-esteem and empowerment, and considered that this was achieved through strengthened social networks, skills acquisition, emotional coaching, and personalized technical assistance. They also described some negative impacts, mainly related to the labour market situation. We observed marked gender differences in the discourses of program participants.Conclusions: The results obtained have allowed us to identify different perceived effects and mechanisms by which the “Employment in the Neighbourhoods” Active Labour Market Programme can influence quality of life of participants from the most deprived areas of Barcelona.
Clinical and histologic tissue responses of skin incisions closed with glycomer 631 and lactomer 9-1 using a subcuticular technique in pigs
Authors: Plavec Tanja , Švara Tanja , Zdovc Irena , Gombač Mitja , Damjanovska Marija , Pintarič Tatjana Stopar , Cvetko Erika , Seliškar Alenka
Published: February 2020

Background : Glycomer 631 and lactomer 9-1 are absorbable suture materials indicated for soft tissue approximation in non-infected wounds. Pigs are often used as surgical models in translational research; however, reports of tissue reactions to both suture materials in pigs are limited. The aim of this study was to assess clinical and histologic responses of skin incisions closed with a subcuticular technique using glycomer 631 and lactomer 9-1 in pigs.
Results: Skin incisions on 17 pigs were closed with glycomer 631 and lactomer 9-1, and a clinical reactive score (CRS) including erythema, swelling, discharge and dehiscence was calculated on postoperative days 7 and 14. Subcuticular tissue reaction was assessed histologically on postoperative day 14 (the presence of extravascular neutrophils, macrophages, multinucleated giant cells, lymphocytes, fibroblasts, bacterial colonies and the overall severity of the inflammatory response to the suture material), and the cumulative score of the variables was calculated as an aggregate tissue irritation score (ATIS). Tissue samples were examined for suture extrusion and evaluated microbiologically. The clinical reactive score did not differ between the suture materials. Only one ATIS variable, namely the overall severity of the inflammatory response, was lower ( p = 0.029) when glycomer 631 was used. Suture extrusion was found in 10/17 of the incisions closed by glycomer 631 and in 7/13 of the incisions closed by lactomer 9-1. Trueperella pyogenes was isolated from the skin and from the area of tissue reaction in six pigs.
Conclusions: No difference in CRS between the suture materials was observed, and thus both materials may be used for the subcuticular technique in pigs. Glycomer 631 induced less tissue reaction only in terms of the overall severity of the inflammatory response. Suture extrusion was observed in more than 50% of incisions regardless of the suture material, possibly due to a large amount of suture material in the wound. Trueperella pyogenes was the only pathogen isolated from the tissue surrounding the suture material.
Novel heavy metal resistance gene clusters are present in the genome of Cupriavidus neocaledonicus STM 6070, a new species of Mimosa pudica microsymbiont isolated from heavy-metal-rich mining site soil
Authors: Klonowska Agnieszka , Moulin Lionel , Ardley Julie , Braun Florence , Gollagher Margaret , Zandberg Jaco Daniel , Marinova Dora , Huntemann Marcel , Reddy T.B.K. , Varghese Neha , Woyke Tanja , Ivanova Natalia , Seshadri Rekha , Kyrpides Nikos , Reeve Wayne
Published: February 2020

Background

Cupriavidus strain STM 6070 was isolated from nickel-rich soil collected near Koniambo massif, New Caledonia, using the invasive legume trap host Mimosa pudica. STM 6070 is a heavy metal-tolerant strain that is highly effective at fixing nitrogen with M. pudica. Here we have provided an updated taxonomy for STM 6070 and described salient features of the annotated genome, focusing on heavy metal resistance (HMR) loci and heavy metal efflux (HME) systems.Results

The 6,771,773 bp high-quality-draft genome consists of 107 scaffolds containing 6,118 protein-coding genes. ANI values show that STM 6070 is a new species of Cupriavidus. The STM 6070 symbiotic region was syntenic with that of the M. pudica-nodulating Cupriavidus taiwanensis LMG 19424T. In contrast to the nickel and zinc sensitivity of C. taiwanensis strains, STM 6070 grew at high Ni2+ and Zn2+ concentrations. The STM 6070 genome contains 55 genes, located in 12 clusters, that encode HMR structural proteins belonging to the RND, MFS, CHR, ARC3, CDF and P-ATPase protein superfamilies. These HMR molecular determinants are putatively involved in arsenic (ars), chromium (chr), cobalt-zinc-cadmium (czc), copper (cop, cup), nickel (nie and nre), and silver and/or copper (sil) resistance. Seven of these HMR clusters were common to symbiotic and non-symbiotic Cupriavidus species, while four clusters were specific to STM 6070, with three of these being associated with insertion sequences. Within the specific STM 6070 HMR clusters, three novel HME-RND systems (nieIC cep nieBA, czcC2B2A2, and hmxB zneAC zneR hmxS) were identified, which constitute new candidate genes for nickel and zinc resistance.Conclusions

STM 6070 belongs to a new Cupriavidus species, for which we have proposed the name Cupriavidus neocaledonicus sp. nov.. STM6070 harbours a pSym with a high degree of gene conservation to the pSyms of M. pudica-nodulating C. taiwanensis strains, probably as a result of recent horizontal transfer. The presence of specific HMR clusters, associated with transposase genes, suggests that the selection pressure of the New Caledonian ultramafic soils has driven the specific adaptation of STM 6070 to heavy-metal-rich soils via horizontal gene transfer.
College Students Responding to the Chinese version of Cardiff Fertility Knowledge Scale Show Deficiencies in Their Awareness: A cross-sectional survey in Hunan, China
Authors: Zhou Yanhui , Luo Yang , Wang Ting , Cui Yanhui , Chen Mingzhu , Fu Jingxia
Published: February 2020

Background: Fertility knowledge is vital to the fertility health of young people and greatly impacts their fertility choices. Delayed childbearing has been increasing in high-income countries, accompanied by the risk of involuntary childlessness or having fewer children than desired. The aim of this study was to investigate knowledge about fertility issues, the related influencing factors, the method of acquiring fertility knowledge, and the relationship between fertility knowledge and fertility intentions among college students. Methods: An online cross-sectional survey of Chinese college students was conducted in Hunan Province from March to April 2018. A total of 867 college students from three comprehensive universities responded to a poster invitation utilizing the Chinese version of the Cardiff Fertility Knowledge Scale (CFKS-C). Data were explored and analysed by SPSS (version 22.0) software. Descriptive statistics, chi-squared tests, T-tests, and Pearson’s correlations were used for the measurements. Results: The average percent-correct score on the CFKS-C was 49.9% (SD=20.8), with greater knowledge significantly related to living in a city district, currently having a stable relationship, majoring in medicine/health, being in year 4 or above of study, and intention to have children (all p＜0.05). A total of 81.9% of the participants reported that they would like to have children, the average score of the importance of childbearing was 6.3 (SD=2.7), and the female score was lower than the male score (p=0.001). A small positive relationship was observed between the CFKS-C and the importance of childbearing (r=0.074, p=0.035). Respondents indicated that they gained most of their knowledge from the media and internet (41.4%) and from schools (38.2%). Conclusion: Yong people in college have a modest level of fertility knowledge, a relatively low intention to have a child, and deficiencies in fertility health education. There is a need to improve the accessibility of fertility health services by developing a scientific and reliable fertility health promotion strategy. Key words: Fertility knowledge; Fertility intention; Childbearing; College students;
Genome-wide Survey of the bHLH Super Gene Family in Brassica napus and its Role in Roots
Authors: Ke Yunzhuo , Wu Yunwen , Zhou Hongjun , Chen Ping , Wang Mangmang , Liu Mingming , Li Pengfeng , Yang Jing , Li Jiana , Du Hai
Published: February 2020

Background: The basic helix-loop-helix (bHLH) gene family is one of the largest transcription factor families in plants and is functionally characterized in diverse species. However, less is known about its functions in the economically important allopolyploid oil crop, Brassica napus. Results: We identified 602 potential bHLHs in the B. napus genome (BnabHLHs) and categorized them into 35 subfamilies, including seven newly separated subfamilies, based on phylogeny, protein structure, and exon-intron organization analysis. The intron insertion patterns of this gene family were analyzed and a total of eight types were identified in the bHLH regions of BnabHLHs. Chromosome distribution and synteny analyses revealed that hybridization between Brassica rapa and Brassica oleracea was the main expansion mechanism for BnabHLHs. Expression analyses showed that BnabHLHs were widely in different plant tissues and formed seven main patterns, suggesting they may participate in various aspects of B. napus development. Furthermore, when roots were treated with five different hormones (IAA, auxin; GA3, gibberellin; 6-BA, cytokinin; ABA, abscisic acid and ACC, ethylene), the expression profiles of BnabHLHs changed significantly, with many showing increased expression. The induction of five candidate BnabHLHs was confirmed following the five hormone treatments via qRT-PCR. Up to 246 BnabHLHs from nine subfamilies were predicted to have potential roles relating to root development through the joint analysis of their expression profiles and homolog function. Conclusion: The 602 BnabHLHs identified from B. napus were classified into 35 subfamilies, and those members from the same subfamily generally had similar sequence motifs. Overall, we found that BnabHLHs may be widely involved in root development in B. napus. Moreover, this study provides important insights into the potential functions of the BnabHLHs super gene family and thus will be useful in future gene function research.
Exploring factors of diagnostic delay for patients with bipolar disorder: A population-based cohort study
Authors: Lublóy Ágnes , Lilla Keresztúri Judit , Németh Attila , Mihalicza Péter
Published: February 2020

Background

Bipolar disorder if untreated, has severe consequences: widespread role impairment, higher health care costs, mortality and morbidity. Although effective treatment is available, the delay in diagnosis might be as long as 10-15 years. In this study we aim at documenting the length of the diagnostic delay in Hungary and identifying factors associated with it.

Methods

Kaplan-Meier survival analysis and Cox proportional hazards model was employed to examine factors associated with the time to diagnosis of bipolar disorder measured from the date of the first presentation to any specialist mental healthcare institution. We investigated three types of factors associated with delays to diagnosis: demographic characteristics, clinical predictors and patient pathways. Administrative data was retrieved from specialist care; the population-based cohort includes 8,935 patients from Hungary.

Results

In the sample, diagnostic delay was 6.46 years on average. The mean age of patients at the time of the first bipolar diagnosis was 43.59 years. 11.85% of patients were diagnosed with bipolar disorder without any delay, and slightly more than one third of the patients (35.10%) were never hospitalized with mental health problems. 88.80% of the patients contacted psychiatric care for the first time in outpatient settings, while 11% in inpatient care. Diagnostic delay was shorter, if patients were diagnosed with bipolar disorder by non-specialist mental health professionals before. In contrast, diagnoses of many psychiatric disorders received after the first contact were coupled with delayed bipolar diagnosis. We found empirical evidence that in both outpatient and inpatient care prior diagnoses of schizophrenia, unipolar depression without psychotic symptoms, and several disorders of adult personality were associated with increased diagnostic delay. Patient pathways played an important role as well: the hazard of delayed diagnosis increased if patients consulted mental healthcare specialists in outpatient care first or they were hospitalized.

Conclusions

We systematically described and analysed the diagnosis of bipolar patients in Hungary controlling for possible confounders. Our focus was more on clinical variables as opposed to factors controllable by policy-makers. To formulate policy-relevant recommendations, a more detailed analysis of care pathways and continuity is needed.
Parents' and healthcare professionals' perceptions of the use of live video recording in neonatal units: A focus group study
Authors: BRIS Aude LE , MAZILLE Nadia , SIMONOT Pauline , LUHERNE Maude , FLAMANT Cyril , GASCOIN Geraldine , Laighin Gearóid Ó , HARTE Richard , PLADYS Patrick
Published: February 2020

Background: The emerging use of video in neonatology units raises ethical and practical questions. This study aims to gain a better understanding of the suitability, limitations and constraints concerning the use of live video as a tool in neonatal clinical practice. The perceptions of parents and healthcare professionals in regard to live video were examined. Methods : Nine focus groups were conducted in four neonatal units involving 20 healthcare professionals and 19 parents. Data were triangulated using transcripts and field notes and analyzed using inductive and semantic thematic analysis. Results: The seven major themes that emerged from the healthcare professionals focus groups were (i) the impact of video recording on healthcare professionals’ behavior; (ii) the impact on parents; (iii) forensic issues ;(iv) guarantee of use; (v) benefits for the newborn; (vi) methodology of use; and (vii) technical considerations & feasibility. The five major themes that emerged from parents focus groups were (i) benefits for the newborn and care enhancement; (ii) impact on parents and potential benefits in case of newborn child/parent separation; (iii) informed consent and guarantee of use;(iv) concern about a possible disruptive impact on healthcare professionals; and (v) data protection. Conclusion: Both parents and healthcare professionals found video recording useful and acceptable if measures were taken to protect the data and mitigate any negative impacts on healthcare professionals.
Comparative Efficacy of Neuraxial and General anesthesia for hip fracture surgery: A meta-analysis of randomized clinical trials
Authors: Zheng Xinxun , Tang Yuming , Gao Yuan , Liu Zhiheng
Published: February 2020

Background: The choice of anesthesia technique remains debatable in patients undergoing surgical repair of hip fracture. This meta-analysis was performed to compare the effect of neuraxial (epidural/spinal) versus general anesthesia on perioperative outcomes in patients undergoing hip fracture surgery. Methods: Medline, Cochrane Library, Science-Direct, and EMBASE databases were searched to identify eligible studies focused on the comparison between neuraxial and general anesthesia in hip fracture patients between January 2000 and May 2019. Perioperative outcomes were extracted for systemic analysis. The sensitivity analyses were performed by the leave-one-out approach. The evidence quality for each outcome was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: Nine randomized controlled trials (RCTs) including 1084 patients fulfilled our selection criteria. The results showed that there were no significant differences in the 30-day mortality (OR = 1.34, 95% CI 0.56, 3.21; P = 0.51), length of stay (MD = -0.65, 95% CI -0.32, 0.02; P =0.06), and the prevalence of delirium (OR = 1.05, 95% CI 0.27, 4.00; P = 0.95), acute myocardial infarction (OR = 0.88, 95% CI 0.17, 4.65; P = 0.88), deep venous thrombosis (OR = 0.48, 95% CI 0.09, 2.72; P = 0.41), and pneumonia (OR = 1.04, 95% CI 0.23, 4.61; P = 0.96) for neuraxial anesthesia compared to general anesthesia. There was a significant difference in terms of blood loss in favor of the neuraxial anesthesia (MD = -137.8, 95% CI -241.49, -34.12; p = 0.009). The evidence quality for each outcome evaluated by the GRADE system was low. Conclusions: In summary, our present study demonstrated that neuraxial anesthesia is associated with a reduced blood loss in patients undergoing hip fracture surgery compared to general anesthesia. Due to small sample size and enormous inconsistency in the choice of outcome measures, more high-quality studies with large sample size are needed to clarify this issue.
Physical activity intervention for non-diabetic patients with non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials
Authors: Wang Shu-ting , Zheng Jing , Peng He-wei , Cai Xiao-lin , Pan Xin-ting , Li Hui-quan , Hong Qi-zhu , Peng Xian-E
Published: February 2020

Background: Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease nowadays. Changes in diet and lifestyle have led to a dramatic increase in the prevalence of NAFLD around the world. This meta-analysis is to investigate the efficacy of physical activity intervention on liver-specific endpoints in the population with NAFLD, including hepatic enzyme, serum lipid, glucose metabolism and intra-hepatic lipid. Methods: PubMed and China National Knowledge Infrastructure (CNKI) databases were searched for randomized clinical trials of physical activity intervention on NAFLD patients through April 20th, 2019. Effect sizes were reported as standardized mean difference (SMD) and 95% confidence intervals (CI). Quality of included studies was assessed according to the Cochrane risk of bias tool. Meta-analyses were conducted using random-effect or fixed-effect models depending on the significance of heterogeneity. Subgroup analyses according to types and duration of physical activity were conducted to investigate clinical variability. Results: 9 studies with a cumulative total of 951 participants met selection criteria. Physical activity was found associated with small reductions in hepatic enzyme parameters: ALT (SMD -0.17, 95% CI:-0.30 to -0.05), AST (SMD -0.25, 95% CI: -0.38, -0.13) and GGT (SMD -0.22, 95% CI: -0.36, -0.08). Significant small improvements were also found in serum lipid parameters including TC (SMD = -0.22, 95% CI: -0.34, -0.09), TG (SMD = -0.18, 95% CI: -0.31 to -0.06) and LDL-C (SMD = -0.26, 95% CI: -0.39 to -0.13). Significant improvement was also found in intra-hepatic lipid content (SMD = -0.21, 95% CI: -0.36 to -0.06) There was no difference between physical intervention group and control group in HDL and three glucose metabolism parameters. Subgroup analysis suggested both aerobic exercise alone and resistance exercise alone can improve most liver function and longer period of exercise generally had better improvement effect. Conclusions: Our findings suggest that physical activity alone can only slightly improve hepatic enzyme levels, most serum lipid levels and intra-hepatic lipid content in non-diabetic patients with NAFLD.
Milk exosome-derived miRNAs from water buffalo are implicated in immune response and metabolism process
Authors: Chen Zujing , Xie Yueqin , Luo Junyi , Chen Ting , Xi Qianyun , Zhang Yongliang , SUN JIAJIE
Published: February 2020

Background: Buffalo milk represents an indispensable source of nourishment, and exosomes from buffalo milk, compared with cow-milk, would yield novel miRNAs that would inform the potential physiological importance of consumption of buffalo-milk exosomes.Results: Here, we isolated exosomes from buffalo and cow milk samples that were obtained at mid-lactation period, and the exosomal miRNA profiles were then generated using RNA-seq. As control, miRNA sequencing data of pig, human and panda milk exosomes were downloaded from GEO database. Finally, a total of 27 milk exosomal miRNA profiles that included 4 buffalo, 4 cow, 8 pig, 4 human and 7 panda were analyzed using the miRDeep2 program. For these datasets there were 558 unique miRNA candidates existed across all species, and the top 10 highly expressed miRNA were evolutionarily conserved across multiple species. Functional analysis revealed that these milk enriched miRNAs targeted 400 putative sites to modulate disease resistance, immune responsiveness and basic metabolism events. In addition, a total of 32 miRNAs in buffalo milk were significantly up-regulated compared with non-buffalo milks, while 16 were significantly down-regulated. Of interest, functional analysis showed that up-regulated miRNA were mainly related to host metabolism processes, while the predicted functions of down-regulated miRNAs were enriched in immune response.Conclusion: In this study, we explored the exosomal miRNAome differences between milks of different animals, expanding the theoretical basis for potential applications of the miRNA-containing vesicles.
Electroencephalogram (EEG) Recording Protocol for Cognitive and Affective Human Neuroscience Research
Authors: Farrens Jaclyn L. , Simmons Aaron M. , Luck Steven J. , Kappenman Emily S.
Published: February 2020

Electroencephalography (EEG) is one of the most widely used techniques to measure human brain activity. EEG recordings provide a direct, high temporal resolution measure of cortical activity from noninvasive scalp electrodes. However, the signals are small relative to the noise, and optimizing the quality of the recorded EEG data can significantly improve the ability to identify signatures of brain processing. This protocol provides a step-by-step guide to recording the EEG from human research participants using strategies optimized for producing the best quality EEG.
“The midwife helped me... Otherwise I could have died” Women’s experience of professional midwifery services in rural Afghanistan. A qualitative study in the provinces Kunar and Laghman
Authors: Thommesen Trude , Kismul Hallgeir , Kaplan Ian , Safi Khadija , Berg Graziella Van den
Published: February 2020

Background Afghanistan has one of the world’s highest maternal mortality ratios, in some areas more than 60% of women have no access to a skilled birth attendant. The main challenges for Afghan childbearing women are access to skilled birth attendance, emergency obstetric care and reliable contraception. The NGO-based project Advancing Maternal and Newborn Health in Afghanistan has supported education of midwives since 2002, according to the national plan for midwifery education. The aim of this study is to explore women´s experiences with professional midwifery care in four villages in Afghanistan covered by the project, to uncover challenges and improve services in rural and conflict-affected areas of the country. Methods An explorative case study approach was adopted. Fourteen in-depth interviews and four focus group discussions were conducted. Totally, 39 women participated; 25 who had given birth during the last six months, 11 mothers-in-laws and three community midwives in the provinces of Kunar and Laghman. Data generated by the interviews and observations was analysed through a thematic content analysis. Findings The women reported that the trained midwives’ life-saving competence, skills and care were important reasons for giving birth in a clinic, and the midwives seemed to be appreciated by many of the women, making more women to choose to give birth in the clinic. Women further appreciated midwives’ promotion of immediate skin-to-skin contact and breastfeeding. However, some women experienced rudeness, discrimination and negligence from the midwives. Moreover, disapproval from relatives, shame and problems with transport and security were important obstacles to women giving birth in the clinics. Conclusions Local recruitment and professional education of midwives as promoted by Afghan authorities and applied in the project seem successful in promoting utilization and satisfaction with maternal and newborn health services in rural Afghanistan. Nevertheless, the quality of the services is still wanting, with some women complaining of disrespectful care. There seems to be a need to focus more on communication issues during the education of midwives. An increased focus on in-service training and factors promoting quality care and respectful communication is necessary and should be prioritized.
Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study
Authors: Lin Po-Hsun , Chien Jui-Teng , Hung Jung-Pin , Hong Chih-Kai , Tsai Tzung-Yi , Yang Chang-Chen
Published: February 2020

Background With an increase in the elderly population, the occurrence of hip fractures, femoral neck fractures, and intertrochanteric fractures (ITFs) is also increasing. It is important to establish effective perioperative methods that would help reduce the morbidity and mortality rates associated with ITFs. The purpose of this study was to determine the effects of ITFs according to the AO classification for perioperative hemoglobin drop. Methods Seventy-six patients with ITFs classified as AO 31-A1 or A2 and fixated with intramedullary nails participated in this retrospective cohort study. Medical records of these patients were retrospectively reviewed from September 2016 to August 2018. The perioperative hemoglobin drop was chosen as the main outcome measure and calculated as the difference between pre- and postoperative hemoglobin levels. Multivariate linear regression analysis was performed and included the following variables: AO classification (A1.1-A2.1 [stable] vs. A2.2-A2.3 [unstable]), time interval between injury and surgery, age, body mass index, and use of anticoagulation medicine. Results Among the 76 patients who met the inclusion criteria, a significantly higher hemoglobin drop was observed in the AO 31 A2.2-A2.3 (unstable) group than in the AO 31 A1.1-A2.1 (stable) group (p = 0.04). The multivariate analysis also showed a greater hemoglobin drop in the unstable group (p < 0.05). Conclusions Patients with unstable ITFs showed a greater hemoglobin drop and suspected hidden blood loss around the fracture site. Therefore, aggressive presurgical blood transfusion for patients with unstable ITFs may reduce anemia and any associated postoperative complications, especially in patients with severe anemia or high mortality risk.
Prevalence of HCV among people who inject drugs in Brussels – A Respondent Driven Sampling Survey
Authors: Baelen Luk Van , Plettinckx Els , Antoine Jérôme , Gremeaux Lies
Published: February 2020

Background: In Belgium, people who inject drugs (PWID) are at a high risk of being infected by hepatitis C (HCV) as injecting drug use is the main mode for transmission of HCV in Europe. Estimates about the number of people living with HCV in Belgium are rare and even less is known about the prevalence of HCV among PWID. Method: Between 1 February 2019 and 26 April 2019, PWID and high risk opiate users (HROU) were recruited in Brussels through respondent driven sampling (RDS). They were invited to a questionnaire and underwent a rapid HCV-test. Results: 253 respondents participated in the study, of which 168 were PWID and 238 were HROU, with 153 respondents belonging to both categories. The overall unweighted sample average for HCV antibodies was 41.1%. The weighted population estimates were 43.7% (95%CI: 30.6% - 56.8%) for RDS-II and 43.4% (95%CI: 28.9% - 58.0%) for RDS-SS. Conclusions: This prevalence is lower than the prevalence estimates reported elsewhere in Europe. However, the data still suggest that serious efforts are needed to reach the goal set by the WHO to reduce HCV by 2030 with 90%.
Noise after total knee arthroplasty has limited effect on joint awareness and patient reported clinical outcomes.
Authors: Taniguchi Hiroto , Itoh Masafumi , Yoshimoto Nobuyuki , Itou Junya , Kuwashima Umito , Okazaki Ken -
Published: February 2020

Background: Some patients complain of noise after total knee arthroplasty (TKA). Controversy still exists how the noise affect the clinical outcomes including joint awareness after TKA. Forgotten Joint Score-12 (FJS-12) measures the clinical outcomes focusing on joint awareness after surgery. The Knee Society Scoring System-2011 (KSS-2011) includes questionnaires for satisfaction, expectation, and functional activities. The aim of this study is to clarify the relationship among FJS-12, KSS-2011 and the noise. Furthermore, the relationship between FJS-12 and KSS-2011 was validated.
Methods: Using the FJS-12 and KSS-2011, 295 knees from 225 patients who underwent TKA was retrospectively evaluated. Noise perception was evaluated by a questionnaire with five grades which is a method that follows the questionnaire form of FJS-12 [“Are you aware of the noise of your artificial joint?” ; never, almost never, seldom, sometimes, mostly]. The correlations among FJS-12, KSS-2011, and noise were analyzed. In addition, patients were divided into four groups based on the mechanism of their implant [cruciate retaining, posterior stabilized, cruciate sacrificed, and bicruciate stabilized (BCS)]. FJS-12, KSS-2011, and noise were compared among the groups.
Results: A strong correlation was observed between FJS-12 and the total score of KSS-2011 (0.70; P < 0.001). FJS-12 also was correlated with KSS-2011 subcategories for “symptoms,” “satisfaction,” and “standard activities” that these correlation coefficients were approximately 0.60. Noise was limited to have weak correlations with FJS-12 (0.28; P < 0.001) and KSS-2011 (0.20 P < 0.001). With comparison among the TKA mechanisms, BCS showed significantly better KSS-2011 and greater range of movement but worse noise scores.
Conclusions: Noise perception after TKA had limited effect on joint awareness and clinical outcomes. FJS-12 was correlated strongly with KSS-2011 and associated with satisfaction, residual symptoms, and daily activities as assessed by KSS-2011 subscores.
Health-related quality of life in adolescents with CFS/ME, a cross-sectional population based Norwegian study.
Authors: Similä Wenche Ann , Halsteinli Vidar , Helland Ingrid B. , Suvatne Christer , Elmi Hanna , Rø Torstein Baade
Published: February 2020

Purpose The primary aim was to measure health related quality of life (HRQoL) in a Norwegian cohort of adolescents with Chronic Fatigue Syndrome (CFS/ME). A secondary aim was to identify factors initial to diagnosis, at time of diagnosis and at follow-up that were associated with HRQoL. Methods In this cross-sectional population-based study, HRQoL was measured by PedsQL Generic Core scale (PedsQL4.0) in 63 adolescents with CFS/ME. In addition, fatigue was measured by PedsQL Multidimentional Fatigue scale (PedsQL-MFS), depressive symptoms were measured by the Short Mood and Feelings Questionnaire (SMFQ), and disruption in school activities was measured by The De Paul Pediatric Health Questionnaire (DPHQ-N). Data were also collected from patient journals and patient interviews.Results Age at diagnosis was 15 (2) years (mean (SD)), and four out of five participants were female. Time from diagnosis to reply was 39 (22) months. Adolescents with CFS/ME reported PedsQL4.0 score 50 (17), and boys reported a better score than girls (64 vs 47, CI (-27;-6)). There were positive associations between overall HRQoL and follow-up by school teacher, school attendance or participation in leisure activities. There were negative associations between overall HRQoL and delayed school progression, having been to rehabilitation stay and depressive symptoms.Conclusion HRQoL in adolescents diagnosed with CFS/ME was low compared to healthy adolescents. The associations between HRQoL, healthcare provided, teacher follow-up, school attendance and participation in leisure activity may provide information of value when developing refined strategies for follow-up of adolescents with CFS/ME. Possible causal relationships must however be explored in future longitudinal studies.
Diversity of cucumber fruit tip is attributed to the epistatic QTL pairs Ft4.1 and Ft6.1
Authors: Zhu Pinyu , Zhang Kaijing , Kun Liang , Wang Xueyan , Wang Tuantuan , Qin Xiaodong , Zhong Tinglong , Xu Jian , Wu Zhe , Chen Jinfeng , Li Ji
Published: February 2020

BackgroundThe shape of fruit tip is critical to appearance quality and commodity value of cucumber (Cucumis sativus L.). Although diversity of cucumber fruit tip is rich, the genetic basis and molecular mechanism were poorly understood. In this study, the morphological and histological features of fruit tip were investigated to accurately evaluate the diversity in cucumber germplasm. QTLs of fruit tip were genetically mapped by using F2 and RILs populations. Candidate genes of major-effect QTLs were predicted. Results The appearance of cucumber fruit tip was generally divided into sharp, oval-round and blunt-round categories, but morphological measurement showed that the angle of fruit tip was continuously distribute in range of 99~173° and the fruit tip index (the ratio of diameter and length of tips) was in range of 1.4~3.5. Histological analysis suggested that the different structures of fruit tips were owed to the different distribution of cell number in vertical and horizontal direction, rather than difference in cell size. In total, thirty fruit tip related QTLs were identified from two mapping populations including a F2 population derived from EC1 (blunt round tip) × 8419s-1 (sharp tip) and a RILs population derived from IL52 (oval round tip) × CCMC (sharp tip). Two major-effect QTLs were detected, of which Ft4.1 was detected in both mapping population, while Ft6.1 was only identified in F2 population. The phenotypes of Ft4.1 were epistatically suppressed by dominant Ft6.1 genotype, suggesting that Ft6.1 has epistatic dominance interaction to Ft4.1. The candidate genes of Ft4.1 were predicted based on genome re-sequencing of parental lines, including CsEXT (Extension-like family protein), CsPRK (leucine-rich repeat protein kinase protein) and CsRNApase (RNA polymerase beta subunit protein), of which CsEXT and CsPRK play important functions during cell division and expansion. ConclusionsDifferent shapes of fruit tip were owed to the different frequency and orientation of cell division in tip structures. The fruit tip variation in cucumber maybe controlled by the major QTLs Ft4.1 and Ft6.1 through epistatic interaction.
Interventionist videothermometry: A new model of cardiac ischemia evaluation
Authors: Silva Tomas Tomas Ottoni Barroso da , Vidal Leonardo Waldstein de Moura , Cabral Paula Gebe Abreu , Costa Matheus Roberto da Mota , Cadena Silvia Marcela Ruiz , Junior Marcelo Borges Santos , Antunes Fernanda , Oliveira André Lacerda de Abreu
Published: February 2020

Background: The purpose of the present study was to evaluate, through videothermometry, the temperature variation in the hearts of rabbits, that underwent induced myocardial ischemia and reperfusion. Results: A total of 20 female rabbits, were divided into two groups: a treated group and a sham group. Throughout the experiment, the animals were monitored by videothermometry, observing the thermal variations of the myocardial tissue. During the experiment, at different times, blood gas tests and tests to evaluate the lactate concentrations were performed. At the end of the experiment, each heart was submitted to histopathological evaluation. In the treated group, there was a reduction in temperature of the myocardial tissue during the circulatory arrest compared to the sham group. Additionally, a colder area next to the caudal vena cava ostium and the right atrium was observed. Notably, despite the 5 minutes of cardiac arrest in the treated group, both the lactate and bicarbonate levels were maintained without significant variation. However, there was an increase in PaCO2 and pH reduction, featuring respiratory acidosis. In relation to the histopathological study, the presence of hydropic degeneration in the myocardium of animals in the treated group was observed.Conclusions: Based on these results, the videothermometry was efficient in identifying the range of myocardial tissue temperature, suggesting that the first areas to suffer due to cardiac arrest were the caudal vena cava ostium and the right atrium. However, in regard to the angiographic coronary thermography, the study was not feasible due to the small size of the coronary. There was no variation between the groups regarding the presence of myocardial infarction, myocardial congestion, myocardial edema and myocardial hemorrhage.