bluuebunny/crossref_metadata_2025 huggingface dataset:
A quantile-based method to efficiently determine model response at boundary probabilities
Authors: Lai Xiongming , Liu Yisheng , Ji Tianchen , Wang Cheng , Zhang Yong
Published: April 2020

Quantiles are values of a function associated with specific probabilities. Two very specific quantiles, that is, ±3, are usually used for estimating probabilistic distribution of the function. Aiming at the engineering complex implicit function, the article provides an algorithm for calculating these values efficiently and rapidly. First, build kriging model with initial high-efficiency samples and the model is taken as the approximate initial analytical expression of the original function. Then, seek for the approximate most probable point with kriging model and performance measure approach. The most probable points found every time and their corresponding function responses are taken as new samples to reconstruct the built kriging model. After several times of reconstructing kriging model, the convergence value for the corresponding quantile can be obtained. Finally, the illustrative cases in this article demonstrate that the quantile-based method can provide accurate results with high efficiency and in this way, the quantile convergence value can be obtained by a few samples.
Geometrical effects on performance and inner flow characteristics of a pump-as-turbine: A review
Authors: Asomani Stephen Ntiri , Yuan Jianping , Wang Longyan , Appiah Desmond , Zhang Fan
Published: April 2020

A pump-as-turbine is a hydraulic machine that can operate as a pump and turbine at the same time. Pump-as-turbine happens to be the most appropriate method for meeting the world’s energy demands, particularly in rural and isolated areas of a country. Furthermore, the operating cost of microhydropower systems is lower compared to conventional hydrodynamic turbines, but it requires high initial investment. Pump-as-turbine has been applied in many engineering fields such as irrigation, sewage, reverse osmosis, water distribution systems, farms, small pump storage power house, and pressure dropping valves. However, pump-as-turbine operates inefficiently at part-load due to lack of flow control device. In addition, the pump generates high flow instabilities in pump-as-turbine mode due to the shift of the best efficiency point toward higher head and discharge. This study extensively discusses the flow mechanism, modifications, and flow instabilities in the pump-as-turbine mode operation. First, the mechanism of the pump-as-turbine can be described as drawing out mechanical energy from the flow in the reverse mode. Since the energy drawn mainly depends on the major hydraulic components of the pump (impeller and volute), many studies have been conducted on the impeller and volute. It can be concluded that high amount of hydraulic losses is generated in pump-as-turbine mode operation. This can partly be attributed to the fixed geometrical parameters such as the stationary volute. To increase the usage of pump-as-turbine, it is very crucial to predict their performance in advance before manufacturing, which requires the understanding of the flow behavior as a result of geometrical parameters. In order to improve the energy conversion and understand the flow behavior in the centrifugal pump functioning as pump-as-turbine, the key geometrical parameters should be carefully designed. The designs of the main geometrical parameters do affect not only the hydraulic performance of pump-as-turbine but also the operational instability. The operational instability of hydraulic machines mainly depends on the pressure and the velocity fluctuation intensity generated within the flow passage as a result of the impeller–volute interaction. The magnitudes of the instabilities have the tendency to cause noise, vibration, harshness, and cavitation which reduces the life span of the hydraulic machine. Moreover, appropriate selection of the pump and unavailability of pump data contribute to the challenges faced. Finally, this review proposes specific solutions in terms of geometrical modifications and improvement of the computational design methods to handle the hydraulic losses faced during the pump operation; thus, this study can serve as a point of reference for a pump-as-turbine performance optimization.
Health Adversity and Value Change
Authors: Bleidorn Wiebke , Schwaba Ted , Hopwood Christopher J.
Published: April 2020

Life span theories of human development assert that people prioritize emotional values over informational values when they believe their time is limited. This process unfolds naturally as people age but may be accelerated by life-threatening events. We tested whether the experience of serious health adversity leads to changes in value orientation. Using 10 annual waves of data from a nationally representative sample, we charted the course of value change in 247 individuals who experienced serious health adversity in comparison to a propensity score–matched group of 714 healthy individuals. Although there were no differences in values related to friendship and love for those with and without health adversity, we found that the importance of social recognition declined in the face of health problems and continued to recede thereafter. This finding is consistent with folk wisdom about value changes in the face of mortality.
Quantitative Evaluation of Dynamic Lateral Meniscal Extrusion After Radial Tear Repair
Authors: Winkler Philipp W. , Wierer Guido , Csapo Robert , Hepperger Caroline , Heinzle Bernhard , Imhoff Andreas B. , Hoser Christian , Fink Christian
Published: April 2020

Background:

Radial tears of the lateral meniscus frequently accompany acute anterior cruciate ligament (ACL) injuries and lead to increased joint stress and pathological meniscal extrusion (ME). The dynamic behavior of the lateral meniscus after radial tear repair with respect to ME has not been described.

Purpose:

To quantitatively assess dynamic lateral ME after all-inside radial tear repair.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients who underwent ACL reconstruction and all-inside radial tear repair of the lateral meniscus and had no history of contralateral knee injuries were included. Magnetic resonance imaging scans were acquired in loaded (50% of body weight) and unloaded conditions of both the injured and noninjured knees. A custom-made pneumatically driven knee brace was used for standardized knee positioning in 10° of flexion and with axial load application. Quantitative measures included the absolute lateral ME, meniscal body extrusion ratio, and Δ extrusion. Preoperative and postoperative unloaded extrusion data were compared by paired t tests. For postoperative data, the concomitant influence of the factors “leg” and “condition” were assessed through factorial analyses of variance.

Results:

A total of 10 patients with a mean follow-up of 47.9 months were enrolled. The intraclass correlation coefficient (ICC) confirmed good interrater reliability (ICC, 0.898) and excellent intrarater reliability (ICC, 0.976). In the unloaded injured leg, all-inside repair reduced ME from 3.15 ± 1.07 mm to 2.13 ± 0.61 mm (–32.4%; P = .033). Overall, load application led to a significant increase in ME (+0.34 mm [+21.8%]; P = .029). Significantly greater ME was observed in the injured knee (+1.10 mm [+93.2%]; P = .001) than in the noninjured knee. The condition × leg interaction was not significant ( P = .795), suggesting that the compression-associated increase in ME did not differ significantly between the injured and noninjured knees.

Conclusion:

Lateral ME depends on the knee status and loading condition. All-inside repair of radial meniscal tears led to a reduction of extrusion with no alteration in dynamic lateral ME. Meniscus-preserving therapy is recommended in the case of a radial lateral meniscal tear to preserve its dynamic behavior.
Assessment of Attitudes Toward the Emergency Triage System in Belize
Authors: Genisca Alicia E. , Sampayo Esther M. , Mackey Joy M. , Johnson Lisa , Crouse Heather L.
Published: April 2020

Objective. Triage in resource-limited settings (RLS) improves outcomes. Emergency Triage Assessment and Treatment (ETAT) is a simple triage algorithm that improves assessment and initial management of children in RLS. In Belize, pediatric triage varies with setting, from a 5-level Emergency Severity Index (ESI) used at the National Referral Hospital to a lack of triage at government health centers (GHC). Most data on ETAT implementation are in settings where no triage system existed; data on how to integrate ETAT into existing, heterogeneous triage systems are lacking. The aim of this study is to explore health care providers’ (HCPs) attitudes toward the current triage system prior to national pediatric triage process implementation. Methods. A qualitative study was performed via convenience sampling of HCPs who participated in an ETAT training course using focus groups immediately and 1 year after an initial ETAT training. Focus groups were digitally recorded and transcribed. Three coders analyzed all transcripts to identify emerging themes. Constant comparison analysis was performed until achieving thematic saturation. Results. The following principal themes emerged: (1) importance of triage education and implementation to standardize and improve communication; (2) major limitations of ESI include its complexity, lack of pediatric-specific criteria, and dependence on equipment not consistently available; and (3) desire to implement a simple, low-resource pediatric-specific triage system. Conclusions. Participants believe triage education and process implementation is essential to improve communication and pediatric emergency care. Simple, low-resource pediatric-specific triage systems, like ETAT, may improve utilization by providing faster recognition and improved care for acutely ill children.
ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic
Authors: Yahalom Joachim , Dabaja Bouthaina Shbib , Ricardi Umberto , Ng Andrea , Mikhaeel N. George , Vogelius Ivan R. , Illidge Tim , Qi Shunan , Wirth Andrew , Specht Lena
Published: April 2020

The International Lymphoma Radiation Oncology Group (ILROG) guidelines for using radiation therapy (RT) in hematological malignancies are widely used in many countries. The emergency situation created by the COVID-19 pandemic may result in limitations of treatment resources. Furthermore, in recognition of the need to also reduce the exposure of patients and staff to potential infection with COVID-19, the ILROG task force has made recommendations for alternative radiation treatment schemes. The emphasis is on maintaining clinical efficacy and safety by increasing the dose per fraction while reducing the number of daily treatments. The guidance is informed by adhering to acceptable radiobiological parameters and clinical tolerability. The options for delaying or omitting RT in some hematological categories are also discussed.
Laparoscopic hysterectomy versus total abdominal hysterectomy: a retrospective study at a tertiary hospital
Authors: Aboulfotouh Mahmoud Elmorsi , Chaalan Fouad , Mohammed Abdelbaset Fakhry
Published: April 2020

Objective

To compare laparoscopic hysterectomy (LH) with total abdominal hysterectomy (TAH) regarding different outcome measures at our tertiary hospital.

Study design

This retrospective comparative cross-sectional study was conducted at the Department of Obstetrics and Gynecology Department, Women’s Hospital, Hamad Medical Corporation, Doha, Qatar. It included 44 patients who had LH (group 1) and 95 patients who had TAH (group 2) during the period from January 2009 through June 2014.

Results

Three patients were converted from LH to TAH and were excluded from the final analysis. The size of the uterus was smaller in the LH group than the TAH group (7.38 ± 1.92 vs 10.25 ± 3.84 cm, respectively; p < 0.0005). The operative time was shorter in TAH than in LH (2.22 ± 0.93 vs 2.43 ± 0.94, respectively; p = NS). The blood loss was less in the LH group than the TAH group (258.54 ± 65.26 vs 370.32 ± 74.8, respectively; p = NS). There were no significant differences between both groups regarding rates intraoperative and early postoperative complications; however, late postoperative complications were significantly higher in the TAH group (p < 0.05). The length of hospital stay was shorter with LH than TAH (3.63 ± 1.28 vs 5.22 ± 4 days, respectively; p < 0.001)

Conclusion

LH compares to TAH in terms of duration of surgery, rates of intraoperative and early postoperative complications, and the need for blood transfusion. However, it has significantly less rate of late postoperative complications and length of hospital stay.
Comparative transcriptome analysis of two contrasting wolfberry genotypes during fruit development and ripening and characterization of the LrMYB1 transcription factor that regulates flavonoid biosynthesis
Authors: Wang Cuiping , Dong Yan , Zhu Lizhen , Wang Libin , Yan Li , Wang Mengze , Zhu Qiang , Nan Xiongxiong , Li Yonghua , Li Jian
Published: April 2020

Background

Lycium barbarum and L. ruthenicum have been used as traditional medicinal plants in China and other Asian counties for centuries. However, the molecular mechanisms underlying fruit development and ripening, as well as the associated production of medicinal and nutritional components, have been little explored in these two species.

Results

A competitive transcriptome analysis was performed to identify the regulators and pathways involved in the fruit ripening of red wolfberry (L. barbarum) and black wolfberry (L. ruthenicum) using an Illumina sequencing platform. In total, 155,606 genes and 194,385 genes were detected in red wolfberry (RF) and black wolfberry (BF), respectively. Of them, 20,335, 24,469, and 21,056 genes were differentially expressed at three different developmental stages in BF and RF. Functional categorization of the differentially expressed genes revealed that phenylpropanoid biosynthesis, flavonoid biosynthesis, anthocyanin biosynthesis, and sugar metabolism were the most differentially regulated processes during fruit development and ripening in the RF and BF. Furthermore, we also identified 38 MYB transcription factor-encoding genes that were differentially expressed during black wolfberry fruit development. Overexpression of LrMYB1 resulted in the activation of structural genes for flavonoid biosynthesis and led to an increase in flavonoid content, suggesting that the candidate genes identified in this RNA-seq analysis are credible and might offer important utility.

Conclusion

This study provides novel insights into the molecular mechanism of Lycium fruit development and ripening and will be of value to novel gene discovery and functional genomic studies.
Patient self-management of oral anticoagulation with vitamin K antagonists in everyday practice: clinical outcomes in a single centre cohort after long-term follow-up
Authors: Corrochano M. , Jiménez B. , Millón J. , Gich I. , Rambla M. , Gil E. , Caparrós P. , Macho R. , Souto J. C.
Published: April 2020

Background

Patient self-management (PSM) of vitamin K antagonists (VKA) seems a very promising model of care for oral anticoagulation in terms of efficacy and safety. In comparison with other management models of VKA therapy, the number of scientific publications supporting the advantages of PSM is more limited. Currently, most of the scarce information comes from randomized clinical trials. Moreover, a small number of studies have assessed PSM of VKA therapy in real life conditions.

Methods

We analyzed clinical outcomes of 927 patients in a single center (6018.6 patient-years of follow-up). Recruitment took place between 2002 and 2017. All patients followed a structured training program, conducted by specialized nurses.

Results

Fifty percent of individuals had a mechanical heart valve (MHV), 23% suffered from recurrent venous thromboembolism (VTE) or high-risk thrombophilia, and 13% received VKA therapy because of atrial fibrillation (AF). Median follow-up was 6.5 years (range 0.1–15.97 years), median age was 58.1 years (IQR 48–65.9) and 46.5% were women. The incidence of major complications (either hemorrhagic or thromboembolic) was 1.87% patient-years (pt-ys) with a 95% CI of 1.54–2.27. The incidence of major thromboembolic events was 0.86% pt-ys (95% CI 0.64–1.13) and that of major hemorrhagic events was 1.01% pt-ys (95% CI 0.77–1.31). The incidence of intracranial bleeding was 0.22% pt-ys (95% CI 0.12–0.38). In terms of clinical indication for VKA therapy, the incidence of total major complications was 2.4% pt-ys, 2.0% pt-ys, 0.9% pt-ys and 1.34% pt-ys for MHV, AF, VTE and other (including valvulopathies and myocardiopathies), respectively. Clinical outcomes were worse in patients with multiple comorbidities, previous major complications during conventional VKA therapy, and in older individuals. The percentage of time in therapeutic range (TTR) was available in 861 (93%) patients. Overall, the mean (SD) of TTR was 63.6 ± 13.4%, being higher in men (66.2 ± 13.1%) than women (60.6 ± 13.2%), p < 0.05.

Conclusions

In terms of clinically relevant outcomes (incidence of major complications and mortality), PSM in real life setting seems to be a very good alternative in properly trained patients.
Brief episodes of rapid irregular atrial activity (micro-AF) are a risk marker for atrial fibrillation: a prospective cohort study
Authors: Fredriksson Tove , Gudmundsdottir Katrin Kemp , Frykman Viveka , Friberg Leif , Al-Khalili Faris , Engdahl Johan , Svennberg Emma
Published: April 2020

Background

Short supraventricular tachycardias with atrial fibrillation (AF) characteristics are associated with an increased risk of developing AF over time. The aim of this study is to determine if presence of very short-lasting episodes of AF-like activity (micro-AF) can also be used as a marker of undiagnosed silent atrial fibrillation.

Methods

In the STROKESTOP II study, a Swedish mass screening study for AF among 75- and 76-year-olds, participants with NT-proBNP ≥125 ng/L performed intermittent ECG recordings 30 s, four times daily for 2 weeks. Participants with micro-AF (sudden onset of irregular tachycardia with episodes of ≥5 consecutive supraventricular beats and total absence of p-waves, lasting less than 30 s) were invited to undergo extended AF screening using continuous event recording for 2 weeks. A control group of individuals without micro-AF was examined using the same ECG modalities.

Results

Out of 3763 participants in STROKESTOP II who had elevated NT-proBNP levels and were free of AF, n = 221 (6%) had micro-AF. The majority of participants with micro-AF (n = 196) accepted further investigation with continuous ECG monitoring which showed presence of AF in 26 of them. In the control group (n = 250), continuous monitoring detected 7 new AF cases. Thus, AF was significantly more common in the micro AF group (13%) compared to the control group (3%), p < 0.001.

Conclusions

Presence of short-lasting episodes of AF-like activity (micro-AF) indicates increased likelihood for undetected AF. Continuous screening therefore seems recommendable if a finding of AF would change clinical management.

Trail registration

ClinicalTrials.gov, identifier: NCT02743416, registered April 19, 2016.
Jejunogastric intussusception after Whipple procedure with B-II reconstruction: a case report
Authors: Lyu Yun-Xiao , Xu Yue-Ming
Published: April 2020

Background

Jejunogastric intussusception (JGI) is a rare but severe complication after gastric surgery. JGI can occur from a few days to 55 years postoperatively and has a reported incidence of < 0.1% in patients who undergo gastric surgery. We firstly report a male patient with duodenal cancer who underwent Whipple’s procedure with side-to-side gastrojejunostomy and who subsequently developed JGI. A literature review is provided.

Case presentation

A 68-year-old man was admitted to our emergency department with left upper quadrant abdominal pain and hematemesis of 4 h’ duration. He had undergone Whipple’s procedure (duct-to-mucosa pancreaticojejunostomy and side-to-side gastrojejunostomy) with B-II reconstruction for duodenal papillary adenocarcinoma 5 years earlier. His vital signs were stable with a blood pressure of 163/93 mmHg, temperature of 37.0 °C; and heart and respiratory rates of 86 per/min and 20 per/min, respectively. Physical assessment showed mild tenderness in the left upper quadrant, only. A complete blood count showed white cell and platelet counts of 11.69 × 103/L and 196 × 103/L, respectively, and a hemoglobin level of 13.5 g/L. Abdominal computed tomography (CT) suggested a retrograde intussusception of the intestines into the stomach with dilatation of the remnant stomach. The patient immediately underwent exploratory laparotomy, which revealed a 20-cm retrograde efferent limb at the remnant stomach that had travelled through the previous gastrojejunostomy. There was no evidence of malignancy. We manually reduced the intussuscepted loop using gentle traction, and the viability of the intestinal loop was preserved. The patient had an uneventful postoperative recovery.

Conclusion

JGI is a rare but potentially fatal complication after gastric surgery, especially following Whipple’s procedure. Early diagnosis and treatment are crucial, and surgery is considered the most effective treatment for JGI.
Activity interventions to improve the experience of care in hospital for people living with dementia: a systematic review
Authors: Lourida Ilianna , Gwernan-Jones Ruth , Abbott Rebecca , Rogers Morwenna , Green Colin , Ball Susan , Hemsley Anthony , Cheeseman Debbie , Clare Linda , Moore Darren , Hussey Chrissy , Coxon George , Llewellyn David J. , Naldrett Tina , Thompson Coon Jo
Published: April 2020

Background

An increasingly high number of patients admitted to hospital have dementia. Hospital environments can be particularly confusing and challenging for people living with dementia (Plwd) impacting their wellbeing and the ability to optimize their care. Improving the experience of care in hospital has been recognized as a priority, and non-pharmacological interventions including activity interventions have been associated with improved wellbeing and behavioral outcomes for Plwd in other settings. This systematic review aimed at evaluating the effectiveness of activity interventions to improve experience of care for Plwd in hospital.

Methods

Systematic searches were conducted in 16 electronic databases up to October 2019. Reference lists of included studies and forward citation searching were also conducted. Quantitative studies reporting comparative data for activity interventions delivered to Plwd aiming to improve their experience of care in hospital were included. Screening for inclusion, data extraction and quality appraisal were performed independently by two reviewers with discrepancies resolved by discussion with a third where necessary. Standardized mean differences (SMDs) were calculated where possible to support narrative statements and aid interpretation.

Results

Six studies met the inclusion criteria (one randomized and five non-randomized uncontrolled studies) including 216 Plwd. Activity interventions evaluated music, art, social, psychotherapeutic, and combinations of tailored activities in relation to wellbeing outcomes. Although studies were generally underpowered, findings indicated beneficial effects of activity interventions with improved mood and engagement of Plwd while in hospital, and reduced levels of responsive behaviors. Calculated SMDs ranged from very small to large but were mostly statistically non-significant.

Conclusions

The small number of identified studies indicate that activity-based interventions implemented in hospitals may be effective in improving aspects of the care experience for Plwd. Larger well-conducted studies are needed to fully evaluate the potential of this type of non-pharmacological intervention to improve experience of care in hospital settings, and whether any benefits extend to staff wellbeing and the wider ward environment.
Determinants of isoniazid preventive therapy completion among people living with HIV attending care and treatment clinics from 2013 to 2017 in Dar es Salaam Region, Tanzania. A cross-sectional analytical study
Authors: Robert Masanja , Todd Jim , Ngowi Bernard J. , Msuya Sia E. , Ramadhani Angella , Sambu Veryhel , Jerry Isaya , Mujuni Martin R. , Mahande Michael J. , Ngocho James S. , Maokola Werner
Published: April 2020

Background

Tuberculosis (TB) disease is a common opportunistic infection among people living with HIV (PLHIV). WHO recommends at least 6 months of isoniazid Preventive Therapy (IPT) to reduce the risk of active TB. It is important to monitor the six-month IPT completion since a suboptimal dose may not protect PLHIV from TB infection. This study determined the six-month IPT completion and factors associated with six-month IPT completion among PLHIV aged 15 years or more in Dar es Salaam region, Tanzania.

Methods

Secondary analysis of routine data from PLHIV attending 58 care and treatment clinics in Dar es Salaam region was used. PLHIV, aged 15 years and above, who screened negative for TB symptoms and initiated IPT from January, 2013 to June, 2017 were recruited. Modified Poisson regression with robust standard errors was used to estimate prevalence ratios (PR) and 95% confidence interval (CI) for factors associated with IPT completion. Multilevel analysis was used to account for health facility random effects in order to estimate adjusted PR (APR) for factors associated with IPT six-month completion.

Results

A total of 29,382 PLHIV were initiated IPT, with 21,808 (74%) female. Overall 17,092 (58%) six-month IPT completion, increasing from 42% (773/1857) in year 2013 to 76% (2929/3856) in 2017. Multilevel multivariable model accounting for health facilities as clusters, showed PLHIV who were not on ART had 46% lower IPT completion compared to those were on ART (APR: 0.54: 95%CI: 0.45–0.64). There was 37% lower IPT completion among PLHIV who transferred from another clinic (APR: 0.63: 95% CI (0.54–0.74) compared to those who did not transfer. PLHIV aged 25–34 years had a 6% lower prevalence of IPT completion as compared to those aged 15 to 24 years (APR:0.94 95%CI:0.89–0.98).

Conclusion

The IPT completion rate in PLHIV increased over time, but there was lower IPT completion in PLHIV who transferred from other clinics, who were aged 25 to 34 years and those not on ART. Interventions to support IPT in these groups are urgently needed.
A comparison of the efficacy of three different peak airway pressures on intraoperative bleeding point detection in patients undergoing thyroidectomy: a randomized, controlled, clinical trial
Authors: Beyoglu Cigdem Akyol , Teksoz Serkan , Ozdilek Aylin , Akcivan Murat , Erbabacan Emre , Altindas Fatis , Koksal Guniz
Published: April 2020

Background

Various techniques are used to detect intraoperative bleeding points in thyroid surgery. We aimed to assess the effect of increasing peak airway pressure to 30, 40 and 50 cm H2O manually in detecting intraoperative bleeding points.

Methods

One hundred and 34 patients scheduled for total thyroidectomy were included to this prospective randomised controlled clinical study. We randomly assigned patients to increase peak airway pressure to 30, 40 and 50 cm H2O manually intraoperatively just before surgical closure during hemostasis control. The primary endpoint was the rate of bleeding points detected by the surgeon during peak airway pressure increase.

Results

The rate of detection of the bleeding points was higher in 50 cm H2O Group than the other two groups (15.9 vs 25.5 vs 40%, P = 0.030), after pressure administration, the HR, SpO2, and P peak were similar between groups (P = 0.125, 0.196, 0.187, respectively). The median duration of the bleeding point detection after the pressure application was 21.82 s in 30 cm H2O, 25 s in 40 cm H2O, and 22.50 s in 50 cm H2O groups. Postoperative subcutaneous hematomas or hemorrhages requiring surgery were not seen in any patient.

Conclusions

Manually increasing peak airway pressure to 50 cm H2O during at least 22.50 s may be used as an alternative way to detect intraoperative bleeding points in thyroid surgery.

Clinical trial registration

NCT03547648. Registered 6 June2018
Impact of transparent tray-based application of bioactive glasses desensitizer on the permeability of enamel and dentin to hydrogen peroxide: an in vitro study
Authors: Ma Qian , Chen Jingwen , Xu Xiao , Wang Tianda
Published: April 2020

Background

To investigate the effect of transparent tray-based application of bioactive glasses (BGs) desensitizer on the permeability of enamel and dentin to hydrogen peroxide (H2O2).

Methods

Freshly extracted human first premolars were divided into 6 groups (n = 8). Group A and B: without pretreatments; Group C and E: treated with BGs desensitizer only; Group D and F: treated with BGs desensitizer dispensed with a transparent tray. After roots and pulp tissues of the treated tooth specimens were thoroughly removed, acetate buffer was added into pulp chambers and the treated specimens were immersed in distilled water (Groups A, E, and F) or 30% H2O2 (Groups B, C, and D) for 30 min at 37 °C. The amount of H2O2 in the pulp chamber of each group was measured using ultraviolet-visible spectrophotometry.

Results

In control groups (Group A, E, and F), H2O2 was not detected. The amount of pulpal H2O2 in Group B, C, and D were 21.149 ± 0.489 μg, 9.813 ± 0.426 μg, and 4.065 ± 0.268 μg respectively. One-way ANOVA analysis indicated that significant differences existed in these groups (F = 459.748, p < 0.05).

Conclusions

The effect of BGs desensitizer in reducing the permeability of enamel and dentin to H2O2 could be enhanced when dispensed with a transparent tray.
Periodontal health in an indigenous Sámi population in Northern Norway: a cross-sectional study
Authors: Bongo Ann-Kristine Sara , Brustad Magritt , Oscarson Nils , Jönsson Birgitta
Published: April 2020

Background

The aim of the study was to describe prevalence, severity and distribution of periodontal disease as well as associated risk factors in an indigenous Sámi population in Northern Norway, and to investigate differences between the indigenous Sámi and the non-Sámi population.

Methods

This cross-sectional study included data from the Dental Health in the North study (N = 2078; 18–75 years). Data on Ethnicity, household income, education, smoking habits, dental attendance, and tooth brushing habits were collected by a questionnaire. Periodontal conditions were assessed by clinical examination. A modified version of the new AAP/EFP classification system of periodontal disease was used to estimate the severity of periodontitis. Three stages were used: ‘Non-severe periodontitis’, ‘Stage II’, and stage ‘III/IV’.

Results

Of the total study population 66.5% reported Sámi affiliation. The total prevalence of periodontitis was 49.7%, with 20.1% in Stage III/IV, but no differences between Sámi and non-Sámi. When controlled for sex, age, education, smoking and dental attendance the Sámi had higher probability of having more severe stages of periodontitis; Odds RatioStage II(OR) = 1.3; 95% CI: 1.1–1.7; and ORStage III/IV(OR) = 1.6; 95% CI: 1.1–2.2) compared to non-Sámi. A higher proportion of Sámi had one or more PD ≥ 6 mm than the non-Sámi (p < 0.05).

Conclusions

The prevalence of periodontitis was high in communities in the core area of Sámi settlement in Northern Norway, regardless of ethnicity. People with Sámi ethnicity had deep periodontal pockets and an increased odds of having severe stages of periodontitis. Future studies should address possible explaining factors behind the potential higher risk of having more severe periodontitis among indigenous people in Sámi settlements.
Qualitative study of socio-cultural challenges in the nursing profession in Pakistan
Authors: Abbas Sidra , Zakar Rubeena , Fischer Florian
Published: April 2020

Background

In a patriarchal social system, a women-dominated profession like nursing is mostly seen as a disempowered group due to its stereotypical image and negative connotations. The low social prestige of this profession is based on the roles typically assigned to men and women to maintain gender identity according to their performance and embodiment. The aim of this study was to explore the social and cultural challenges faced by nurses while creating their professional image within the regional context of Lahore (Punjab) in Pakistan.

Methods

A qualitative research design was chosen to conduct one-to-one, in-depth interviews with twelve nurses. Recruitment was based on purposive sampling from three large public hospitals in Lahore to learn about nurses’ perceptions of social and cultural challenges in the nursing profession. A thematic analysis was conducted using the data analysis software package NVivo 12 Plus.

Results

Cultural values give preference for female nurses. We have identified four major themes related to the social and cultural challenges facing the nursing profession: 1) gender-segregated profession, 2) inappropriate portrayals by the media, 3) issues around marriage settlement, and 4) identity from a religious perspective. These conflicts are affecting the professional status and changing perceptions of nurses, who either do not choose to remain in the nursing profession or do not recommend nursing as a career option. These ongoing constraints are still perpetuating and increasing shortage of nurses within the Pakistani healthcare system.

Conclusion

The present study solely highlights nurses’ perspectives on redefining gender roles and gender integration within the nursing profession. It argues that there is a need for positive portrayals in the media for the removal of public misperceptions related to nursing. This would reduce the shortage of nurses along with increasing retention and improving the quality of healthcare delivered to the public.
Indoor residual spraying for malaria control in sub-Saharan Africa 1997 to 2017: an adjusted retrospective analysis
Authors: Tangena Julie-Anne A. , Hendriks Chantal M. J. , Devine Maria , Tammaro Meghan , Trett Anna E. , Williams Ignatius , DePina Adilson José , Sisay Achamylesh , Herizo Ramandimbiarijaona , Kafy Hmooda Toto , Chizema Elizabeth , Were Allan , Rozier Jennifer , Coleman Michael , Moyes Catherine L.
Published: April 2020

Background

Indoor residual spraying (IRS) is a key tool for controlling and eliminating malaria by targeting vectors. To support the development of effective intervention strategies it is important to understand the impact of vector control tools on malaria incidence and on the spread of insecticide resistance. In 2006, the World Health Organization (WHO) stated that countries should report on coverage and impact of IRS, yet IRS coverage data are still sparse and unspecific. Here, the subnational coverage of IRS across sub-Saharan Africa for the four main insecticide classes from 1997 to 2017 were estimated.

Methods

Data on IRS deployment were collated from a variety of sources, including the President’s Malaria Initiative spray reports and National Malaria Control Programme reports, for all 46 malaria-endemic countries in sub-Saharan Africa from 1997 to 2017. The data were mapped to the applicable administrative divisions and the proportion of households sprayed for each of the four main insecticide classes; carbamates, organochlorines, organophosphates and pyrethroids was calculated.

Results

The number of countries implementing IRS increased considerably over time, although the focal nature of deployment means the number of people protected remains low. From 1997 to 2010, DDT and pyrethroids were commonly used, then partly replaced by carbamates from 2011 and by organophosphates from 2013. IRS deployment since the publication of resistance management guidelines has typically avoided overlap between pyrethroid IRS and ITN use. However, annual rotations of insecticide classes with differing modes of action are not routinely used.

Conclusion

This study highlights the gaps between policy and practice, emphasizing the continuing potential of IRS to drive resistance. The data presented here can improve studies on the impact of IRS on malaria incidence and help to guide future malaria control efforts.
Adherence to the Australian dietary guidelines and development of depressive symptoms at 5 years follow-up amongst women in the READI cohort study
Authors: Opie Rachelle S. , Ball Kylie , Abbott Gavin , Crawford David , Teychenne Megan , McNaughton Sarah A.
Published: April 2020

Background

Depression is the single largest contributor to global disability. There is growing evidence that a healthy diet is associated with reduced depression risk. However, beyond the Mediterranean diet, few longitudinal studies have explored the relationship between adherence to national dietary guidelines and depression. Hence, this study investigates the relationship between adherence to Australian Dietary Guidelines and depressive symptoms.

Methods

Data was drawn from the READI longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-sample of 837 women. A generalized linear model was used to explore whether baseline diet (assessed using the Dietary Guideline Index (DGI-2013; score range 0 to 85)) was associated with risk of developing depressive symptoms (measured by the Centre for Epidemiologic Studies Depression (CES-D)) at 5 years follow-up, whilst adjusting for potential confounders. A fixed-effects model was used to assess associations between concurrent changes in diet quality and depressive symptoms from baseline to 5 years follow-up.

Results

An association between baseline diet quality and risk of developing depressive symptoms at follow-up was observed, where a 10 unit increase in DGI-2013 score was associated with an estimated 12% lower risk of developing heightened depressive symptoms (RR = 0.875, 95%CI 0.784 to 0.978, p = 0.018). The fixed-effects model indicated that an increase in DGI score over 5 years follow-up was associated with a lower (improved) CES-D score (B = -0.044, 95% CI − 0.08 to − 0.01, p = 0.024).

Conclusions

Our results provide evidence that better adherence to the Australian Dietary Guidelines may result in improved depressive symptoms. The growing high-quality evidence regarding the diet-depression relationship provides us with a rationale for developing strategies for supporting dietary behaviour change programs to lower depression rates.
GIS-modelled built-environment exposures reflecting daily mobility for applications in child health research
Authors: Mizen Amy , Fry Richard , Rodgers Sarah
Published: April 2020

Background

Inaccurately modelled environmental exposures may have important implications for evidence-based policy targeting health promoting or hazardous facilities. Travel routes modelled using GIS generally use shortest network distances or Euclidean buffers to represent journeys with corresponding built-environment exposures calculated along these routes. These methods, however, are an unreliable proxy for calculating child built-environment exposures as child route choice is more complex than shortest network routes.

Methods

We hypothesised that a GIS model informed by characteristics of the built-environment known to influence child route choice could be developed to more accurately model exposures. Using GPS-derived walking commutes to and from school we used logistic regression models to highlight built-environment features important in child route choice (e.g. road type, traffic light count). We then recalculated walking commute routes using a weighted network to incorporate built-environment features. Multilevel regression analyses were used to validate exposure predictions to the retail food environment along the different routing methods.

Results

Children chose routes with more traffic lights and residential roads compared to the modelled shortest network routes. Compared to standard shortest network routes, the GPS-informed weighted network enabled GIS-based walking commutes to be derived with more than three times greater accuracy (38%) for the route to school and more than 12 times greater accuracy (92%) for the route home.

Conclusions

This research advocates using weighted GIS networks to accurately reflect child walking journeys to school. The improved accuracy in route modelling has in turn improved estimates of children’s exposures to potentially hazardous features in the environment. Further research is needed to explore if the built-environment features are important internationally. Route and corresponding exposure estimates can be scaled to the population level which will contribute to a better understanding of built-environment exposures on child health and contribute to mobility-based child health policy.
Agrobacterium tumefaciens mediated transformation of the aquatic carnivorous plant Utricularia gibba
Authors: Oropeza-Aburto A. , Cervantes-Pérez S. A. , Albert V. A. , Herrera-Estrella L.
Published: April 2020

Background

The genusUtriculariabelongs to Lentibulariaceae, the largest family of carnivorous plants, which includes terrestrial, epiphytic and aquatic species. The development of specialized structures that evolved for carnivory is a feature of this genus that has been of great interest to biologists since Darwin‘s early studies.Utricularia gibbais itself an aquatic plant with sophisticated bladder traps having one of the most complex suction mechanisms for trapping prey. However, the molecular characterization of the mechanisms that regulate trap development and the biophysical processes involved in prey trapping are still largely unknown due to the lack of a simple and reproducible gene transfer system.

Results

Here, we report the establishment of a simple, fast and reproducible protocol for genetic transformation ofU. gibbabased on the T-DNA ofAgrobacterium tumefaciens. An in vitro selection system using Phosphinotricin as a selective agent was established forU. gibba. Plant transformation was confirmed by histochemical GUS assays and PCR and qRT-PCR analyses. We report on the expression pattern of the 35S promoter and of the promoter of a trap-specific ribonuclease gene in transgenicU. gibbaplants.

Conclusions

The genetic transformation protocol reported here is an effective method for studying developmental biology and functional genomics of this genus of carnivorous plants and advances the utility ofU. gibbaas a model system to study developmental processes involved in trap formation.
An efficient system for Agrobacterium-mediated transient transformation in Pinus tabuliformis
Authors: Liu Shuangwei , Ma Jingjing , Liu Hongmei , Guo Yingtian , Li Wei , Niu Shihui
Published: April 2020

Background

Functional genomic studies using genetics approaches of conifers are hampered by the complex and enormous genome, long vegetative growth period, and exertion in genetic transformation. Thus, the research carried out on gene function in Pinus tabuliformis is typically performed by heterologous expression based on the model plant Arabidopsis. However, due to the evolutionary and vast diversification from non-flowering (gymnosperms) to flowering (angiosperms) plants, several key differences may alter the underlying genetic concerns and the analysis of variants. Therefore, it is essential to develop an efficient genetic transformation and gene function identification protocol for P. tabuliformis.

Results

In the present study we established a highly efficient transgene Agrobacterium-mediated transient expression system for P. tabuliformis. Using a β-glucuronidase gene (GUS) as a reporter gene expression, the highest transformation efficiency (70.1%) was obtained by co-cultivation with Agrobacterium strain GV3101 at an optical density at 600 nm of 0.8, with 150 μM acetosyringone for 30 min followed by 3 days in the dark at 23 ± 1 °C. This protocol would be applied to other conifers; GUS staining was observed 24 h post-infection.

Conclusions

We report a simple, fast, and resilient system for transient Agrobacterium-mediated transformation high-level expression of target genes in P. tabuliformis, which will also improve transformation efficiency in other conifer species.
A novel ECG-biomarker for cardiac arrest during hypothermia
Authors: Dietrichs Erik Sveberg , Tveita Torkjel , Myles Rachel , Smith Godfrey
Published: April 2020

Background

Treatment of arrhythmias evoked by accidental or therapeutic hypothermia and rewarming remains challenging. We aim to find an ECG-biomarker that can predict ventricular arrhythmias at temperatures occurring in therapeutic and accidental hypothermia.

Main body

Evaluation of ECG-data from accidental and therapeutic hypothermia patients and experimental data on ECG and ventricular fibrillation (VF) threshold in hypothermic New Zealand White Rabbits. VF threshold was measured in rabbit hearts cooled to moderate (31 °C) and severe (17 °C) hypothermia. QRS-interval divided by corrected QT-interval (QTc) was calculated at same temperatures. Clinical QRS/QTc data were obtained after a systematic literature review. Rabbit QRS/QTc values correlated with risk for VF (correlation coefficient: 0.97). Human QRS/QTc values from hypothermic patients, showed similar correlation with risk for ventricular fibrillation in the experimental data (correlation coefficient: 1.00).

Conclusions

These calculations indicate that QRS/QTc has potential as novel biomarker for predicting risk of hypothermia-induced cardiac arrest. Our findings apply both to victims of accidental hypothermia and to patients undergoing therapeutic hypothermia during surgery or after e.g. cardiac arrest.
Biological and morphological consequences of dsRNA-induced suppression of tetraspanin mRNA in developmental stages of Echinococcus granulosus
Authors: Mousavi Seyed Mohammad , Afgar Ali , Mohammadi Mohammad Ali , Mortezaei Seifollah , Faridi Ashkan , Sadeghi Balal , Fasihi Harandi Majid
Published: April 2020

Background

Cystic echinococcosis, caused by the cestode Echinococcus granulosus, is a neglected tropical disease with remarkable morbidity in humans and a problem of worldwide economic importance in livestock industry. Understanding the molecular basis of the parasite growth and development is essential for the disease diagnosis, management and control. The tetraspanin (TSP) family of proteins are transmembrane proteins with a role in many physiological processes of eukaryotic organisms. TSPs present in the tegumental surface of platyhelminths play pivotal roles in host-parasite interaction. However, little is known about the role of TSPs in growth and development in the Platyhelminthes. To understand the role of TSP1 in the growth and development of E. granulosus we investigated the effect of EgTSP1-specific long dsRNA in different in vitro stages of the parasite.

Methods

Different stages of E. granulosus, protoscoleces and strobilated worms, were cultivated In vitro in di-phasic media. Using long dsRNA and two delivery methods, i.e. electroporation and electro-soaking, EgTSP1 silencing was performed with an EgTSP1-specific dsRNA. The TSP1 expression profile was assessed as well as the biological and ultrastructural properties of the parasites.

Results

After three days of dsRNA treatment, EgTSP1 expression was significantly reduced in both stages of E. granulosus as compared to irrelevant/unrelated dsRNA and untreated controls. Silencing expression of EgTSP1 in different stages of E. granulosus resulted in reduced viability and body contractions, inhibition of protoscoleces evagination and distinctive tegumental changes. Ultrastructural morphology of the strobilated worms treated with EgTSP1-specific dsRNA was indicative of the microtriches impairments and vacuolated tegument compared to the control helminths.

Conclusions

Results of the present study suggest that EgTSP1 plays important structural roles in tegument configuration in E. granulosus. EgTSP1 is proved to be a potential target for the development of vaccines and RNAi-based drugs.