bluuebunny/crossref_metadata_2025 huggingface dataset:
Persuasive antimicrobial stewardship intervention in the context of a KPC outbreak: a controlled interrupted time series analysis
Authors: Pereira Nuno Rocha , Dias Paulo Figueiredo , Correia Sofia , Shahriari Shirin , Neves João , Teixeira José , Paiva José Artur , Alves Carlos Lima , Azevedo Ana
Published: December 2019

Introduction: Antimicrobial resistance is a major public health threat. Antimicrobial stewardship (AMS) is one of the key strategies to overcome resistance, but robust evidence on the effect of specific interventions is lacking. We report an interrupted time series (ITS) analysis of a persuasive AMS intervention implemented during a KPC producing Klebsiella pneumoniae outbreak. Methods: A controlled ITS for carbapenem consumption, total antibiotic consumption and antibiotic-free days, between January 2012 and May 2018 was performed, using segmented regression analysis. The AMS intervention was implemented in the Vascular Surgery ward starting on April 2016 in the context of a KPC outbreak. The General Surgery ward was taken as a control group. Data were aggregated by month for both wards, including 51 pre-intervention and 26 intervention points. Results: The AMS intervention produced a level change in carbapenem consumption of -9.92 DDDs/100 patient-days accompanied by a reduction of total antibiotic consumption and an increase of 4% in antibiotic-free days in Vascular Surgery ward. These differences were not apparent in the control group. No differences in mortality or readmission rates between pre-intervention and intervention periods were noticed in any of the groups. Conclusion: Persuasive AMS interventions on top of previously implemented restrictive interventions can reduce carbapenem consumption and increase antibiotic-free days. Starting persuasive AMS interventions in an outbreak setting does not compromise the sustainability of the intervention.
Utilization of all components in biomass through high reducing sugar production and lignin nanoparticles preparation
Authors: Liu Wei , Zhuo Shengnan , Su Xianfa , Si Mengying , Zhang Kejing , Tong Aizi , Shi Yan
Published: December 2019

BackgroundLignocellulosic biomass for biofuel production was considered as an effective way to develop new energy. However, the efficient sugar conversion of cellulose and practical utilization of lignin are great challenges for sustainable biorefinery. In addition, sugar conversion and lignin utilization are generally performed separately. In this study, high reducing sugar production and multiple lignin nanoparticles preparation were realized in a pattern based on tetrahydrofuran-water (THF-H2O) pretreatment of corn straw (CS). ResultsThe maximum production of the reducing sugar was 26.79 g/l, which was significantly higher than the theoretical yield of 20.65 g/l. Lignin nanoparticles with different sizes ranged from 239 to 798 nm were prepared using dissolved lignin in the supernatant fluid from different THF-H2O pretreatment conditions through self-assembly with introducing water. The formation of lignin particles with different sizes were influenced by soluble lignin characteristics in the pretreatment liquid. The lignin molecular, functional groups, and structure were explored to elucidate the effects on the variation of lignin particles sizes by GPC, FTIR, and 2D-HSQC-NMR. The guaiacyl (G)-type lignin was easier to be dissolved in the mild pretreatment liquid, contributing to form smaller lignin nanoparticles with a good dispersibility. Comparatively, a small content of syringyl- and G-type lignin which caused by the lignin depolymerization retained in the severe pretreatment liquid to form the larger sphere particles. ConclusionsThe optimal pretreatment under TH22 (THF-H2O pretreatment at 120 °C for 2 h) simultaneously realized the utilization of all components in biomass through high reducing sugar production and the smaller lignin particles preparation. This new pattern of CS pretreatment plays a novel perspective for the technical design of lignocellulosic biomass conversion.
Recovery and resiliency of skin microbial communities on the southern leopard frog (Lithobates sphenocephalus) following two biotic disturbances
Authors: Weeks Denita Mychele , Parris Matthew James , Brown Shawn Paul
Published: December 2019

Background: Microorganisms have intimate functional relationships with invertebrate and vertebrate taxa, with the potential to drastically impact health outcomes. Perturbations that affect microbial communities residing on animals can lead to dysbiosis, a change in the functional relationship, often associated with disease. Batrachocytrium dendrobatidis (Bd), a fungal pathogen of amphibians, has been responsible for catastrophic amphibian population declines around the globe. Amphibians harbor a diverse cutaneous microbiome, including some members which are known to be antagonistic to Bd. Anti-Bd microorganisms have allowed some frog populations to persist in the presence of Bd, where other populations that lack anti-Bd microorganisms have perished. Research suggests disease-antagonistic properties of the microbiome may be a function of microbial community interactions, rather than individual bacterial species. Further, dysbiosis of microbial communities has been associated with Bd disease epidemics. Conservation efforts have identified amphibian-associated bacteria that exhibit anti-fungal properties for use as ‘probiotics’ on susceptible amphibian populations. Probiotic application, usually with a single bacterial species, may benefit from a greater understanding of amphibian species-specific microbiome responses to disturbances (e.g. dysbiosis vs. recovery). We assessed microbiome responses to two microbial disturbance events over multiple time points. Results: Exposing Lithobates sphenocephalus (southern leopard frog) adults to the biopesticidal bacteria, Bacillus thuringiensis, followed by exposure to the fungal pathogen Bd, did not have long term impacts on the microbiome. After initial shifts, microbial communities returned to a state that resembled pre-disturbance. Conclusions: Our results indicate microbial communities on L. sphenocephalus are robust and resistant to permanent shifts from some disturbances. This resiliency of microbial communities may explain why L. sphenocephalus is not experiencing the population declines from Bd that impacts many other species. Conservation efforts may benefit from studies outlining amphibian species-specific microbiome responses to disturbances (e.g. dysbiosis vs. recovery). If microbial communities on a threatened amphibian species are unlikely to recover following a disturbance, additional measures may be implemented to ameliorate the impacts of physical and chemical stressors on host-associated microbial communities.
Radiotherapy related skin toxicity (RAREST-02): A reminder app developed to reduce radiation dermatitis in patients with head-and-neck cancer
Authors: Rades Dirk , Narvaez Carlos , Dömer Claudia , Janssen Stefan , Olbrich Denise , Tvilsted Soeren , Conde-Moreno Antonio J , Cacicedo Jon
Published: December 2019

Background: Radiotherapy of head-and-neck cancer can be associated with significant toxicities including dermatitis and oral mucositis. Severe toxicities may require interruptions of the radiation treatment associated with impairment of the patients’ prognoses. This study will investigate whether the addition of a reminder app to standard care can reduce dermatitis and oral mucositis rates during radiotherapy in these patients. Methods: This randomized trial compares standard care supported by a reminder app (Arm A) to standard care alone (Arm B) with respect to grade ≥2 radiation dermatitis and oral mucositis at 60Gy of radiotherapy, the minimum planned dose for patients receiving definitive or adjuvant radiotherapy for locally advanced head-and-neck cancer. Moreover, radiation-induced dermatitis and oral mucositis grade ≥3 at 60Gy and both grade ≥2 and grade ≥3 at the end of radiation treatment (EOT) will be evaluated, as well as quality of life and pain. According to sample size calculations, 80 patients are required per arm within the full analysis set. Taking into account that 5% of patients will not qualify for full analysis set, 168 patients should be randomized. The impact of the reminder app will be considered clinically relevant, if the rates of grade ≥2 radiation dermatitis (primary endpoint) and oral mucositis (secondary endpoint) can be reduced by 20%. Discussion: If the addition of a reminder app to standard care will lead to a significant reduction of radiation dermatitis and oral mucositis, it could become a helpful tool for head-and-neck cancer patients during radiotherapy. Trial registration: clinicaltrials.gov (NCT04110977; URL: https://clinicaltrials.gov/show/NCT04110977). Registered on 27th of September, 2019. First patient is planned to be included in December 2019.
Structure and Function of the Arctic and Antarctic Marine Microbiota as Revealed by Metagenomics
Authors: Zhang Weipeng , Cao Shunan , Ding Wei , Chen Xiu-Lan , Mcminn Andrew , Wang Min , He Jianfeng , Zhang Yu-Zhong
Published: December 2019

Background: The Arctic and Antarctic are the two most geographically distant bioregions on earth. Recent sampling efforts and following metagenomics have shed light on the global ocean microbial diversity and function, yet the microbiota of polar regions has not been included in such global analyses.Results: Here a metagenomic study of seawater samples (n = 60) collected from different depths at 28 locations in the Arctic and Antarctic zones was performed, together with metagenomes from with the Tara Oceans datasets. More than 7,500 (19%) polar seawater-derived operational taxonomic units could not be identified in the Tara Oceans datasets, and more than 3,900,000 protein-coding gene orthologs had no hits in the Ocean Microbial Reference Gene Catalog. Analysis of 214 genome bins, recovered from the polar seawater microbiomes, revealed strains that are prevalent in the polar regions while nearly undetectable in temperate seawater. Metabolic pathway reconstruction for these microbes suggested versatility for saccharide and lipids biosynthesis, nitrate and sulfate reduction, and CO2 fixation. Comparison between the Arctic and Antarctic microbiomes revealed that antibiotic resistance genes were enriched in the Arctic while functions like DNA recombination were enriched in the Antarctic.Conclusions: Our data highlight the occurrence of dominant and endemic microbes in the Arctic and Antarctic seawater with unique functional traits for environmental adaption, and provide a foundation for analyzing the global ocean microbiome in a more complete perspective.
Acute myeloid leukemia with inv(16)(p13.1q22) and deletion of the 5’MYH11/3’CBFB gene fusion: a report of two cases and literature review.
Authors: Lv Lili , Yu Jingwei , Qi Zhongxia
Published: December 2019

Background Acute myeloid leukemia (AML) with inv(16)(p13.1q22) or t(16;16)(p13.1;q22) is associated with a high rate of complete remission (CR) and favorable overall survival (OS) when treated with high-dose Cytarabine. At the inversion breakpoints, deletion of 3’CBFB has been reported, but most of them were studied by chromosome and fluorescence in situ hybridization (FISH) analyses. The genomic characteristics of such deletions remain largely undefined, hindering further understanding of the clinical significance of the deletions. Case presentation We report here two AML cases with inv(16) and deletion of the 5’MYH11/3’CBFB gene fusion, which were characterized by chromosome, FISH, and single nucleotide polymorphism (SNP) microarray analyses. Both cases have achieved CR for more than three years.Conclusions Deletion of 3’CBFB in AML with inv(16) is also accompanied with deletion of 5’MYH11 in all the cases studied by SNP microarray, suggesting that 3’CBFB and 5’MYH11 were most likely deleted together as a fusion product of inv(16) instead of occurring separately. In concert with the findings of other published studies of similar patients, our study suggests that deletion of 5’MYH11/3’CBFB in AML with inv(16) may not have negative impact on the prognosis of the disease.
Nitrogen status assessment for multiple cultivars of strawberries using portable NIR spectrometers combined with cultivar recognition and multivariate analysis
Authors: Wu Gangshan , Jiang Qiyou , Bai Yuhao , Tian Chongfeng , Pan Wei , Zhang Baohua
Published: December 2019

Background The assessment of nitrogen status non-destructively in strawberry was performed to indicate its growth and provide guidance for precise management of N fertilizer using near-infrared reflectance (NIR) spectroscopy with leaf spectral reflectance. The Leaf soil plant analysis development (SPAD) value was thought as an indicator data that indirectly reflects nitrogen status in strawberry. However, the variation of cultivars would lead to differences in the cell structure and light scattering and/or reflection effects of strawberry leaves when assessed strawberry N status, which caused that no single leaf SPAD threshold value or same N demand can be applied for all strawberry cultivars. As a result, accurate detection of SPAD values and N status in strawberries with multiple cultivars is still challenging.Results In this study, Individual-cultivar model, hybrid-cultivar model and multi-cultivar model were developed for the determination of SPAD values, and the performance of the models in lessening the impact of cultivar variation were studied and compared. Individual-cultivar model was constructed on the basis of the single cultivar of strawberry leaf; hybrid-cultivar model was developed by merging the spectrum reflectance data and SPAD values of all studied leaf samples, and multi-cultivar model was built in combination with cultivar identification, individual-cultivar models, and model search strategy.Conclusion The results indicated that multi-cultivar model was more superior to the other two models for SPAD values estimation of strawberry leaves from different cultivars, with the overall Rp and RMSEP value respectively being 0.966 and 0.468. We demonstrate that the leaf N content per strawberry is profoundly affected by cultivar variation, and establishing a multi-cultivar model might be more useful in monitoring nitrogen status and guiding N fertilization recommendations for different strawberry cultivars.
Critical clinical situations in adult patients with Mucopolysaccharidosis (MPS)
Authors: Stepien Karolina M , Gevorkyan A. K. , Hendriksz Christian J , Lobzhanidze T V , Pérez-López J , Tol Govind , Riera Mireia delToro , Vashakmadze N D , Lampe Christina
Published: December 2019

Background: Mucopolysaccharidoses (MPS) are rare, inherited disorders associated with enzyme deficiencies that result in glycosaminoglycan (GAG) accumulation in multiple organ systems. Management of MPS is evolving as patients increasingly survive to adulthood and undergo multiple surgeries throughout their lives. As surgeries in these patients are considered to be high risk, this can result in a range of critical clinical situations in adult patients. Results: We discuss strategies to prepare for and manage critical clinical situations in adult patients with MPS, including supporting the multidisciplinary team, preoperative and airway assessments, surgical preparations, and postoperative care. We also present eight critical clinical cases (age range: 21–38 years) from four leading inherited metabolic disease centres in Europe to highlight challenges and practical solutions to optimise the care of adult patients with MPS. Critical clinical situations included surgical procedures, pregnancy and a thrombus in a port-a-cath. Conclusions: Individualised strategies to manage critical clinical situations need to be developed for each patient to compensate for the heterogeneous symptoms that may be present and the potential complications that may occur. These strategies should include input from the wider MDT, and be coordinated by metabolic specialists with expertise in the management of MPS disorders and surgery in adult patients with MPS.
Engineering the β-ketoacyl-acyl carrier protein synthase gene in the synthesis of cell wall mycolic acids in Mycobacterium neoaurum for enhancing the bioconversion of steroidal intermediates from phytosterols
Authors: Xiong Liang-Bin , Liu Hao-Hao , Zhao Ming , Liu Yong-Jun , Song Lu , Xie Zhi-Yong , Xu Yi-Xin , Wang Feng-Qing , Wei Dong-Zhi
Published: December 2019

Background: The bioconversion of phytosterols into high value-added steroidal intermediates is the cornerstone in steroid pharmaceutical industry. However, the low transportation efficiency of hydrophobic substrates into mycobacterial cells severely limits the transformation. In this study, a robust and stable modification of the cell wall strikingly enhanced the cell permeability for the high production of steroids.Results: The interference of the nonessential β-ketoacyl-acyl carrier protein synthase KasB resulted in a disturbed proportion and a shortened length of mycolic acids (MAs), thus leading to a remarkable improvement of cell permeability. The yield of 9α-hydroxy-4-androstene-3,17-dione (9-OHAD) was increased by 137.7% in the vegetative cell transformation. Ultimately, the 9-OHAD productivity in an industrial used resting cell system was reached 0.1135 g/L/h (10.9 g/L 9-OHAD from 20 g/L phytosterol) and the conversion time was shortened by 33%. In addition, a similar self-enhancement effect (34.5%) was realized in the 22-hydroxy-23,24-bisnorchol-4-ene-3-one (4-HBC) producing strain.Conclusions: The modification of kasB resulted in a meaningful change in the cell wall mycolic acids. Deletion of the kasB gene remarkably improved the cell permeability, leading to a self-enhancement of the steroidal intermediate conversion. The results showed a high efficiency and feasibility of this construction strategy.
The Potential Role of Long Noncoding RNAs in Primary Open-Angle Glaucoma
Authors: Zhang Feng , Zhao Yang , Cao Mengdan , Jia Xu , Pan Zheng , Zhou Dengming , Liu Ke , Duan Xuanchu
Published: December 2019

Background To identify the potential genes in human trabecular meshwork (TM) related to primary open-angle glaucoma (POAG). At first, long noncoding RNA (LncRNA) and mRNA expression profiles in TM samples from 4 control subjects and POAG patients were accessed by microarray analyses. Then, twenty lncRNAs were validated by real-time quantitative PCR in the same samples from microarray analyses. Finally, eight highly expression lncRNAs were further tested by real-time quantitative PCR in TM from 8 normal controls and 19 POAG patients. Expression data were normalized and analyzed using the R software. Pathway analyses were performed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis.Results: A total of 2179 lncRNAs and 923 mRNAs in the TM of POAG patients were significantly up-regulated, and 3111 lncRNAs and 887 mRNAs were significantly down-regulated. ENST00000552367, ENST00000582505, ENST00000609130, NR_029395, NR_038379, and ENST00000586949 expression levels were significantly higher in the TM from a different cohort of POAG patient than normal controls.Conclusion: ENST00000552367, ENST00000582505, ENST000006091- 30, NR_029395, NR_038379, and ENST00000586949 may play essential roles in the development of POAG.
A Calorically Restricted High-fat Diet Reverses High-fat Diet-induced Injurious Effects on Health and Gene Expression in Rats
Authors: Wu Yuqing , Guan Yue , Ling Fan , Zhu Qiushuang , Zhang Dandan , Li Yuqiao , Liu Jinxiao , Niu Yucun
Published: December 2019

Background: A High-fat diet has been reported to produce excess lipid accumulation and increase inflammatory factors and oxidative stress in various metabolic diseases. Caloric restriction (CR) is one of the most valuable tools in reducing inflammation, enhancing anti-oxidative activity and ameliorating various metabolic diseases. However, excess CR may restrain growth, development and normal physiological processes. Our study was conducted to investigate the effects of a high-fat diet containing the same number of calories as a basic diet on the health and gene expression patterns of rats.Methods: 30 Wistar male rats were randomly devided into a normal control (NC) group, an equicaloric high-fat (EHF) group as the NC group, and a high-fat (HF) ad libitum group. Food consumption and body weight were recorded once a week. Blood biochemistical and genomic assessments of the liver were carried out after intervention for 20 weeks. Results: Compared with the NC group, serum triglycerides (TG), total cholesterol (TCHO), low-density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST) and andalanine aminotransferase (ALT) levels were significantly increased in the HF group, and the serum levels of interleukin- 6 (IL-6), reactive oxygen species (ROS) and glutathione (GSH) were significantly decreased in the HF group. Compared with the HF group, serum TG,TCHO,LDL-C, AST, ALT, IL-6, ROS levels were significantly decreased in the EHF group, and the serum levels of GSH and superoxide dismutase (SOD) were also significantly increased. Histological studies showed decreased macrovesicular steatosis, inflammatory cell infiltration and structural damagein EHF group compared to the HF group. In addition, transcription analysis revealed that an EHF led tochanges in gene expression, including a reduction inToll-like receptor 4 (TRL4),which inhibited NF-kappa B signaling pathway and upregulatedglutathione S-transterases (GSTs) to increase antiocidative activity.Conclusions: an EHF restored deleterious changes in the health and gene expression patterns induced by a high-fat diet ad libitum in rats via reduced inflammation and increased antioxidative activity.
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: December 2019

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.
PTP1B inhibitor alleviates deleterious microglial activation and neuronal injury after ischemic stroke by modulating ER stress-autophagy axis via PERK signaling in microglia
Authors: Zhu Yu , Yu Jianbo , Gong Jiangbiao , Ye Di , Cheng Dexin , Xie Zhikai , Zeng Jianping , Shen Jian , Zhou Hengjun , Weng Yuxiang , Pan Jianwei , Zhan Renya
Published: December 2019

Background : Cerebral ischemia/reperfusion (IR) after ischemic stroke causes microglial activation which lead to neuronal injury. Protein tyrosine phosphatase 1B (PTP1B) emerges to be a positive regulator of neuroinflammation, yet the effect of its inhibition on microglial activation as well as cerebral IR injury is largely unknown. Here we explored whether PTP1B inhibitor sc-222227 attenuates microglial activation and mitigates neuronal injury after cerebral IR injury. Methods : Cerebral IR injury rat model was induced by transient middle cerebral artery occlusion (MCAO) and reperfusion. PTP1B inhibitor sc-222227 was administered intracerebroventricularly 0.5 h before IR injury. Neurological deficits, infarct volume and brain water content were examined. In vitro IR injury model were established by oxygen glucose deprivation/reoxygenation (OGD/R) in rat primary microglia. PTP1B protein level, microglial activation, neuroinflammation, endoplasmic reticulum (ER) stress, autophagy and neuronal apoptosis were detected in vivo and/or in vitro using western blot, immunohistochemistry, immunofluorescence, ELISA and real-time PCR assay. Protein interaction were assessed by proximity ligation assay. Results : PTP1B expression were significantly increased after cerebral IR injury in vivo, and the enhancement was most prominent in microglia. PTP1B inhibitor reduced IR-induced microglial activation both in vitro and in vivo, and further attenuated IR-induced microglial ER stress and autophagy in rat. In vitro experiment showed PTP1B inhibitor mitigated OGD/R-induced microglial activation through inhibiting ER stress-dependent autophagy, whose effect was partly abolished by PERK activator CCT020312. The protein interaction between PTP1B and phosphorylated PERK were significantly increase in response to OGD/R in primary microglia. Finally, PTP1B inhibitor reduced neuronal apoptosis and improved neurologic function after cerebral IR injury in rat. Conclusions : PTP1B inhibitor ameliorated neuronal injury and neurologic deficits following cerebral IR injury via attenuating deleterious microglial activation and subsequent neuroinflammation through modulating ER stress-autophagy axis in microglia. Treatment targeting microglial PTP1B might be a potential therapeutic strategy for ischemic stroke treatment.
Risk Assessment of Heavy Metal in the Surface Sediment at the Drinking Water Source of the Xiangjiang River in South China
Authors: Huang Zhifeng , Liu Chengyou , Zhao Xingru , Dong Jing , Zheng Binghui
Published: December 2019

Background: The Xiangjiang River is an important drinking water resource for the Hunan province of China. It is crucial to ascertain the pollution status, influencing factors, ecological risks, and possible sources of heavy metals in the sediments of the Xiangjiang River. Sediment is both a source and a sink of heavy metals in aquatic ecosystems. In this study, surface sediment was collected from the Zhuzhou Reach of the Xiangjiang River and eight heavy metals were investigated.Results: In all sediment samples, all eight heavy metals were detected and their average concentration fell in the order of Zn > Pb > As > Cu > Cr > Ni > Cd > Co. Assessment shows extremely serious Cd pollution and a very high potential ecological risk from Cd. According to correlation analysis and principle component analysis (PCA), As, Cu, Ni, Pb, and Zn originate from industrial wastewater and mineral smelting activities, whereas Co, Cr, and Ni come from natural sources. Redundancy analysis (RDA) reveals that the organic matter content and the particle size of the sediment have some influence on the enrichment of heavy metals.Conclusion: Among all eight examined heavy metals in the surveyed area, the content of Zn, Pb, and As is the highest, and that of Cd and Co is the lowest. Despite a low level of absolute content, the Cd in sediment already renders a high ecological risk and thus calls for urgent attention. Anthropogenic activities are the main source of heavy metals in the sediment. The distribution of heavy metals is also influenced by sediment properties. The results provide guidance for controlling heavy metal pollution and protecting drinking water sources in the Xiangjiang River.
Comparison of three small-area mortality metrics according to urbanity in Korea: the standardized mortality ratio, comparative mortality figure, and life expectancy
Authors: Kim Ikhan , Lim Hwa-Kyung , Kang Hee-Yeon , Khang Young-Ho
Published: December 2019

Background: This study aimed to compare three small-area level mortality metrics according to urbanity in Korea: the standardized mortality ratio (SMR), comparative mortality figure (CMF), and life expectancy (LE) by urbanity.Methods: We utilized the National Health Information Database to obtain annual age-specific numbers of population and deaths for all neighborhood-level areas in Korea between 2013 and 2017. First, differences in the SMR by urbanity were examined, assuming the same age-specific mortality rates in all neighborhoods. Second, we explored the differences in ranking obtained using the three metrics (SMR, CMF, and LE). Third, the ratio of CMF to SMR by population was analyzed according to urbanity.Results: We found that the age-specific population distributions in urbanized areas were similar, but rural areas had a relatively old population structure. The age-specific mortality ratio also differed by urbanity. Assuming the same rate of age-specific mortality across all neighborhoods, we found that comparable median values in all areas. However, areas with a high SMR showed a strong predominance of metropolitan areas. The ranking by SMR differed markedly from the rankings by CMF and LE, especially in areas of high mortality, while the latter two metrics did not differ notably. The ratio of CMF to SMR showed larger variations in neighborhoods in rural areas, particularly in those with small populations, than in metropolitan and urban areas.Conclusions: In a comparison of multiple SMRs, bias could exist if the study areas have large differences in population structure. The use of CMF or LE should be considered for comparisons if it is possible to acquire age-specific mortality data for each neighborhood.
Total Injectable Anesthesia of Dogs and Cats for Remote Island Veterinary Sterilization Clinic
Authors: Posner Lysa Pam , Applegate Jeffrey , Cannedy Allen , Deresienski Diane , Mozzachio Kristie , Serrano Maria , Lewbart Gregory
Published: December 2019

Background: Sterilization clinics may occur in remote places where anesthesia machines and compressed oxygen are unavailable. This study evaluated the efficacy of total injectable anesthesia in dogs and cats presented for sterilization on Isabela Island, Galápagos, Ecuador. Results: A total of 100 animals were sterilized; 26 female cats (FC), 22 male cats (MC), 28 female dogs (FD), and 24 male dogs (MD). FC were anesthetized with dexmedetomidine (20 mcg/kg), ketamine (8 mg/kg) and hydromorphone (0.1 mg/kg) IM. MC were anesthetized with dexmedetomidine (15 mcg/kg), ketamine (5 mg/kg) and hydromorphone (0.1 mg/kg) IM. Inadequate anesthesia in cats was treated with alfaxalone (1mg/kg) IM. All cats were administered meloxicam at 0.3mg/kg SQ. FD were anesthetized with dexmedetomidine (15 mcg/kg), ketamine (7-10 mg/kg) and hydromorphone (0.1 mg/kg) IM. MD were anesthetized with dexmedetomidine (15mcg/kg), ketamine (5 mg/kg) and hydromorphone (0.1 mg/kg) IM. All dogs had IV catheter and endotracheal tube placed. If SpO2<90%, dogs had assisted ventilation via Ambu bag. Inadequate anesthesia in dogs was treated with alfaxalone (1mg/kg) IV. All dogs were administered meloxicam at 0.2 mg/kg SQ. Following surgery, atipamezole (0.05-0.1mg/kg) IM was administered to any patient that did not have voluntary movement. All patients survived and were discharged. Less than 25% of cats and male dogs required supplemental anesthesia. Fifty seven percent of female dogs required supplemental anesthesia. More than 89% of patients (in any group) required atipamezole administration. One cat recovered with agitation and hyperthermia (41.1C/ 106F). Some dogs required ventilatory assistance to remain normoxemic while anesthetized. Conclusion: Total injectable anesthesia can be accomplished for remote location sterilization clinics with minimal morbidity.
Land use/land cover change effect on Soil erosion and Sediment Delivery on Winike Watershed, Omo Gibe Basin, Ethiopia
Authors: Aneseyee Abreham Berta
Published: December 2019

Background: Information on soil loss and sediment export is essential to identify hotspots of soil erosion for conservation interventions in a given watershed. This study aims at investigating the dynamic of soil loss and sediment export associated with land use/land cover change and identifies soil loss hotspot areas in Winike watershed of Omo-gibe basin of Ethiopia. Spatial data collected from satellite images, topographic maps, meteorological and soil data were analyzed. Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) of sediment delivery ratio (SDR) model was used based on analysis of land use/land cover maps and RUSLE factors. Result: The results showed that total soil loss increased from 774.86 thousand tons in 1988 to 951.21 thousand tons in 2018 while the corresponding sediment export increased by 3.85 thousand tons in the same period. These were subsequently investigated in each land-use type. Cultivated fields generated the highest soil erosion rate, which increased by 10.02 t/ha/year in 1988 to 43.48 t/ha/year in 2018. This corresponds with the expansion of the cultivated area that increased from 44.95 thousand ha in 1988 to 59.79 thousand ha in 2018. This is logical as the correlation between soil loss and sediment delivery and expansion of cultivated area is highly significant (p<0.01). Sub-watershed six (SW-6) generated the highest soil loss (62.77 t/ha/year) and sediment export 16.69 t/ha/year, followed by Sub-watershed ten (SW-10) that are situated in the upland plateau. Conversely, the lower reaches of the watershed are under dense vegetation cover and experiencing less erosion. Conclusion: Overall, the changes in land use/land cover affect significantly the soil erosion and sediment export dynamism. This research is used to identify an area to prioritize the watershed for immediate management practices. Thus, land use policy measures need to be enforced to protect the hydropower generation dams at downstream and the ecosystem at the watershed.
Analyzing the impacts of urbanization on runoff characteristics in Adama city, Ethiopia
Authors: Bulti Dejene Tesema , Girma Birhanu
Published: December 2019

Background It has been increasingly recognized that urbanization is responsible for alterations of land use/land cover globally with substantial environmental impacts on all temporal and spatial scales. Particularly, it significantly affects the hydrologic cycle. Floods are the major threats to several cities worldwide with more effects in developing countries. Likewise, urban water management has become the main focus of sustainable urban development and poses higher demand for information related to the interaction between the urbanization process and hydrological attributes, but little is known in the context of Ethiopian urban centers. For this, Adama city, a fast grown and flood vulnerable urban area is considered to examine the impacts of urbanization on the storm runoff at different spatial scales from 1995 to 2019. Preparing land use/land cover (LULC) maps for different periods, the dynamics of LULC transformations were analyzed. The SCS-CN method was used to compute runoff at respective years from which spatiotemporal changes of the city’s hydrology were assessed at the city and watershed levels. Regression analysis was used for exploring the relation between the spatiotemporal changes of imperviousness ratio and runoff.Results The findings show that the urban built-up area undergone about 22% expansion annually from 1995 to 2019. Besides the runoff is increased by 23% in the City and 31% and 16.6% in the watersheds. Moreover, the significant direct linear relationship is found between the spatiotemporal variations of runoff and imperviousness ratio at both spatial scales.Conclusions Adama city has experienced significant LULC transformations over the last 24 years with significant effects on hydrological attributes, which pressed an alarm for increasing ﬂood hazards. Hence, in order to realize sustainable growth of the city, future developments should be guided by impervious surface-based land use regulations.
Effects of Gastric Sleeve Surgery in the Serum Levels of GH, IGF-1 and IGF-binding Protein 2 in Morbidly Obese Patients
Authors: Al-Regaiey Khalid , Alshubrami Suad , Al-Beeshi Ibrahim , Alnasser Torki , Alwabel Abdulnasser , Al-Beladi Hassan , Al-Tujjar Omar , Alnasser Abdulrahman , Alfadda Assim , Iqbal Muhammad
Published: December 2019

Background Bariatric or weight loss surgery is an effective treatment for severe obesity. Reduced calorie intake or malabsorption are not the only mechanism, alterations in the activity of certain hormones and neurotransmitters are also the contributory mechanisms. In this study, we investigated the levels of GH, IGF-1 and IGF-binding protein (IGFBP-2) after bariatric surgery in obese individuals.Method Plasma GH, IGF-1 and IGFBP-2 levels were measured by ELISA in 33 obese (BMI >38.3) healthy male subjects age ranged from 25 to 50 years before and six months after gastric sleeve surgery. Plasma glucose, BMI, insulin, HOMA-IR and lipid profile were also investigated.Results Systemic GH (from 12.32±1.3 to 50.97±0.339 ρg/mL, P<0.001) and IGFBP-2 (51.86±11.21 to 68.81±13.36 ρg/mL, P<0.001) levels were elevated after bariatric surgery. However there was no change in IGF-1 levels. BMI (from 52.18±9.86 Kg/m2 to 40.11±8.92 Kg/m2, P<0.001), insulin (19.35±0.304 mIU/L to 8.80±0.181 mIU/L, P<0.001) and Homeostatic model assessment- Insulin resistance (HOMA-IR) index was also reduced from 6.48+0.164 to 2.52 ± 0.061 (p<0.001) were also reduced 6 months after bariatric surgery. Cholesterol, high density lipoproteins (HDL), and low density lipoproteins (LDL) levels were increased after surgery (4.26±0.027 to 5.12±0.026 mmol/L and 0.90±0.007 to 1.55±0.011 mmol/L and 2.62±0.02 to 2.98±0.022 mmol/L, P<0.001) respectively. There was no correlation between GH, IGF-1, IGFBP-2and insulin and lipid parameters.Conclusions Our study suggests that improved circulating GH and IGFBP-2 levels associated with increased levels cholesterol and triglycerides may be an endocrine response to mediate beneficial effects of bariatric surgery.
A modified prediction system using combined preoperative anthropomorphic imbalance and fistula risk score for predicting the occurrence of clinically relevant postoperative pancreatic fistula after pancreaticoduodenectomy
Authors: Abe Tomoyuki , Amano Hironobu , Kobayashi Tsuyoshi , Hattori Minoru , Nakahara Masahiro , Ohdan Hideki , Noriyuki Toshio
Published: December 2019

Background: The aim of this study was to evaluate the efficacy of the combination of fistula risk score (FRS) and preoperative body composition factors for predicting the occurrence of clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD).Methods: In this study, 136 consecutive patients who underwent PD between 2006 and 2018 were enrolled. The risk factors of CR-POPF (grades B and C) were analyzed. Preoperative visceral adipose tissue area (VATA), skeletal mass index (SMI), and subcutaneous adipose tissue area (SATA) were calculated from computed tomography data.Results: The overall 30-day mortality and morbidity rates were 0.7% and 38%, respectively. The incidence rates of grade B and C CR-POPF were 27% and 4%, respectively. A univariate analysis revealed that male sex, habitual smoking, prognostic nutritional index < 45, VATA/SATA ≥ 0.9, VATA/SMI ≥ 1.4, and FRS > 4 were significantly associated with the incidence of CR-POPF. A multivariate analysis revealed that VATA/SMI ≥ 1.4 and FRS > 4 were the independent risk factors of CR-POPF. A modified prediction score using the combination of VATA/SMI and FRS significantly predicted CR-POPF after PD.Conclusions: Preoperative anthropomorphic imbalance and FRS were equally accurate in predicting CR-POPF. Patients with high-risk factors should be closely monitored during the postoperative period.
Prevalence of Anemia in School Age Children (SAC) of District Swabi, KPK, Pakistan
Authors: ali irfan , khan ahsan , ahmad mushtaq , rehman Ihtisham ur , hayat fahad , khan mohsin
Published: December 2019

Background: Pakistan has one of the highest prevalence’s of child anemia as compared to other developing countries. This narrative about the prevalence of anemia in school age children’s at district Swabi. Although Swabi has experienced rapid economic growth over the decades, significant health and nutrition problem remains unfortunately because little work has been done to track basic diseases such as anemia. Results: The goal of this research is to assess the prevalence of anemia in Swabi. A total of 400 children of school age participated in this study. District Swabi was divided into four tehsils Topi, Swabi, Razzar and Lahor and 100 samples of blood of both genders were collected from each subject to measure hemoglobin level. From tehsil Swabi 60 boys and 40 girls, tehsil Topi 70 boys and 30 girls, Razar 50 boys and 50 girls and Lahor 80 boys and 20 girls, were examined in the current study. Children included in the study sample were divided into two groups, anemic and non-anemic. In tehsil Swabi 42% of school going children were anemic. The prevalence of anemia in school going children of tehsil Topi was 48%, in tehsil Razar the count of anemic children was 63%and 58% children found anemic in tehsil Lahor. The prevalence was high in tehsil Razar, Lahor, Topi and Swabi respectively. The total anemic children were 52.0% and non-anemic were 48.0%. The mean Hb level of anemic children was 10.9 Gm. %. Conclusion: The presence of anemia reduces resistance, physiological development and declines physical and mental activities. The percentage of anemia in children of lower class families (fewer earnings) was higher 70% as compare to children of upper class families 32%.
Assessment of Kenyan Optometrists Knowledge, Skills and Practice on Cataract, Kisumu County, Western Kenya
Authors: Muma Shadrack , Obonyo Stephen
Published: December 2019

BackgroundCataract is a major contributor to avoidable blindness in the world. It is the clouding of the normally clear lens of the eye characterized by reduced vision, increasing difficulty with vision at night and sensitivity to light and glare. The risk factors of cataract include increased age, smoking and excess exposure to sunlight. Though studies have focused on the causes and treatment of cataract, there is no data on optometrist knowledge, skill and practice on cataract in Kenya. The optometrists are the primary health care providers for cataract patients, they are well placed to assess, provide advice and refer cataract patients to the ophthalmologists.Methods: a cross sectional design was used. Stratified random sampling was used to select sample. Fisher’s formula was used.ResultsA total of 49 optometrists were interviewed over a period of four months, the male to female ratio was 2:1, mean age of 45.8(72%) years, age ranged from 25-39 years with mean duration of practice of one year and maximum of 10 years. One hundred percent optometrists had good knowledge and understanding of importance of slit lamp assessment in making cataract diagnosis. However, our results found that (83.6%) of optometrists used pen torch for assessment of lens changes in patients. On skills, optometrists were classified as having poor skills with thirty nine (79.6%) being unable to diagnose. 61.2% of optometrists did not screen patients aged 40 years and above who attended eye clinics for cataract. The most common challenges reported for not screening was long queues. The study further established that the optometrists had various reasons to refer patients to another hospital including 52.6% for availability of ophthalmologists and 39.5% of optometrists for availability of equipment.ConclusionThe study established that despite the good level of knowledge among the optometrist on cataract, there exist gaps in skills in categorizing the type of cataract. Most optometrists do not screen patients aged 40 years and above for cataract. Hence there is need to sensitize optometrists on the significance of screening for cataract to prevent blindness due to cataract.
Factors affecting the implementation of a whole school mindfulness program: A qualitative study using the Consolidated Framework for Implementation Research
Authors: Hudson Kristian , Lawton Rebecca , Hugh-Jones Siobhan
Published: December 2019

Background Preventing the onset of poor mental health in adolescence is an international public health priority. Universal, whole school preventative approaches are valued for their reach, and anti-stigmatising and resilience building principles. Mindfulness approaches to well-being have the potential to be effective when delivered as a whole school approach for both young people and staff. However, despite growing demand, there is little understanding of possible and optimal ways to implement a mindfulness, whole school approach (M-WSA) to well-being. This study aimed to identify the determinants of early implementation success of a M-WSA. We tested the capacity of the Consolidated Framework for Implementation Research (CFIR), to capture the determinants of the implementation of a mental health intervention in a school setting.Methods Key members of school staff (n=15) from five UK secondary schools attempting to implement a M-WSA were interviewed at two-time points, six months apart, generating a total of 30 interviews. Interviews explored participants’ attitudes, beliefs and experiences around implementing a M-WSA. Interview data were coded as CFIR constructs or other (non CFIR) factors affecting implementation. We also mapped school-reported implementation activity and perceived success over 30 months.Results The CFIR captured the implementation activities and challenges well, with 74% of CFIR constructs identifiable in the dataset. Of the 38 CFIR constructs, 11 appeared to distinguish between high and low implementation schools. The most essential construct was school leadership. It strongly distinguished between high and low implementation schools and appeared inter-related with many other distinguishing constructs. Other strongly distinguishing constructs included relative priority, networks and communications, formally appointed implementation leaders, knowledge and beliefs about the intervention, and executing.Conclusions The CFIR appears useful for assessing the implementation of mental health programs in UK secondary schools. Our findings suggest key implementation constructs that schools, commissioners and policy makers should focus on to promote successful early implementation of mental health programs. School leadership is a key construct to target at the outset.