bluuebunny/crossref_metadata_2025 huggingface dataset:
El devenir del arte como lugar de la revalorización del espacio útil de la creatividad y del pensamiento crítico para un diseño pedagógico relacionado con las artes: lugar de inspiración del artist teacher = The rendering of art as a place of revaloration of the useful space of creativity and critical thinking for a pedagogical design related to the arts: inspiration site for the artist teacher
Authors: Ranilla Rodríguez Miguel
Published: January 2020

ResumenEl presente artículo quiere reflexionar sobre el cómo diseccionando el panorama del arte actual, fundamentándonos en pensadores partidarios en instaurar su declive como poder cultural potencial, podemos recuperar de la manera más sensible el verdadero valor del arte contemporáneo e instaurarlo dentro del marco de la educación; recuperando lo utilitario y elevando su condición al grado de lo fundamental.El en lugar del arte, muchos son por tanto los creadores transformados en artistas lo que llevan a las aulas la pretensión por fomentar el pensamiento crítico, por querer enseñar arte.A este tenor, el método para enseñar las artes pasa entonces por desestimar las artes y situarlas en su contexto ideológico actual; enfrentar este absurdo -que tiene de creación y permutación fútil- al lugar en que la intención se transforma en un acto de reflexión creativa ligada a la nadería. Y de ese lugar de las cenizas, empoderar al arte y alumno en el proceso meramente creativo para esclarecer que el arte en la pedagogía, se transforma con el objetivo de (re)crear para explicar; y de esa flexibilidad se empodera lo inefable perdido del arte.AbstractThis article wants to reflect on how to dissect the current art panorama,based on ourselves on party thinkers in establishing its decline as a potential cultural power, we can recover in the most sensitive way the true value of contemporary art and establish it within the framework of education; recovering the utilitarian and elevating its condition to the degree of the fundamental.In place of art, many are the creators transformed into artists that lead tothe classroom the pretension to encourage critical thinking, for wanting to teachart.To this extent, the method to teach the arts then passes by rejecting thearts and placing them in their current ideological context; to confront this absurdity - which has a futile creation and permutation - to the place in which the intention is transformed into an act of creative reflection linked to the nudity. And from that place in the ashes, to empower art and student in the purely creative process to clarify that art in pedagogy is transformed with the aim of (re) creating to explain;and from that flexibility is empowered the ineffable lost of art.
El retrato en la docencia de las bellas artes = The portrait in the teaching of the fine arts
Authors: Ruiz Gómez Esperanza Macarena
Published: January 2020

ResumenCentrándonos en el retrato desde un punto de vista pictórico, su ejecución no consiste en hacer únicamente un inventario físico, pues el físico debe de ser el vehículo que nos hace penetrar en el retratado. En relación a la enseñanza de este género desde la pintura, si bien podemos decir que hay tantas maneras de ejecutar un retrato como pintores existen, en la etapa de formación es necesario canalizar al alumno mediante unas pautas de trabajo determinadas, las cuales van desde la realización de ejercicios los cuales podíamos denominar de síntesis, para pasar posteriormente a una apertura de superficies en donde toma mayor relevancia el estudio de la fisonomía, así como la pincelada.AbstractFocusing on the portrait from a pictorial point of view, its execution does not consist in making only a physical inventory, since the physical must be the vehicle that makes us penetrate the portrayed. In relation to the teaching of this genre from painting, althoughwe can say that there are as many ways to perform a portrait as painters exist, in the stage of formation it is necessary to channel the student through certain work patterns, ranging from the realization of exercises which we could call synthesis, to pass later to an opening of surfaces in which the study of the physiognomy, as well as the brushstroke, becomes more relevant.
Peningkatan kemampuan menyelesaikan soal cerita penyajian data melalui model teams gimes tournament (tgt) peserta didik kelas v sekolah dasar
Authors: Fitriani Lucky Dwi
Published: January 2020

The purpose of research design was to increase the capability solve the story problem of presenting data by appliying the TGT learning model. Two cycles was used in this research design amount teacher and student 5th grade of primary school of SD N Mangkuyudan Surakarta conduct 30 students as the subject research. The data collecting techniques were test, observation, interview, and documentation. And the analyze data used a modified learning model with activities carried out outside the classroom. The first cycle result is of 50% for classical and result of second cycle is a 83,33% for classical. The conclusion is applying TGT model activities can work up the capability solve the story problem of presenting data in the fifth grade of SD N Mangkuyudan Surakarta in the 2018/2019. 
Penerapan Model Student Facilitator and Explaining untuk Meningkatkan Pemahaman Konsep Energi Gerak
Authors: Aji Giri Seno , Winarni Retno , Wahyuningsih Siti
Published: January 2020

The purpose of this research was to improve the understanding ability of the concept of motion energy through the application of the Student Facilitator and Explaining (SFE) model in third-grade students of SD NegeriKarangasem IV No.204 Laweyan District, Surakarta City in academic year 2016/2017. This type of research was classroom action research (CAR) conducted in two cycles. Each cycle was carried out in four stages, consisting of planning, implementation, observation, and reflection. The subjects of this study were third-grade students of SD NegeriKarangasem IV Laweyan Surakarta in the 2016/2017 academic year, totaling 31 students. Data collection techniques in this study consisted of tests, observations, interviews, and documentation. Test validity used technical triangulation and source triangulation. The data analysis technique used an interactive analysis model from Miles &Huberman. The conclusion of this research show that the application of Student Facilitator and Explaining (SFE) models can improve the understanding ability of motion energy concepts in third-grade students of SD NegeriKarangasem IV No.204 Laweyan District, Surakarta City in academic year 2016/2017.
Peningkatan keterampilan membaca pemahaman melalui model pembelajaran connecting organizing reflecting extending (core) pada peserta didik kelas iv sekolah dasar
Authors: Wulandari Fitri
Published: January 2020

The purpose of this study is to improve reading comprehension skills with the Connecting Organizing Reflecting Extending (CORE) learning model. This type of research was classroom action research. This research carried out for two-cycle with each cycle consisting of four activities that are planning, implementation, observation, and reflection. The techniques used to collect data in this study include observation, interviews, tests, and documentation. The data validity techniques used were instrument content validity, source triangulation, and technique triangulation. Data analysis in this study uses comparative descriptive analysis techniques and interactive data analysis. The results of research that have been carried out at the pre-action stage, the class average is 45.69 with classical completeness is 14.29%. The class average increased in the cycle I with an average grade is 68.25 and classical completeness 57.14%, then increased again in cycle II with an average class 79.30 and classical completeness 85.71%. Based on the research results, it can be seen that the application of the Connecting Organizing Reflecting Extending (CORE) learning model can improve reading comprehension skills on the fourth-grade students of the elementary school of Banyurip academic year 2018/2019.
Upaya Peningkatkan Prestasi Belajar tentang Sistem Periodik Unsur melalui Metode KIMLA Pada Siswa Kelas X MIPA SMA
Authors: Setyawati Happy
Published: January 2020

Abstract. The national curriculum of learning takes place through the Scientific Approach, students are guided to be able to find learning material by themselves. Not all students can be easily active in learning, because they are afraid to ask questions, lazy even some do not understand so learning is increasingly confusing. Learning with the habits of students want to explain the teacher, making students less active in the learning process and the results obtained are not optimal. Chemistry is often considered to be an elusive lesson that causes student
dislike. Pleasant learning methods are needed so as to create joyful nuanced learning situations that make students absorbed, comfortable and excited. The learning method chosen in this study was the KIMLA learning method, namely the method of discussion using songs as a medium in learning Chemistry. With the KIMLA method, it is expected that there will be an increase in the activeness and learning achievement of students in the periodic Chemistry System Learning subject elements. This research is a Classroom Action Research conducted at
SMA 1 Ceper Klaten, in the odd semester of the 2018/2019 academic year in September 2018 - October 2019, the target in this study was the tenth grade students of MIPA 1 with 28 students consisting of 12 sons and 16 daughters. Data obtained through observation are direct observations when taking student learning activities data, and assessment sheets are continued by analysis of the average pre-action test scores, cycle 1 and cycle II. The criteria for the success of giving an action are if students get a minimum score of 67 KKM, with the percentage of learning completeness 75% of 28 students, while the success criteria for learning
activeness are 80%. Based on the results of the research and discussion it was concluded that there was an increase in the activeness of students to 96.4% and 100% learning outcomes completed with an average of 79.
Upaya Meningkatkan Kompetensi Guru Menggunakan Media Pembelajaran ICT melalui Supervisi dengan Teknik Individual di Sekolah Dasar
Authors: Rusmiyati S
Published: January 2020

Abstract. The  of this study was to improve teacher competence in SD Negeri 
Kalinanas in using ICT learning media. The study was conducted in SD Negeri 1
Kalinanas for ± 5 months starting Friday, July 22, 2016 until Saturday, November 19,
2016. The subjects of this study were 9 teachers. Data collection is done through
interviews, observation and documentation. From the interviews, the results show that it is important to use ICT learning media very well. The study was conducted in 2 cycles. In the pre cycle, the average score was 78 with a percentage of 53% achievement of all teachers in the research indicators for the use of ICT learning media, in the first cycle 88 average values were obtained with 69% achievement of all teachers in the research indicators of ICT learning media use, and in cycle II obtained an average value of 97 with a percentage of 88% achievement of all teachers in the research indicators of the use of ICT learning media. There has been an increase in teacher competency in the use of ICT learning media after being supervised with individual techniques by the principal of SD Negeri 1 Kalinanas.
Family Member Incarceration, Psychological Stress, and Subclinical Cardiovascular Disease in Mexican Women (2012–2016)
Authors: Connors Kaela , Flores-Torres Mario H. , Stern Dalia , Valdimarsdóttir Unnur , Rider Jennifer R. , Lopez-Ridaura Ruy , Kirschbaum Clemens , Cantú-Brito Carlos , Catzin-Kuhlmann Andrés , Rodriguez Beatriz L. , Correa Catalina Pérez , Lajous Martín
Published: January 2020

Objectives. To examine the association between family member incarceration, psychological stress, and subclinical cardiovascular disease (CVD).

Methods. Between 2012 and 2016, 1849 CVD-free women from the Mexican Teachers’ Cohort responded to questions on family incarceration from the Life Stressor Checklist. Perceived stress and hair cortisol levels were measured in a subset of participants. Carotid intima-media thickness was measured, and carotid atherosclerosis was determined in all participants. We used multivariable quantile, linear, and logistic regression models to evaluate the association between family member incarceration, stress, and subclinical CVD.

Results. Among women with a mean age of 49.7 years (SD ±5.2), 15.3% reported family member incarceration. We found that both perceived stress and hair cortisol levels were significantly higher in women with an incarcerated family member relative to women without one. After multivariable adjustment, women who reported family member incarceration had 41% (95% confidence interval = 1.04, 2.00) higher odds of carotid atherosclerosis compared with those who did not.

Conclusions. Family member incarceration was associated with robust markers of stress and cardiovascular risk. Mass incarceration may have a long-lasting impact on physical health of affected families.
The Effect of Health Insurance on Health Care Utilization in the Justice-Involved Population: United States, 2014–2016
Authors: Farrell Caitlin M. , Gottlieb Aaron
Published: January 2020

Objectives. To examine the impact of health insurance coverage on utilization of outpatient, hospital, and emergency department care among justice-involved individuals in the United States.

Methods. We performed repeated cross-sectional analyses with data from the National Survey of Drug Use and Health. The study population included 6086 adults with justice involvement within the past year. We used logistic regression to examine the odds of health care utilization based on either a dichotomous or categorical measure of health insurance coverage. We used negative binomial regression to examine the number of times a specific type of care was utilized with both a dichotomous measure of health insurance coverage and a categorical measure of type of health insurance.

Results. Health insurance was associated with increased utilization of outpatient, inpatient, and emergency department care.

Conclusions. Health insurance coverage was associated with increased utilization of outpatient, inpatient, and emergency department health care among justice-involved individuals. Therefore, expanding access to health insurance in this population has the potential to increase care utilization of all types and decrease barriers to medical services.
Primary Total Hip Arthroplasty in Patients 20 Years Old and Younger
Authors: Pallante Graham D. , Statz Joseph M. , Milbrandt Todd A. , Trousdale Robert T.
Published: January 2020

Background:

Historically, total hip arthroplasty (THA) performed in patients ≤20 years old has been associated with poor survivorship because of bearing-surface wear with conventional polyethylene, acetabular loosening with cemented sockets, and liner fracture in ceramic-on-ceramic (CoC) THA. For this population, there is a paucity of data regarding outcomes of THAs performed with use of modern implants and bearing surfaces. The purpose of the present study was to examine the mid- to long-term outcomes of modern THA in patients ≤20 years old.

Methods:

Utilizing a single-institution, prospectively collected total joint registry, we retrospectively identified 91 primary THAs performed in 78 patients ≤20 years old from 1998 to 2016. The average patient age was 17 years (range, 11 to 20 years), and the average body mass index was 26 kg/m2 (range, 16 to 49 kg/m2). Forty-eight THAs (53%) were performed in male patients, and 47 (52%) were performed on the right hip. Bearing surfaces included CoC (53 THAs, 58%), metal-on-highly cross-linked polyethylene (MoP; 28 THAs, 31%), and ceramic-on-highly cross-linked polyethylene (CoP; 10 THAs, 11%). Outcome measures included reoperations, revisions, complications, clinical outcome scores, and bearing-surface wear.

Results:

At an average follow-up of 8 years (range, 2 to 18 years), the average modified Harris hip score was 92 (range, 54 to 100), and 95% of patients reported feeling “much better” following the surgical procedure. Survivorship at 2, 5, and 10 years postoperatively was 96.7%, 96.7%, and 95.0% for reoperation; 98.9%, 98.9%, and 97.2% for revision; and 91.2%, 91.2%, and 89.5% for complications, respectively. The most common complications were instability (3 THAs, 3%), aseptic acetabular loosening (2 THAs, 2%), and postoperative foot drop (2 THAs, 2%). Linear articular wear averaged 0.019 mm/yr. There were no correlations between age, sex, body mass index, bearing surface, femoral head size, use of cement, or operative time and survivorship from complications, reoperations, or revisions. There were no differences in linear wear among CoC, CoP, and MoP bearing surfaces.

Conclusions:

In patients ≤20 years old, THAs performed with use of modern implants exhibit excellent clinical outcome scores and survivorship at mid- to long-term follow-up. CoC, CoP, and MoP bearing surfaces have similar survivorship, clinical outcomes, and bearing-surface wear in this population.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Defining the Volume-Outcome Relationship in Reverse Shoulder Arthroplasty
Authors: Farley Kevin X. , Schwartz Andrew M. , Boden Susanne H. , Daly Charles A. , Gottschalk Michael B. , Wagner Eric R.
Published: January 2020

Background:

As the utilization of reverse total shoulder arthroplasty (RSA) grows, it is increasingly important to examine the relationship between hospital volume and RSA outcomes. We hypothesized that hospitals that perform a higher volume of RSAs would have improved outcomes. We also performed stratum-specific likelihood ratio (SSLR) analysis with the aim of delineating concrete definitions of hospital volume for RSA.

Methods:

The Nationwide Readmissions Database was queried for patients who had undergone elective RSA from 2011 to 2015. Annual hospital volume and 90-day outcome data were collected, including readmission, revision, complications, hospital length of stay (LOS), supramedian cost, and discharge disposition. SSLR analysis was performed to determine hospital volume cutoffs associated with increased risks for adverse events. Cutoffs generated through SSLR analysis were confirmed via binomial logistic regression.

Results:

The proportion of patients receiving care at high-volume centers increased from 2011 to 2015. SSLR analysis produced hospital volume cutoffs for each outcome, with higher-volume centers showing improved outcomes. The volume cutoffs associated with the best rates of 90-day outcomes ranged from 54 to 70 RSAs/year, whereas cost and resource utilization cutoffs were higher, with the best outcomes in hospitals performing >100 RSAs/year. SSLR analysis of 90-day readmission produced 3 hospital volume categories (1 to 16, 17 to 69, and ≥70 RSAs/year), each significantly different from each other. These were similar to the strata for 90-day revision (1 to 16, 17 to 53, and ≥54 RSAs/year) and 90-day complications (1 to 9, 10 to 68, and ≥69 RSAs/year). SSLR analysis produced 6 hospital volume categories for cost of care over the median value (1 to 5, 6 to 25, 26 to 47, 48 to 71, 72 to 105, and ≥106 RSAs/year), 5 categories for an extended LOS (1 to 10, 11 to 25, 26 to 59, 60 to 105, and ≥106 RSAs/year), and 4 categories for non-home discharge (1 to 31, 32 to 71, 72 to 105, and ≥106 RSAs/year).

Conclusions:

We have defined hospital surgical volumes that maximize outcomes after RSA, likely related to surgical experience, ancillary staff familiarity, and protocolized pathways. This information may be used in future policy decisions to consolidate complex procedures, such as RSA, at high-volume destinations, or to encourage lower-volume institutions to strategize an approach to function as a higher-volume center.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Genetic markers-based genome assembly and the reference genome of the selfing fish Kryptolebias hermaphroditus: Identification of 63 cytochrome P450 genes and the interspecific syntenic comparison
Authors: Choi Beom-Soon , Han Jeonghoon , Kim Min-Sub , Sakakura Yoshitaka , Lee Bo-Young , Lee Jae-Seong
Published: January 2020

The authors have withdrawn this preprint from Research Square
Palliative care quiz for nurses-Indonesian version (PCQN-I): A cross-cultural adaptation, validity, and reliability study
Authors: Herta Nuzul Sri , Wicaksana Anggi Lukman , Effendy Christantie , Kao Chi-Yin
Published: January 2020

The authors have withdrawn the journal submission associated with this preprint and requested that the preprint also be withdrawn.
The impact of exercise of lower limbs on dynamic balance and valgus of the knees among young footballers
Authors: Wilczyński Bartosz , Zorena Katarzyna , Wąż Piotr
Published: January 2020

The authors have withdrawn this preprint from Research Square
Global dissection of the BAHD acyltransferase gene family in soybean: Expression profiling, metabolic functions, and evolution
Authors: Ahmad Muhammad Zulfiqar , Zeng Xiangsheng , Dong Qiang , Manan Sehrish , Jin Huanan , Li Penghui , Wang Xiaobo , Benedito Vagner A. , Zhao Jian
Published: January 2020

Background: Members of the BAHD acyltransferase (ACT) family play important roles in plant defence against biotic and abiotic stresses. Previous genome-wide studies explored different acyltransferase gene families, but not a single study was found so far on the overall genome-wide or positive selection analyses of the BAHD family genes in Glycine max . A better understanding of the functions that specific members of this family play in stress defence can lead to better breeding strategies for stress tolerance. Results: A total of 103 genes of the BAHD family (GmACT genes) were mined from the soybean genome, which could be grouped into four phylogenetic clades (I- IV). Clade III was further divided into two sub-clades (IIIA and IIIB). In each clade, the constituent part of the gene structures and motifs were relatively conserved. These 103 genes were distributed unequally on all 20 chromosomes, and 16 paralogous pairs were found within the family. Positive selection analysis revealed important amino acids under strong positive selection, which suggests that the evolution of this gene family modulated soybean domestication. Most of the expression of ACT genes in soybean was repressed with Al 3+ and fungal elicitor exposure, except for GmACT84 , which expression increased in these conditions 2- and 3-fold, respectively. The promoter region of GmACT84 contains the maximum number of stress-responsive elements among all GmACT genes and is especially enriched in MYB-related elements. Some GmACT genes showed expression specific under specific conditions, while others showed constitutive expression in all soybean tissues or conditions analysed. Conclusions: This study provided a genome-wide analysis of the BAHD gene family and assessed their expression profiles. We found evidence of a strong positive selection of GmACT genes. Our findings will help efforts of functional characterisation of ACT genes in soybean in order to discover their involvement in growth, development, and defence mechanisms.
Using Polio GIS drawn maps to increase immunization coverage during mass immunization campaigns in northern Nigeria
Authors: Mahmud Mahmud Zubairu , Seamans Vince , Mustapha Mahmud
Published: January 2020

Background. Before now, reaching all settlements by vaccinators during mass polio campaigns was a big challenge in northern Nigeria consequent of poor micro plans. This made the attainment of very high immunization coverage which is necessary to interrupt transmission of polio virus in the region difficult. The objective of this study was to devise a means to reach all settlements (BUAs, SSAs, Has) visible on satellite imagery and significantly increase the overall coverage during mass polio immunization campaigns.Methods. We provide the procedure by which geographic information system GIS drawn maps can be harnessed to improve immunization coverage. We also show the extent to which the maps increase immunization coverage when used to draw vaccination team micro plans in northern Nigeria. The method simply involves the provision of training on map comprehension to relevant health workers (IPDs personnel) followed by the demarcation of the ward polio GIS drawn maps into clusters of settlement areas – commensurate with the total number of vaccination teams allocated to the ward. The maps were then employed to guide IPDs personnel in providing polio immunization services to all households in the ward during the January 2019 mass polio immunization campaign. The study area was a distinct and homogeneous geographical area called Horserizum ward in Hong local government area of Adamawa state, Nigeria and all resident households or members of the communities (totaling 19,698 persons by the recent local census) in ward was the study population.Results. At the conclusion of the January campaign, the number of settlements in the Ward unreached by health workers (as shown by the GIS dashboard, www.vts.eocng.org) was compared to previous polio immunization campaigns when no GIS maps were used to guide vaccination activities. Results revealed an immunization coverage of 82% (for January 2019 campaign) versus 43% during the previous campaign held in December 2018.Conclusions. The results were statistically significant (P< 0.0000001, t = 5.175.) and we conclude that, using GIS maps to guide vaccination activities (GIS micro planning) has a very significant positive impact on immunization coverage.
Suppression of Gremlin by RNA interference attenuates glucose-induced fibrogenesis in rat mesangial cells
Authors: Zhang Xiujuan , Zhang Li , Wang Xinzhe , Song Yuwen , Lou Kai , Chen Haiyan , He Yong , Han WenXia
Published: January 2020

Background: diabetic nephropathy (DN) is the most common cause of end-stage of renal disease. It is beneficial for us to find effective way to treat the disease. Gremlin is deemed as a key factor in the development of diabetic nephropathy at present. We hypothesized that the pathological changes might be prevented by eliminating Gremlin function in high glucose-induced renal fibrosis. Methods: lentiviral vector targeting Gremlin was applied to inhibit Gremlin expression at a high glucose concentration which simulated diabetic nephropathy in rat mesangial cells. Results: the shRNA vector, designated shGremlin, significantly inhibited Gremlin expression in rat mesangial cells cultured under high glucose conditions. Increase in BMP-7 as well as its downstream genes or proteins including phospholated Smad 1/5/8, type IV collagen and fibronectin was observed. Conclusions: our work provides a valuable method to prevent glomerular/renal fibrosis with RNA interference, and also enable development of new therapies that target Gremlin.
Hearing status gradients in the risk of hospitalization among Chinese middle-aged and older adults
Authors: Ye Xin , Zhu Dawei , He Ping
Published: January 2020

Background: Hearing is one of the basic means of perception and communication, which is closely related with quality of life. However, hearing impairment is often unrecognized and undertreated, and impaired hearing may lead to greater burden of diseases as well as risk of hospitalization. To gain further insight into the association between hearing and hospitalization, we examined the shape and magnitude of hearing status gradients in the risk of hospitalization among Chinese middle-aged and older adults. Methods: We obtained data from a retrospective survey of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013 and 2015, including 11,721 participants aged 45 years old and above with no hospitalization in 2011 baseline. Hospitalization variables included time to incident (first) hospitalization, annual number of hospitalizations and duration of last-time hospitalization. Cox proportional hazards models, negative binomial models and lognormal regression were fitted to examine the relationship between self-rated hearing status gradients and risk of hospitalization. Results: Of the total 11,721 participants, 54.46% reported having fair or poor hearing and 20.94% experienced at least one hospitalization during the study period. Older adults were exposed to higher risk of hospitalization than the middle-aged adults. For older adults, compared with excellent or very good hearing people, those with good, fair and poor hearing experienced a shorter time to incident (first) hospitalization, a greater annual number of hospitalizations and a longer last-time duration of hospitalization with the deterioration of hearing. However, there was no significant association for the middle-aged adults. Conclusions: We found a gradient decrease in time to first hospitalization, an increase in annual number of hospitalizations and duration of last-time hospitalization with the deterioration of hearing status in older adults. Actions should be taken to prevent and treat their hearing impairment, so as to decrease risk of hospitalization and improve their life quality.
Amoxicillin exposure significantly increases the population and virulence of antibiotic-resistant Klebsiella pathogen in the simulated human intestinal microbiota
Authors: Liu Lei , Chen Zeyou , Wang Qing , Shi Jingliang , Bi Wenjing , Wang Siyi , Gao Yanyu , Lin Huai , Qi Hongmei , Zhu Siyuan , Yang Jing , Xue Yingang , Mao Daqing , Luo Yi
Published: January 2020

Background: The extensive use and misuse of antibiotics have caused the emergence and spread of antibiotic resistance among bacterial pathogens, which is threatening to this idyllic world. The human intestinal microbiota is significant to health, while its composition and stability are easily perturbed by antibiotic exposure. However, the association between antibiotic exposure and the abnormal bloom of opportunistic pathogens in human gut, and its health implications are not fully understood. Therefore, this study investigated the influence of amoxicillin (AMX), one of the most prescribed antibiotics in human life, on human intestinal microbiota using the simulator of the human intestinal microbial ecosystem (SHIME). Results: Our results suggest that AMX exposure could cause the substantial effect on human intestinal microbiota in different colon regions, with most significant alteration in ascending colon. Intriguingly, AMX significantly increased the abundance of antibiotic-resistant Klebsiella pathogen in gut microbiota, resulting in the enrichment of human disease-related pathways. By isolation of Klebsiella strains from SHIME before and after exposure to AMX, we also observed that the virulence phenotypes of these pathogens including biofilm formation, serum resistance, and Galleria mellonella infection were significantly increased after AMX administration. The genotype analysis from whole genome sequencing indicated that the enhanced virulence phenotypes were plausibly caused by the mutations of virulence factors relevant to fimbriae, lipopolysaccharide, capsule, and siderophores. More importantly, the effects from AMX administration could not be fully recovered after two-week drug discontinuance, showing the potential long-term adverse influence of this antibiotic. Conclusions: This study for the first time demonstrates that AMX used for the treatment of bacterial infections may cause adverse effects on human health via significantly increasing population and virulence of intestinal Klebsiella opportunistic pathogen. Given that inherent resistance to β-lactam already poses a significant therapeutic challenge for Klebsiella infections, the AMX-induced virulence increasing phenomenon found in this study undoubtedly further increases its health risk.
Heat stress induced gut microbiota changes activate TLR4 / NF-κB signaling pathway contributing to inflammatory bowel disease in pigs
Authors: Hu Canying , Yadnyavalkya Patil , Gong Dongliang , Yu Tianyue , Li Junyu , Wu Lianyun , Liu Xiaoxi , Yu Zhichao , Ma Xinbing , Chen Jinjun , Gooneratne Ravi , Yong Yanhong , Ju Xianghong
Published: January 2020

Background Various stressors alter the 'brain-gut axis' and contribute to many gastrointestinal disorders such as inflammatory bowel disease. However, the pathological mechanisms of these perturbations are poorly understood. Here, we report on the induction of intestinal inflammation in heat-stressed pigs and apply fecal microbiota transplantation from pigs to mice to elucidate the role of intestinal microbiota in TLR4/NF-κB signaling pathway activation. Results Twelve healthy adult pigs were subjected to heat stress (34 ± 1 °C and 75–85% relative humidity) and compared with 12 control pigs exposed to 25 ± 3 °C and the same humidity level. The pigs were sacrificed on days 1, 7, 14, and 21. Their colonic contents were collected for microbiome analyses and their colonic epithelia underwent transcriptome analyses. Pseudo-germ-free mice were gavaged with fecal bacteria from heat-stressed and control pigs on the collection days to determine whether gut microbiomes and immune responses resembling those in the pigs could be induced in the mice. Heat-stressed pigs presented with fever and diarrhea from day 7 and their colonic villus length, crypt depth/width, and goblet cell number were significantly lower than those of the controls. Their TLR4, TRAF6, and nuclear p65 were upregulated at the RNA and protein levels. Their proinflammatory IL-6, IL-8, and IL-17 were also upregulated. Colonic microflora composition in the heat-stressed pigs markedly differed from that of the controls. By day 14, the former presented with substantial increases in opportunistic pathogens such as Campylobacterales , Veillonellaceae , and Megasphaera . Intestinal lipopolysaccharide concentrations were higher in the heat-stressed than the control pigs. Mice administered fecal transplantation from heat-stressed pigs had a distinctly different colonic microflora composition from those receiving control pig fecal transplantation. Bacteroides were significantly diminished and Akkermansia were significantly augmented in mice administered feces from heat-stressed pigs for 14 d. In the colonic tissues of mice given feces from heat-stressed pigs, the TLR4/NF-κB signaling pathway was activated and there was a mild inflammatory response. Conclusion Heat stress promotes changes in gut microflora composition which, in turn, activates the TLR4/NF-κB signaling pathway and causes inflammatory bowel disease in pigs.
MAUI-seq: Metabarcoding using amplicons with unique molecular identifiers to improve error correction
Authors: Fields Bryden , Moeskjær Sara , Friman Ville-Petri , Andersen Stig U. , Young J. Peter W.
Published: January 2020

Background Sequencing and PCR errors are a major challenge when characterising genetic diversity using high-throughput amplicon sequencing (HTAS). Results We have developed a multiplexed HTAS method, MAUI-seq, which uses unique molecular identifiers (UMIs) to improve error correction by exploiting variation among sequences associated with a single UMI. We show that two main advantages of this approach are efficient elimination of chimeric and other erroneous reads, outperforming DADA2 and UNOISE3, and the ability to confidently recognise genuine alleles that are present at low abundance or resemble chimeras. Conclusions The method provides sensitive and flexible profiling of diversity and is readily adaptable to most HTAS applications, including microbial 16S rRNA profiling and metabarcoding of environmental DNA.
Impact and Clinical Implications of the Cognitive Function and Nutritional Assessment at Admission on Hospital Outcomes and Mortality in Acutely Ill Geriatric Patients
Authors: Yamamoto Hiroshi , Ogawa Kenichi , Morooka Toshifumi , Hisamatsu Yasushi , Ishitake Tatsuya
Published: January 2020

Background The nutritional and mental status of older patients are closely related and may serve as an indicator of hospital outcomes and early nutrition interventions.Objective We aim to appraise the impact on mortality and hospital outcomes by the revised simplified short-term memory recall test (STMT-R) and the short-form mini-nutritional assessment (MNA-SF) simultaneous at admission.Methods The subjects were 727 acute inpatients with ≥50 years of age from December 2014 to September 2015. Following the collection of clinical data (base illness, length of stay, etc.), survival was subsequently measured for 4-5 years until September 2019. An STMT-R score of ≤4 and MNA-SF score ≤7 were considered to indicate cognitive dysfunction and malnourishment respectively. Cox’s proportional hazards regression models were used to evaluate the hazard of death according to the severity of dementia and the nutrition status, with adjustment for potential covariates. Survival was estimated using the Kaplan-Meier method.Results The mean age of the study population was 78.9 years old, and 52.7% of the patients were female. 118 patients could not complete the cognitive test (Incomplete Testing Group [ITG]). 385 and 224 patients were classified into the cognitive dysfunction (CDG) and non-cognitive dysfunction groups (NCDG), respectively. 370, 299 and 58 patients were classified into the “malnourished” (MNG), “at risk of malnutrition” (ARNG) and “well-nourished” (WNG) groups, respectively. A poor cognitive function and poor nutritional status at admission were associated with worse clinical indicators. 276 patients (38.0%) died during the 4 to 5 years of follow-up. The risks of mortality in the ITG, CDG and MNG was 3.88 (hazard ratio; 95% confidence interval: 2.57-5.98), 1.84 (1.28-2.72) and 4.22 (1.76-13.9), respectively. In addition, the cumulative survival rate was 23.6% for the combination of advanced dementia and malnutrition, but 51.0% for moderate dementia and malnutrition. Even undernourishment may improve the prognosis of patients with mild to moderate cognitive impairment.Conclusion The early simultaneous measurements of the cognitive function and nutritional status is expected to be useful for predicting the the hospital prognosis, mortality and the effects of early comprehensive nutritional intervention in acute elderly patients with cognitive decline.
Persistently high levels of immune activation and their correlation with the HIV-1 proviral DNA and 2-LTR circles loads, in a cohort of Mexican individuals following long-term and fully suppressive treatment.
Authors: Orta-Resendiz Aurelio , Viveros-Rogel Monica , Fuentes-Romero Luis L , Vergara-Mendoza Moises , Romero-Rodriguez Damaris P , Munoz-Lopez Monica , Zancatl-Diaz Martha L , Vidal-Laurencio Elsa Y , Rodriguez-Diaz Roberto A , Soto-Ramirez Luis E
Published: January 2020

Background The main cause of the persistently high levels of immune activation in HIV positive patients undergoing suppressive chronic cART is still unknown. Previous findings have suggested a link between ongoing residual viral replication originating from the HIV reservoir and the immune activation levels. However, there is no clear evidence of this assumption. The aim of this study was to investigate the correlation between the reservoir and the levels of immune activation in chronic patients under fully suppressive cART. Methods We conducted a prospective longitudinal study in a cohort of HIV positive patients undergoing cART for more than 5 years without any documented blips. We quantified the HIV proviral DNA and the 2-LTR circles loads from PBMCs, the levels of immune activation and proliferation markers of T-cells (CD38+, Ki-67+), and the levels of plasmatic IL-7 at enrollment and 1-year of follow-up. Correlation analysis and group comparison were performed. Results 29 participants with a median of 8 years (IQR, 6.9-9.4) under suppressive cART were enrolled and successfully followed at 1 year. In this cohort, we found higher levels of CD8+ T-cell activation (CD38+) after 1-year (P = .000). There was a very weak correlation between the levels of immune activation and the proviral DNA of CD4+ T-cell and CD8+ T-cell. The levels of Ki-67+ T-cells declined on time without significant differences, and there was no significant correlation with the proportion of activated T-cells. The plasmatic levels of IL-7 decreased at the follow-up observation (P = .094), but there was no correlation with the levels of immune activation either. Conclusions We found a weak correlation of the levels of CD4+ and CD8+ T-cell activation with the proviral DNA and 2-LTR circles. This suggests the likely occurrence of further mechanisms driving chronic versus early immune activation other than viral replication by itself in subjects under chronic suppressive cART. More importantly, we highlight the relevance of decreasing T-cell activation in chronic patients to lower the risk of morbidity and early mortality by investigating other activation pathways in specifically chronic phases.
Demand and Supply Side Factors Associated with the Use of Contraceptive Methods in Pakistan: A Contemplative Study of Demographic and Health Surveys, 1990-2018
Authors: Jabeen Sadia , Rathor Adnan , Riaz Maria , Zakar Rubeena , Fischer Florian
Published: January 2020

Background: A remarkable decline in fertility rates has been observed in many countries, with a primary determinant being an increase in the use of contraceptives. Therefore, this study aims to assess the effect of demand and supply-side factors associated with the use of contraceptive measures in Pakistan. Method: Secondary data analysis of four data series of the Pakistan Demographic and Health Surveys (PDHS 1990–91, 2006–07, 2012–13, and 2017–18) were used. The data includes ever-married women aged 15–49 years who had given birth in the previous five years and participated in the family-planning module of the PDHS. A total number of 25,318 women were included in the analysis. Data was analysed by investigating the associations between independent variables (demand and supply-side factors) and the use of contraceptive measures through unadjusted Odds Ratios (OR) and adjusted OR (AOR). Results: A majority of the women were illiterate and not in employment. There was an increase in the number of women who did not use contraceptive methods in rural areas over time. Among demand-side factors, the results indicated that, in 2012–13, women without media exposure were less likely to use contraceptives (OR 0.396, 95% CI 0.353–0.442), and the trend remains almost constant for 2017–18 (OR 0.432, 95% CI 0.391–0.477). These findings change slightly in the adjusted analysis (AOR 0.664, 95% CI 0.562–0.784) in 2012–13 and (AOR 0.654, 95% CI 0.483–0.885) in 2017–18; however, they still show a lower likelihood of using contraceptives without media exposure. Among supply-side factors, the results indicated that absence of transport (2012–13) and limited visits by family-planning workers over the previous 12 months (2006–07, 2012–13, and 2017–18) remained significant factors for not using contraceptive methods. Conclusion: The results of the study indicate that certain demand and supply-side factors are associated with the use of contraceptive measures in Pakistan. It highlights the need for the provision of family-planning resources and further structural factors, particularly in remote areas.
First symptoms of prenatally undetected heart defects
Authors: Pavlicek Jan , Klaskova Eva , Kapralova Sabina , Palatova Alzbeta , Piegzova Alicja , Spacek Richard , Gruszka Tomas
Published: January 2020

Background: Severe or critical congenital heart defects (CHDs) are 35% of those detected only after birth. The aim of the study was to measure the incidence of these CHDs, identify their clinical symptoms, and determine individual risk periods for CHD manifestation. Methods: This retrospective cohort study was conducted from 2009 to 2018 in a population of 175,153 live births. Occurrence of the first symptoms of CHD was noted as early neonatal (0–7 days), late neonatal (8–28 days), in early infancy (1–6 months), or in late infancy (6–12 months). The first symptom for which the child was referred to a pediatric cardiologist was defined as a symptom of CHD. Results : There were 598 severe CHDs diagnosed (3.3 cases/1000), and 70% were isolated anomalies. A concomitant genetic disorder was diagnosed in 20%, and extracardiac pathology with a normal karyotype was present in 10%. Of the total, 53% of CHDs were detected prenatally and excluded. The remaining 47% developed CHD symptoms postnatally. Of these, 74% were diagnosed as early neonates, 16% as late neonates, and 10% as infants. Defects requiring repeated operations manifested significantly earlier than those with requiring one primary correction. The most common symptoms leading to the diagnosis of CHD were heart murmur and cyanosis. Conclusions : Despite the effectiveness of prenatal diagnosis, some children will be born with undiagnosed major heart defects. Assessment of symptoms and early detection of the defect is crucial.
Adherence to Plasmodium vivax malaria treatment in Hanura Public Health Center, Pesawaran District of Indonesia
Authors: Rosa Emantis , Shafira Indah Dian , Oktaria Dwita , Arifiyanto Achmad
Published: January 2020

Background: The Indonesian government has put malaria as a priority disease that needs to be addressed. Lampung is one of the provinces with a high malaria incidence with Annual Paracite Incidence at 4.44 per 1000 population. The most cases occurred in Pesawaran Regency. There were 1.915 malaria cases in 2016. The highest positive case of malaria occurred in the Hanura Health Center with 1.738 cases, with the most cases being vivax malaria. The high case of malaria in the region is due to the favorable natural conditions as mosquito breeding places such as forests, lagoons and abandoned ponds. One of the biggest challenges in the treatment of malaria is the decline in the efficacy of even anti-malaria drug resistance due to low adherence in taking the drug. So this research is important to know the level of adherence to take medication in patients with vivax malaria in the work area of ​​the Hanura Health Center.Methods: This research was a descriptive analytic study with survey methods. Morisky Medication Adherence Scale (MMAS-8) questionnaire was used as the instrument. Eligible patients’who had undergone treatment with Artemisinin-based Combination Therapy and primaquine for 14 days were The subject of study. They were numbered 68 people in the working area of ​​Hanura Health Center.Results: The level of adherence to take medication in patients with vivax malaria in the working area of ​​Hanura Health Center is classified as low, namely a high compliance rate of 44.1% and a low compliance rate of 55.9%. The highest proportion of respondents with low levels of adherence were aged 25-45 years (55.3%), low education level (81.6%), working (57.9%), and having a history of malaria more than once (94, 7%).Conclusions: The level of adherence to take treatment in patients with vivax malaria in the working area of ​​Hanura Health Center is relatively low, with the highest proportion of adults, low education, work and have a history of malaria more than once.