bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study
Authors: Sande Odala , Burtscher Doris , Kathumba Daneck , Tweya Hannock , Phiri Sam , Gugsa Salem
Published: April 2020

Background Differentiated models of care (DMOC) are used to make antiretroviral therapy (ART) accessible to people living with HIV (PLHIV). In Malawi, Lighthouse Trust has piloted various DMOCs aimed at providing quality care while reducing personal and logistical barriers when accessing clinic-based healthcare. One of the approaches was community-based provision of ART by nurses to stable patients. Methods To explore how the nurse-led community ART programme (NCAP) is perceived, we interviewed eighteen purposively selected patients receiving ART through NCAP and the four nurses providing the community-based health care. Information obtained from them was complemented with observations by the study team. Interviews were recorded and transcribed. Data was analysed using manual coding and thematic analysis. Results Through the NCAP, patients were able to save money on transportation and the time it took them to travel to a health facility. Caseloads and waiting times were also reduced, which made patients more comfortable and gave nurses the time to conduct thorough consultations. Closer relationships were built between patients and care providers, creating a space for more open conversations (although this required care providers to set clear boundaries and stick to schedule). Patients’ nutritional needs and concerns related to stigma remain a concern, while operational issues affect the quality of the services provided in the community. Considerations for community-led healthcare programmes include the provision of transportation for care providers; the physical structure of community sites (in regard to private spaces); the timely consolidation of data collected in the field to a central database; and the need for care providers to cover multiple facility-based staff roles. Conclusions The patients interviewed in this study preferred the NCAP approach to the facility-based model of care because it saved them money on transport, reduced waiting-times, and allowed for a more thorough consultation, while continuing to provide quality HIV care. However, when considering a community-level DMOC approach, certain factors – including staff transportation and workload – must be taken into consideration and purposefully planned.
Cigarette smoking is associated with high level of ferroptosis in seminal plasma and affects semen quality
Authors: Ou Zhanhui , Wen Qirong , Deng Yu , Yu Yang , Chen Zhiheng , Sun Ling
Published: April 2020

Purpose The effects of cigarette smoking on male semen quality are controversial, and the molecular mechanisms underlying how cigarette smoking affects semen quality are not clear yet. Methods In this study, semen samples from 70 heavy smokers and 75 non-smokers receiving infertility treatment were included. Basic semen parameters in non-smokers and heavy smokers were evaluated. Levels of glutathione (GSH), lipid reactive oxygen species (ROS), iron and GSH-dependent peroxidase 4 (GPX4) protein level) were observed in human seminal plasma and in GC-2Spd cells exposed to cigarette smoke condensate (CSC). Results Heavy smokers had significantly higher abnormalities (sperm viability and sperm progressive motility) than non-smoking counterparts. Comparing non-smokers group, GSH level was reduced in the group of heavy smokers (P<0.05). However, the level of lipid ROS and iron were significantly increased (P<0.05). Besides, GSH level was reduced following treatment with CSC for 24 h, while lipid ROS and iron levels were increased (P<0.05). However, the levels were reduced after being co-cultured with Ferrostatin-1 (Fer-1) (P<0.05). The level of GPX4 protein was reduced after being treated with CSC in 24 h, and increased after being co-cultured with Fer-1(P<0.05). Conclusion Cigarette smoking is associated with high level of ferroptosis in seminal plasma and affect semen quality.
Assessment of left atrial function in feline hypertrophic cardiomyopathy by using two- dimensional speckle tracking echocardiography
Authors: Kiatsilapanan Arisara , Surachetpong Sirilak
Published: April 2020

Background : Left atrial (LA) function plays an important role in diastolic dysfunction in cats with hypertrophic cardiomyopathy (HCM). Two-dimensional speckle tracking echocardiography (2D-STE) is a novel technique for assessing LA function. This study aimedto evaluate changes in the LA function inHCM cats compared to normal cats, using 2D-STE. Results: Seventeen client-owned cats affected with HCM and twenty healthy control cats. Conventional echocardiographic and 2D-STE variables were measured and compared between groups (the normal and HCM groups). The difference between two groups was compared by using the independent Student’s t-test. A p -value less than 0.05 was considered significant. Variability from the 2D-STE variables tests displayed good reproducibility (coefficient of variation ≤15%). The mean value of peak atrial longitudinal strain (PALS) in the HCM group (13.16 ± 8.64) was lower in the control group (28.54 ±10.31) ( p < 0.001). PALS was lowest at the LA roof region. The atrial longitudinal strain of septal and lateral regions was significantly lower in the HCM group than the normal group. PALS correlated with the percentage of the LA fractional shortening (LA-FS) (r=0.538, p =0.001), the percentage of the LA ejection fraction (LA-EF) (r =0.797, p <0.001), and the LA fractional area change (FAC) (r =0.746, p <0.001). Conclusions: PALS can be used to evaluate changes in theLA function in HCM cats. It is a reproducible method for assessing the LA function in cats affected with HCM.
ESCRT machinery is required for proper microautophagy induction after TORC1 inactivation
Authors: Morshed Shamsul , Ushimaru Takashi
Published: April 2020

Microautophagy is promoted after nutrient starvation and the inactivation of target of rapamycin complex 1 (TORC1) protein kinase. In budding yeast, microautophagy has been commonly assessed using processing assays with green fluorescent protein (GFP)-tagged vacuolar membrane proteins, such as Vph1 and Pho8. The endosomal sorting complex required for transport (ESCRT) system is proposed to be required for microautophagy, because degradation of vacuolar membrane protein Vph1 was compromised in ESCRT-defective mutants. However, ESCRT is also critical for the vacuolar sorting of most vacuolar proteins, and hence reexamination of the involvement of ESCRT in microautophagic processes is required. Here, we show that the Vph1-GFP processing assay is unsuitable for estimating the involvement of ESCRT in microautophagy, because Vph1-GFP accumulated highly in the prevacuolar class E compartment in ESCRT mutants. In contrast, GFP-Pho8 destined for vacuolar membranes via an alternative adaptor protein-3 (AP-3) pathway, was properly localized on vacuolar membranes in ESCRT-deficient cells even during microautophagy induction after TORC1 inactivation. Nevertheless, microautophagic degradation of GFP-Pho8 after TORC1 inactivation was hindered in ESCRT mutants, indicating that ESCRT is indeed required for microautophagy after nutrient starvation and TORC1 inactivation. We confirmed this using another AP-3 pathway-dependent vacuolar membrane protein Sna4. This study provides evidence of the direct role of ESCRT in microautophagy induction.
Ultraviolet irradiation improves the hydrophilicity and osteo-conduction of hydroxyapatite
Authors: Kaneko Sho , Yamamoto Yuji , Wada Kaniichro , Kumagai Gentaro , Harada Yoshifumi , Yamauchi Ryota , Ishibashi Yasuyuki
Published: April 2020

Background
Treating a titanium or titanium alloy implant with ultraviolet (UV) light is known to improve its associated cell growth and osseointegration. However, little is known about the effect of UV irradiation on hydroxyapatite (HA), which is also used frequently in orthopaedic and dental surgery. Here we examined the effect of UV irradiation on the hydrophilicity of HA, and on its osteoconduction ability in rats.
Methods
HA implants of low and high porosity were treated with UV light, and photofunctionalisation was assessed by the contact angle of a water drop on the surface. HA implants were also inserted into rat femurs, and the rats were killed two or four weeks later. The bone volume and bone area ratio were calculated from microcomputed tomography and histological data.
Results
The contact angle of a water drop on HA implants of both porosities was significantly reduced after UV irradiation. In the rat femurs, there was no significant difference in the bone volume between the UV light-treated and control implants at two or four weeks. The bone area ratio for the UV light-treated versus control implants was significantly increased at two weeks, but there was no significant difference at four weeks.
Conclusions
The surface of UV-irradiated HA disks was hydrophilic, in contrast to that of non-irradiated HA disks. Photofunctionalisation accelerated the increase in the bone area ratio in the early healing stage. This technology can be applied to surgical cases requiring the early fusion of bone and HA.
Molecular epidemiology and risk factors of Stenotrophomonas maltophilia infections in a Chinese teaching hospital
Authors: Duan Zhongliang , Qin Juanxiu , Liu Yao , Li Cui , Ying Chunmei
Published: April 2020

Background: Stenotrophomonas maltophilia (S. maltophilia) is an important opportunistic pathogen obtained in hospitals. With the abuse of broad spectrum antibiotics and invasive surgical devices, the rate of S. maltophilia infections is increasing year by year. This study is aimed at epidemiological analysis of the clinical and molecular characteristics of S. maltophilia infections in a Chinese teaching hospital. We wish to have a comprehensive understanding of the status of S. maltophilia infections, in order to provide strong epidemiological data for the prevention and treatment of S. maltophilia infections. Results: 93 isolates from the Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine were included, in which 62 strains were from male patients and 81 isolates were cultured from sputum samples. 86 patients had underlying diseases. All patients have received antibiotic therapeutics. MLST analysis indicated that 61 different sequence types (STs) were found (including 45 novel STs), and MLST did not show significantly adominant STs. PFGE showed weak genetic linkage between strains. The resistant rates of Trimethoprim/sulfamethoxazole (TMP/SMX) and levofloxacin were 9.7% and 4.3%. All the strains were susceptible to minocycline. The positive rates of the four virulence genes Stmpr1, Stmpr2, Smf-1 and Smlt3773 locus were 79.6%, 91.4%, 94.6% and 52.7%. The positive rates of the three biofilm genes rmlA, spgM and rpfF were 82.8%, 92.5% and 64.5%. The mean biofilm forming level of OD492 was 0.54 ± 0.49, and there was no significant difference between genders and among different age groups. The data from patients with ICU and the control group were analyzed retrospectively, and the risk factors infected in ICU included the hypoimmunity and the increase of the use of antibiotics were independent risk factors. Conclusion: Most of the patients had prior medical usage history and baseline diseases. The carrying rate of virulence genes was high, the drug resistance rate of S. maltophilia was low, and the biofilm formation ability was strong. The increased use of antibiotics is an independent risk factor for S. maltophilia infection, which should be payed more attention. No obvious clonal transmission was found in the same department.
A Practical Blockchain Framework using Image Hashing for Image Authentication
Authors: Paul Manoranjan , White Cameron C , Chakraborty Subrata
Published: April 2020

Blockchain is a relatively new technology that can be seen as a decentralised database. Blockchain systems heavily rely on cryptographic hash functions to store their data, which makes it difficult to tamper with any data stored in the system. A topic that was researched along with blockchain is image authentication. Image authentication focuses on investigating and maintaining the integrity of images. As a blockchain system can be useful for maintaining data integrity, image authentication has the potential to be enhanced by blockchain. There are many techniques that can be used to authenticate images; the technique investigated by this work is image hashing. Image hashing is a technique used to calculate how similar two different images are. This is done by converting the images into hashes and then comparing them using a distance formula. To investigate the topic, an experiment involving a simulated blockchain was created. The blockchain acted as a database for images. This blockchain was made up of devices which contained their own unique image hashing algorithms. The blockchain was tested by creating modified copies of the images contained in the database, and then submitting them to the blockchain to see if it will return the original image. Through this experiment it was discovered that it is plausible to create an image authentication system using blockchain and image hashing. However, the design proposed by this work requires refinement, as it appears to struggle in some situations. This work shows that blockchain can be a suitable approach for authenticating images, particularly via image hashing. Other observations include that using multiple image hash algorithms at the same time can increase performance in some cases, as well as that each type of test done to the blockchain has its own unique pattern to its data.
Effect of preoperative segmental range of motion on patient outcomes in cervical disc arthroplasty
Authors: Wu Tingkui , Liu Hao , Ding Chen , Rong Xin , He Jun-bo , Huang Kang-kang , Hong Ying , Wang Beiyu
Published: April 2020

BackgroundCervical disc arthroplasty (CDA) has been demonstrated in clinical trials as an effective and safe treatment for patients diagnosed with radiculopathy and/or myelopathy. However, the current CDA indication criteria based on the preoperative segmental range of motion (ROM), comprise a wide range of variability. Although the arthroplasty level preserved ROM averaged 7°-9° after CDA, there are no clear guidelines on preoperatively limited or excessive ROM at the index level, that could be considered as suitable for CDA in any given trials.MethodsPatients who underwent CDA between January 2008 to October 2018 using Prestige-LP discs in our hospital, were reviewed retrospectively. They were divided into the small-ROM (≤5.5°) and the large-ROM (> 12.5°) groups according to preoperatively index-level ROM. Clinical outcomes, including the Japanese Orthopedics Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) scores, were evaluated. Radiological parameters, including cervical lordosis, disc angle (DA), global and segmental ROM, disc height (DH), and complications were measured.ResultsOne hundred and twenty-six patients, with a total of 132 arthroplasty segments were analyzed. There were 64 patients in the small-ROM and 62 in the large-ROM group. There are more patients diagnosed with cervical spondylosis in the small-ROM than in the large-ROM group (P=0.046). Patients in both groups had significantly improved in JOA, NDI, and VAS scores after surgery, but the intergroup difference was not significant. Patients in the small-ROM group increased dramatically in cervical lordosis, global and segmental ROM postoperatively (P < 0.001). However, global and segmental ROM paradoxically decreased in the large-ROM group postoperatively (P < 0.001). Patients in the small-ROM group had lower DH preoperatively (P=0.012), and a higher rate of heterotopic ossification (HO) postoperatively (P=0.037).ConclusionPatients with preoperatively limited or excessive segmental ROM could achieve satisfactory clinical outcomes at 3 years postoperatively. Patients with limited segmental ROM had more, and severe HO and significantly increased segmental mobility, which decreased in patients with excessive segmental ROM after surgery.
Dynamic waitlisted design for evaluating a randomized trial of evidence-based quality improvement of comprehensive women’s health care implementation in low performing VA facilities
Authors: Hamilton Alison B. , Olmos-Ochoa Tanya , Canelo Ismelda , Rose Danielle , Hoggatt Katherine , Than Claire , Yano Elizabeth M
Published: April 2020

Background : Women’s Health Services (WHS) in the Veterans Health Administration (VA) has long partnered with VA researchers to evaluate how VA care is organized for women Veterans. This partnership has yielded substantial evidence of 1) variations in women Veterans’ access to comprehensive healthcare services that contribute to disparities in quality and patient experience, and 2) the positive impacts of gender-specific care models for women Veterans’ quality and satisfaction. In an effort to provide support specifically to sites that were low-performing in women’s health, WHS and the VA Quality Enhancement Research Initiative co-funded an effort to roll out and evaluate evidence-based quality improvement (EBQI), an implementation strategy with demonstrated effectiveness in a prior cluster randomized trial in women’s health clinics.
Methods : We will identify 21 low-performing VA facilities through a combination of WATCH data, VA quality metrics (by gender) and other indicators. In partnership with WHS, an EBQI contractor will deliver the EBQI “package” – local consensus-development and priority-setting using stakeholder panels, multilevel stakeholder engagement, practice facilitation, local EBQI team training, and formative feedback – to participating sites. We propose a dynamic wait-listed design to evaluate the WHS plans for seven EBQI launches per year over three years. The goal is to evaluate: (1) barriers and facilitators to achieving delivery of comprehensive women’s health care in low-performing VA facilities; (2) effectiveness of EBQI in supporting low-performing VA facilities achieve improved practice features (e.g., level of comprehensive services available, care coordination arrangements, Patient Aligned Care Team (PACT) features implemented, environment of care improvements), provider/staff attitudes (e.g., improved gender awareness, women’s health knowledge and practice), quality of care, and patient experience; and (3) contextual factors, local implementation processes, and organizational changes over time.
Discussion : Access to comprehensive women’s health care reduces fragmentation of care, improves patient satisfaction and results in better patient outcomes. We hypothesize that EBQI implementation will result in changes in leadership awareness and buy-in, multilevel engagement in problem-solving, an enhanced culture of quality improvement, structural changes in care, improved provider/staff attitudes, and better quality and patient experience.
Dietary L-Citrulline supplementation modulates nitric oxide synthesis and anti-oxidant status of laying hens during summer season
Authors: UYANGA VICTORIA ANTHONY , Jiao Hongchao , Zhao Jingpeng , Wang Xiaojuan , Lin Hai
Published: April 2020

Background
L-Citrulline (L-Cit), a non-protein amino acid, has been implicated in several physiological functions including anti-inflammatory, anti-oxidative, and hypothermic roles, however, there is paucity of information with regards to its potential in poultry production. This study was designed to investigate the effects of dietary L-Cit supplementation on the production performance, nitric oxide production and anti-oxidant status of laying hens during summer periods. Hy-line laying hens (n = 288, 34 weeks old) were allotted to four treatment with 6 replicates of 12 chickens each. Dietary treatments of control (basal diets), 0.25%, 0.50% and 1.00% L-Cit supplementation were fed to chickens for eight (8) weeks. Production performance, egg quality characteristics, nitric oxide production and antioxidant properties were measured. Blood samples were collected at 4th and 8th weeks of experiment.
Results
Air temperature monitoring indicated average minimum and maximum recordings of 25.02 0C and 31.01 0C respectively. Dietary supplementation with L-Cit did not significantly (P > 0.05) influence the production performance, plasma biochemistry and rectal temperatures of laying hens. Egg shape index was increased with L-Cit diet, similarly, albumen heights and Haugh units also tended (P < 0.10) to improve with higher L-Cit supplementation. Plasma nitric oxide (NOx) concentration was observed to increase with highest contents at 1% L-Cit supplementation. Likewise, nitric oxide synthase (NOS) enzyme activity for both total NOS (tNOS) and inducible NOS (iNOS) were upregulated with increasing L-Cit levels, although, tNOS was not affected at week 4. Anti-oxidant enzymes including catalase and superoxide dismutase (SOD) were increased with L-Cit supplementation, however, SOD activity was unchanged at week 4. Total anti-oxidant capacity increased with L-Cit groups at week 8. L-Cit supplementation attenuated the extent of lipid peroxidation measured by malondialdehyde levels, and also inhibited glutathione peroxidase activity.
Conclusion
Dietary L-Cit supplementation enhanced nitric oxide synthesis, promoted antioxidant defense systems, and tended to improve internal egg quality traits of laying hens during summer season. 1% L-Cit supplementation proved most effective in enhancing both nitric oxide production and anti-oxidant defenses.
Metagenomic Profiling of Ocular Surface Microbiome Changes in Meibomian Gland Dysfunction
Authors: Zhao Fuxin , Zhang Dake , Ge Chaoxiang , Zhang Lei , Reinach Peter S , Tian Xiangjun , Tao Chengcheng , Zhao Zhelin , Zhao Chenchen , Fu Wenjie , Zeng Changqing , Chen Wei
Published: April 2020

Background: Ocular surface microbiome changes can affect meibomian gland dysfunction (MGD) development, which in turn may increase the risk of tissue infection. To delineate what these changes are, we used shot-gun metagenomic analysis to determine if there are differences between the microbial communities in ocular sites surrounding the meibomian gland in healthy and patients afflicted with MGD. This comparison entailed comparing the microbe content in different microbiomes of the eyelid skin, conjunctiva and meibum with those from the same locations in healthy individuals (HC) and those with this disease. Results: The meibum bacterial content of these microbiomes was different in these two different types of individuals. Almost all of the most significant taxonomic changes in the meibum microbiome of these individuals with MGD were also present in their eyelid skin, but not in the conjunctiva. Such site-specific microbe pattern changes accompany increases in the gene expression levels controlling carbohydrate and lipid metabolism. Most of the microbiomes in MGD disease possess a microbe population capable of metabolizing benzoate. Interestingly, microbe preponderance seemed to be less in patients afflicted with more severe MGD. Nevertheless, pathogens known to underlie ocular infection were evident in these patients. In meibum samples from HC, Pseudomonas fluorescens was present in more than 90% of the samples. Cupriavidus metallidurans and Pseudomonas putida had a positive rate over 50%. MGD meibum contained instead an abundance of Campylobacter coli, Campylobacter jejuni, and Enterococcus faecium pathogens, which were almost absent from HC. Functional annotation indicated that in the microbiomes of MGD meibum their capability to undergo chemotaxis and display immune evasive virulence and mediate Type IV secretion was different than that in the microbiomes of meibum isolated from HC. Conclusions: MGD meibum contained distinct microbiota different from HC, and MGD meibum microbiome community population was much smaller than in the HC group. Profiling differences in the meibum microbiome makeup between HC and MGD patients may uncover unique targets for improved treatment of this disease.
Detecting fabrication in large-scale molecular omics data
Authors: Bradshaw Michael , Payne Samuel H
Published: April 2020

Background: Fraud is a pervasive problem and can occur as fabrication, falsification, plagiarism or theft. The scientific community is not exempt from this universal problem and several studies have recently been caught manipulating or fabricating data. Current measures to prevent and deter scientific misconduct come in the form of the peer-review process and on-site clinical trial auditors. As recent advances in high-throughput omics technologies have moved biology into the realm of big-data, fraud detection methods must be updated for sophisticated computational fraud. In the financial sector, machine learning and digit-preference are successfully used to detect fraud. Results: Drawing from these sources, we develop methods of fabrication detection in biomedical research and show that machine learning can be used to detect fraud in large-scale omic experiments. Using the raw data as input, the best machine learning models correctly predicted fraud with 84-95% accuracy. With digit frequency as input features, the best models detected fraud with 98%-100% accuracy. All of the data and analysis scripts used in this project are available at https://github.com/MSBradshaw/FakeData . Conclusions: Using digit frequencies as a generalized representation of the data, multiple machine learning methods were able to identify fabricated data with near perfect accuracy.
Evaluation of Small Bowel Motion and Feasibility of using the Peritoneal Space to Replace Bowel Loops for Dose Constraints during Intensity-Modulated Radiotherapy for Rectal Cancer
Authors: Li Siyuan , Gong Yanping , Yang Yongqiang , Guo Qi , Qian Jianjun , Tian Ye
Published: April 2020

Background
The goal of this study was to assess small bowel motion and explore the feasibility of using peritoneal space (PS) to replace bowel loops (BL) via the dose constraint method to spare the small bowel during intensity-modulated radiotherapy (IMRT) for rectal cancer.
Methods
A total of 24 patients with rectal cancer who underwent adjuvant radiotherapy were selected. Weekly repeat CT scans from pre-treatment to the fourth week of treatment were acquired and defined as Plan, 1W, 2W, 3W, and 4W. BL and PS contours were delineated in all of the scans. Two IMRT plans called PPS and PBL were designed on Plan CT using two dose PS and BL constraint methods, respectively, and then copied to CT 1 ~ 4W. The shift%, dose volume, and NTCP of the small bowel in PPS and PBL during treatment were evaluated.
Results
Overall, 109 sets of CT scans from 24 patients were acquired, and 218 plans were designed and copied. The PS and BL volumes were 1339.28 cc and 250.27 cc. The BL and PS shift% V15 was 28.48% and 11.79% (p = 0.000), which was less in the prone position than in the supine position (25.24% vs 32.10%, p = 0.000; 9.9% vs 14.85%, p = 0.000). On all of the CT scans, most PPS small bowel dose volumes were less than from PBL. V15 was 170.07 cc vs 178.58 cc (p = 0.000), and they had a significant correlation. The NTCP of chronic and acute side effects from PPS was significantly less than PBL (2.80% vs 3.00%, p = 0.018; 57.32% vs 58.64%, p = 0.000).
Conclusions
This study indicated that small bowel motion may lead to uncertainties in its dose volume and NTCP evaluation during IMRT for rectal cancer. The BL movements were significantly greater than PS, and the prone position was significantly less than the supine position. Using PS instead of BL can spare the small bowel. V15 < 830 cc is the dose constraint standard.
Development of risk prediction models to predict urine culture growth for patients with suspected urinary tract infection in the emergency department: protocol for an electronic health record study from a single UK hospital
Authors: Rockenschaub Patrick , Gill Martin J , McNulty David , Carroll Orlagh , Freemantle Nick , Shallcross Laura
Published: April 2020

Background: Urinary tract infection (UTI) is a leading cause of hospital admissions and is diagnosed based on urinary symptoms and microbiological cultures. Due to lags in the availability of culture results of up to 72 hours, and the limitations of routine diagnostics, many patients with suspected UTI are started on antibiotic treatment unnecessarily. Predictive models based on routinely collected clinical information may help clinicians to rule out a diagnosis of bacterial UTI in low-risk patients shortly after hospital admission, providing additional evidence to guide antibiotic treatment decisions.Methods: Using electronic hospital records from Queen Elizabeth Hospital Birmingham (QEHB) collected between 2011 and 2017, we aim to develop a series of models that estimates the probability of bacterial UTI at presentation in the emergency department (ED) among individuals with suspected urinary tract infection syndromes. Predictions will be made during ED attendance and at different time points after hospital admission to assess whether predictive performance may be improved over time as more information becomes available about patient status. All models will be externally validated for expected future performance using QEHB data from 2018/19.Discussion: Risk prediction models using electronic health records offer a new approach to improve antibiotic prescribing decisions, integrating clinical and demographic data with test results to stratify patients according to their probability of bacterial infection. Used in conjunction with expert opinion, they may help clinicians to identify patients that benefit the most from early antibiotic cessation.
Staging Procedures Fail to Benefit Women with Borderline Ovarian Tumours Who Want to Preserve Fertility: A Retrospective Analysis of 448 cases
Authors: Li Na , Gou Jinhai , Li Lin , Ming Xiu , Hu Tingwenyi , Li Zhengyu
Published: April 2020

Background: To evaluate the effect of clinicopathologic factors on the prognosis and fertility outcomes of BOT patients.Methods: We performed a retrospective analysis of BOT patients who underwent surgical procedures in West China Second University Hospital from 2008 to 2015. The DFS outcomes, potential prognostic factors and fertility outcomes were evaluated.Results: 448 patients were included; 52 recurrences were observed. 92 patients undergoing FSS achieved pregnancy. No significant differences in fertility outcomes were found between the staging and unstaged surgery groups. Staging surgery was not an independent prognostic factor for DFS. Laparoscopy resulted in better prognosis than laparotomy in patients with stage I tumours and a desire for fertility preservation.Conclusion: Patients with BOT fail to benefit from surgical staging. Laparoscopy is recommended for patients with stage I disease who desire to preserve fertility. Physicians should pay more attention to risk of recurrence in patients who want to preserve fertility.
Multimorbidity patterns, polypharmacy and their association with liver and kidney abnormalities in people over 65 years of age: a longitudinal study
Authors: Villen Noemi , Guisado-Clavero Marina , Fernández-Bertolín Sergio , Troncoso Amelia , Foguet-Boreu Quinti , Amado Ester , Pons-Vigues Mariona , Roso-Llorach Albert , Violán Concepción
Published: April 2020

Background: The implementation of individual clinical practice guidelines in patients with multimorbidity often results in polypharmacy. Our aim was to analyse medication use according to longitudinal multimorbidity patterns (MPs) and determine during a 5-year which MPs are associated with abnormal liver and kidney function in primary care patients over 65 years of age living in Catalonia. Methods: Design: Longitudinal study (years 2012 to 2016) based on the electronic health records (EHR) contained in the primary care information system database of the Catalan Institute of Health (SIDIAP). Variables : age, sex, MPs, medication and polypharmacy (drug exposure obtained from the Pharmacy Invoice Registry). Medicines were classified in accordance with the Anatomical Therapeutic Chemical Classification System. Glomerular filtration rate was used to determine abnormal kidney function, and serum levels of alkaline phosphatase, alanine transaminase and gamma-glutamyl transpeptidase were used to diagnose abnormal liver function. Statistics : For medication use in MPs, we calculated annual mean packages of each drug in each MP, and observed/expected ratios (O/E-ratios) were obtained by dividing mean packages in the cluster by mean packages of the same drug in the overall population. Logistic regression models were fitted to estimate the association between MPs at baseline and abnormal kidney and liver function tests during follow up. Results: 916,619 patients were included, and 743,827 completed the follow up. We identified one polypharmacy profile per MP, and concluded that the most prescribed drugs in each pattern corresponded to the diseases overrepresented in that specific MP. The median of drugs ranged from 3 (Cluster 1 - Non-Specific) to 8 (Cluster 10 - Multisystem Pattern). Abnormal kidney function was most commonly observed in the C4-Cardio-Circulatory and Renal (OR 2.19; CI 95% 2.15-2.23) and C3-Minority Metabolic Autoimmune-Inflammatory (OR 2.16; CI 95% 2.12-2.20) MPs. A higher risk of abnormal liver function was observed in the C8-Digestive (OR 3.39; CI 95% 3.30-3.49), and C4-Cardio-Circulatory and Renal (OR 1.96; CI 95% 1.91-2.02) MPs. Conclusions: A higher risk of abnormal kidney and liver function was observed in specific MPs. The long-term characterisation of MPs and polypharmacy illustrates the burden of chronic multimorbidity and polypharmacy in the elderly population.
Estimation and influence of blood loss under endoscope for percutaneous endoscopic lumbar discectomy (PELD): a clinical observational study combined with in-vitro experiment
Authors: Sun DongDong , Lv Dan , Wu Wei Zhou , Ren HeFei , Bao BuHe , Liu Qun , Sun MingLin
Published: April 2020

Purpose: The purpose of this study is to come up with new methods to quantitate the blood loss under endoscope and explore the influence of blood loss on percutaneous endoscopic lumbar discectomy (PELD). Methods: Clinical research and in-vitro experiment are combined. In the in-vitro experiment, 2.0 ml blood was diluted in different ratio to simulate the rinse solution of PELD, the hematocrit method (HCT-M) and red blood cell count method (RBC-M) were came up to estimate blood loss and the new methods were calibrated with the directly measurement method (Direct-M). In clinical research, 74 patients with L5/S1 disc herniation were treated with PELD, HCT-M and the empirical method (EMP-M) were used to estimate the blood loss under endoscope. According to blood loss, all patients were divided into group A (≤10 ml) and group B (>10 ml). The blood loss, operation time, fluoroscopy frequency, visual analog scale (VAS) and oswestry disability index (ODI) scores were compared between the two groups. Results: In the in-vitro experiment, the hematocrit of the rinse solution was always stable over time. The estimated blood loss by HCT-M was stable and quite approximate to actual blood volume (2.0 ml) whatever the blood dilution ratio, while according to RBC-M, the estimated blood loss was close to the actual blood volume only when the dilution ratio was greater than 300 times. In clinical research, the blood loss estimated by HCT-M was higher than that by EMP-M in both groups (P<0.05). There was a significant difference between group A and group B in blood loss (7.40±1.61 vs 19.91±10.94 ml), operation time (80.51±34.70 vs 136.51±41.88 min), and fluoroscopy frequency (6.92±1.52 vs 11.11±2.32 times) (P<0.05). The VAS and ODI scores in group B were higher than that in group A 1 week after operation (P<0.05), however the scores were not different between the two groups at pre-operation (P>0.05). Conclusion: HCT-M is a reliable method to estimate endoscopic blood loss in PELD. The amount of endoscopic blood loss affects the operative procedure in operation time and fluoroscopy frequency, as well as clinical effects in VAS and ODI scores after operation in short-term
Comparison transcriptome analysis revealed resistance differences of Cavendish bananas to Fusarium oxysporum f.sp. cubense race1 and race4
Authors: Dong Honghong , Ye Yiting , Guo Yongyi , Li Huaping
Published: April 2020

Background: Banana Fusarium wilt is a devastating disease of bananas caused by Fusarium oxysporum f. sp. cubense (Foc) and is a serious threat to the global banana industry. Knowledge of the pathogenic molecular mechanism and interaction between the host and Foc is limited. Results: In this study, we confirmed the changes of gene expression and pathways in the Cavendish banana variety ‘Brazilian’ during early infection with Foc1 and Foc4 by comparative transcriptomics analysis. 1862 and 226 differentially expressed genes (DEGs) were identified in ‘Brazilian’ roots at 48 h after inoculation with Foc1 and Foc4, respectively. After Foc1 infection, lignin and flavonoid synthesis pathways were enriched. Glucosinolates, alkaloid-like compounds and terpenoids were accumulated. Numerous hormonal- and receptor-like kinase (RLK) related genes were differentially expressed. However, after Foc4 infection, the changes in these pathways and gene expression were almost unaffected or weakly affected. Furthermore, the DEGs involved in biological stress-related pathways also significantly differed after infection within two Foc races. The DEGs participating in phenylpropanoid metabolism and cell wall modification were also differentially expressed. By measuring the expression patterns of genes associated with disease defense, we found that five genes that can cause hypersensitive cell death were up-regulated after Foc1 infection. Therefore, the immune responses of the plant may occur at this stage of infection. Conclusion: Results of this study contribute to the elucidation of the interaction between banana plants and Foc and to the development of measures to prevent banana Fusarium wilt.
Invasão à Crimeia: influência ocidental na Ucrânia e retaliação Russa
Authors: Leite Alexandre Cesar Cunha , Lucena Arthur Mastroiani , Nobre Fábio
Published: April 2020

Este artigo tem o intuito de analisar as medidas de política externa adotadas pela Rússia nos anos de 2014-2015 que resultaram na invasão da Federação à Crimeia, sob a ótica do Modelo de Hermann, com a seguinte questão norteadora: diante da invasão à Crimeia e quebra da soberania do país, em que medida as ações de política externa da Rússia foram influenciadas pelas mudanças de governo na Ucrânia? Para isto, levou-se em consideração breve contexto histórico da crise ucraniana, bem como as três mudanças de governo em curto prazo e se aplicou o modelo de Hermann, contextualizado com o entendimento conceitual de GuerraHíbrida, uma vez que as estratégias de guerra do governo russo na Crimeia foram de vias convencionais e não convencionais. Como síntese da pesquisa aqui apresentada, produziu-se um quadro demonstrativo da aplicação do Modelo de Hermann nas mudanças dos governos ucranianos e os tipos de guerra observados.
A small improvement: small cities lag in expanding household water coverage across urban India
Authors: Subramanyam Nidhi
Published: April 2020

This paper investigates how progress towards meeting the sustainable development goal of providing universal and equitable access to drinking water for all is distributed across the spectrum of urban settlements. The study measures how urban local governments (N = 3,547) in a rapidly urbanizing country, India, have increased their coverage of water supply to households between 2001 and 2011. I use theories on multilevel governance of urban services to develop a multilevel linear regression to model the city- and state-level factors associated with growth in water supply coverage. The results show that 68% of cities and towns have recorded water coverage growth, but the extent of this progress is unequally distributed across cities in different states and between cities of different sizes. Small cities and towns, which house over two-thirds of India's urban population, have recorded significantly lower water coverage growth rates as have cities in low-income states. These findings suggest that policies for urban water infrastructure development should focus on smaller cities and towns if we are to achieve spatial equity in access to water for all in an increasingly urban world.
Covid-19 Pandemisi: Karantina İçin Beslenme Önerileri
Authors: ESKİCİ Günay
Published: April 2020

Covid-19’a karşı korunmada güçlü bir bağışıklık sistemi ile birlikte virüsün yayılımını azaltmada koruyucu yöntem olan karantina uygulaması son derece önemlidir. Karantina durumu, bireylerin duygu durumlarını, duygu durumları da beslenme durumunu etkiler. Evde geçirilen sürenin artması, sürekli dinlenen ve izlenen pandemi haberleri, artan endişeler, duygu durumuna bağlı yiyecek tüketme (özellikle karbonhidratlı gıdaları) arzusunun artması ve fiziksel aktivitenin azalması, vücut ağırlığında istenmeyen artışlara neden olabilmektedir. Gerek ağırlık kontrolünü sağlamak gerekse bağışıklığı güçlü tutmak adına beslenmede doğru davranışlarda bulunmak gerekmektedir. Rafine hazır gıdalardan uzak durmak, Akdeniz diyetinin temelini oluşturan meyve, sebze ve tam tahıllı ürünlerden zengin, doymuş yağ içeriği düşük beslenme modeline uymak önemlidir. Ayrıca bağışıklık sistemi üzerinde olumlu etkileri olduğu bilinen antioksidan vitaminler, D vitamini, omega 3, çinko, pre ve probiyotiklerin tüketimine günlük beslenmede özen gösterilmelidir.
PENGEMBANGAN METODE ANALISIS PARAMETER MINYAK DAN LEMAK PADA CONTOH UJI AIR
Authors: Sunardi Setyani Hardiani , Mukimin Aris
Published: April 2020

Minyak dan lemak merupakan parameter yang konsentrasi maksimumnya dipersyaratkan untuk air limbah industri dan air permukaan. Analisis infra merah dan gravimetri adalah dua metode standar yang  hingga  saat  ini  digunakan. Kelemahan metode-metode tersebut  yaitu  penggunaan pelarut CCl4(metode IR) dan daerah konsentrasi analisis yang besar (metode gravimetri) sehingga penting dilakukan penelitian penggunaan pelarut lain dan penurunan limit deteksi, khususnya metode gravimetri. Pelarut C2Cl4  dan S316 digunakan sebagai pelarut ekstraksi pada metode IR  karena tergolong pelarut yang masih direkomendasikan untuk penggunaannya. Variasi volume sampel dan tahapan ekstraksi dengan n-heksan sebagai pelarut dilakukan untuk pengembangan metode gravimetri sehingga mampu menurunkan limit deteksi di bawah 10 mg/L. Jenis minyak yang digunakan sebagai sampel yaitu minyak nabati dan minyak mineral. Pada pembacaan absorbansi pelarut C2Cl4 dan S316 menunjukkan level respon yang sangat tinggi yaitu 18 mg/L (C2Cl4) dan 15 mg/L (S316) sehingga tidak bisa digunakan untuk analisis minyak dengan metode infra merah. Pada metode gravimetri diperoleh persen  recovery  92,28%  (sampel  minyak  nabati)  dan  99,25%  (sampel minyak  mineral)  dengan konsentrasi analit sebesar 0,9 mg/L dan 0,88 mg/L. Nilai persen recovery tersebut diperoleh pada volume sampel 2000 mL dan teknik ekstraksi 4 tahap dengan limit deteksi 0,5639 mg/L dan 0,4736 mg/L sehingga pengembangan metode gravimetri ini layak digunakan untuk analisis sampel air limbah dan air permukaan.
MODIFIKASI PERALATAN SAMPLING HVAS PORTABEL UNMODIFIKASI PERALATAN SAMPLING HVAS PORTABEL UNTUK ANALISIS TOTAL PARTIKULAT DI UDARA AMBIENTUK ANALISIS TOTAL PARTIKULAT DI UDARA AMBIEN
Authors: Budiarto Agung
Published: April 2020

High Volume Air Sampler (HVAS) adalah alat pengambil sampel partikulat di udara ambien yang memiliki prinsip kerja dengan sistem vakum dengan menarik udara lingkungan sekitar melalui inlet dengan ukuran-selektif dan melalui filter berukuran 20,3 x 25,4 cm (8” x 10”) pada laju alir 1.132 liter/menit. Pada standard US-EPA (United States Environmental Protection Agency) sering menemui alat sampling yang digunakan memiliki bentuk yang besar (45,5” x 22,5” x 20”) dan berat sekitar 15-20 kg, sehingga timbul ide penelitian untuk membuat desain modifikasi alat pengambil sampel partikulat ambien dengan bentuk yang lebih fleksibel, ringan dan ringkas dengan menggunakan metode uji Gravimetri. Tahap awal penelitian ini adalah melakukan identifikasi peralatan HVAS standard dan peraturan yang mengatur tentang pengujian partikulat. Kemudian merubah bentuk fisik luarnya (memperkecil) tanpa merubah fungsi yang ada didalamnya dan diuji coba bersamaan kinerjanya. Hasil uji coba diolah menggunakan statistik. Dengan menggunakan hasil identifikasi HVAS standard EPA, maka didapat desain modifikasi HVAS dengan dimensi unit utama 15,35” x 15,35” x 10” (PxLxT), kaki knockdown sepanjang 4,5” dari hollow 4x4cm sebanyak 12 buah, dan memiliki berat total sekitar 23 lbs / 10,58 kg.Keseluruhan proses pembuatan alat ini hanya memerlukan biaya sebesar Rp.11.350.000,-. HVAS modifikasi memiliki kemampuan yang tidak beda nyata dengan HVAS existing berdasarkan nilai Anova, dimana nilai P =0,985. HVAS modifikasi yang didesain telah memenuhi standard dengan bentuk lebih kecil dan lebih ringan, sehingga bisa memudahkan dalam penyimpanan dan mobilisasi pengujian sampel partikulat ambien. Berdasarkan penggunaan material untuk pembuatan HVAS modifikasi didapatkan angka yang lebih murah karena reduksi material pembentuk rangka HVAS. HVAS modifikasi dapat dipergunakan sebagai alat sampling untuk pengujian sampel partikulat di udara ambien.
PENGGUNAAN KHAMIR RHODOTORULA MUCILAGINOSA UNTUK BIOSENSOR BOD MENGGUNAKAN ELEKTRODA EMAS
Authors: Rame Rame
Published: April 2020

Aplikasi biosensor BOD pada dasarnya meningkat seiring dengan berkembangnya keperluan manusia dan kemajuan IPTEK. Tetapi secara umum tetap didominasi untuk aplikasi dibidang medis dan lingkungan hidup.Biosensor BOD berdasarkan metabolisme khamir dikembangkan dalam rangka mempersingkat waktu pengukuran nilai BOD untuk monitoring lingkungan. Pengembangan biosensor dibuat melalui imobilisasi khamir pada film tipis dalam matrik agarose dengan Nafion sebagai membran untuk proses pertukaran ion. Khamir diambil dari fermentasi Rhodotorula mucilaginosa. Film tipis kemudian dilekatkan pada emas sebagai elektroda kerja. Biosensor BOD  dikalibrasi  menggunakan larutan yang mengandung glukosa yang setara sebagai sampel standar. Kondisi optimum diamati dengan waktu tunggu pengukuran 20 menit pada potensial  500 mV (vs Ag/AgCl). Untuk analisis glukosa, waktu tunggu adalah 20 menit dengan batas deteksi 1 mg/l. Hubungan linier yang baik diperoleh dari larutan standar glukosa yaitu, 2 0.99 dan estimasi kesalahan pengukuran 2,45%. Nilai BOD yang diperoleh dari biosensor menunjukkan perbandingan yang baik dengan konvensional.
ANALISIS PENERAPAN PRODUKSI BERSIH MENUJU INDUSTI NATA DE COCO RAMAH LINGKUNGAN
Authors: Ariyanti Melia , Purwanto P , Suherman S
Published: April 2020

Penerapan produksi bersih pada industri nata de coco dapat mengurangi dampak negatif ke lingkungan. Penelitian ini bertujuan untuk menganalisis penerapan produksi bersih di salah satu industri nata de coco.Metode yang digunakan adalah observasi, perhitungan dan wawancara.Hasil menunjukkan bahwa penerapan produksi bersih yang dilakukan dapat memberikan manfaat positif dari sisi lingkungan dan ekonomi.Manfaat ekonomi berupa penghematan biaya produksi dan peningkatan keuntungan yang diperoleh sebesar Rp 55.406.830,- per tahun. Sedangkan manfaat lingkungan berupa pengurangan timbulan limbah cair sebesar 919.341,5 liter/ tahun (pengurangan limbah cair sebesar 72,8%) dan pengurangan timbulan limbah padat sebanyak 127.246 kg/ tahun (terjadi pengurangan timbulan limbah padat sebesar 98,2%).Penerapan produksi bersih akan menurunkan persentase Keluaran Bukan Produk (NPO) sebesar 6,95 %. Langkah penerapan produksi bersih akan mengurangi dampak terhadap lingkungan menuju industri nata de cocoyang lebih ramah lingkungan.