bluuebunny/crossref_metadata_2025 huggingface dataset:
In vitro study of foot bone kinematics via a custom-made cadaveric gait simulator
Authors: Zhu Genrui , Wang Zhifeng , Yuan Chengjie , Geng Xiang , Yu Jian , Zhang Chao , Huang Jiazhang , Wang Xu , Ma Xin
Published: January 2020

BackgroundQuantifying detailed kinematics of the intrinsic foot bone during gait is crucial for understanding biomechanical functions of the foot complex musculoskeletal structure and making appropriate surgery decisions.Research question The purpose of this experiment is to measure bones kinematic of the normal foot in a gait cycle via a custom-made cadaveric gait simulator.MethodsIn this experiment, we used a custom-made 6 degrees of freedom (DOF)of robotic gait simulator simulating normal human gait to measure the 3-dimensional (3D) kinematics of tibia, calcaneus, cuboid, navicular, medial cuneiform, first metatarsal, and fifth metatarsal through six cadaveric feet.ResultsThe results showed that the kinematic of the intrinsic foot bones in the stance phase of the gait was successfully quantified using a custom-made robotic gait simulator. During walking stance, the joints in the medial column of foot had less movement than those in the lateral column. And during the later portion of stance, no rotational cease was observed in the movement between navicular and cuboid, calcaneocuboid joint, or cuneonavicular joint.SignificanceThis study described foot bone motion using a biomechanically near-physiological gait simulator with 6 DOF of the tibia. The kinematic data helps to clarify previous descriptions of several joints kinematics that are difficult to study in vivo. The methodology also provides a platform for researchers to explore more invasive foot biomechanics under dynamic and near-physiologic conditions.
Translating evidence into practice: A longitudinal qualitative exploration of allied health decision making.
Authors: White Jennifer , Grant Kellie , Sarkies Mitchell , Haines Terrence
Published: January 2020

BackgroundHealth policy and management decisions rarely reflect research evidence. In response, it is important to determine how to improve evidence-informed decision-making. As part of a broader study exploring implementation science strategies we examined how allied health managers respond to two distinct recommendations and the evidence that supports them. MethodsAllied health managers across Australia and New Zealand who were responsible for weekend allied health resource allocation decisions towards the provision of inpatient service to acute general medical and surgical wards, and sub-acute rehabilitation wards were eligible for inclusion. Consenting participants were randomised to: (1) control group or; (2) Implementation Group 1: received an evidence-based policy recommendation document guiding weekend allied health resource allocation decisions, or (3) Implementation Group 2: received the same policy recommendation document guiding weekend allied health resource allocation decisions with support from a knowledge broker. Serial focus groups were conducted with a sample of over 80 allied health managers recruited to Implementation Group 2 only. Out of 6 waves of recruitment, up to four focus groups were conducted with each wave during the 12 months study period. In total 17 health services participated in serial focus groups according to their allocated wave, over a 12-month study period. Data were analysed using an inductive thematic approach with constant comparison. Thematic saturation was achieved.ResultsResults provide insights into resource allocation and decision-making, including the interplay between barriers and facilitators concerning implementation of recommendations outlined in evidence-based policy recommendation document. Five key themes emerged: (1) Local data trumps, or is more influential; (2) How good is the evidence and does it apply to us; (3) It is difficult to change things; (4) Historically that’s how we have done things; and (5) What if we get complaints?ConclusionsThis study explored implementation of strategies to bridge gaps in evidence-informed decision-making. Results provide insight into barriers, which prevent the implementation of evidence base practice from fully, and successfully occurring such as attitudes towards evidence, limited skills in critical appraisal, and lack of authority to promote change. In addition, strategies are needed to manage the risk of confirmation biases in decision-making processes.
Screening of organic micropollutants in raw and drinking water in the Yangtze River Delta, China
Authors: Ren Hanwei , Tröger Rikard , Ahrens Lutz , Wiberg Karin , Yin Daqiang
Published: January 2020

Background The vast occurrence of organic micropollutants in surface waters has raised concerns about drinking water safety and public health. The Tai Hu Basin region in China, a typical developing and populous area, is facing the challenge of water pollution. To ensure drinking water safety, the knowledge on how treatment techniques and raw water quality affect the quality of finished water must be improved. The aim of the current study was to evaluate drinking water quality in relation to source water origin and treatment strategies. Five drinking water treatment plants (DWTPs), using three different source waters in the Tai Hu River Basin, (i) Yangtze River, (ii) Wetland River Network, and (iii) Lake Tai Hu, were studied by analyzing 291 micropollutants in raw and finished water.Results Major differences in water characteristics were observed among the source waters. The dominating group of micropollutants in the River Network was pesticides, while Yangtze was mainly polluted by flame retardants. The total concentration of poly- and perfluoroalkyl substances (PFASs) in Tai Hu water was far higher than in others. In total, 51 compounds were detected in finished water, with an overall average total concentration of 730 ± 160 ng L -1 . The removal efficiency of the detected compounds in the DWTPs averaged 24 ± 149%, which highlights the major challenge for the DWTPs to remove emerging organic micropollutants through current treatment processes.Conclusions Our study showed that if the source water contains high levels of PFASs and organophosphorus flame retardants, even advanced treatment procedures are inefficient in removing the micropollutants, and the finished water may contain cumulative levels in the mg L -1 range. On the other hand, if pesticides and pharmaceuticals dominate, high overall treatment efficiencies may be obtained if using advanced treatment techniques. DWTPs are advised to use advanced treatment techniques or alternative water sources to guarantee the safety of drinking water. As surface water systems are highly impacted by upstream activities, efforts should also be made in the comprehensive water sector for improved surface water quality.
The high resistance of bacteria to clindamycin and cefepime: a call to revisit antibiotics reserved for use at tertiary hospitals in Tanzania
Authors: Mikomangwa Wigilya P. , Bwire George M. , Kilonzi Manase , Mlyuka Hamu , Mutagonda Ritah , Kibanga Wema , Marealle Alphonce Ignace , Minzi Omary , Mwambete Kennedy D.
Published: January 2020

Background Antibiotic resistance poses burden to the community and health care services. Efforts are being made at local, national and global level to combat the rise of antibiotic resistance including antibiotic stewardship. Surveillance to antibiotic resistance is of importance to aid in planning and implementing infection prevention and control measures. The study was conducted to assess the resistance pattern to cefepime, clindamycin and meropenem, which are reserved antibiotics for use at tertiary hospitals in Tanzania Methods A Hospital-based antibiotic resistance surveillance was conducted between July and November 2019 using 201 consecutively selected clinical isolates at Muhimbili National Hospital and Bugando Medical Center, Tanzania. All organisms isolated were identified based on colony morphology, Gram staining and relevant biochemical tests. Antibiotic susceptibility testing was performed on Muller-Hinton agar using Kirby-Bauer disc diffusion method. Antibiotic susceptibility on the selected antibiotic discs (cefepime, clindamycin and meropenem) was performed according to the protocol by National Committee for Clinical Laboratory Standards. Results A total of 201 clinical samples were tested in this study. Urine (39.8%, n=80) and blood (35.3%, n=71) accounted for most of the collected samples followed by pus (16.9%, n=34). The overall bacterial resistance to clindamycin, cefipime and meropenem was 70.1%, 72.4% and 8.5% respectively. Most (88.9%) of Enterococcus spp were resistant to clindamycin. About 68.4% Staphylococcus aureus isolates were resistant to clindamycin whereby 56.3%, 75.6%, 93.8% and 100% of the tested Escherichia coli , Klebsiella spp , Pseudomonas aeruginosa and Enterobacter cloacae respectively, were cefepime resistant. About 8.5% of isolated Klebsiella spp were resistant and 6.4% had intermediate susceptibility to meropenem. Also , Pseudomonas aeruginosa was resistant by 31.2% and 25% had intermediate susceptibility to meropenem. All Acinetobacter baumannii and Proteus spp (both 100.0%, n=4) were susceptible to meropenem. Conclusion The overall bacterial resistance to clindamycin and cefepime is high and low in meropenem. Henceforth, culture and susceptibility results should be used to guide the use of these antibiotics. Antibiotics with low resistance rate should be introduced to the reserve category and continuous antibiotic surveillance is warranted.
Fecundity disorders in older women: declines in follicular development and endometrial receptivity
Authors: Wang Li , Lv Shulan , Mao Wenjun , Bai E , Yang Xiaofeng
Published: January 2020

Background Fecundity declines in older women are associated with decreased ovarian function and oocyte quality, but little research is available on endometrial receptivity in older women. This study aimed to assess follicular development and endometrial receptivity, and to evaluate ultrasonic parameters in predicting endometrial receptivity during the implantation window in older women.Methods For this prospective case-control study, 224 older women and 215 women under the age of 35 were recruited. The follicular development and endometrial thickness were monitored by transvaginal ultrasound before ovulation. During the implantation window, defined as 6 to 7 days after ovulation, the pulsatility index (PI) and resistance index (RI) of the uterine arteries and subendometrial region were calculated based on colour Doppler, and the endometrial volume, vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were also determined using the VOCAL imaging program with 3-D mode power Doppler. The ultrasonic parameters were used to assess endometrial receptivity in older women.Results The serum anti-Mullerian hormone (AMH) concentration and antral follicle count (AFC) were significantly lower in older women than in controls ( P <0.05). The average diameter of the dominant follicle was significantly smaller, and the subendometrial region RI was significantly higher in older women compared with controls ( P <0.05). The normal ovulation rate was significantly lower in older women than in controls ( P <0.01). The subendometrial region RI was significantly higher, and the endometrial VI, FI, and VFI were significantly lower in older women compared with controls ( P <0.05). The biochemical pregnancy rate, clinical pregnancy rate and ongoing pregnancy rate of older women were significantly lower than those of controls ( P <0.05). The best ultrasonic parameter for predicting endometrial receptivity during the implantation window in older women was VI, followed by FI.Conclusions Older women present decreased serum AMH concentrations and AFC, defined as indicators of ovarian reserve function. Older women are characterized by decreased follicular development and endometrial receptivity, which may lead to fecundity disorders.
Qualitative stocktaking on assessment of barriers and facilitators to contraceptive and post-abortion care services use following Zika epidemic in Tegucigalpa, Honduras.
Authors: Belizan Maria , Maradiaga Edna , Roberti Javier , Casco-Aguilar Maricela , Ortez Alison F. , Avila-Flores Juan C. , González Gloria , Bustillo Carolina , Calderón Alejandra , Bock Harry , Cafferata María L. , Tavares Adriano , Alger Jackeline , Ali Moazzam
Published: January 2020

Background. Zika virus (ZIKV) infection during pregnancy has severe consequences on the new-born. The World Health Organization declared the Zika outbreak to be a Public Health Emergency of International Concern (PHEIC) in 2016. Health facilities in the regions most affected by Zika lacked the capacity to respond to the increased demand for contraception. The objective was to explore and describe users’ experiences regarding access to and use of contraceptive and post-abortion care (PAC) services in the context of a Zika outbreak in Tegucigalpa, Honduras, and to follow these services over time. Methods. This study was part of a broader implementation research study. We used an inductive inquiry method consistent with grounded theory approach. Semi-structured interviews and focus groups were performed with women and their partners who used contraceptive services or received PAC services. Data was collected in two stages from December 2017 to July 2018. Themes explored included contraception, Zika and PAC services. Results. Participants had positive attitude towards the use of contraceptive methods and demanded more information on safety, efficacy and on side effects. Health care services were inconsistent in the provision of information on Zika and contraception services. ZIKV vector transmission was known but fewer participants were aware of risk of sexual transmission of Zika. Barriers to access healthcare services included contraceptive and PAC services included distance to healthcare facilities, disorganized admission process, long waiting times and out-of-pocket expenditure to purchase medicines. Furthermore, poor quality, mistreatment and abuse of women seeking PAC was prevalent. Some positive changes were noted over time, such as improvements in infrastructure including improved privacy and cleanliness, removal of fees, requisite to bring clean water to hospital. Conclusions. Our results highlighted the challenges and areas for improvement in policy and practice related to contraceptive services and PAC in the context of ZIKV infection. Public policies to prevent epidemics should focus more on providing proper sanitation; removing barriers to access and use of effective contraception as human rights priority. Zika epidemic has highlighted weaknesses in health systems that obstruct access to and use of sexual and reproductive health services.
Association between Doppler snuffbox resistive index and tissue perfusion in septic patients
Authors: Wang Cui , wang xiaoting , Zhang Hongmin , Huang Wei , Liu Dawei
Published: January 2020

Background: Doppler snuffbox resistive index (SBRI) can be a accurate parameter at the bedside to evaluate the status of peripheral vascular. We evaluated whether SBRI could relate to tissue hypoperfusion and could predict lactate clearance in septic patients.
Methods: We conducted a prospective observational study in a tertiary general and teaching hospital in China.From July 2019 to Decemeber 2019,all consecutive adult patients with septic shock who required ICU admission were included. At the same time,postoperative patients were studied as a control group.we recorded the hemodynamic parameters including SBRI and PI which were measured simultaneously after involved .
Results: We evaluated 44 patients with septic shock in study group and 20 stable postoperative patients in control group. Patients with septic shock had higher SOFA scores,PCT, CI and lactate than patients in control group.The SBRI was correlated with PI and lactate. The CI was not correlated with lactate in all patients.Based on Lactate clearance in first 6 hours, the septic shock patients were divided into the Lactate clearance ≥20% or the Lactate clearance <20% group.CI is no significal difference between two groups.SBRI of the Lactate clearance <20% group is higher than Lactate clearance≥20% group and control group.PI of the Lactate clearance <20% group is lower than Lactate clearance≥20% group and control group.The cutoff of the SBRI value was ≥1.09 for predicting 6h-lactate clearance after resuscitation, resulting in a sensitivity of 68.8% and a specificity of 85.7%. The cutoff of the PI value was ≤0.99 for predicting 6h-lactate clearance after resuscitation, resulting in a sensitivity of 64.3% and a specificity of 81.2%. The SBRI was significantly better than the PI for predicting 6h-lactate clearance after resuscitation.
Conclusions: SBRI is correlated with tissue perfusion parameters in critical ill patients. Abnormal SBRI was better than PI in suggesting disorder of lactate clearance of septic patients. SBRI is a better indicator of abnormal tissue perfusion than CI. Further investigations are required to determine whether the correction of abnormal SBRI and PI may improve success rate of resuscitation of septic shock.
Clinical value of full-length tryptophanyl-tRNA synthetase for sepsis detection in critically ill patients-A retrospective clinical assessment
Authors: Choi Ji Soo , Yoon Bo Ra , Sin Ju Hye , Lee Su Hwan , Leem Ah Young , Park Moo Suk , Kim Young Sam , Chung Kyung Soo
Published: January 2020

Background Sepsis is associated with high mortality, and the related innate immune system activation and diagnostic factors are not fully understood. This study aimed to statistically analyse the clinical value of full-length tryptophanyl-tRNA synthetase (WRS) induced through inflammatory stimuli in the detection of sepsis and mortality prediction in critically ill patients. Method In this retrospective analysis, we prospectively collected blood samples from patients in the medical intensive care unit (ICU) at Yonsei University College of Medicine, from March 2015 to June 2018. Sepsis detection and mortality prediction using WRS levels were compared to that with procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6) levels, and with Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, using area under the receiver operating characteristic curve (AUROC) and Cox proportional-hazards and Kaplan-Meier survival analyses.Results We enrolled 241 study patients, of whom 190 (78.8%) had been diagnosed with sepsis on ICU admission. The AUROCs for sepsis discrimination with WRS, PCT, CRP, and IL-6 levels, and SOFA and APACHE II scores were 0.864, 0.727, 0.625, 0.651, 0.840, and 0.754, respectively. The prediction of 28-day mortality in patients with sepsis using WRS levels was possible and non-inferior to that with the SOFA score (WRS vs. SOFA, AUROC 0.687 vs. 0.711; AUROC difference, 0.024; P = 0.650). Conclusions WRS secreted early in sepsis may be useful not only for early detection of sepsis but also for mortality prediction in critically ill patients.
Mean arterial pressure within 24 hours of admission predicts short-term prognosis in patients with intermediate-risk and high-risk pulmonary embolism
Authors: Chen Jialong , Lin Jing , Wu Danshen , shi songjing
Published: January 2020

OBJECTIVEPulmonary embolism is a terrible cardiovascular condition with considerable morbidity and mortality.Previous studies have investigated that systolic blood pressure(Systolic BP)and diastolic blood pressure(Diastolic BP) were related to 30-day and in-hospital mortality.We aimed to determine if the average mean arterial pressure(aMAP) in the first 24 hours of hospital admission is useful to predict short-term outcomes of intermediate-risk and high-risk PE patients.MethodWe conducted a single center retrospective study.From May 2012 and April 2019, 122 intermediate-risk and high-risk PE patients were included.The primary outcome was in-hospital mortality.The secondary outcome was adverse events.ROC curves and cut-off values for aMAP predicting in-hospital-death were computed.According to cut-off values,we categorize five groups defined as followed:group 1:aMAP<70mmHg;group2:70mmHg≤aMAP<80mmHg;group3:80mmHg≤aMAP<90mmHg;group4:90mmHg≤aMAP<100mmHg;group5:aMAP≥100mmHg.Cox regression models were calculated to investigate associations between aMAP and in-hospital-death.ResultIn the study group of 122 patients,15 patients (12.30%) died in hospital due to PE.ROC analysis for MAP predicting in-hospital-death revealed an AUC of 0.729 with cut-off value of 79.4mmHg.Cox regression models showed a significant association between in-hospital death and aMAP group1(Ref),aMAP group2(OR1.680,95CI%0.020-140.335),aMAPgroup3(OR0.003,95CI%0.0001-0.343),aMAPgroup4(OR0.006,95CI%0.0001-1.671),aMAPgroup5(OR0.003,95%CI0.0001-9.744. It is aMAP 80-90mmHg that suffer from minimum adverse events ConclusionPrognostic role of MAP at the first 24 hours of hospital admission should be emphasized in patients with PE.80 to 90mmHg may be the optimal range of MAP for intermediate-risk and high-risk PE patients.
Childhood cancer incidence and survival trends in Estonia (1970–2016): a nationwide population-based study
Authors: Paapsi Keiu , Baburin Aleksei , Mikkel Sirje , Mägi Margit , Saks Kadri , Innos Kaire
Published: January 2020

Background: Childhood cancers represent a small proportion of all cancers but are still a major public health problem. The study analysed long-term trends in childhood cancer incidence and survival in Estonia in relation to societal and health care transition. Methods: Data on all malignant tumours, diagnosed in children aged 0–14 during 1970–2016, were derived from the Estonian Cancer Registry. Age-standardised (World standard) incidence rates were calculated by ICCC-3 site groups and joinpoint regression was used to estimate annual percentage change (APC) for incidence trends. Cohort and period approach were used to estimate 5-year survival. Internal age standardisation was applied. Results: A total of 1628 incident cancer cases were diagnosed during the study period and overall incidence increased significantly at a rate of 0.5% per year. Significant increases were seen for neuroblastoma and germ cell tumours, for lymphoid leukemias and some CNS sub-sites. At the same time, decline in incidence was seen in almost all subgroups of unspecified neoplasms. The overall 5-year survival improved from 24% in 1970–1979 to 73% in 2010–2016, with the largest changes occurring in the 1990s and 2000s. For many sites, survival increase thereafter has been marginal. Conclusion: In this first comprehensive population-based study of childhood cancer incidence and survival in Estonia, long-term trends are shown in the context of societal and health care changes. Even though the increasing incidence of some sites may, at least partially, be explained by improved diagnostics reflected in the decreased incidence of unspecified neoplasms, the overall cancer incidence in children seems to be rising. Rapid progress in diagnosis and care have improved childhood cancer survival immensely, but deficit in Estonia persists compared to other European countries. Results of the study accentuate the need for a more in-depth analysis of clinical data, but also for the prioritization of childhood cancer in Estonia, to ensure access to standard care and innovative treatments.
Age and Gender Specific Lung Cancer Incidence and Mortality in Hungary: Trends from 2011 Through 2016
Authors: Tamási Lilla , Horvath Krisztian , Kiss Zoltan , Bogos Krisztina , Ostoros Gyula , Müller Veronika , Urbán László , Bittner Nóra , Sárosi Veronika , Vastag Aladár , Polányi Zoltán , Nagy-Erdei Zsófia , Dániel Andrea , Nagy Balázs , Rokszin György , Abonyi-Tóth Zsolt , Moldvay Judit , Vokó Zoltán , Gálffy Gabriella
Published: January 2020

Background: No assessment was conducted describing the age and gender specific epidemiology of lung cancer (LC) prior to 2018 in Hungary, thus the objective of this study was to appraise the detailed epidemiology of lung cancer (ICD-10 C34) in Hungary based on a retrospective analysis of the National Health Insurance Fund database.Methods: This longitudinal study included patients aged ≥20 years with LC diagnosis (ICD-10 C34) between 1th January 2011 and 31th December 2016. Patients with different cancer-related codes 6 months before or 12 months after LC diagnosis or having any anti-cancer treatment different from lung cancer protocols were excluded. Results: Lung cancer incidence and mortality increases with age, peaking in the 70–79 age group (375.0/100,000 person-years) among males, while at 60–69 age group for females (148.1/100,000 person-years). The male-to-female incidence rate ratio reached 2.46 to 3.01 (p<0.0001) among the 70–79 age group. We found 2-11% decrease in male incidence rate at most age groups, while a significant 1-3% increase was observed in older females (>60) annually during the study period.Conclusion: This nationwide epidemiology study demonstrated that LC incidence and mortality in Hungary is decreasing in younger male and female population, however we found significant increase of incidence in older female population, similar to international trends. Incidence rates peaked in younger age-groups compared to Western countries, most likely due to higher smoking prevalence in these cohorts, while lower age LC incidence could be attributed to higher competing cardiovascular risk resulting in earlier mortality in smoking population.
Simultaneous palmar divergent dislocation of scaphoid and lunate concurrent with i psilateral humeroradial joint dislocation and humerus shaft fracture: report a rare case and add a new subtype
Authors: Feng Wan-wen , Xia Ya-yi , Liu Yue-peng , liu yuping
Published: January 2020

Background: Simultaneous palmar dislocation of scaphoid and lunate is a rare condition generally resulting from high-energy trauma and usually classified into two types. The literature has only reported nine patients with palmar divergent dislocation of scaphoid and lunate. Here we we present a case of accompanied ipsilateral humeroradial joint dislocation and open humeral shaft fracture caused by the same violence travelling from the wrist. Considering the emerging cases with their own characteristics, we suggest this severer injury be expanded into the third type of palmar dislocation of scaphoid and lunate.
Case presentation: A 31-year-old male who fell from a three-storey building, with his right wrist directly hitting the ground, was admitted to the orthopaedic department of our hospital. Physical and radiographic examinations defined simultaneous palmar divergent dislocations of scaphoid and lunate concurrent with ipsilateral humeroradial joint dislocation and open humeral shaft fracture. After debridement and internal fixation for humerus and close reduction for humeroradial joint, the scaphoid and lunate were treated with open reduction and fixation by Kirschner’s wires, and the palmar scapholunate ligament and anterior capsule were repaired through volar approach. After a 3-year follow-up, his humeral fracture healed without recurrent dislocations, collapse or avascular necrosis of scapholunate. Favorable hand function regained .
Conclusions: Palmar divergent dislocation of scaphoid and lunate caused by considerable violence is rare and appropriate to urgent open reduction and fixation with Kirschner’s wires and repair of the stronger palmar scapholunate ligament through single volar approach. When the residual violence continues to transmit to the upper extremity, ipsilateral dislocation or fracture may occur. We advise that this complex injury be classified into a third subtype of simultaneous palmar dislocation of scaphoid and lunate to avoid misdiagnosis.
Global atrial longitudinal strain is a powerful predictor of atrial fibrillation ablation outcomes in patients with normal echocardiographic images.
Authors: Pilichowska-Paszkiet Ewa , Baran Jakub , Kulakowski Piotr , Zaborska Beata
Published: January 2020

Background: Speckle tracking echocardiography (STE) with recent standardized left atrial (LA) deformation allows for the assessment of various LA function parameters. Proper qualification for catheter ablation (CA) for atrial fibrillation (AF) is still an issue. We aimed to assess the value of detailed evaluations of LA function parameters in patients without abnormal baseline standard echocardiography to predict the outcomes after CA for AF.Methods: We studied 84 patients (59% males, mean age 57.3±9.4 years) with nonvalvular paroxysmal AF who underwent CA and had normal preprocedural echocardiographic examinations. Peak longitudinal LA strain (LAS) and strain rate (LASR) during the reservoir (r), conduit (cd) and contraction (ct) phases were measured by STE. AF recurrence was confirmed by serial 4-7 day Holter ECG monitoring during a 12-month follow-up period. Three definitions of ablation success were used: complete success – freedom from symptomatic and asymptomatic AF without antiarrhythmic drug therapy (AA), success on AA – freedom from any AF with continued AA and partial success – clinically relevant reduction of the symptoms. The remaining patients were classified as having ablation failure.Results: Complete success was achieved in 37 (45.1%) patients, success on AA in 7 (8.5%) patients, and partial success in 11 (13.4%) patients. Altogether, 55 (67.1%) patients benefited from CA. The remaining 27 (32.9%) patients were classified as having CA failure. In the multivariate logistic regression analysis, only global LASr was identified as an independent predictor of AF recurrence after CA (OR [95% CI]: 1.27 [1.136-1.423], p<0.0001). The receiver operating characteristic analysis identified LASr as a powerful parameter for predicting the outcome after CA with an area under the curve (AUC) of 0.8548. When CA success was defined as all patients who benefited from CA, the multivariate logistic regression analysis also showed that only global LASr was an independent predictor of whether patients would benefit from CA (OR [95% CI]: 1.44 [1.207-1.716], p<0.0001)Conclusions: In patients with paroxysmal AF and normal standard echocardiographic assessments, LA strain analysis is crucial for selecting the best candidates for catheter ablation. LA reservoir strain is the only echocardiographic parameter that is an independent predictor of either complete success or clinical benefits from catheter ablation.
The Effect of Probe Geometry on Rind Puncture Resistance Testing of Maize Stalks
Authors: Cook Douglas D. , Meehan Kyler , Asatiani Levan , Robertson Daniel J
Published: January 2020

Background: Stalk lodging (breaking of plant stems prior to harvest) is a major impediment to increasing agricultural yields of grain crops. Rind puncture resistance is commonly used to predict the lodging resistance of several crop species. However, there exist no standard operating procedures or suggested protocols for conducting rind penetration experiments. In addition, experimental details of rind penetration tests such as the shape and size of the penetrating probe are rarely reported in the literature. This has prevented meta-analysis of results and has likewise prevented key findings of past studies from being replicated. As a first step towards establishing an agreed upon measurement standard for rind puncture resistance this study investigates the effect of the puncturing probe’s geometry on test results.Results: Results demonstrate that probe geometry has a significant impact on test results. In particular, results showed that a 2mm diameter chamfered probe produced stronger correlations with stalk bending strength than a 1.5mm diameter pointed probe. The chamfered probe was also more strongly correlated with geometric features of the stalk that are known to influence stalk lodging resistance (e.g., rind thickness, diameter and section modulus). In addition, several alternative rind penetration metrics were investigated, and some were found to be superior to the most common rind penetration metric of maximum load. Conclusions:There is a need in the agricultural and plant science community to create agreed-upon operating procedures and testing standards related to mechanical traits of plant stems. In particular, a standardized probe geometry and insertion rate for rind penetration studies are needed to enable greater interoperability and meta-analysis of results. Probe shape and size should be reported in any study conducting rind penetration tests as these factors significantly impact test results.
Transplantation of neural stem cells encapsulated in hydrogels improve functional recovery in a cauda equina lesion model
Authors: Fu Zhiyi , Wang Huidong , Wu Yujie , Zhu Tong
Published: January 2020

Background This study explored the therapeutic effects of transplantation of neural stem cells (NSCs) encapsulated in hydrogels in a cauda equina lesion model.Methods NSCs were isolated from neonatal dorsal root ganglion (DRG) and cultured in three-dimensional porous hydrogel scaffolds. Immunohistochemistry, transmission electron microscopy, Luxol fast blue staining, TUNEL assay were performed to detect the differentiation capability, ultrastructural and pathological changes, and apoptosis of NSCs. Furthermore, the functional recovery of sensorimotor reflexes was determined using the tail-flick test.Results NSCs derived from DRG were able to proliferate to form neurospheres and mainly differentiate into oligodendrocytes in the three-dimensional hydrogel culture system. After transplantation of NSCs encapsulated in hydrogels, NSCs differentiated into oligodendrocytes, neurons or astrocytes in vivo . Moreover, NSCs engrafted on the hydrogels decreased apoptosis and alleviated the ultrastructural and pathological changes of injured cauda equina. Behavioral analysis showed that transplanted hydrogel-encapsulated NSCs decreased the tail-flick latency and showed a neuroprotective role on injured cauda equina.Conclusions Our results indicate transplantation of hydrogel-encapsulated NSCs promotes stem cell differentiation into oligodendrocytes, neurons or astrocytes and contributes to the functional recovery of injured cauda equina, suggesting that NSCs encapsulated in hydrogels may be applied for the treatment of cauda equina injury.
The effect of proprioception training on knee kinematics after anterior cruciate ligament reconstruction
Authors: Jiang Lisi , Wang Yongjian , Huang Wenhan
Published: January 2020

Background Proprioception is essential for the normal movement of joint knees. The degree of functional recovery after ACL reconstruction is related with the degree of postoperative recovery of proprioception. The current study aimed to investigate the effect of proprioception training on functional level of activity and knee kinematics after anterior cruciate ligament reconstruction. Methods Forty patients who underwent ACL reconstruction between January 2017 and June 2019 were included. The patients were divided into proprioception group (n=20) and control group (n=20). All the patients followed common postoperative rehabilitation program. The proprioception group were given proprioception enhancement program besides common postoperative rehabilitation program. All the patients were assessed preoperatively, 6 months and 1 year after operation. The lymsolm scores, hop distances, and knee kinematics during unanticipated jump–cut maneuver were compared at different follow-up time points. Results There were no significant differences preoperative and postoperative Lysholm scores between two groups. After surgery, the proprioception group showed significantly higher hop distance (133.9 ± 26.2 cm) when compared with the control group (81.2 ± 17.2 cm, P=0.026) in 6-months and one-year follow-up (153.1 ± 19.3 vs 105.8 ± 20.7cm, P=0.034). For knee joint kinematics, the proprioception training group showed reduced knee abduction (valgus) angles and external rotations, and increased knee flexion when compared with the common training group. Conclusions We conclude that proprioceptive rehabilitation training enhance the kinematic performance and single leg hop distance in ACL-reconstructed populations during jump-stop, unanticipated cut maneuver. The findings will be scientific evidences to help clinicians and physiotherapists to evaluate the patients’ readiness for exercises and sports, especially in the cases of loading and extreme rotation conditions. Trial registration This study was retrospectively registered on Clnicaltrails.gov on 24 December.
Multilevel Anterior Cervical Corpectomy and Fusion for Ossification of the Posterior Longitudinal Ligament
Authors: Zhang Zhichao , Chen Jingxuan , Huang Wenmao , Zhao Yin , Sun Yanqing , Zhou Shengyuan , Chen Xiongsheng , Jia Lianshun
Published: January 2020

Background Cervical ossification of the posterior longitudinal ligament (OPLL) is a kind of spinal disorder widely spared in Asia. In dealing with multilevel cervical OPLL, the ideal surgical approach is still under debate. Here we introduce our findings of multilevel anterior cervical corpectomy and fusion (ACCF) in treating multilevel cervical OPLLMethods 79 patients with multilevel cervical OPLL who had ACOR on C4-C5 or C5-C6 were retrospectively reviewed. Patients’ Japanese Orthopedic Association (JOA) Score, the improvement rate of JOA Scores (RIS), sagittal cervical mobility (SCM) and the distance between the lower endplate of the vertebra body above the titanium mesh and the superior endplate of the vertebra body below the titanium mesh ( L ) were analyzed and subjected into paired-t test. Radiographic features and complications were described as well.Results p<0.001 in all paired-t tests of JOA Scores, SCM and L at 1day, 6months, 1year and 2year follow-ups compared with preoperative ones. Patients’ RIS continued to increase in 2 years. 6 (7.59%) patients’ L at the 2 years follow-up shortened more than 10mm than their postoperative L. 1 (1.27%) patient had severe titanium mesh canting.Conclusions Multilevel ACCF procedure has positive outcomes in treating multilevel cervical OPLL. Postoperative complications like titanium subsidence and dislocation can happen after this procedure. Follow-ups should be conducted regularly and thoroughly with this kind of patients.
Maintenance considerations in elderly dependent patients with implants
Authors: Sato Yuji , Koyama Shigeto , Ohkubo Chikahiro , Ogura Shin , Kamijo Ryutaro , Sato Soh , Aida Jun , Izumi Yuichi , Atsum Mihoko , Isobe Akio , Baba Shunsuke , Ikum Noriharu , Watanabe Fumihiko
Published: January 2020

Background Self-care and professional care of implants may prove difficult for elderly people who require nursing care. However, the actual state of care and problems remains unknown. In this study, we investigated the actual state of implant problems in elderly people living in their own home or in a nursing home who received visiting dental treatment due to their inability to visit a dental clinic.MethodsWe mailed questionnaire survey forms to 2339 representatives or specialists who were members of the Japanese Society of Oral Implantology, the Japanese Society of Gerodontology or the Japan Prosthodontic Society. We narrowed down the respondents to those who provided visiting dental treatment, and analyzed the actual state of implants observed during visiting dental treatment (type, care, problems, countermeasures, etc.).ResultsOf the 924 dentists who responded to the questionnaire survey, 291 (22%) provided visiting dental treatment. While the majority of implant types encountered in the previous 12 months were root-form implants, there were still a certain number of blade and subperiosteal implants. Daily implant care involved mostly cleaning with a toothbrush + auxiliary tools (such as interdental brushes). The most frequent implant problems encountered in the past were difficulty in cleaning and peri-implantitis. Medication and antiphlogistic treatment were most frequently adopted as countermeasures to implant problems, followed by observation. When we classified the results into those for the dentists who provided implant treatment and those for the dentists who did not, we found that many of the dentists who did not provide implant treatment opted for observation or medication, while those who provided implant treatment also implemented removal of the upper structure, retightening of screws, repair and so forth.Conclusions Since this survey was a questionnaire survey, future field surveys are necessary, it may be necessary for dentists who provide visiting dental treatment to acquire knowledge and skills for implant treatment or coordinate closely with experts.
Effects of no-till and rice varieties on nitrogen and phosphorus balance in rice fields
Authors: Yang Jiao , LIANG XINQIANG , Li Hua , Chen Yanfeng , Tian Guangming
Published: January 2020

Background: Nutrient balance in rice paddy fields can change under different tillage management practices; however, the extent of the change may differ for various rice varieties. A field experiment was conducted over 2 successive years from June 2016 to June 2018 to clarify the effects of different tillage methods and rice varieties on nutrients remaining in the surface soil and those taken up by the rice. There were four tillage/rice variety treatments: no-till/japonica rice (NTJ), no-till/glutinous rice (NTG), conventional tillage/japonica rice (CTJ), and conventional tillage/glutinous rice (CTG) with three replicates of each.Results: The tillage method and rice variety had interactive effects on the surface balance of nitrogen (N) and phosphorus (P). After the 2-year experiment, total N and P pools in the 20 cm surface soil layer were highest under the NTJ treatment (4757.0 kg N ha-1, 2428.5 kg P ha-1) and lowest under the CTG treatments (4726.3 kg N ha-1, 2412.0 kg P ha-1). Under no-till conditions, japonica rice had higher grain yield but lower straw biomass than that of glutinous rice. NTG treatment significantly increased the N and P content in rice grains and straw. The environmental losses of N and P in the rice fields mainly occurred during the rice season. Based on nutrient balance estimation, N losses in the NTJ, NTG, and CTJ treatments were reduced by 15.03 kg N ha-1, 11.55 kg N ha-1, 6.72 kg N ha-1, respectively, as compared with that of the CTG treatment. The corresponding P losses were reduced by 8.02 kg P ha-1, 7.84 kg P ha-1, and 3.96 kg P ha-1. In terms of economic benefits, NTJ also resulted in the highest actual income (18896.5 yuan ha-1) and the highest ratio of production to investment (6.40).Conclusion: No-till was more likely to maintain soil N and P nutrients than conventional tillage, and this advantage was most significant when planting japonica rice. In addition, no-till was conducive to N and P uptake by rice, but only japonica rice exhibited increased grain yield. Consequently, the NTJ treatment was recommended.
Strategies adopted by Aphanizomenon flos-aquae in response to phosphorus deficiency and their role on growth
Authors: Chen Xiaoyan , Dolinova Iva , Sevcu Alena , Jurczak Tomasz , Frankiewicz Piotr , Wojtal-Frankiewicz Adrianna , Wan Lingling , Deng Qinghui , Song Chunlei , Zhou Yiyong , Cao Xiuyun
Published: January 2020

Background: The N2-fixing cyanobacterium, Aphanizomenon flos-aquae is a globally distributed bloom causing species that degrades water quality of freshwater and ocean worldwide. Overcoming phosphorus (P) deficiency is one of the ecological advantages for bloom forming cyanobacteria. It remains unclear to what extent can A. flos-aquae alleviate P deficiency by regulating P using strategies.Results: Based on in situ observations of extracellular alkaline phosphatase (APase) in A. flos-aquae via enzyme-labeled fluorescence in freshwater bodies in China, Poland and Czechia, we further investigated responses of isolated A. flos-aquae to different P supplies (sufficient inorganic P (Pi) as +DIP, α-glycerophosphate and β-glycerophosphate as +DOPα and +DOPβ, P-free condition as -P). The significantly negative relationships between percentage of APase producing cells and soluble reactive P concentration in fields and cultures respectively suggested that the excretion of APase was regulated by ambient Pi supply. Suffering from extreme P deficiency in the -P treatments, A. flos-aquae showed the highest APase activity reaching a vigorous growth at the early stage, which might also benefit from the formation of polyphosphate body (PPB) and the decrease of cellular P content. In the +DOP treatments, the coordination of dissolved organic P (DOP) mineralization and continuous utilization and formation of PPB might contribute to a maintenance but not reproduction of A. flos-aquae when relying on DOP, since the highest cell density reached only 13.38% of that in +DIP treatments while photochemical efficiency was comparable during the whole experiment. Luxury uptake of phosphate as PPB in the +DIP treatments was consistent to the canonical view of polyphosphate as P storage. Conclusion: A. flos-aquae could achieve an instantaneous growth in response to P deficiency with the coordination of P utilization strategies, while only a long-term sustainable growth could be maintained under DOP condition. Persistent and active reproduction could only be achieved in high Pi supply, which implying that an effective consequence can be expected for combating the bloom of A. flos-aquae when controlling P supply.
Factors associated with low fifth minute Apgar score in term and preterm singleton live births in a Ghanaian hospital
Authors: Abukari Alhassan Sibdow , Mohammed Shamsudeen , Awuni Nathaniel , Yakubu Ibrahim , Yakubu Adam , Yakubu Sumani
Published: January 2020

Background: Apgar score remains the most effective measure of newborn health outcomes in the first few minutes of delivery and it is useful in diagnosing perinatal asphyxia and metabolic acidosis. Methods: This retrospective cross-sectional study was conducted at the Baptist Medical Centre in the North East Region of Ghana. For the period January 1 to December 31 2018, we extracted information on 3011 women who delivered at the facility from birth records. Binary logistic regression models were used to determine the factors associated with low fifth minute Apgar score, preterm low fifth minute Apgar score, and term low fifth minute Apgar score.Results :Nearly half of the participants had experienced 2 to 5 pregnancies (47.1%) and had given birth to 2 to 5 children (47.7%). Most of the women delivered at 37 weeks gestation or more (87.6%), attended 1 to 4 antenatal care visits (53.2%), and received 1 to 3 doses of sulfadoxine-pyrimethamine (70.9%). The majority of the newborns weighed 2.5kg or more at birth (90.7%), were delivered through the vagina (79.8%), and a little over half of them (51.40%) were males. After adjusting for potential confounders, we found evidence that multigravid women were 0.67 (95% CI 0.49 - 0.90) times less likely to deliver a child with low fifth minute Apgar score while delivery at less than 37 weeks gestation, birth weight of less than 2.5kg, and caesarean delivery were associated with increased odds of low fifth minute Apgar score. For infants born at term, being born to a multigravid mother was protective against low fifth minute Apgar score while delivery through caesarean section increased the odds of low fifth minute Apgar score among this group of newborns. Among preterm infants, our study found strong evidence that those born with low birth weight (<2.5kg) had about 4 times the odds of suffering low fifth minute Apgar score compared to those with normal birth weight.Conclusion:In designing interventions to improve the survival and the Apgar score of newborns, measures to properly diagnose and prevent preterm delivery and low birth weight should be of great concern.