bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of group LASSO regression based Bayesian networks in risk factors exploration and disease prediction for acute kidney injury in hospitalized patients with hematologic malignancies
Authors: Li Yang , Chen Xiaohong , Wang Yimei , Hu Jiachang , Shen Ziyan , Ding Xiaoqiang
Published: December 2019

Background: This study aims to explore a novel machine-learning algorithm, Bayesian networks (BNs), to delineate the interrelationships between acute kidney injury (AKI) and its associated risk factors among patients with hematologic malignancies (HM), to assess the prediction ability of BNs model, and to infer the probability of AKI under different clinical settings. Methods: From 1 October 2014 to 30 September 2015, 2501 hospitalized patients diagnosed with HM in Zhongshan Hospital, Fudan University, Shanghai of China, were recruited in this retrospective study. Data on demographics, comorbidities, and baseline clinical lab records were exported from the electronic medical records. The group-LASSO (gLASSO) regression was performed to select the candidate predictors of AKI, which were further presented in BNs analysis for interrelationship exploration and disease prediction. Results: Among 2395 eligible patients, 370 episodes were diagnosed with AKI (15.4%). Patients with multiple myeloma (24.1%) and leukemia (23.9%) shared a higher AKI incidence than lymphoma (13.4%). Screened by the gLASSO regression, variables as age, gender, diabetes, hemopathy category, anti-tumor treatment, hemoglobin, serum creatinine (SCr), estimated glomerular filtration rate (eGFR), serum uric acid, serum sodium and potassium level were found with significant associations with AKI occurrence. BNs model revealed a complex interrelationship between these factors, among which there were direct connections between AKI and age, hemoglobin, eGFR, serum sodium and potassium. Moreover, HM category and anti-tumor treatment were indirectly linked to AKI through hemoglobin and eGFR; diabetes was connected with AKI through serum sodium level. BNs inferences indicated that when poor GFR, anemia and hyponatremia occurred simultaneously, the probability of AKI might reach 78.5%. The area under the receiver operating characteristic curve (AUC) of BNs model was 0.835, higher than that in logistic score model (0.763) and showed a robust performance in 10-fold cross-validation. Conclusion: AKI is common in HM hospitalized patients and is affected by multiple risk factors. The application of Bayesian networks and gLASSO regression can provide a novel strategy to explore the potential risk factors integrally and deep into their interrelationships, in accordance with the tide of e-alert and big-data for AKI early detection.
Alterations in gut microbiota of abdominal aortic aneurysm mice
Authors: Xie Jiahe , Lu Weiling , Zhong Lintao , Hu Yuhua , Li Qingrui , Ding Rongming , Zhong Zhonggao , Liu Ziyou , Xiao Hai , Xie Dongming , Zheng Guofu , Ye Bo , Zhong Yiming , Liu Zuheng
Published: December 2019

Background：The gut microbiome plays an important role in various cardiovascular diseases, such as atherosclerosis and hypertension, which are associated with abdominal aortic aneurysms (AAAs).
Methods: Here, we used 16S rRNA sequencing to explore gut microbiota in C57BL ApoE-/- mice with AAAs. A mouse model of abdominal aortic aneurysms was induced with angiotensin II (Ang II) (1000 ng/min per kg). On day 28 after the operation, fecal samples were collected and stored at −80 °C until DNA extraction. We determined the relative abundances of bacterial taxonomic groups using 16S rRNA amplicon metabarcoding, and sequences were analyzed using a combination of mother software and UPARSE.
Results: We found that the gut microbiome was different between control and AAA mice. The results of correlation analysis between AAA diameter and the gut microbiome as well as LEfSe of the genera Akkermansia, Odoribacter, Helicobacter and Ruminococcus might be important in the progression of AAAs.
Conclusions: AAA mice is subjected to gut microbial dysbiosis, and gut microbiota might be a potential target for further investigation.
Evolutionary relationships among bifidobacteria and their hosts and environments
Authors: Rodriguez Cynthia Itzel , Martiny Jennifer B.H.
Published: December 2019

Background The assembly of animal microbiomes is influenced by multiple environmental factors and host genetics, although the relative importance of these factors remains unclear. Bifidobacteria (genus Bifidobacterium , phylum Actinobacteria) are common first colonizers of gut microbiomes in humans and inhabit other mammals, social insects, food, and sewages. In humans, the presence of bifidobacteria in the gut has been correlated with health-promoting benefits. Here, we compared the genome sequences of a subset of the over 400 Bifidobacterium strains publicly available to investigate the adaptation of bifidobacteria diversity. We tested 1) whether bifidobacteria show a phylogenetic signal with their isolation sources (hosts and environments) and 2) whether key traits encoded by the bifidobacteria genomes depend on the host or environment from which they were isolated. We analyzed Bifidobacterium genomes available in the PATRIC and NCBI repositories and identified the hosts and/or environment from which they were isolated. A multilocus phylogenetic analysis was conducted to compare the genetic relatedness the strains harbored by different hosts and environments. Furthermore, we examined differences in genomic traits and genes related to amino acid biosynthesis and degradation of carbohydrates. Results We found that bifidobacteria diversity appears to have evolved with their hosts as strains isolated from the same host were non-randomly associated with their phylogenetic relatedness. Moreover, bifidobacteria isolated from different sources displayed differences in genomic traits such as genome size and accessory gene composition and on particular traits related to amino acid production and degradation of carbohydrates. In contrast, when analyzing diversity within human-derived bifidobacteria, we observed no phylogenetic signal or differences on specific traits (amino acid biosynthesis genes and CAZymes). Conclusions Overall, our study shows that bifidobacteria diversity is strongly adapted to specific hosts and environments and that several genomic traits were associated with their isolation sources. However, this signal is not observed in human strains alone. Looking into the genomic signatures of bifidobacteria strains in different environments can give insights into how this bacterial group adapts to their environment and what types of traits are important for these adaptations.
Albumin to alkaline phosphatase ratio: does it predict survival in grade 1 and grade 2 neuroendocrine tumors?
Authors: Acikgoz Yusuf , Bal Öznur , Doğan Mutlu
Published: December 2019

The authors have withdrawn the journal submission associated with this preprint and requested that the preprint also be withdrawn.
The incidence of collagen-associated adverse events in pediatric population with the use of Fluoroquinolones: a nationwide cohort study in Taiwan
Authors: Yu Pei-Han , Hu Chih-Fen , Liu Jen-Wei , Chung Chi-Hsiang , Chen Yong-Chen , Sun Chien-An , Chien Wu-Chien
Published: December 2019

Background: To evaluate the safety of using fluoroquinolones (FQs) in pediatric population in Taiwan.Methods: Patients aged 0~18-year-old with FQs prescriptions ≥3 consecutive days during year 2000 to 2013 were selected from the National Health Insurance Research Database, 4-time case number were selected as controls. We evaluated the patient’s outcome after the use of FQs by reviewing a newly diagnosis of the following collagen-associated adverse events by ICD-9-CM codes, covering tendons rupture, retinal detachments, gastrointestinal tract perforation, aortic aneurysm or dissection.Results: Of the enrolled patients (n=167,105), collagen-associated adverse effects developed in 85 cases (0.051%) in 6-month tracking, including 0.051% in the FQs study cohort (17 in 33,421) and 0.051% (68 in 133,684) in the FQs free comparison cohort. The crude HR for collagen-associated adverse events in the FQs group was 0.997 (0.586-1.696; p=0.990). After adjusting for age, sex, catastrophic illness, low-income household, seasons, levels of urbanization, and healthcare, the corrected HR in 6-month tracking with FQs was 1.360 (95% CI; 0.795-2.326; p=0.261).Conclusions: There is no significant difference of collagen-associated adverse effects between FQs group and FQs free group from our data. We propose that FQs for pediatric population in clinical practice may be not so harmful as previous references reported.
Preoperative pain aggravates postoperative cognitive deficits and hippocampal neuroinflammation in rats
Authors: Gao Xiang , Ding Xian , Yi Huan , Lin Chuan-tao , Wang Yu-ping , Yu De-biao , Yan Jian-ying
Published: December 2019

Background Perioperative neurocognitive disorder (PND) is the progressive deterioration of cognitive function after surgery. The purpose of this study was to observe the effect of preoperative pain on inflammatory factors and neuronal apoptosis in the hippocampus of rats. Methods 36 adult male Sprague-Dawley rats were randomly divided into 4 groups: the control group, the pain group, the pain+operation group, and the operation group. 6 days before the surgery, the rats received cognitive training, and the cognitive evaluation was carried out on the1, 3 and 7th days after the surgery. The rats were killed on the first, third and seventh days after the surgery (n = 3 rats/day). The cognitive function of rats was evaluated by the Morris Water Maze (MWM), and the expression levels of the pro-inflammatory cytokines interleukin 6(IL-6), Interleukin 1β(IL-1β)and Tumor Necrosis Factor-α(TNF-α), Acetylcholine(Ach)and Cyclic Adenosine monophosphate(cAMP), protein kinase A(PKA)and gamma-aminobutyric acid type A receptors(GABAA) in the hippocampus were measured on the 1st, 3rd and 7th days after the operation. Results Our results showed that the pain model rats exhibited impaired behavior on the first day (P< 0.001), and this lasted until the 7th day after the operation (P≤0.002 and P≤0. 001, respectively). Preoperative pain model rats showed a higher level of apoptosis than that shown by the simple operation rats. On the 1st, 3rd and 7th days after the operation, the protein content of IL-1β, IL-6 and TNF-α in the pain operation group was increased compared to that in the simple operation group (P<0.001). ACh, cAMP, PKA and GABAA expression in the hippocampus was decreased after operation in the preoperative pain model rats. Conclusion Preoperative pain is a key risk factor for the development of PND. The ACh-PKA-GABAA signaling pathway plays a key role in the acetylcholine pathway.
Prevalence of PfDHFR and PfDHPS Mutations Associated with Drug Resistance Among Pregnant Women Receiving IPTp-SP at Msambweni County Referral Hospital, Kwale County, Kenya
Authors: Gikunju Stella Wanjiku , Agola Eric L. , Ondondo Raphael Omusebe , Kinyua Johnson Kangethe , Kimani Francis , LaBeaud Angelle Desiree , Malhotra Indu , King Charles H. , Thiong’o Kelvin , Mutuku Francis
Published: December 2019

Background: Prevention and treatment of malaria during pregnancy is crucial in dealing with maternal mortality and adverse fetal outcomes. WHO’s recommendation to treat all pregnant women with sulphadoxine-pyrimethamine (SP) through antenatal care structures was implemented in Kenya in the year 1998 but concerns about its effectiveness in preventing malaria in pregnancy has arisen due to the spread of parasites resistant to SP. We aimed to determine the prevalence of SP resistance markers in Plasmodium falciparum parasites isolated from pregnant women seeking antenatal care at Msambweni County Referral Hospital, located in coastal Kenya, between the year 2013 and 2015. Methods: This hospital-based study included 106 malaria positive whole blood samples for analysis of SP resistance markers within the PfDHFR gene (codons 51,59 &108) and PfDHPS gene (codons 437 & 540). The venous blood collected from all pregnant women was tested for malaria via light microscopy, then thereafter separated into plasma and red cells and stored in a -86⁰ freezer for further studies. Archived red blood cells were processed for molecular characterization of SP resistance markers within the PfDHFR gene and PfDHPS using real time PCR platform. Results: All samples had at least one mutation in the genes associated with drug resistance; polymorphism prevalence of PfDHFR51I, 59R and 108N was at 88.7%, 78.3% and 93.4%, respectively, while PfDHPS polymorphism accounted for 94.3% and 91.5% at 437G and 540K, respectively. Quintuple mutations (at all the five codons) conferring total SP resistance had the highest prevalence of 86%. Quadruple mutations were observed at a frequency of 10.4%, and 24.5% had a heterogeneous outcome with both wildtype and mutant genotypes in the genes of interest. Conclusion: The data suggest a high prevalence of Pf genetic variations conferring resistance to SP among pregnant women, which may explain reduced efficacy of IPTp treatment in Kenya. There is need for extensive SP resistance profiling in Kenya to inform IPTp drug choices for successful malaria prevention during pregnancy.
In vivo curative antimalarial effects of the aqueous extract of Entandrophragma angolense bark on Plasmodium berghei infection in mice
Authors: Kamkumo Raceline Gounoue , Betene Abel Narcisse Messi , Fokou Patrick Valère Tsouh , Donfack Jean Hubert , Nangap Marius Jaures Tsakem , Ngako Albertine , Fokou Roberto , TchatatTali Brice Mariscal , Tsofack Florence Ngueguim , Dimo Théophile , Boyom Fabrice Fekam
Published: December 2019

Background Research for new antimalarial drugs remains a permanent quest for the control of malaria disease due to the emerging parasite resistances. The present study investigates the effects of the aqueous extract of Entandrophragma angolense (E. angolense) bark on Plasmodium. berghei-induced malaria in mice. Methods Eight weeks old female mice, were intraperitoneally infested with 200 μL of mouse blood, containing 1x106 P. berghei-infected-erythrocytes. Parasitaemia was determined using a 10% giemsa stained blood smear read under optical microscope (x100). The infected animals were randomized into 5 groups of 10 animals each and daily treated for 5 days with the plant extract at 125, 250 and 500 mg / kg. The malaria control received distilled water (10 mL / kg) while the chloroquine control was treated with 10 mg / kg of chloroquine. A group of healthy mice was used as the normal control and received distilled water. Body weight, parasitaemia and survival time were monitored daily during treatment and follow up periods. Five animals from each group were sacrificed under anaesthesia at the end of treatment (d8) and after the follow up period (d28). Venous blood was used for haematological and biochemical tests. Organs (liver, kidneys and spleen) were also collected for biochemical and histological analyses. Results Administration of the aqueous extract of E. angolense bark to infected mice significantly inhibited parasite development (p < 0.001) with ED50 estimated at 25.32 mg / kg. The extract prevented animal from death, body weight loss, anaemia, leucocytosis, high transaminases (ALT and AST), high bilirubin, creatinine and MDA levels, oxidative stress and anatomical alteration in organs as compared to the malaria control. Conclusions The E. angolense bark possesses antimalarial properties, supporting its use in traditional medicine to treat malaria.
High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis
Authors: Abrar Daniel B. , Schleich Christoph , Nebelung Sven , Frenken Miriam , Radke Karl Ludger , Vordenbäumen Stefan , Brinks Ralph , Schneider Matthias , Ostendorf Benedikt , McGonagle Dennis , Sewerin Philipp
Published: December 2019

Background: To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel high resolution hand coil.Methods: Seventeen patients with active PsA, 20 patients with active RA and 16 healthy controls (HC) underwent high-resolution 3T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses Spearman rho correlation was calculated.Results: Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p<0.001) and HC (mean difference 0.2 mm, p<0.001) and showed a higher degree of associated inflammatory changes (mean difference from RA: 4.7, p= 0.048; mean difference from HC: 14.65, p<0.001). Additionally, there was a strong correlation of accessory pulley inflammation and PsAMRIS and its acute-inflammatory sub-scores, flexor tenosynovitis, synovitis and periarticular inflammation (for second digit: synovitis ρ= 0.72, flexor tenosynovitis ρ= 0.7, overall PsAMRIS ρ= 0.72, p< 0.01). Similar robust correlations were evident in digits 3-5. Weaker correlations were evident in RA (synovitis ρ= 0.49, flexor tenosynovitis ρ= 0.49, periarticular inflammation ρ= 0.4).Conclusion: The assessment of MRI changes of flexor tendon pulleys is potentially beneficial for disease detection in PsA, as well as for its distinction from RA and HC.
Inhibition of formyl peptide receptors improves the outcome in a mouse model of Alzheimer disease
Authors: Schröder Nicole , Schaffrath Anja , Welter Josua A. , Putzka Tim , Griep Angelika , Ziegler Patrick , Brandt Elisa , Samer Sebastian , Heneka Michael T. , Kipp Eugenia , Pufe Thomas , Tauber Simone C. , Kipp Markus , Brandenburg Lars-Ove
Published: December 2019

Background: An important hallmark of Alzheimer's disease (AD) is the increase of Aβ1-42 burden and its accumulation to senile plaques, leading the reactive gliosis and neurodegeneration. The modulation of glia cell function represent an attractive therapeutic strategy, but is currently limited by an incomplete understanding of its relevance for AD. The chemotactic G-protein coupled formyl peptide receptor (FPR), which is known to modulate Aβ1-42 uptake and signal transduction, might be one candidate molecule regulating glia function in AD. Here, we investigate whether the modulation of FPR exerts beneficial effects in an AD preclinical model. Methods: To address this question, APP/PS1 double-transgenic AD mice were treated for 20-weeks with either the pro-inflammatory FPR agonist fMLF, the FPR1/2 antagonist Boc2 or the anti-inflammatory FPR2 agonist Ac2-26. Spatial learning and memory were evaluated using a Morris water maze test. Immunohistological staining, gene expression studies and flow cytometry analyses were performed to study neuronal loss, gliosis and Aß-load in the hippocampus and cortex, respectively. Results: FPR antagonism by Boc2-treatment significantly improved spatial memory performance, reduced neuronal pathology, induced the expression of homeostatic growth factors, and ameliorated microglia, but not astrocyte, reactivity. Furthermore, the elevated levels of amyloid plaques in the hippocampus were reduced by Boc2-treatment, presumably by an induction of amyloid degradation.Conclusions: We suggest that the modulation of FPR signaling cascades might be considered as a promising therapeutic approach for alleviating the cognitive deficits associated with early AD. Additional studies are now needed to address the downstream effectors as well as the safety profile of Boc2.
Evaluation of lateral flow immunochromatographic assay for diagnostic accuracy of cryptococcosis
Authors: Xie Li-Min , Lin Geng-ling , Dong Hao-Neng , Liao Ying-Xia , Liu Ye-Ling , Qin Jian-Feng , Guo Xu-guang
Published: December 2019

Background: Cryptococcus is a conditional pathogenic fungus causing cryptococcosis, which is one of the most serious fungal diseases faced by humans. Lateral flow immunochromatographic assay (LFA) is successfully applied to the rapid detection of cryptococcal antigens. Methods: Studies were retrieved systematically from the Embase, PubMed, Web of Science, and Cochrane Library before July 2019. The quality of the studies was assessed by Review Manager 5.0 based on the Quality Assessment of Diagnostic Accuracy Study guidelines. The extracted data from the included studies were analyzed by Meta-DiSc 1.4. Stata 12.0 software was used to detect the publication bias.Results: A total of 15 articles with 31 fourfold tables were adopted by inclusion and exclusion criteria. The merged sensitivity and specificity in serum were 0.98 and 0.98, respectively, and those in the cerebrospinal fluid were 0.99 and 0.99, respectively.Conclusions: Compared to the urine and other samples, LFA in serum and cerebrospinal fluid is favorable evidence for the diagnosis of cryptococcosis with high specificity and sensitivity.
Genome-wide analysis of the citrus B3 superfamily and their association with somatic embryogenesis
Authors: Liu Zheng , Ge Xiao-Xia , Wu Xiao-Meng , Atkinson Ross G. , Guo Wen-Wu
Published: December 2019

Background In citrus, genetic improvement via biotechnology is hindered by the obstacle of in vitro regeneration via somatic embryogenesis (SE). Although a few B3 transcription factors are reported to regulate embryogenesis, little is known about the B3 superfamily in citrus, and which members might be involved in SE.Results Genome-wide sequence analysis identified 72 ( CsB3 ) and 69 ( CgB3 ) putative B3 superfamily members in the genomes of sweet orange ( Citrus sinensis , polyembryonic) and pummelo ( C. grandis , monoembryonic), respectively. Genome duplication analysis indicated that segmental and tandem duplication events contributed to the expansion of the B3 superfamily in citrus, and that the B3 superfamily evolved under the effect of purifying selection. Phylogenetic relationships were well supported by conserved gene structure and motifs outside the B3 domain, which allowed possible functions to be inferred by comparison with homologous genes from Arabidopsis . Expression analysis identified 23 B3 superfamily members that were expressed during SE in citrus and 17 that may play functional roles at late SE stages. Eight B3 genes were identified that were specific to the genome of polyembryonic sweet orange compared to monoembryonic pummelo. Of these eight, CsARF19 was found to be specifically expressed at higher levels in embryogenic callus (EC), implying its possible involvement in EC initiation.Conclusions This study provides a genome-wide analysis of the citrus B3 superfamily, including its genome organization, evolutionary features and expression profiles, and identifies specific family members that may be associated with SE.
The genetic basis of diurnal preference in Drosophila melanogaster
Authors: Pegoraro Mirko , Flavell Laura M.M. , Menegazzi Pamela , Colombi Perrine , Dao Pauline , Helfrich-Förster Charlotte , Tauber Eran
Published: December 2019

Background Most animals restrict their activity to a specific part of the day, being diurnal, nocturnal or crepuscular. The genetic basis underlying diurnal preference is largely unknown. Under laboratory conditions, Drosophila melanogaster is crepuscular, showing a bi-modal activity profile. However, a survey of strains derived from wild populations indicated that high variability among individuals exists, including flies that are nocturnal.Results Using a highly diverse population, we have carried out an artificial selection experiment, selecting flies with extreme diurnal or nocturnal preference. After 10 generations, we obtained highly diurnal and nocturnal strains. We used whole-genome expression analysis to identify differentially expressed genes in diurnal, nocturnal and crepuscular (control) flies. Other than one circadian clock gene ( pdp1 ), most differentially expressed genes were associated with either clock output ( pdf, to ) or input ( Rh3 , Rh2, msn ). This finding was congruent with behavioural experiments indicating that both light masking and the circadian pacemaker are involved in driving nocturnality.Conclusions Our study demonstrates that natural genetic variation in fly wild populations is contributing to substantial variation in diurnal preference. We identified candidate genes associated with diurnality/nocturnality, and the data emerging from our expression analysis and behavioural experiments suggest that both the clock and clock-independent pathways are involved in shaping diurnal preference. The diurnal and nocturnal selection strains provide us with a unique opportunity to understand the genetic architecture of diurnal preference.
The nurse anesthetist perioperative dialog
Authors: Abelsson Anna , Nygårdh Annette
Published: December 2019

Background: In the perioperative dialogue, pre-, intra- and post-operatively, the patient shares their history. In the dialogue, nurse anesthetist (NA) gets to witness the patient's experiences, and can alleviate the patients’ suffering while waiting for, or undergoing surgery. The aim of this study was to describe the certified registered nurse anesthetist experiences of the perioperative dialogue. Methods: The study had a qualitative design. Interviews were conducted with 12 NA and analyzed with interpretive content analysis. The methods were conducted in accordance with the COREQ guidelines. Results: In the result, two categories emerge: A mutual meeting (the preoperative dialogue) where the patient and the NA through contact creates a relationship. The NA is present and listens to the patient, to give the patient confidence in the NA. In the category, On the basis of the patient's needs and wishes (the intraoperative dialogue), the body language of the NA, as well as the ability to read the body language of the patient, is described as important. Conclusion: The patient is met as a person with their own needs and wishes. It includes both a physical and a mental meeting. In a genuine relationship, the NA can confirm and unreservedly talk with the patient. When the patients leave their body and life in the hands of the NA, they can help the patients to find their inherent powers, which allows for participation in their care. Understanding the patient is possible when entering in a genuine relationship with the patient and confirm the patient. The perioperative dialogue forms a safety for the patients in the operating environment.
The Comparative Study of Clinical Competence of Emergency Nurses Using Self-Assessment and Evaluation Methods by Head Nurses
Authors: Ghahfarokhi Motahareh Musavi , Mehrafruz Elina , Radmehr Arman , Kiarsi Maryam , Shamloo Marziyeh Beigom Bigdeli
Published: December 2019

Background: Clinical competency is the ability of nurses in playing a professional role in a clinical environment specially emergency department as the quality of the services provided. The present study aimed to compare the clinical competence of the emergency nurses using self-assessment and evaluation methods by head nurses. Method: The study was designed in a descriptive-analytical way, collecting self-assessment questionnaire and evaluation methods by head nurse’s data. 70 nurses working in Emergency Departments of 3 Hospitals were selected and studied for 3 months based on entry requirements to the census. The instrument was a clinical competency questionnaire with questions in 7 functional fields and 63 skills. The data obtained from descriptive and inferential statistics were analyzed by SPSS-16. Result: The viewpoints of nurses and head nurses on the clinical competencies of nurses were assessed at a moderate level in the majority of domains. Nurses defined their clinical competencies at a significantly higher level compared to the head nurses (P<0.05). conclusion : The periodic assessment of emergency nurses as a critical part and the turning point of the hospital can guide the managers and nursing managers to pay attention to professional competence and promote continuing education programs for improving their competencies in this section.
Rationale and design of individualized quality improvement based on the Computer Analysing system to improve Stroke management quality Evaluation (CASE): a multicentre historically controlled study
Authors: Chen Yi , Zhong Wansi , Gong Xiaoxian , Hu Haitao , Yan Shenqiang , Zhang Xuting , Chen Zhicai , Zhou Ying , Lou Min
Published: December 2019

Background: Guideline-based medical care has been identified to improve outcomes in stroke. However, data acquisition and medical quality management during hospital stay still need to be improved in China. We have developed a computer-based medical data collecting system, together with automated calculation of Key Performance Indicators (KPIs) and regular individualized education, and thus aim to explore whether it can improve the medical care quality of acute ischemic stroke (AIS) during hospital stay in stroke centers.Methods: The individualized quality improvement based on the Computer Analysing system to improve Stroke management quality Evaluation (CASE) trial is a prospective, multi-center, historical control study among 30 stroke centers in China. In this trial, the data is directly extracted from the saved original medical record of each AIS patient during hospital stay, regardless of different Electronic Medical Record System (EMRS) in each center. Then the automated calculation of KPIs and the regular education via tele-conference per month allows the clinicians to examine the causes of non-compliance of guideline-based care and develop programs to decrease their frequency. Discussion: We compare KPIs between pre-intervention stage and post-intervention stage (without or with education) among stroke centers. If proved effective, this approach might be generalized around China and even worldwide, where a unified EMRS is difficult to be applied and in-patient care needs to be improved.
Humoral immune response against Anopheles bites as a measure of exposure to Plasmodium falciparum in asymptomatic infections in a malaria endemic area of Colombia
Authors: Montiel Jehidys , Carbal Luisa Fernanda , Tobón-Castaño Alberto , Vásquez Gissella M. , Fisher Michael L. , Londono Berlin L.
Published: December 2019

Background The humoral immune response against Anopheles salivary glands proteins in the vertebrate host can reflect the intensity of exposure to Anopheles bites and the risk of Plasmodium infection. In Colombia, the identification of exposure biomarkers is necessary due to the several Anopheles species circulating. The purpose of this study was to evaluate human exposure to Anopheles bite by measuring antibody responses against salivary glands extracts from An. albimanus and An. darlingi and also against the gSG6-P1 peptide of An. gambiae in asymptomatic P. falciparum infections in the Colombian Pacific coast.Methods We eluted dried blood spots samples to measure the IgG antibodies against salivary gland extracts of An. albimanus and An. darlingi and the gSG6-P1 peptide by ELISA in uninfected people and microscopic and submicroscopic Plasmodium carriers from the Colombia Pacific Coast. A multiple linear mixed regression model, Spearman correlation, and Mann-Whitney U-test were used to analyze IgG data.Results Significant differences in specific IgG levels were detected between infected and uninfected groups for salivary glands extracts from An. albimanus and for gSG6-P1, also IgG response to CTG and gSG6-P1 peptide were positively associated with the IgG response to P. falciparum in the mixed model.Conclusion The CTG and STE An. albimanus salivary glands extracts are a potential source of new Anopheles salivary biomarkers to identify exposure to the main malaria vector in the Colombian Pacific coast. Also, the gSG6-P1 peptide has the potential to quantify human exposure to the subgenus Anopheles vectors in the same area.
Incidence and Determinants of Transfusion-Transmissible Infections in Voluntary Blood Donors in Malawi, 2005-2015
Authors: Kinge Constance Wose , Kagura Juliana , M’baya Bridon , Njolomole Stephen , Chasela Charles
Published: December 2019

Background Blood transfusion has been associated with a high risk of transfusion-transmissible infections (TTIs). These infections pose great threats to the availability and safety of blood supply for transfusion, particularly in sub-Saharan Africa (SSA) where the burden of disease is alarmingly high. We describe the incidence and determinants of TTIs to help target interventions for safety and increased access to safe blood. Methods This was secondary data analysis of a cohort of blood donors from the Malawi Blood Transfusion Service (MBTS) who donated blood from 2005–2015. Incidence was obtained by dividing the number of new cases by the total person-years at risk and survival probabilities computed by Kaplan-Meier estimates. Logistic regressions were used for risk factors. Results We analysed data from 47,075 registered blood donors of which the majority were male (84%) with a median age of 22 years (IQR=18–22). Of the registered donors, 3,439 (7.31%) were infected with at least one TTI (HIV, HCV or HBV). HBV was the most common TTI with 2.63% (n=1,238), followed by HIV with 1.74% (n=818) and HCV with 1.28% (n=602). Overall, TTI incidence was 43.4 per 10,000. Donors aged 20–24 (OR= 2.15, 95% CI= 1.35–3.40), and 30–34 (OR= 2.68, 95% CI= 1.67–4.32), males (OR= 1.65; 95% CI= 1.47–1.85), and married donors (OR= 1.93; 95% CI= 1.38–2.69) had significantly higher odds of TTI in the multivariate logistic model. Infection with syphilis was a common significant risk factor for incident HIV (OR= 2.62, 95% CI= 1.57–4.38), HCV (OR= 2.03, 95% CI= 1.04–3.98), and HBV (OR= 1.71, 95% CI= 1.01–2.89). Conclusion The overall incidence of TTIs in the Malawian donor population is comparatively low. The incidence of HIV, HCV and HBV is high in males, the unemployed, donors living in the Central Region, involved in high-risk sexual behaviour, and co-infected with syphilis. HBV is most common among supposedly healthy donors, followed by HIV and HCV. TTI therefore, remains a cause for concern toward availability and safe blood supply. Implementation of strict and proper donor selection criteria and continuous screening for TTI indicators can help maximise safe blood supply and transfusion.
Substance use among patients in specialized mental health services in Norway: prevalence and patient characteristics based on a national census
Authors: Andersson Helle Wessel , Lilleeng Solfrid E. , Ruud Torleif , Ose Solveig Osborg
Published: December 2019

Background: Most studies on substance use among psychiatric patients focus on patients within specific diagnostic categories. Less is known about substance use among the general psychiatric patient population. The aim of this study was to investigate the clinical and demographic variation in the prevalence of substance use among psychiatric in-patients and outpatients in Norway.Methods: A national census in psychiatric institutions and outpatient clinics was conducted. Data were returned for 2,358 in-patients (response rate, 65%) and 23,167 outpatients (response rate, 60%). Substance use was measured based on substance use disorder diagnosis or reported substance use in the last four weeks (alcohol 2–4 days a week or illicit drug use). Regression analyses controlling for demographic and socio-demographic characteristics were carried out.Results: Substance use was identified in 32.4% of in-patients and 13.9% of outpatients. The most frequently reported substances used were alcohol, sedatives and cannabis. Among in-patients, the prevalence of substance use was highest in patients with schizophrenia, personality disorders and anxiety disorders. Among outpatients, the prevalence was highest in patients with schizophrenia and other psychoses. In-patients with anxiety disorders and outpatients with schizophrenia and other psychoses had a significantly higher risk of substance use than other patients. In both samples, the prevalence of substance use was higher among males, 24–29-year-olds and the most socially deprived.Conclusions: This study provides further knowledge about patients at risk for co-morbid substance abuse and poor treatment outcomes. Clinicians may consider targeting patients with severe mental illness, young males and those who are socially deprived in efforts to prevent emerging substance abuse and improve outcomes.
Anterior or posterior approach in the surgical treatment of cervical radiculopathy; neurosurgeons’ preference in the Netherlands.
Authors: Broekema Anne Elsina Henderika , Groen Rob JM , Tegzess Erzsi , Reneman Michiel F , Soer Remko , Kuijlen Jos MA
Published: December 2019

Background For cervical foraminal nerve root decompression, anterior cervical discectomy with fusion (ACDF) or posterior cervical foraminotomy (PCF) can be applied. Amongst neurosurgeons, there seems to be a tendency to prefer ACDF over PCF, even though there are some advantages in favor of PCF. The object of present study is to evaluate which factors determine the choice for an anterior or posterior surgical approach in patients with a cervical radicular syndrome based on foraminal pathology. Methods A web-based survey was sent to all 133 neurosurgeons in the Netherlands. The first part focused on general perceived (dis)advantages of ACDF and PCF. The second part concerned questions about the choice between the two procedures. Furthermore, it was analyzed if exposure during training, amount of performed surgeries, assumed reoperation and complication rates influenced the choice of procedure by conducting Chi-square tests with post-hoc analysis. Results A total of 56 neurosurgeons responded (42%). Of these, 77% performed more than 10 ACDF and 25% more than 10 PCF annually. An overall preference for ACDF was observed, even when differentiating for a pure disc prolapse, a spondylotic or a combined stenosis. The most relative important factors for motivating the preference for either ACDF or PCF were: the assumed best decompression of the nerve root (18%), perceived congruence with current literature (16%), exposure during residency (12%), personal comfort with the procedure (11%), and experience with the technique (11%). Conclusions In this survey, there was an overall preference for ACDF above PCF for the surgical treatment of a foraminal cervical radiculopathy. In addition to subjective factors as “experience” and “ comfort” with the procedure, the respondents often motivated their choice as “the best one according to literature”. As there is currently no evidence about the superiority of any of the procedures in literature, this assumption is remarkable.
Correlation between the efficacy of stem cell therapy to osteonecrosis of the femoral head and cell viability
Authors: Wu ZhanYu , Sun Qi , Liu Ming , Grottkau Brian , He ZhiXu , Zou Qiang , Ye Chuan
Published: December 2019

Background: Osteonecrosis of the femoral head (ONFH) is a common disease that greatly affects the quality of life of patients. Repair of necrotic area is the key to treatment.At present, the combination of stem cell transplantation and decompression is used clinically to promote the repair of necrotic areas through the characteristics of stem cells. However, a considerable number of patients cannot achieve a satisfactory outcome in repairing the femoral head necrotic area. It is very important to find out the reasons for the poor curative effect. The aim of this study was to investigate the correlation between stem cell viability and the repair efficacy of stem cell therapy combined with core decompression to early-stage of ONFH. Methods: A total of 30 patients with idiopathic ONFH were performed core decompression combined with autologous stem cell transplantation. The Harris score (HHS) and necrosis area change of patients before and after operation were observed. The mean value of repair ratio was set as a threshold dividing the patients into group A (ratios greater than the mean value) and group B (ratios less than the mean value). The ultrastructure, proliferative capacity and multidirectional differentiation ability were compared between the groups. Results: At 9 months after surgery, HHS and magnetic resonance imaging (MRI) findings had improved by varying degrees. Based on the repair ratio, i.e., (62.2 ± 27.0) %, 62.2% was set as a threshold dividing the patients into group A and group B. Better repair(Group A) showed faster proliferation efficiency and healthier ultrastructure. The cells of Group A also showed stronger specific staining after osteogenesis and chondrogenesis induced differentiation. The activity of alkaline phosphatase (ALP) was also higher in group A (OD 2.39 ± 0.44 vs 1.85 ± 0.52; P <0.05) after osteogenic differentiation. Conclusions: The quality of implanted stem cells is closely related to the efficacy of this procedure and determines whether the defects of self-repair in the necrotic areas can be corrected to enhance the repair capacity of necrotic tissue and to promote the repair of necrotic areas to achieve the desired therapeutic outcome.
Factors affecting postoperative survival of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality
Authors: Ohba Tetsuro , Yokomi Hiroshi MD , Koy Kensuke MD , Tanaka Nobuki , Oda Kotaro , H Hirotaka MD
Published: December 2019

Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a long-term risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. To evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine long-term mortality. Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Morbidity was estimated using the Kaplan-Meier method and a log-rank test. To determine which risk factors led to death among the OVF cases, the preoperative backgrounds of patients were analyzed. Kaplan-Meier curves were used to estimate survival based on the preoperative albumin levels of ≤3.5 g/dL (hypoalbuminemia) versus >3.5 mg/dL. Results: The mean follow-up for survival was 4.1 ±0.8 years. Two years after surgery, 15% of patients with OVF had died. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. Multivariate analysis revealed that only serum albumin ≤3.5 g/dL was a significant risk factor for long-term postoperative mortality of people with OVF. Conclusions: Preoperative hypoalbuminemia was associated with long-term postoperative mortality following surgery for OVF.
Cross-cultural adaptation and validation of the Romanian Knee disability and Osteoarthritis Outcome Score for Joint Replacement (KOOSJR)
Authors: Florescu Sorin , Vermesan Dinu , Haragus Horia , Patrascu Jenel M , Timar Bogdan , Todor Adrian
Published: December 2019

Aim: To perform validation of the Romanian Knee disability and Osteoarthritis Outcome Score for Joint Replacement (KOOSJR).Method: 96 patients (101 knees) with advanced osteoarthritis (OA) scheduled for total knee replacement completed Romanian translations of KOOSJR and IKDC (International Knee Documentation Committee – subjective knee form) and Euroqol EQ-5D-5L, and the treating physician completed the original knee society score (KSS). Results: Average age was 66.4 (range 50-83) years and male to female ratio 1:3.76. There was moderate correlation between the test-retest (average 4 days) KOOSJR (r=0.618, n=45) and IKDC (r=-0.671, n=99), weak between KOOSJR and EQ-5D-5L Index (r=-0.431, n=100) and VAS (r=-0.364, n=99) and very weak to KSS score (r=-0.133, n=98) and function (r=-0.072, n=97) For the first KOOSJR, Cronbach's alpha was 0.816 and intraclass correlation coefficient (ICC) 0.816 (95% CI 0.755-0.866) for average measures. For the retest, Cronbach's alpha was 0.841 (95% CI 0.760-0.903) for averages.Conclusion: The Romanian Knee disability and Osteoarthritis Outcome Score for Joint Replacement (KOOSJR) is a valid, reliable, consistent and reproducible clinical score for patients with OA requiring arthroplasty.
The complete genome sequence of the nitrile biocatalyst Rhodocccus rhodochrous ATCC BAA-870
Authors: Frederick Joni , Hennessy Fritha , Horn Uli , Cortés Pilar de la Torre , Broek Marcel van den , Strych Ulrich , Willson Richard C. , Hefer Charles A. , Daran Jean-Marc G. , Sewell Trevor , Otten Linda G. , Brady Dean
Published: December 2019

Background
Rhodococci are industrially important soil-dwelling Gram-positive bacteria that are well known for both nitrile hydrolysis and oxidative metabolism of aromatics. Rhodococcus rhodochrous ATCC BAA-870 is capable of metabolising a wide range of aliphatic and aromatic nitriles and amides. The genome of the organism was sequenced and analysed in order to better understand this whole cell biocatalyst.

Results
The genome of R. rhodochrous ATCC BAA-870 is the first Rhodococcus genome fully sequenced using Nanopore sequencing. The circular genome contains 5.9 megabase pairs (Mbp) and includes a 0.53 Mbp linear plasmid, that together encode 7548 predicted protein sequences according to BASys annotation, and 5535 predicted protein sequences according to RAST annotation. The genome contains numerous oxidoreductases, 15 identified antibiotic and secondary metabolite gene clusters, several terpene and nonribosomal peptide synthetase clusters, as well as 6 putative clusters of unknown type. The 0.53 Mbp plasmid encodes 677 predicted genes and contains the nitrile converting gene cluster, including a nitrilase, a low molecular weight nitrile hydratase, and an enantioselective amidase.
Although there are fewer biotechnologically relevant enzymes compared to those found in rhodococci with larger genomes, such as the well-known Rhodococcus jostii RHA1, the abundance of transporters in combination with the myriad of enzymes found in strain BAA-870 might make it more suitable for use in industrially relevant processes than other rhodococci.

Conclusions
The sequence and comprehensive description of the R. rhodochrous ATCC BAA-870 genome will facilitate the additional exploitation of rhodococci for biotechnological applications, as well as enable further characterisation of this model organism. The genome encodes a wide range of enzymes, many with unknown substrate specificities supporting potential applications in biotechnology, including nitrilases, nitrile hydratase, monooxygenases, cytochrome P450s, reductases, proteases, lipases, and transaminases.
DETERMINATION OF FORMATION REGIMES FOR BILAYER COBALT DYSPROSIUM INTERMETALIC SURFACE ALLOY
Authors: Kovalenko Vadym , Kondratyev Denis , Kotok Valerii , Chernova Olga , Kovalenko Ihor , Zhykovin Sergey , Ved Viktor , Verbitskiy Volodymyr
Published: December 2019

High tech industrial fields on modern development stage are in need of construction materials with an optimal ratio of volume and surface properties, along with low cost of material itself. As evidenced by studies, in order to give a set complex of properties to a workpiece that operates under specific conditions, it is often sufficient to only modify its surface area. Over the course of studies, by means of gravimetric, influence of technological parameters (temperature and time samples are kept in the melt) on specific mass change of cobalt samples, that act as substrate, during electroless diffusive saturation with dysprosium in eutectic melt of lithium and potassium chlorides have been studied. A mathematical dependency was established for specific mass change of cobalt samples on time spent in melt for temperature range of 873–973 K. Composition of intermetallic coats obtained on surface of cobalt samples was studied means of EDX and SEM analyses. It was discovered, that for chosen temperature range, diffusion layers formed on surface of cobalt samples consists of two structural zones that correspond to Co-Dy and Cp2Dy phases.