bluuebunny/crossref_metadata_2025 huggingface dataset:
The assistance of Er,Cr:YSGG laser in pulp injury related to anterior teeth trauma
Authors: Balan Gülşah , Peteers Harry Huiz , Akyüz Serap
Published: December 2019

Background: Erbium chromium or erbium lasers constitute preferred instruments for the preparation of that section of tooth adjacent to the pulp chamber rather than high-speed drills, especially in cases of dental injury. Their advantages can support modified operations in achieving optimum recovery and avoiding complications related to the healing process. Purpose: The aim of the study was to describe another modality of the assistance of erbium, chromium:yattrium-scandium-gallium-garnet (Er,Cr:YSGG) laser in traumarelated pulp injury affecting the anterior teeth. Case(s): The results of laser treatment applied to four pulp injuries of three children were analyzed in this case report. Case Management: Er,Cr:YSGG laser-assisted cavity preparation was performed without resort to a local anesthetic, the cavities being sealed with mineral trioxide aggregate (MTA). None of the cases demonstrated symptomatic or peri-radicular pathology during clinical or radiographic examinations. Conclusion: The results contained in this case report support the application in pediatric dentistry of a Er,Cr:YSGG laser to pulpotomy cavities as part of the treatment of traumatic pulpal injuries to permanent incisors.
Topical application of snail mucin gel enhances the number of osteoblasts in periodontitis rat model
Authors: Hendrawati H. , Agustha Hanindya Noor , Sari Rezmelia
Published: December 2019

Background: Repair of bone damage represents a fundamental issue in the treatment of periodontitis. The important indicator employed to monitor the bone damage repair process is the number of osteoblast cells. Achatina Fulica snail mucin (SM) contains glycosaminoglycans which have the potential to increase their number. However, the use of SM in dentistry remains limited. Purpose: To determine and prove the effect of SM gel in increasing the number of osteoblasts in rat models suffering from periodontitis. Methods: This study used 36 rat models divided into three groups, namely; a treatment group (T: 20% snail mucin gel, n = 12), a positive-control group (P: hyaluronic acid gel, n = 12) and a negative-control group (N: CMC-Na gel, n = 12). 0.2 ml of all material was applied to a pocket by means of a tuberculin syringe once a day for 14 days. Histologic observations using Haematoxylin-Eosin staining were carried out on days 3, 5, 7 and 14. Data was analyzed by two-way ANOVA followed by a post-hoc LSD. Results: A significant difference existed between the number of osteoblasts in the test groups. The highest number of osteoblasts observed was consistently that in the treatment group. Conclusion: The application of 20% snail mucin gel was effective in enhancing the number of osteoblasts in rats suffering from periodontitis.
The activity of polyclonal IgY derived from Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis in inhibiting colonization of Fusobacterium nucleatum and Streptococcus sanguinis
Authors: Lestari Oktaviani Suci , Ridwan Rini Devijanti , Kusumaningsih Tuti , Sidarningsih S.
Published: December 2019

Background: Fusobacterium nucleatum (F. nucleatum) and Streptococcus sanguinis (S. sanguinis) play a role in dental plaque formation which leads to periodontitis. Immunoglobulin Y (IgY) is present in both serum and egg yolk and can bind to the surface components of bacteria. F. nucleatum and S. sanguinis feature the same type of IV pili as Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans). Saliva binding protein (SsaB) in S. sanguinis is a FimA homolog. FimA constitutes a surface element of Porphyromonas gingivalis (P. gingivalis). F. nucleatum and P. gingivalis possess the same outer membrane protein (OMP) molecular mass. Purpose: The study aimed to determine the activity of A. actinomycetemcomitans and P. gingivalis polyclonal IgY present in serum and egg yolk that can inhibit colonization of F. nucleatum and S. sanguinis. Methods: IgY samples were diluted with phosphate buffer saline (PBS). Several holes were made in the nutrient medium with 10 μl antigen (F. nucleatum/S. sanguinis) being inserted into the center hole. 10 μl PBS, 1:1, 1:2, 1:4, 1:8, 1:16 A. actinomycetemcomitans or P. gingivalis polyclonal IgY were subsequently introduced into the surrounding holes. The results of incubation at 37°C were observed after 24-48 hours. Kruskal Wallis and MannWhitney tests were administered to analyse the data. Results: A. actinomycetemcomitans and P. gingivalis polyclonal IgY groups in serum showed a precipitation line at dilution ratios of 1:1 and 1:2, whereas in egg yolk this occurred only at a 1:1 dilution ratio with F. nucleatum and S. sanguinis bacteria in this study. No significant differences were evident between each dilution (p>0.05) and none existed between serum and egg yolk (p>0.05). Conclusion: IgY polyclonal of A. actinomycetemcomitans and P. gingivalis in both serum and egg yolk initiate activities that can inhibit colonization of F. nucleatum and S. sanguinis.
PEMANTAUAN DINAMIKA TINGGI MUKA AIR SECARA OTOMATIS DI LAHAN GAMBUT
Authors: Wakhid Nur , Zainudin Zainudin
Published: December 2019

Ground Water level fluctuation data on tropical peatland is necessary to restore the degraded peatlands as well as for peatland sustainable management. Peatland restoration always begins with groundwater level restoration (GWL). Therefore, measurement of GWL is necessary for further management. GWL fluctuation on peat soil greatly varies even during a day, therefore automatic GWL measurements are inevitably needed. This study aim is to develop an automatic GWL measurement (TMA) by comparing 2 automatic water level loggers in tropical peatlands. This research was conducted in a rubber plantation on Peat Soil I in Jabiren, Pulang Pisau, Central Kalimantan, from February to December 2014. The measurement of GWL was conducted by manual measurement and using 2 automatic water level monitoring devices. Automatic GWL measurement showed a more detail variation than that of manual measurement. The different of GWL between manual, automatic 1 and 2 were on the range of 16-30 cm. Automatic measurement instruments that users were having their advantages or disadvantages, with the result of measurements were significantly different.
Survival analysis of Rural Clinical School of Western Australia graduates: the long-term work of building a long-term rural medical workforce
Authors: Gupta Surabhi , Ngo Hanh , Burkitt Tessa , Puddey Ian , Playford Denese
Published: December 2019

Objective –Deficits in the size of the rural medical workforce is an international issue. In Australia, The Rural Clinical School intervention is effective for initial recruitment of rural doctors. However, the extent of retention is not yet established. This paper summarises rural retention over a 10-year period. Methods –Rural Clinical School graduates of STATE NAME were surveyed annually, 2006-2015, and post Graduate Years (PGY) 3-12 included. Survival was described as “tours of service”, where a tour was either a period of ≥1 year, or a period of at ≥2 weeks, working rurally. A tour ended with a rural work gap of ≥52 weeks. Considering each exit from urban as an event, semi-parametric repeated measures survival models were fitted. Results – Of 468 graduates, using the ≥2 weeks definition, 239 PGY3-12 graduates spent at least one tour rurally (average 61.1, CI 52.5 – 69.7 weeks), and a total length of 14,607 weeks. Based on the tour definition of ≥1 year, 120 graduates completed at least one tour (average 1.89, 1.69 – 2.10 years), and a total of 227 years’ rural work. For both definitions, the number of tours increased from one to four by PGY10/11, giving 17,786 total weeks (342 years) across all PGYs for the ≥2 weeks tour definition, and 256 years total for ≥1 year. Significantly more graduates exited from urban work for the 2007-09 middle cohort compared with 2010-11 (HR 1.876, p=0.022), but no significant difference between 2002-06 and 2010-11. Rural origin, age and gender were not statistically significant. Conclusions – PGY3 – 12 RCS graduates contributed substantially to the rural workforce: 51% did so by short rotations, which have not previously been described, while 26% contributed whole years of service. There was an apparent peak in entry and retention for the middle cohort and decline thereafter, likely attributable to lack of rural advanced/specialist vocational training. These data indicate a real commitment to rural practice by RCS graduates, and the need for rural postgraduate vocational training in the rural context as a key element of a successful rural retention strategy.
Predictive risk factors for postoperative pneumonia after heart transplantation
Authors: Vidal Charles , Pasqualotto Romain , James Arthur , Dureau Pauline , Rasata Julie , Coutance Guillaume , Varnous Shaida , Leprince Pascal , Amour Julien , Bouglé Adrien
Published: December 2019

Background: Pneumonia is a frequent complication in patients undergoing heart transplantation (HTx) that increases morbidity and mortality in this population. Nevertheless, the risk factors for postoperative pneumonia (POP) are still unknown. The aim of this study was to investigate the predictive risk factors for POP in HTx recipients. Methods: In this retrospective study, all patients undergoing HTx between January 2014 and December 2015 were included. All cases of POP occurring until hospital discharge were investigated. The study aimed to determine risk factors using univariate and multivariate Cox regression models. Data are expressed in Odds Ratio [95% CI]. P<0.05 was necessary to reject the null hypothesis. Results: A total of 175 patients were included without any patients being lost to follow-up, and 89 instances of POP were diagnosed in 59 (34%) patients. Enterobacteriaceae and Pseudomonas aeruginosa were the most common pathogens. In the multivariate analysis, the risk factors were preoperative mechanical ventilation (OR 1.42 [1.12-1.80], P<0.01) and perioperative blood transfusion (OR 1.42 [95% CI: 1.20-1.70], P<0.01). POP significantly impacted mortality at 30 days (OR: 4 [1.3 - 12.4], P=0.01) and 1 year (OR: 6.8 [2.5-8.4], P<0.01) and was associated with a longer duration of mechanical ventilation, time to weaning from venoarterial extracorporeal membrane oxygenation and stay in an intensive care unit. Plasma exchanges and intravenous administration of immunoglobulins did not increase the risk of POP. Conclusion: After HTx, preoperative mechanical ventilation and blood transfusion were risk factors for POP and were associated with increased mortality. Enterobacteriaceae and Pseudomonas aeruginosa are the most common pathogens of POP
Qualitative investigation of the factors that generate ambivalent feelings in women who give birth after receiving negative results from non-invasive prenatal testing
Authors: Yotsumoto Junko , Sekizawa Akihiko , Inoue Satomi , Suzumori Nobuhiro , Samura Osamu , Yamada Takahiro , Miura Kiyonori , Masuzaki Hideaki , Sawai Hideaki , Murotsuki Jun , Hamanoue Haruka , Kamei Yoshimasa , Endo Toshiaki , Fukushima Akimune , Katagiri Yukiko , Takeshita Naoki , Ogawa Masaki , Nishizawa Haruki , Okamoto Yoko , Tairaku Shinya , Kaji Takashi , Maeda Kazuhisa , Matsubara Keiichi , Ogawa Masanobu , Osada Hisao , Ohba Takashi , Kawano Yukie , Sasaki Aiko , Sago Haruhiko
Published: December 2019

Background: Women who receive negative results from non-invasive prenatal genetic testing (NIPT) may find that they later have mixed or ambivalent feelings, for example, feelings of accepting NIPT and regretting undergoing the test. This study aimed to investigate the factors generating ambivalent feelings among women who gave birth after having received negative results from NIPT.
Methods: A questionnaire was sent to women who received a negative NIPT result, and a contents analysis was conducted focusing on ambivalent expressions for those 1562 women who responded the questionnaire. The qualitative data gathered from the questionnaire were analyzed using the N-Vivo software package.
Results: Environmental factors, genetic counseling-related factors, and increased anticipatory anxiety, affected the feeling of ambivalence among pregnant women. Furthermore, pregnant women desired more information regarding the detailed prognosis for individuals with Down syndrome and living with them and/or termination, assuming the possibility that they were positive.
Conclusions: Three major interrelated factors affected the feeling of ambivalence in women. Highlighting and discussing such factors during genetic counseling may resolve some of these ambivalences, thereby enhancing the quality of decisions made by pregnant women.
Activating the interleukin-6-Gp130-STAT3 pathway ameliorates ventricular electrical stability in myocardial infarction rats by modulating neurotransmitters in the paraventricular nucleus
Authors: Gao Meng , Yin Dechun , Chen Jugang , Qu Xiufen
Published: December 2019

Background: Malignant ventricular arrhythmias are the most common cause of death in acute myocardial infarction. Recent studies have revealed direct paraventricular nucleus (PVN) involvement in occurrence of ventricular arrhythmias (VAs)，however, the mechanisms are incompletely understood. In this study we investigated the changes of Interleukin-6 (IL-6)-glycorprotein130-STAT3 pathway in the PVN during acute myocardial infarction and its effect on ventricular stability.
Methods: The rats were divided into control group, myocardial infarction group, and paraventricular injected anti-IL-6 antibody group and paraventricular injected SC144 group to observe how interleukin-6 and its downstream glycoprotein130-STAT3 pathway in paraventricular nucleus effect the ventricular stability. Left anterior descending coronary artery was ligated to make myocardial infarction. After that, anti-Interleukin-6 antibody and SC144 were injected into the paraventricular. All data are expressed as the mean ± SEM and were analyzed by ANOVA by a post-hoc LSD test. p<0.05 was considered statistically significant.
Results: After myocardial infarction (MI), the concentration of inflammatory factor interleukin-6 increased and its downstream glycorprotein130-STAT3 pathway was activated in the PVN. After anti-interleukin-6 antibody and glycorprotein130 inhibitor (SC144) injection into the PVN in MI rats, glutamate increased and γ-aminobutyric acid (GABA) decreased in the PVN. We also observed a higher plasma norepinephrine concentration, which increased the vulnerability to ventricular arrhythmias.
Conclusions: In summary, interleukin-6 in the PVN plays a protective role in MI rats, and the glycorprotein130-STAT3 pathway plays a key role in this process. We anticipate that our findings will provide new ideas for the prevention and treatment of arrhythmia after MI.
Smokeless tobacco use: its prevalence and relationships with dental symptoms, nutritional status and blood pressure among rural women in Burkina Faso
Authors: Diendéré Jeoffray , Zeba N. Augustin , Nikiéma Leon , Kaboré Ahmed , Sawadogo W. Paul , Tougouma Somnoma Jean Baptiste , Tinto Halidou , Ouédraogo Arouna
Published: December 2019

Introduction: Sub-Saharan women use smokeless tobacco (SLT) more than smoked tobacco. Among Western Africa countries, the estimated weighted prevalence of SLT use in rural women was the highest in Burkina Faso (after Sierra Leone). This study aimed to assess the prevalence of SLT use and its associated factors among rural women in Burkina Faso by using nationally representative data.
Methods: We used data from the 2013 STEPwise approach to Surveillance (STEPS) study, which provided sociodemographic, clinical (anthropometric, systolic blood pressure [SBP], diastolic blood pressure [DBP], dental symptoms), biological (total and high-density lipoprotein cholesterol and fasting blood sugar), and tobacco and alcohol consumption data. Data for 1730 rural women were used, and we performed Student’s, chi-squared, and Fisher’s exact tests and logistic regression.
Results: The prevalence of current SLT use was 13.8% (95% CI: 12.2-15.5). Significant risks for SLT use were the presence of dental symptoms (adjusted odds ratio [aOR] = 2.59; p = 0.0001), undernourishment (aOR = 1.78; p = 0.002), a decrease in waist circumference (aOR = 0.98; p = 0.023), a decrease in DBP (aOR = 0.97; p = 0.006), increase in the unit of SBP (aOR = 1.01; p = 0.017), and an increase in differential blood pressure (aOR = 1.01; p = 0.041). The co-use of alcohol was also a significant risk factor (aOR = 2.80; p = 0.0001).
Conclusion: The prevalence of current SLT use was high among rural women in Burkina Faso, and significant concerns for users included alcohol co-use, the occurrence of dental symptoms, undernourishment, and an increase in differential blood pressure. National Public Health interventions are needed to reduce SLT use and its health-related concerns.
Explaining the successes and failures of tuberculosis treatment programs; a tale of two regions in rural Eastern Uganda
Authors: Izudi Jonathan , Tamwesigire Imelda K , Bajunirwe Francis
Published: December 2019

Background. Optimally performing tuberculosis (TB) programs are characterized by treatment success rate (TSR) of at least 90%. In rural eastern Uganda, and elsewhere in sub Saharan Africa, TSR varies considerably across district TB programs and the reasons for the differences are unclear. This study explored factors influencing the low and high TSR across four districts in rural eastern Uganda. Methods. We interviewed District TB and Leprosy Supervisors, Laboratory focal persons, and health facility TB focal persons from four districts in Eastern Uganda as key informants. Interviews were audio recorded, transcribed verbatim, and imported into ATLAs.ti where thematic content analysis was performed and results were summarized into themes. Results. The emerging themes were categorized as either facilitators of or barriers to treatment success. The emerging facilitators prevailing in the districts with high rates of treatment success were using data to make decisions and design interventions, continuous quality improvement, capacity building, and prioritization of better management of people with TB. The barriers common in districts with low rates of treatment success included lack of motivated and dedicated TB focal persons, scarce or no funding for implementing TB activities, and a poor implementation of community-based directly observed therapy short course. Conclusion. This study shows that several factors influence the differing rates of treatment success in rural eastern Uganda. These factors should be the focus for TB control programs in Uganda and similar settings in order to improve rates of treatment success.
Spiral artery blood flow during pregnancy: a systematic review and meta-analysis.
Authors: Schiffer Veronique , Evers Laura , de Haas Sander , Ghossein Chahinda , Al-Nasiry Salwan , Spaanderman Marc
Published: December 2019

Background: Downstream remodeling of the spiral arteries (SpA) decreases utero-placental resistance drastically, allowing sustained and increased blood flow to the placenta at all circumstances. We systematically evaluated available reports to visualize adaptation of spiral arteries throughout pregnancy by ultra-sonographic measurements and evaluated when this process is completed.Methods: A systematic review and meta-analysis of spiral artery flow (pulsatility index (PI), resistance index (RI) and peak systolic velocity (PSV)) was performed. English articles were obtained from Pubmed, EMBASE and Cochrane Library and included articles were assessed on quality and risk of bias. Weighted means of Doppler indices were calculated using a random-effects model. Results: In healthy pregnancies, PI and RI decreased from 0.75 (95% CI: 0.67-0.83) and 0.49 (95% CI: 0.46-0.53) in the first trimester to 0.52 (95% CI: 0.48-0.56, p=0.003) and 0.40 (95% CI: 0.38-0.42, p=0.080) in the second trimester and to 0.49 (95% CI: 0.44-0.53, p=0.510) and 0.36 (95% CI: 0.35-0.37, p=0.307) in the third trimester, respectively. In parallel, PSV altered from 0.24 m/s (95% CI: 0.17-0.31 m/s) to 0.28 m/s (95% CI: 0.22-0.34 m/s, p=0.377) and to 0.25 m/s (95% CI: 0.21-0.28 m/s, p=0.919) in the three trimesters. In absence of second and third trimester Doppler data in complicated gestation, only a difference in PI was observed between complicated and healthy pregnancies during the first trimester (1.49 vs 0.76, p<0.001). Although individual studies have identified differences in PI between SpA located in the central part of the placental bed versus those located at its periphery, this meta-analysis could not confirm this (p=0.349).Conclusions: This review and meta-analysis concludes that an observed decrease of SpA PI and RI from the first towards the second trimester parallels the physiological trophoblast invasion converting SpA during early gestation, a process completed in the midst of the second trimester. Higher PI and RI were found in SpA of complicated pregnancies compared to healthy pregnancies, possibly reflecting suboptimal utero-placental circulation. Longitudinal studies examining comprehensively the predictive value of spiral artery Doppler for complicated pregnancies are yet to be carried out.
Icarisid I specifically facilitates ATP or nigericin-induced NLRP3 inflammasome activation and causes idiosyncratic hepatotoxicity
Authors: Gao Yuan , Bai Zhaofang , Xiao Xiaohe , Xu Guang , Niu Ming , Wang Jiabo , Zhan Xiaoyan , Guo Yuming , Wang Zhilei , Ma Li , He Tingting , Qin Nan , Shi Wei
Published: December 2019

Background Epimedii Folium(EF) is commonly used for treating bone fractures and joint diseases, but the potential hepatotoxicity of EF limits its clinical application. Our previous study confirms that EF could lead to idiosyncratic drug-induced liver injury (IDILI) and hepatocyte apoptosis, but the mechanism remains unknown. Studies have shown that NLRP3 inflammasome plays an important role in the development of various inflammatory diseases such as IDILI. Specific stimulus-induced NLRP3 inflammasome activation may has been a key strategy for lead to liver injury. Therefore, main compounds derived from EF were chosen to test whether the ingredients in EF could activate the NLRP3 inflammasome and to induce IDILI.Methods Mouse were treated with Icarisid I, and then stimulated with inflammasome stimuli and assayed for the production of caspase-1 and interleukin 1β (IL-1β) and the release of lactate dehydrogenase (LDH). Determination of intracellular potassium, ASC oligomerization as well as reactive oxygen species (ROS) production were used to evaluate the stimulative mechanism of Icarisid I on inflammasome activation. Mouse models of NLRP3 diseases were used to test whether Icarisid I has hepatocyte apoptosis effects and promoted NLRP3 inflammasome activation in vivo.Results Icarisid I specifically enhances NLRP3 inflammasome activation triggered by ATP or nigericin but not SiO2, poly(I:C) or cytosolic LPS. Additionally, Icarisid I does not alter the activation of NLRC4 and AIM2 inflammasomes. Mechanically, Icarisid I alone does not induce mitochondrial reactive oxygen species (mtROS), which is one of the critical upstream events of NLRP3 inflammasome activation; however, Icarisid I increases mtROS production induced by ATP or nigericin but not SiO2. Importantly, Icarisid I leads to liver injury and NLRP3 inflammasome activation in an LPS-mediated susceptibility mouse model of IDILI, but the effect of Icarisid I is absent in the LPS-mediated mice model pretreated with MCC950, which is used to mimic knockdown of NLRP3 inflammasome activation.Conclusions Our study reveals that Icarisid I specifically facilitates ATP or nigericin-induced NLRP3 inflammasome activation and causes idiosyncratic hepatotoxicity. The findings suggest that Icarisid I or EF should be avoided in patients with diseases related to ATP or nigericin-induced NLRP3 inflammasome activation, which may be risk factors for IDILI.
Comparative evaluation of epidural bupivacaine alone and bupivacaine combined with magnesium sulfate in providing postoperative analgesia: a meta-analysis of randomized controlled trials
Authors: Li Li-Qin , Zhang Hou-Zhong , Fang Mei-Dan , Wang Cong , Lu Hong-Liu , Wang Li-Xue , Xu Hong-Yu
Published: December 2019

Background The comparative efficacy of epidural bupivacaine alone and bupivacaine combined with magnesium sulfate in providing postoperative analgesia remains controversial.Methods We searched Mediline (OvidSP), EMBASE (OvidSP) and Cochrane Central Register of Controlled Trials (CENTRAL) to identify trials that compared epidural bupivacaine and magnesium sulfate combination (intervention) with bupivacaine alone (control). Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework was used to assess the quality of evidence.Results Eleven studies fulfilled our inclusion criteria after screening. We found that epidural bupivacaine combined with magnesium sulfate could prolong the time for first rescue analgesics (SMD 4.96; 95% CI [2.75, 7.17], P<0.00001, I 2 = 98%), reduce the number of patients who need rescue analgesics (RR 0.38; 95% CI [0.20, 0.74], P = 0.004, I 2 = 75%) and requirement for rescue analgesics (SMD -2.65; 95% CI [-4.23, -1.06], P=0.001, I 2 = 96%).Conclusions Magnesium suifate as an adjuvant of epidural bupivacaine improved postoperative analgesia. However, we rated the quality of evidence to be very low because of high heterogeneity, imprecise of results and small sample sizes. Furthermore, further large high-quality trials are still needed to confirm the effects of magnesium sulfate on postoperative analgesia.
Anticholinergics and Benzodiazepines on Cognitive Impairment among Elderly with Alzheimer’s Disease: a One year Follow-Up Study
Authors: Jenraumjit Rewadee , Chinwong Surarong , Chinwong Dujrudee , Kanjanarach Tipaporn , Kshetradat Thanat , Wongpakaran Tinakon , Wongpakaran Nahathai
Published: December 2019

Objective Age-associated decline in central cholinergic activity makes older adults susceptible to harmful effects of anticholinergics (ACs). Evidence exists of an association between effects of AC medications on cognition. This retrospective cohort study examines how ACs affect cognition among older adults with Alzheimer’s disease (AD) who received acetylcholine esterase inhibitors (AChEIs) over the course of 12 months. Results A total of 133 (80% women, mean age 78.38 years, SD 7.4) were recruited. No difference in sex, age and comorbid diseases was observed between participants who took ACs, Benzodiazepines (BZDs) and AChEIs. The most common prescribed ACs was quetiapine, being used for behavioral and psychological symptoms (BPSD). Multilevel analysis showed that the change of mental state examination scores were significantly predicted in the group using ACs (t (169), -2.52, p = .020) but not with the groups using BZD (t (162), 0.84, p = .440). Evidence showed that older adults with Alzheimer’s disease and exposed to ACs exhibited lower global cognitive scores than those without AC exposure. Using ACs could be a trade-off between controlling BPSD and aggravating cognitive impairment. Highlighting the awareness of the potential anticholinergic effect is important and may be the best policy.
Comparison of the results of sputum culture and bronchoscopic lavage fluid culture:an analysis report of large sample size data from the Clinical Microbiology Laboratory
Authors: Tian Lei , Zhang Zhen , He Feng , sun ziyong
Published: December 2019

Background Sputum specimens were the most common for Clinical Microbiology Laboratory in China. For the results of sputum culture, it was difficult for clinicians to evaluate the significance, and even more difficult for laboratory physicians. At present, most Clinical Microbiology Laboratories in China executed quality assessment of sputum specimens. But how to evaluate the results of sputum culture was still very confusing. To solve this problem, we conducted a series of retrospective studies.Methods Based on the culture results of bronchoscopic lavage fluid (BALF), the differences of sputum culture results before (2013-2015) and after (2016-2018) quality control of sputum samples in our hospital were compared.Results Pseudomonas aeruginosa , Acinetobacter baumannii , Klebsiella pneumoniae and Staphylococcus aureus were the four most common pathogens in sputum and BALF culture, both in 2013-2015 years and 2016-2018 years. Antimicrobial susceptibility test from 2013-2015 and 2016-2018 both showed for P. aeruginosa and K. pneumoniae , the susceptibility rates of BALF isolates to all commonly used antibiotics were higher than those from sputum. For A. baumannii and S. aureus , the sensitivity rates of BALF isolates to most antibiotics were higher than those from sputum. After quality control of sputum samples, there was still a difference between the results of sputum culture and those of BALF.Conclusions Even though the quality control of sputum specimens had been carried out, the results of culture and antimicrobial resistance of pathogens from qualified sputum samples were still different from those of BALF.
Ability of near-infrared spectroscopy and chemometrics to predict the age of mosquitoes reared under different conditions
Authors: Ong Oselyne , Kho Elise , Esperança Pedro , Freebairn Chris , Dowell Floyd , Devine Gregor , Churcher Thomas
Published: December 2019

Background: Practical, field-ready age-grading tools for mosquito vectors of disease are urgently needed because of the impact that daily survival has on vectorial capacity. Previous studies have shown that near-infrared spectroscopy (NIRS), in combination with chemometrics and predictive modeling, can forecast the age of laboratory-reared mosquitoes with moderate to high accuracy. However, it remains it is unclear whether the technique has utility for identifying shifts in the age structure of wild-caught mosquitoes or whether models derived from the laboratory or semi-field mosquitoes can be applied to mosquitoes reared under different environments. Methods: NIRS spectral data from adult female Aedes albopictus mosquitoes reared in the laboratory (2, 5, 8, 12 and 15 days old) and in semi-field cages populated by wild-caught pupae (resulting in adults of 1, 7 and 14 days old). Spectral data collected from mosquitoes were used to determine if models derived from laboratory material using partial least squares (PLS) regression for the development of predictive models could be effectively applied to mosquitoes from more natural semi-field environments. Results: Models trained on spectra from laboratory-reared material were able to predict the age of other laboratory-reared mosquitoes with moderate accuracy and successfully differentiated all day 2 and 15 mosquitoes. Models derived with laboratory mosquitoes could not differentiate between semi-field age groups, with age predictions relatively indistinguishable for day 1-14. Pre-processing of spectral data and improving the PLS regression framework to avoid overfitting can increase accuracy, but predictions of mosquitoes reared in different environments remained poor. Principle component analysis confirms substantial spectral variations between laboratory and semi-field mosquitoes despite both being derived from the same island population. Conclusions: Model trained on laboratory mosquitoes were able to predict ages of laboratory mosquitoes with good sensitivity and specificity, however it was unable to predict age class of semi-field mosquitoes. This study suggests that laboratory-reared mosquitoes do not capture enough environmental variation to accurately predict the age of the same species reared under different conditions. Further research is needed to explore alternative pre-processing methods and machine learning techniques, and to understand factors that affect absorbance in mosquitoes before field application using NIRS.
Conserved associations between G-quadruplex-forming DNA motifs and virulence gene families in malaria parasites
Authors: Gage Hunter L. , Merrick Catherine J.
Published: December 2019

Background:
The Plasmodium genus of malaria parasites encodes several families of antigen-encoding genes. These genes tend to be hyper-variable, highly recombinogenic and variantly expressed. The best-characterized family is the var genes, exclusively found in the Laveranian subgenus of malaria parasites infecting humans and great apes. Var genes encode major virulence factors involved in immune evasion and the maintenance of chronic infections. In the human parasite P. falciparum, var gene recombination and diversification appear to be promoted by G-quadruplex (G4) DNA motifs, which are strongly associated with var genes in P. falciparum. Here, we investigated how this association might have evolved across Plasmodium species – both Laverania and also more distantly related species which lack vars but encode other, more ancient variant gene families.
Results:
The association between var genes and G4-forming motifs was conserved across Laverania, spanning ~1 million years of evolutionary time, with suggestive evidence for evolution of the association occurring within this subgenus. In rodent malaria species, G4-forming motifs were somewhat associated with pir genes, but this was not conserved in the Laverania, nor did we find a strong association of these motifs with any gene family in a second outgroup of avian malaria parasites. Secondly, we compared two different G4 prediction algorithms in their performance on extremely A/T-rich Plasmodium genomes, and also compared these predictions with experimental data from G4-seq, a DNA sequencing method for identifying G4-forming motifs. We found a surprising lack of concordance between the two algorithms and also between the algorithms and G4-seq data.
Conclusions:
G4-forming motifs are uniquely strongly associated with Plasmodium var genes, suggesting a particular role for G4s in recombination and diversification of these genes. Secondly, in the A/T-rich genomes of Plasmodium species, the choice of prediction algorithm may be particularly influential when studying G4s in these important protozoan pathogens.
Management of Constipation in Long-term Care Hospitals and its Ward Manager and Organization Factors
Authors: Takaoka Manami , Igarashi Ayumi , Futami Asako , Yamamoto-Mitani Noriko
Published: December 2019

Background: Studies examining organizational factors that may influence constipation management in long-term care (LTC) hospitals are lacking. This study aimed to clarify the practice of constipation management in LTC hospitals and to explore its factors, including ward manager’s perception, organizational climate, and constipation assessment.Methods: In this cross-sectional questionnaire survey of ward managers and staff nurses working in LTC wards, we determined daily assessment and practices regarding constipation management. We also conducted multivariate analyses to examine factors related to constipation management.Results: There was a 20% response rate to the questionnaire. Nearly all LTC wards routinely assessed bowel movement frequency; other assessments were infrequent. Laxatives were used, but the use of dietary fiber and probiotic products was implemented in only 20%–30% of wards. The implementation of non-pharmacological management and adequate use of stimulant laxatives were positively associated with the ward manager’s belief and knowledge, organizational climate, the existence of nursing records for constipation assessment, planned nursing care for constipation, and organized conferences and in-hospital study sessions on constipation management.Conclusion: Areas to improve constipation management in LTC hospitals include altering the ward manager’s perception, improving hospital’s organizational climate, and introducing standardized assessment/care planning systems.
Molecular surveillance of antimalarial drug resistance in Democratic Republic of Congo: high variability of chloroquinoresistance and lack of amodiaquinoresistance
Authors: Yobi Doudou Malekita , Kayiba Nadine Kalenda , Mvumbi Dieudonné Makaba , Boreux Raphael , Kabututu Pius Zakayi , Situakibanza Hippolyte Nani-Tuma , Likwela Joris Losimba , De Mol Patrick , Okitolonda Emile Wemakoy , Speybroeck Niko , Mvumbi Georges Lelo , Hayette Marie-Pierre
Published: December 2019

Background The loss of chloroquine (CQ) effectiveness has led to its withdrawal from national policies as first-line treatment for uncomplicated malaria in several endemic countries such as in the Democratic Republic of Congo (DRC). The K76T mutation on the pfcrt gene has been identified as a marker of CQ resistance and the SVMNT haplotype in codons 72–76 on the same gene has been associated with resistance to amodiaquine (AQ). In DRC, the prevalence of K76T has decreased from 100% in 2000 to 63.9% in 2014. The purpose of the study was to determine the prevalence of K76T mutations in P. falciparum circulating strains, sixteen years after CQ withdrawal in DRC and to investigate the presence of SVMNT haplotype. Methods In 2017, ten geographical sites across DRC were selected. Dried blood samples were collected from patients attending health centers. Malaria was first detected by rapid diagnostic test (RDT) available on site (SD Bioline malaria Ag Pf or CareStart Malaria Pf) or thick blood smear and then confirmed by a P. falciparum species-specific real-time PCR assay. A pfcrt gene segment containing a fragment that encodes amino acids at positions 72-76 was amplified by conventional PCR before sequencing. Results A total of 1070 patients were enrolled. Of the 806 PCR-confirmed P. falciparum positive samples, 764 were successfully sequenced. The K76T mutation was detected in 218 (28.5%; IC95%: 25.4% – 31.9%) samples, mainly (96%) with the CVIET haplotype. The CQ resistance prevalence was unequally distributed across the country ranging from 1.5% in Fungurume to 89.5% in Katana. The SVMNT haplotype, related to AQ resistance, was not detected. Conclusion Overall, the P. falciparum CQ resistance rate has decreased significantly and no resistance marker to AQ was detected in DRC in 2017. However, the between regions variability of CQ resistance remains high in the country. Further studies are needed for a continuous monitoring of the CQ resistance level for a prospective re-use in malaria management. The absence of AQ resistance is in line with the use of this drug in the current DRC malaria treatment policy.
Genome wide association analysis on semen volume and milk yield using different strategies of imputation to whole genome sequence in French dairy goats
Authors: Talouarn Estelle , Bardou Philippe , Palhière Isabelle , Oget Claire , Clément Virginie , Tosser-Klopp Gwenola , Rupp Rachel , Robert-Granié Christèle
Published: December 2019

Goats were domesticated 10,500 years ago to supply humans with useful resources. Since then, specialized breeds that are adapted to their local environment have been developed and display specific genetic profiles. The VarGoats project is a 1,000 genomes resequencing program designed to cover the genetic diversity of the Capra genus. In this study, our main objective was to assess the use of sequence data to detect genomic regions associated with traits of interest in French Alpine and Saanen breeds. Sequence variants were assessed using indicators of quality, depth, minor allele frequency (MAF) and position.
Direct imputation from the GoatSNP50 BeadChip genotypes to sequence level was investigated in these breeds using FImpute and different reference panels: within-breed, all Capra hircus sequenced individuals, European goats and French mainland goats. The best results were obtained with the French goat panel with allele and genotype concordance rates reaching 0.86 and 0.75 in the Alpine and 0.86 and 0.73 in the Saanen breed respectively. Mean correlations tended to be low in both breeds due to the high proportion of variants with low MAF profiles.
For association analysis, imputation was performed using FImpute for 1,129 French Alpine and Saanen males using within-breed and French panels on the 23,338,436 filtered variants. Association analysis was carried out using polygenic models with GCTA. The association results of both imputation scenarios were then compared. In Saanen goats, a large region on chromosome 19 was significantly linked to semen volume and milk yield in both scenarios. Significant variants for milk yield were annotated for 91 genes on chromosome 19 in Saanen goats. For semen volume, the annotated genes include YBOX2 which is related to azoospermia or oligospermia in other species. New signals for milk yield were detected on chromosome 2 in Alpine goats and on chromosome 5 in Saanen goats when using a multi-breed panel. GWAS on imputed sequences confirmed the existence of QTLs and identified new regions of interest in dairy goats. Adding identified candidates to a genotyping array and sequencing more individuals might corroborate the involvement of these regions in functional and production traits while removing potential imputation errors.
Competitive endogenous RNA network reveals that miR-1343 play key regulatory roles in longissimus dorsi muscle between Saba and Yorkshire pigs
Authors: Hu Wei , Chen Qiang , Wang Xiaoyi , Dong Xinxing , Li Mingli , Lan Guoxiang , Yan Dawei , Yang Yu , Lu Shaoxiong
Published: December 2019

Background Pork quality is an important economic trait in pig industry, and increasing data shows that Chinese indigenous and Western commercial pig breeds have significant differences in pork quality. However, the molecular regulatory mechanism of pork quality formation is still unclear. The aim of this study was to explore the transcriptional regulation mechanism of pork quality formation of Chinese Saba pig (SS) and Western Yorkshire pig (YY) breeds.
Results A total of 31 DEmiRNAs, 902 DEmRNAs, 47 DElncRNAs and 198 DEcircRNAs were identified in longissimus dorsi muscles between SSs and YYs. On the basis of differentially expressed RNAs, two ceRNA networks including lncRNA-miRNA-mRNA and circRNA-miRNA-mRNA were established, and two ceRNA networks showed that miR-1343 had the most links in two ceRNA networks, which demonstrated that miR-1343 might play key regulatory roles in longissimus dorsi muscle formation between SS and YY breeds.
Conclusions The present study identified miR-1343 as key regulatory factor in pig longissimus dorsi muscle formation by ceRNA networks, which provides novel insights into molecular regulatory mechanism of pork quality formation between fat-type and lean-type pig breeds.
The role of residents in medical students’ neurology education: current status and future perspectives
Authors: Keser Zafer , Rodriguez Yvo A , Tremont Jennifer , Hsieh Peggy H , McCullough Louise D. , Sandrone Stefano , Stimming Erin F
Published: December 2019

Background: Neurophobia, a well-described fear of Neurology affecting medical students worldwide, may be one of the causes of the decreased interest in neurology, which is leading to a shortage of neurologists in the United States. Within educational systems, residents play a key role in education of students, although often underrecognized. Here we formally investigate the impact of resident teaching on medical students’ neurologic educational experience, analyze how this relates to students’ confidence and interest in neurology. Methods: Third year medical students (n=234) of UTHealth’s McGovern Medical School rotating at Neurology as their core rotation completed two surveys regarding their rotation experiences; before and after their rotation in an anonymous manner to measure their interest and confidence in neurology and the impact of their interactions with the neurology residents on their rotation experience. Also residents underwent a workshop on small group teaching to improve their teaching effectiveness. Non-parametrical comparison and ordinal regression analyses were utilized for data analyses. Results: Rotating medical students felt significantly more confident in managing neurological conditions more interested in pursuing neurology residency after their rotation. There was a significant association between the medical students’ overall rotation experience and the residents’ teaching effectiveness. Their overall rotation experience was also associated with their interest and confidence in neurology. There was a trend of increase in residents’ teaching effectiveness and students’ rotation experience after the workshop. Conclusion: This study shows that resident led teaching efforts are important in improving the medical students’ neurologic education. We also discuss future strategies to exploit “near-peer” teaching in a sustainable fashion to increase the medical students educational experience and competencies and how these could potentially mitigate neurophobia.
Dealing with patient expectations regarding the prescription of antibiotics in ambulatory care in Germany: A qualitative analysis
Authors: Stuermlinger Anna , Poss-Doering Regina , Glassen Katharina , Wensing Michel , Kamradt Martina
Published: December 2019

Background Antibiotics prescription rates are relatively high in primary care in Germany. Patients’ expectations have frequently been mentioned as reason for high prescription rates. The extent to which patients’ expectations play a role and the strategies that physicians use to deal with these expectations and prevent non-indicated prescriptions in acute, uncomplicated infections are the subject of this paper.Methods In this qualitative study, twenty-seven semi-structured interviews with physicians were conducted in 2018. Data were audiotaped, pseudonymized and transcribed verbatim. The analysis was based on a framework analysis according to the Tailored Implementation in Chronic Diseases (TICD) checklist, and was expanded for deeper analysis and completed with the Behavior Change Techniques (BCT) taxonomy. Results The data revealed that patients’ expectations regarding the prescription of antibiotics can play an important role, although they may be ignored by physicians. If physicians respond to patients’ expectations, they use various strategies to deal and communicate with patients. Successful communication is more often achieved, if the physician takes sufficient time with the patient and if this results in a cooperative conversation. Thus, patients get informed about antibiotics and antimicrobial resistance, and it is possible to discuss alternative treatments. Seven strategies from the BCT taxonomy were mentioned by physicians in this study.Conclusion Constructive physician-patient communication was key to reducing antibiotic prescribing. The range of behavior change techniques mentioned by physicians was relatively limited and the use of a wider range of strategies could be the focus of future implementation strategies. Trial registration: ISRCTN, ISRCTN58150046. Registered 24 August 2017. Keywords Antibiotics prescription, patient expectations, physician-patient communication, patient education, communication strategies, behavior change technique, qualitative research