bluuebunny/crossref_metadata_2025 huggingface dataset:
Caracterização Biométrica dos Caprinos da República de Cabo Verde
Authors: Pires L.C. , Machado T.M. , Fonseca J. de D. , Fonseca J.F. , Pile E. , Brandão F.Z.
Published: August 2019

Objetivou-se discernir populações caprinas de cinco ilhas da República de Cabo Verde (n=533) por meio de dados biométricos e análises estatísticas. Foram avaliadas 16 características de fêmeas adultas, através da estatística descritiva simples, análise de variância, teste de multicolinearidade, distância generalizada de Mahalanobis (D²) e algoritmo UPGMA (Unweighted Pair Group Method Arithmetic Mean). Após o teste de multicolinearidade foi identificada e descartada a variável profundidade torácica. As D² foram calculadas com base nas 15 medidas biométricas. O maior valor da D² foi entre as populações das ilhas do Fogo e São Nicolau (22,73), e a menor D² foi entre Santo Antão e São Vicente (3,71). O dendrograma a partir de 15 variáveis em cinco populações colocou as cabras da ilha de Fogo em ramo a parte das demais. Agruparam-se num ramo as cabras das ilhas de Santo Antão e São Vicente. Este resultado está de acordo com a distância geográfica entre as ilhas de Cabo Verde e o histórico recente de intercâmbio de animais entre elas.
Respuesta comportamental de cerdos en crecimiento criados en ambiente cálido húmedo para alimentar los periodos de restricción y la suplementación de ácido ascórbico
Authors: Njoku C.P. , Adeleye O.O. , Egbeyale L.T. , Fagbemi K.A. , Okunniyi T.A. , Adeyemi O.A.
Published: August 2019

Objetivou-se discernir populações caprinas de cinco ilhas da República de Cabo Verde (n=533) por meio de dados biométricos e análises estatísticas. Foram avaliadas 16 características de fêmeas adultas, através da estatística descritiva simples, análise de variância, teste de multicolinearidade, distância generalizada de Mahalanobis (D²) e algoritmo UPGMA (Unweighted Pair Group Method Arithmetic Mean). Após o teste de multicolinearidade foi identificada e descartada a variável profundidade torácica. As D² foram calculadas com base nas 15 medidas biométricas. O maior valor da D² foi entre as populações das ilhas do Fogo e São Nicolau (22,73), e a menor D² foi entre Santo Antão e São Vicente (3,71). O dendrograma a partir de 15 variáveis em cinco populações colocou as cabras da ilha de Fogo em ramo a parte das demais. Agruparam-se num ramo as cabras das ilhas de Santo Antão e São Vicente. Este resultado está de acordo com a distância geográfica entre as ilhas de Cabo Verde e o histórico recente de intercâmbio de animais entre elas.
Controle e susceptibilidade de capim-braquiária e capim-ruziziensis ao glyphosate e fluazifop-p-butil
Authors: Silveira R.R. , Santos M.V. , Ferreira E.A. , Braz T.G.S. , Santos J.B. , Andrade J.C.A. , Costa J.P.R. , Silva A.M.S. , Silva L.D.
Published: August 2019

Este estudo teve como objetivo avaliar o controle e susceptibilidade de capim-braquiária e capim-ruziziensis em crescimento inicial submetidos a diferentes doses dos herbicidas glyphosate e fluazifop-p-butil. Os tratamentos foram arranjados no esquema fatorial 2 × 6, com cinco repetições, sendo duas gramíneas: Brachiaria decumbens cv. Basilisk (capim-braquiária) e B. ruziziensis (capim-ruziziensis), e seis doses dos herbicidas: 0,00; 0,25; 0,50; 1,00; 1,5 e 2,00 vezes a dose comercial indicada pelos fabricantes. Aos 7, 15, 21 e 30 dias após aplicação dos herbicidas (DAA) foram avaliadas visualmente a intoxicação em capim-braquiária e capim-ruziziensis. O glyphosate causou intoxicação de 100% em plantas de capim-braquiária e capim-ruziziensis, mesmo na menor dose (90 g ha-1), podendo ser utilizado com eficiência para o controle dessas espécies no início de desenvolvimento. Foi observado que as plantas submetidas ao fluazifop-p-butil apresentaram rebrota apenas nas doses aplicadas até 100 g ha-1 para capim-braquiária e 50 g ha-1 para o capim-ruziziensis. Esses resultados confirmam a eficiência dessa molécula herbicida no controle dessas duas espécies a partir das doses de 200 g ha-1 e 100 g ha-1 para capim-braquiária e capim-ruziziensis, respectivamente.
Herdabilidade de características de crescimento em bovinos da raça Nelore utilizando métodos da Máxima Verossimilhança Restrita e Inferência Bayesiana
Authors: Paiva J.T. , Resende M.D.V. , Resende R.T. , Oliveira H.R. , Silva H.T. , Caetano G.C. , Lopes P.S. , Silva F.F.
Published: August 2019

O melhoramento animal é uma ciência preditiva que tem na variabilidade genética do rebanho a sua base e na seleção uma importante ferramenta de ação, cuja eficiência é ponderada pela herdabilidade das características de importância econômica, que é um parâmetro específico de cada rebanho. Por ser bom indicador das consequências do manejo genético nos sistemas de produção, a herdabilidade recebeu atenção da pesquisa e contribuição da evolução de recursos computacionais e de métodos estatísticos para a estimação de seus componentes de variância, resultando em estimativas com maior precisão, inicialmente pelo método de mínimos quadrados, em seguida por máxima verossimilhança e estatísticas bayesianas. O rebanho Nelore do Brasil passou por essas etapas no seu processo de melhoramento genético, que tem sido norteado pela seleção em características de crescimento (pesos em idades padrão) como fenótipos de interesse econômico, que apresentam herdabilidade de moderada a alta magnitude. A herdabilidade tem sido estimada por diversos procedimentos, mas a estimação de componentes de variância por máxima verossimilhança restrita (REML) tem sido preferida. No entanto, limitações como a demanda computacional e a grande quantidade de dados tem favorecido o uso da Inferência Bayesiana. Partindo dessas premissas, o objetivo com esta revisão é abordar a herdabilidade das características de crescimento em bovinos da raça Nelore estimada pelos métodos de Máxima verossimilhança restrita e Inferência Bayesiana.
Description of attendance of scheduled follow up clinic visits and weight changes among low-birthweight infants post discharge at a tertiary hospital in Kampala, Uganda.
Authors: Namiiro Flaviah B , Rujumba Joseph , Nankunda Jolly , Kasirye Phillip , Batte Anthony , Mupere Ezekiel
Published: August 2019

Background: Follow up after hospital discharge is a recommended and common medical practice for high risk infants like those born with low birthweight and at preterm, this however is rare in LIC. Premature babies are at risk of long term disabilities and require continued care both at home and in designated facilities. We sought to determine the attendance of scheduled follow up clinic visits for preterm infants post hospital discharge.
Methods: A review of records for all infants seen in the preterm clinic at Mulago National Referral Hospital between January and December 2015 was done. After discharge from the SCBU, infants are followed up in the Kangaroo Mother Care clinic every fortnight until they weigh 2500 grams. They then transition to the Preterm Care Clinic where they are followed up every two to three months until 18 months of corrected age.
Findings: Between September 2014 and December 2015, 7224 neonates were admitted to the SCU of Mulago Hospital. Of these, 3537 (49 %) weighed less or equal to 2500 grams, thus majority were eligible for follow up in the special clinics after discharge.
Of the 590 babies registered in the PTC during 2016; 423 (71.7%) were included for analysis and 167 (28.3) % were excluded due to missing or incomplete data. Majority of the infants weighed 1501-2000gms (50%), only 3% weighed less than 1000gms, 14% more than 2000gms and 5% record of birth weight was missing. Almost 90% of the visits during KMC clinic were on schedule as compared to 64% during PTC visits. The average number of visits in the KMC clinic were three per baby; 105 babies had between 4-5 visits and 15% of all the participants were still attending the clinic by one year of age. Many babies were not seen in the clinic after the age of 6 months.
Conclusion: Scheduled follow up clinic attendance for low birth weight preterm infants is suboptimal with only one out of four were followed up after one year. There is need to strengthen utilization of available services, community support and devise means to improve the long term follow up.
A large-scale comparative study of isoform expressions measured on four platforms
Authors: Zhang Wei , Petegrosso Raphael , Chang Jae Woong , Yong Jeongsik , Chien Jeremy , Kuang Rui
Published: August 2019

Background: Most eukaryotic genes produce different transcripts of multiple isoforms by inclusion or exclusion of particular exons. The isoforms of a gene often play diverse functional roles and thus, it is necessary to accurately measure isoform expressions as well as the genes'. While previous studies have demonstrated the strong agreement between mRNA-sequencing (RNA-seq) and array-based gene and/or isoform quantification platforms (Microarray gene expression and Exon-array), the more recently developed NanoString platform has not been systematically evaluated and compared, especially in large-scale studies across different cancer domains.

Results: In this paper, we present a large-scale comparative study among RNA-seq, NanoString, array-based and RT-qPCR platforms using 46 cancer cell lines across different cancer types to understand and evaluate the calibers of the platforms for measuring gene and isoform expressions in cancer studies. We first performed NanoString experiments on 59 cancer cell lines with 403 custom-designed probes for measuring the expressions of 405 isoforms in 155 genes and additional RT-qPCR experiments for a subset of the measured isoforms in 13 cell lines, and then combined the data with the matched RNA-seq, Exon-array and Microarray data of 46 of the 59 cell lines for the comparative analysis.

Conclusion: In the comparisons of the platforms for evaluating expressions at both isoform and gene levels, we found that (1) the degree of agreement across platforms on quantifying isoform expressions is lower than gene expressions; (2) NanoString and Exon-array are not consistent on isoform quantification even though both techniques are based on hybridization reactions; (3) RT-qPCR experiments are more consistent with RNA-seq quantification results on isoform-level compared to NanoString and Exon-array; (4) different RNA-seq isoform quantification algorithms showed inconsistent results, and two isoform quantification methods Net-RSTQ and eXpress are more consistent across the platforms in the comparison; (5) RNA-seq has the best overall consistent with the other platforms on gene expression quantification.
Homocysteine as a potential predictive factor for high major adverse cardiovascular events risk in female patients with premature acute coronary syndrome
Authors: Wei Mei , Wang Le , Liu Yongsheng , Zheng Mingqi , Ma Fangfang , Qi Yanchao , Liu Gang
Published: August 2019

Background We aimed to investigate correlation of homocysteine (Hcy) level with clinical characteristics, and explore its predictive value for major adverse cardiovascular events (MACE) risk in female patients with premature acute coronary syndrome (ACS).Methods Serum Hcy level was detected from 1,299 female patients with premature ACS. According to the tertile of Hcy level, patients were divided into three groups: lowest tertile group (≤9.1 µmol/L), middle tertile group (9.2~11.6 µmol/L) and highest tertile group (>11.6 µmol/L). MACE incidence was recorded and MACE-free survival was caculated with the median follow-up duration of 28.3 months.Results Increased Hcy correlated with older age ( P <0.001), higher creatinine level ( P <0.001) and enhanced uric acid level ( P =0.001), while reduced fasting glucose concentration ( P <0.001). MACE incidence was 10.7% and it was highest in highest tertile group (22.1%), followed by middle tertile group (7.7%) and lowest tertile group (2.4%) ( P <0.001). Receiver operating characteristic curve showed that Hcy distinguished MACE patients from non-MACE patients with the area under the curve of 0.789 (95% CI: 0.742-0.835). Kaplan-Meier curves revealed that MACE-free survival was shortest in Hcy highest tertile group, followed by middle tertile group and lowest tertile group ( P <0.001). Multivariate Cox’s analyses further showed that higher Hcy level was an independently predictive factor for poor MACE-free survival (middle tertile vs. lowest tertile ( P =0.001, HR: 3.615, 95% CI: 1.661-7.864); highest tertile vs. lowest tertile ( P <0.001, HR: 11.023, 95% CI: 5.356-22.684)).Conclusion Hcy serves as a potential predictive factor for increased MACE risk in female patients with premature ACS.
Clinical characteristics and outcomes for HIV-associated Diffuse Large B-cell Lymphoma in China: A retrospective single-center study
Authors: Wu Jiazhu , Miao Yi , Li Xia , Lou Jincheng , Qian Chuan , Tao Pengfei , Wang Xicheng , Dong Xingqi , Guo JingJing , Liang Jinhua , Xu Wei , Li Jianyong , Min Haiyan
Published: August 2019

Background: Human immunodeficiency virus (HIV) infection is associated with an increased risk of aggressive lymphoma, especially diffuse B cell lymphoma (DLBCL). We aimed to analyze characteristics and outcomes of DLBCL in HIV-associated patients.
Methods: We retrospectively studied HIV-infected patients with DLBCL since 2011. Data on HIV infection and lymphoma characteristics, treatment and outcome were retrieved and analyzed.
Results: In 53 patients with HIV-associated DLBCL, most patients had frequent bad performance status (PS) (74%), elevated LDH level (94%), B symptoms (69%), advanced Ann Arbor (75%), bulky tumor (72%) and extra-nodal involvement (68%) at diagnosis. The median CD4 T cell count was 175/μl, and 17 patients were already on cART treatment. Plasma EBV DNA was detectable in 18 patients (53%, 18/34). Of the patients evaluated at the end of treatment, 21 (64%) achieved CR, 1 (3%) achieved PR and 6 (18%) experienced progressive disease. The 2-year progression free survival (PFS) was 50% and overall survival (OS) rate was 60%. Factors associated with poor PFS in univariate analysis were unfavorable PS, high IPI score and detectable plasma EBV load. High IPI and detectable EBV load correlated with worse OS. However, only detectable plasma EBV load was the independent factor of poor prognosis for PFS (HR: 14.46, 95% CI [2.57-81.50]) and OS (HR: 7.47, 95% CI [1.48-37.59]) in a multivariate Cox regression model.
Conclusions: In our population, HIV-associated DLBCL still presented aggressive characteristics and poor survival outcomes. Plasma EBV DNA could be used as a prognostic factor in HIV-infected DLBCL.
High antimicrobial resistance and plasmid-carrying resistance genes in swine-origin mcr-1-positive Escherichia coli in Guangxi, South China
Authors: Yuan Jingzhi , Wang Xiaoye , Shi Dali , Ge Qiang , Song Xingxing , Hu Wen , Wei Deyuan , Ge Chenling , Li Xun , Hu Chuanhuo
Published: August 2019

Background The discovery of mcr-1-positive Escherichia coli (MCRPEC), a notable superbug, attracted great attention worldwide. Swine-origin multi-drug resistance MCRPEC is a potential threat to public health and safety. To date, few detailed studies regarding swine-origin MCRPEC in Guangxi, South China, have been reported. Results In this study, thirty-three MCRPEC harbored mcr-1 genes were identified from 142 E. coli strains isolated from swine droppings and entrails in Guangxi in 2018. All MCRPEC isolates were assigned to 8 unique STs, including ST10, ST224 and ST410, which overlapped with the human-origin MCRPEC. Additionally, a total of six plasmid replicon types (IncFI, IncHI1, IncY, IncN, IncI1 and IncX1) were found. Moreover, the drug susceptibility of the MCRPEC isolates was tested with 27 antimicrobial agents belonging to 17 antimicrobial categories that are usually used in hospitals. There were 19 extended spectrum beta lactamase (ESBL) E. coli and 12 carbapenem resistant E. coli among the 33 MCRPEC strains. Importantly, the MCRPEC showed a high rate of resistance against two broad-spectrum carbapenem antibiotics, imipenem and meropenem, which are forbidden in livestock production use. Three MCRPEC strains were further identified to be extensively drug-resistant (XDR), and other isolates were recognized as multi-drug-resistant (MDR). Meanwhile, to detect whether plasmid-carrying antimicrobial resistance genes coexisted with the mcr-1 gene in the MCRPEC isolates, a total of 22 plasmid-carrying antimicrobial resistance genes were tested for. The results showed that four ESBL genes and one pAmpC gene were identified. Eight of the MCRPEC isolates also contained the carbapenem gene blaNDM-5, which could cause untreatable infections. Moreover, ten non-lactamase genes were also detected. Conclusion This study indicated that swine-origin MCRPEC isolated in Guangxi seemed to have a high rate of resistance to both regular and final line of defense drugs as well as drug resistance genes, which pose a great threat to human public safety and health.
Installation or exchange of double-J ureteral stent is a risk factor of febrile urinary tract infection in a compromised host
Authors: Kitano Hiroyuki , Teishima Jun , Ohge Hiroki , Matsubara Akio
Published: August 2019

Background : To study the predictors of febrile urinary tract infections (febrile UTI) after the placement of Indwelling double-J ureteral stent (DJS), and effective prophylactic antimicrobial agent.

Methods : Installation or exchange of 298 double-J stents (DJS) ( 66 men and 232 women, median age 67 years, range 42～86) were examined. 258 patients had been given prophylactic antibiotic therapy after the placement of stents, 40 patients with no prophylactic antibiotic therapy.

Results : 14 patients (4.2%) had febrile UTI after the placement of the stent. The pathogens was identified from the pelvic urine culture of 9 patients with febrile UTI. Enterococcus faecalis was the most common pathogen, it accounted for 25.0% of all pathogens. Compromised host was potential risk factors for the febrile UTI in patients with DJS. 1.1% of patients who received with fluoroquinolones or 4.7% of patients with cephalosporin developed a febrile UTI.

Conclusions : Indwelling DJS is a risk factor of febrile UTI in a compromised host, fluoroquinolones may be effective for preventing febrile UTI after placement of DJS.
Validation of EORTC, CUETO and EAU risk stratification in prediction of recurrence, progression and death of patients with initially non-muscle invasive bladder cancer (NMIBC): a cohort analysis with systematic review.
Authors: Jobczyk Mateusz , Stawiski Konrad , Fendler Wojciech , Różański Waldemar
Published: August 2019

Purpose: To validate and summarize current evidence about the reliability of EORTC, CUETO and EAU risk stratification in prediction of recurrence, progression and death of patients with initially non-muscle-invasive bladder cancer (NMIBC).Methods: Retrospective cohort analysis of 322 patients with newly diagnosed NMIBC. We assessed the concordance (Harrell's c-index) of our results with calculated risk scores in Cox proportional hazard regression models and utilized receiver operating characteristic curve analysis (area under curve; AUCROC). Lastly, to further confirm our observations we conducted a systematic reviewResults: 1-year and 5-year c-indices ranged from 0.55 to 0.66 for recurrence and from 0.72 to 0.82 for progression. AUCROC of predictions ranged from 0.46 for 1-year recurrence risk based on CUETO groups to 0.82 for 1-year progression risk based on EAU risk groups. The accuracy of prediction was lower for patients treated with BCG maintenance immunotherapy. EORTC model (overall c-index c=0.64; 95%CI:0.61-0.68) was superior to EAU (p=0.035; 0.62; 95%CI: 0.59-0.66) and CUETO (p<0.001; c=0.53; 95%CI:0.50-0.56) model in recurrence prediction. EORTC model (c=0.82; 95%CI:0.77-0.86) also performed better than CUETO (p=0.008; c=0.73; 95%CI:0.66-0.81) but there was no sufficient evidence that it performed better than EAU (p=0.572; c=0.81; 95%CI:0.77-0.84) for predicting progression. EORTC and CUETO comparably predicted progression in BCG-treated EAU high-risk patients (p=0.48).Conclusions: The division into risk groups by EORTC, CUETO and EAU offered moderately accurate predictions about recurrence and progression of NMIBC, which emphasizes the urgent need for the development of more personalized and accurate predictive tool. EORTC provided the best recurrence and progression prediction.
Treatment of Complex Ureteral Strictures or Defects with Autologous Urinary Tract Muscle Flaps
Authors: Wu Jianchen , LI Xuesong , Pang Dong , Song Zhiqiang , Li Shihai , Chen Biao , Wang Wenjia , Li Shengwen
Published: August 2019

Background The surgical alternatives are complicated for complex ureteral strictures or long defects such as nearly full-length ureteral avulsion and recurrent ureteral strictures after pyeloplasty or ureteroplasty with severe local adhesion. This study was performed to summarize our clinical experience in the treatment of complex ureteral strictures or defects with autologous urinary tract muscle flaps. Methods We retrospectively analyzed seven patients with complex ureteral strictures or defects. The seven patients comprised three men and four women ranging in age from 37 to 61 years (average age, 46 years). The causes of ureteral lesions were nearly full-length ureteral avulsion (n = 2), postoperative ureteral stricture after sigmoid augmentation cystoplasty (n = 1), and postoperative recurrent ureteral stricture due to local inflammation and local adhesion (n = 4). The lengths of the defects in the patients with ureteral avulsion were 22 and 24 cm, and the average length of the recurrent ureteral strictures was 5.2 cm (range, 4–8 cm). The patients underwent ureteroplasty using spiral bladder muscle flaps (n = 4), muscle flaps from the dilated ureter or pelvis segment proximal to the strictures (n = 2), or a bowel segment (sigmoid) (n = 1). Six-French double-J stents were placed in the repaired ureters. Results All operations were successful, and the ureteral double-J stents were safely removed under cystoscopy 8 weeks postoperatively. All of the patients had improvement of hydronephrosis, and none had ureteral strictures on intravenous urography or contrast CT. The patient with failed pyeloplasty was found to have enlarged kidney and dilated calyx postoperatively, but the degree was less severe than preoperatively and three-dimensional CT reconstruction showed renal pelvis reduction and a patent ureter with no stenosis at the reconstruction site. Renal function was normal in all patients. Conclusions Treatment of ureteral strictures or defects with autologous urinary tract muscle flaps can be performed in some complicated cases with good results.
Treatment of Chronic Active Antibody-mediated Rejection in Renal Transplant Recipients – A single center retrospective study
Authors: Chiu Hsien-Fu , Wen Mei-Chin , Wu Ming-Ju , Chen Cheng-Hsu , Yu Tung-Min , Chuang Ya-Wen , Huang Shih-Ting , Tsai Shang-Feng , Lo Ying-Chih , Ho Hao-Chung , Shu Kuo-Hsiung
Published: August 2019

Background: A plethora of evidences suggest that the most important cause of late graft loss in renal transplant recipients is chronic active antibody-mediated rejection. However, there are no consensus on treatment strategies.
Methods: We retrospectively analyzed clinical and pathological data of renal transplant recipients who received kidney graft biopsy with confirmed diagnosis of chronic active antibody-mediated rejection in the past 7 years. The patients were divided into two groups according to treatment strategy: Group 1: aggressive treatment (double filtration plasmapheresis and one of the followings: rituximab, intravenous immunoglobulin, antithymogycte globulin, bortezomib, or methylprednisolone pulse therapy); and group 2: supportive treatment.
Results: From February 2009 to December 2017, a total of 82 graft biopsies with diagnosis of chronic active antibody mediated rejection were identified. Kaplan-Meier analysis of death-censored graft survival showed a worse survival in group 2 (P = 0.015 by log-rank test). Adverse event-free survival was lower in group 1, whereas patient survival was no significant different. Proteinuria and supportive treatment were independent risk factors for graft loss in multivariate analysis.
Conclusions: Aggressive treatment was associated with better graft outcome. However, higher incidence of adverse events merit personalized treatment, especially for those with higher risk of infection. Appropriate prophylactic antibiotics are recommended for aggressive treatment patients.
Therapeutic Iloprost for the treatment of acute respiratory distress syndrome (ARDS) (the ThIlo-Trial): a prospective, randomized, multicenter phase II study
Authors: Haeberle Helene Anna , Prohaska Stefanie , Martus Peter , Straub Andreas , Zarbock Alexander , Marx Gernot , Zago Monica , Giera Martin , Koeppen Michael , Rosenberger Peter
Published: August 2019

Background

Acute respiratory distress syndrome (ARDS) is caused by rapid onset (within hours) acute inflammatory processes in lung tissue, and it is a life-threatening condition with high mortality. The treatment of ARDS to date is focused on the prevention of further iatrogenic damage of the lung rather than the treatment of the initial inflammatory process. Several preclinical studies have revealed a beneficial effect of iloprost on the control of pulmonary inflammation, and in a small number of ARDS patients, iloprost treatment resulted in improved oxygenation. Therefore, we plan to conduct a large multicenter trial to evaluate the effect of iloprost on ARDS.Methods

The Therapeutic Iloprost during ARDS ( ThIIo-Trial) is a multicenter, randomized, clinical phase II trial assessing the efficacy of inhaled Iloprost for the prevention of the development and progression of ARDS in critically ill patients. One hundred fifty critically ill patients suffering from acute ARDS will be treated either by nebulized iloprost or NaCl 0.9% for 5 days. Blood samples will be drawn at defined time points to elucidate the serum levels of iloprost and inflammatory markers during treatment. Mechanical ventilation will be standardized. In follow-up visits at days 28 and 90 as well as 6 months after enrollment, functional status according to the Barthel Index, a health care-related questionnaire and frailty (Vulnerable Elderly Survey) will be evaluated. The primary endpoint is the improvement of oxygenation, defined as the ratio of PaO 2 /FiO 2 . Secondary endpoints include 90-day all-cause mortality, SOFA scores during the study period up to day 90, the duration of mechanical ventilation, the length of ICU stay, ventilator-associated pneumonia, delirium, ICU-acquired weakness and discharge localization. The study will be conducted in three university ARDS centers in Germany.Discussion

The results of the ThIlo-Trial will highlight the anti-inflammatory effect of iloprost on early inflammatory processes during ARDS, resulting in the improvement of outcome parameters in ARDS patients.
Patterns of physical activity and health-related quality of life amongst patients with multimorbidity in a multi-ethnic Asian population
Authors: Subramaniam Mythily , Zhang Yunjue , Lau Jue Hua , Vaingankar Janhavi Ajit , Abdin Edimansyah , Chong Siow Ann , Lee Eng Sing
Published: August 2019

Background: The co-occurrence of two or more chronic medical conditions in an individual is defined as multimorbidity. Lifestyle factors, including poor dietary patterns, physical inactivity, tobacco use, and excessive alcohol consumption are key modifiable risk factors that play a role in the development of chronic medical conditions and potentially multimorbidity. The current study aimed to examine the levels of physical activity among those with multimorbidity and its association with socio-demographic factors, clinical parameters, and health-related quality of life (HRQoL) among community-dwelling adults attending a primary care clinic in Singapore. Methods: This cross-sectional study was conducted among patients with multimorbidity between August 2014 and June 2016. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) Short Form. HRQoL was measured using the EuroQol-5 Dimension (EQ-5D-3L). Data on clinical parameters like hemoglobin A1c (HbA1C), low-density lipoprotein cholesterol (LDL-C), and blood pressure were collected from patient records. Multivariable logistic regression analysis and linear regression were performed to determine the association between IPAQ and clinical health outcomes, five subscales of the EQ-5D and EQ-5D index, respectively. Results: In all, 932 respondents with multimorbidity were recruited for the study. Of them, 500 (53.8%) had low physical activity, 325 (35.0%) had moderate physical activity, while 104 (11.2%) had high physical activity. Respondents with moderate and high physical activity had significantly lower odds of being overweight (OR: 0.57, 95% confidence interval [CI]: 0.41-0.81, p = 0.002), but had significantly higher odds of having high LDL-C levels (OR: 1.50, 95% CI: 1.02-2.22, p = 0.04), as compared to those with low physical activity. The multiple linear regression model revealed that moderate and high activity level was positively associated with higher EQ-5D index scores (β = 0.05, p < .001) as compared to low activity levels in respondents with multimorbidity. Conclusions: The low levels of physical activity among patients with multimorbidity, and its association with overweight status and poorer HRQoL emphasizes the importance of increasing physical activity in this population. Family physicians treating patients with chronic diseases need to continue encouraging and helping individuals to initiate and maintain appropriate physical activity levels.
Oesophageal Cancer Magnitude and Presentation in Ethiopia
Authors: Wondimagegnehu Abigiya , Hirpa Selamawit , Abaya Samson Wakuma , Gizaw Muluken , Getachew Sefonias , Ayele Wondimu , Yirgu Robel , Demeke Tamiru , Dessalegn Berhe , Diribi Jilcha , Kaba Mirgissa , Assefa Mathewos , Jemal Ahmedin , Kantelhardt Eva J. , Addissie Adamu
Published: August 2019

Background Although oesophageal cancer is a public health problem in Ethiopia, there are limited data on the magnitude and distribution of the disease in the country. The aim of this study is to assess the magnitude, socio-demographic and clinical characteristics of oesophageal cancer patients in selected referral hospitals of Ethiopia.Methods A retrospective document review was employed in ten referral hospitals in different regions of Ethiopia. Data were extracted from clinical care records of all clinically and pathologically confirmed oesophageal cancer patients who were diagnosed and treated in those hospitals from 2012 - 2017. A structured data extraction tool was used to collect important variables. Descriptive statistics such as median, interquartile range (IQR) and percentages were computed to describe the regional and national distribution of the disease.Results Over the past six years, a total of 777 oesophageal cancer cases were identified and the median age of these patients was 55 years with IQR of 19. More than half 428 (55.1%) of the cases were males and majority of them were reported from Oromia and Somali regional states with 388 (49.9%) and 202 (25.9%) respectively. The highest number of oesophageal cancer cases were recorded in 2016 with a total number of 185 (23.8%) while the lowest 98 (12.6%) was in 2012. Eighty percent of oesophageal cancer cases were diagnosed at late stage of the disease. More than one-fourth 210 (27.0%) of patients were operated with the majority 156 (74.3%) to insert a feeding tube followed by trans-hiatal oesophagostomy 23 (10.9%). Of the 118 results analysed, squamous cell carcinoma and adeno carcinoma were the predominant histologic type with 67(56.7%), and 43(36.4%) respectively. One fourth 194 (25.0%) of the patients were alive and more than two third 557 (71.7%) patients’ current status were unknown at the time of the review.Conclusions In referral hospitals of Ethiopia, many oesophageal cancer patients came at late stage of the disease and needed palliative care measures. The number of patients seen in Oromia and Somali region hospitals by far exceeds hospitals of the other regions thus postulating possibly unique risk factors in those geographic areas.
Nutritional status of primary school students and its association on academic performance in north-central Ethiopia: Cross sectional study
Authors: Eniyew Tigist , Abebe Fikirtemariam , Gela Debela , Asegid Agezegn , Tiruneh Dawit
Published: August 2019

Background: Under-nutrition is a fundamental factor which resulted in delayed cognitive development and under achievement of academic performance later in children’s life. Despite the great struggle to prevent malnutrition it is still a major global burden which mainly affects children. The extent of under-nutrition in Ethiopia has been established well but there are insufficient evidences about its relationship with educational achievement of school age children.
Objective : To assess the correlation of nutritional status with academic performance among public primary school children
Method: - An institution based cross-sectional study was conducted over 399 primary school children in Debre-Tabor Town, Amhara Regional State North-Central Ethiopia, 2018 after selecting them with simple random sampling. The nutritional status was assessed using anthropometric measurement of WHO 2007 reference as Height for Age Z-score (HAZ), Weight for Age Z-score (WAZ) and Body Mass Index for Age Z-score (BAZ). Academic performance was assessed by calculating two semesters overall subjects average score. Descriptive statistics, Pearson’s correlation test and linear regression were used for statistical analysis. Data were analyzed using SPSS version 24 and nutritional status was analyzed using WHO AnthroPlus version 1.0.4 (5-19 years).
Result: -The prevalence of stunting, wasting, underweight and overweight was 22%, 32.4%, 24.3% and 1.3% respectively. The mean academic performance for study participants was 71.65(±12.63 SD). There was statistically significant positive relationship between academic achievement and HAZ. Age of child and absenteeism were associated negatively while head of house, attending preschool and breakfast habit associated positively with educational achievement of the study participants.
Conclusion:- The prevalence of under-nutrition among study participants was high. Considering correlation of absenteeism, skipping breakfast, having preschool education and HAZ, nutritional interventions should be considered at prenatal, infancy and preschool period to sustain positive impact and reducing negative factors.
Key Terms: Nutritional status, Academic performance, primary school, child1.
School Gardening Activities have Profound Potential in Influencing the Knowledge, Attitude, Self-efficacy and Frequency of Fruit and Vegetable Intake by Late Adolescents
Authors: Kafeero Hussein Mukasa , Kavuma David , Nantume Lillian Wampande , Mbabazi Scovia
Published: August 2019

Back ground

The dietary intake of fruits and vegetables by adolescents is influenced by self-efficacy, attitude and knowledge.This study was designed to understand the role of school gardens in influencing the frequency, attitudes, knowledge and self-efficacy of late in-school adolescents on their dietary intake of fruits and vegetables.Methods

The study followed a cross-sectional study design employing quantitative research methods. The target population comprised of late adolescents 18-25 years attending the two-selected secondary school; one with gardening activities and another not. Self-administered structured questionnaire was used to collect data. Quantitative data was analyzed by t-test , Mann Whitney U test, Pearson Rank Correlation and odds ratio.Results

Generally, there were low fruit (8 & 9) and vegetable (6 & 7) servings per week among the unexposed and the exposed groups respectively as compared to the USDA recommendation (14 and 11) servings per week for fruits and vegetables respectively. However, students exposed to gardening had slightly higher scores of fruits and vegetable frequency as compared to those not exposed (OR=1.0370). Students believed they consumed more fruits than vegetables with the exposed group consuming more fruits (p<0.0001) and vegetables (p<0.0001) than the control group. The students knew more nutritional value for fruit intake than for vegetable intake with the exposed group having higher knowledge scores than the control (OR=1.32). The students in the exposed group were more confident in consuming fruits and vegetables rather than a snack (p=0.008), ice cream (p=0.004), three times a day (p<0.0001) compared to the control group.Conclusion

Overall, there was low fruit and vegetable intake by the study subjects. However, fruits were consumed more than the vegetables with the exposed group posting slightly higher weekly intake of fruits and vegetables than the control group. The students knew the nutritional value of fruits and vegetables attaching more importance on the fruits than vegetables with exposed group having better knowledge than the control. Although students in both groups were confident in consuming fruits and vegetables, the exposed group was more confident than the unexposed.
Individual and community-level factors influencing optimal breastfeeding: A multilevel analysis from a national survey study in Ethiopia
Authors: Hagos Amanuel , Tsadik Mache , Bekele Abate , Tesfahunegn Afewerki
Published: August 2019

Background

Optimal breastfeeding is critical for healthy growth. Despite this about 820,000 children and 20,000 women lost due to inappropriate breastfeeding each year globally. In Ethiopia, about 50,000 children lost related to malnutrition. Of these, about 18% of child death is contributed by poor breastfeeding habit. Many studies reported the individual-level factors; however, little is known about the determinants of breastfeeding at the hierarchical level. Therefore, this study aimed to identify factors associated with optimal breastfeeding among children age 0-5 month in Ethiopia using multilevel analysis.Methods

A five-year representative survey study was conducted to assess the determinants of optimal breastfeeding among 1,087 children aged 0-5 months using the 2016 Ethiopian Demographic and Health Survey data (EDHS). Both bivariate and multivariable multilevel logistic regression analysis were done to identify significant explanatory variables. Fixed effect and random effect were done to estimate the association between the dependent and explanatory variable and to measure the variation explained by the higher level respectively.Results

Among the total of 1,087 children, only 45.4% of optimally breastfed. Children aged 4-5 months (AOR =0.19; 95%CI: 0.12-0.27), children from richest wealth index (AOR=2.87; 95% CI: 1.53- 5.43), children born through cesarean section and residing in Afar region were found significantly associated with optimal breastfeeding. The random-effects showed that the variation between communities was statistically significant.Conclusion

Both individual and community level factors play a significant role in shaping optimal breastfeeding. Future strategies and health interventions should target individual and community level factors that enhance optimal breastfeeding.
Food insecurity and its gender disparity among adult people living with Human Immunodeficiency Virus in Ethiopia: A systematic review and meta-analysis
Authors: Boneya Dube Jara , Ahmed Ahmed Ali , Yalew Alemayehu Worku
Published: August 2019

Background

People living with Human Immunodeficiency Virus may lack access to sufficient quantities of nutritious foods and are vulnerable to food insecurity. Studies suggest there is gender-based inequality in the experience of food insecurity. The few studies conducted on the prevalence of food insecurity among adults living with Human Immunodeficiency Virus in Ethiopia presented inconclusive findings. Therefore, the objective of the current systematic review and meta-analysis was to estimate the pooled prevalence of food insecurity and its gender disparity among adult patients living with HIV and receiving antiretroviral therapy in Ethiopia.Method

We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The research databases PubMed, Google Scholar, CINAHL, PopLine, MedNar, Embase, Cochrane library, the JBI Library and the WEB OF SCIENCE were searched using keywords. We included studies reporting prevalence of food insecurity among adults aged greater than 18 years who were living with HIV and receiving antiretroviral therapy. The meta-analysis was conducted using STATA 14 software. A random effects model was used to estimate the pooled prevalence at 95% CI. Funnel plots and Egger’s and Begg’s tests were used to check for publication bias.Results

A total of 52 studies representing 4031 adults were identified; eleven studies were included in the meta-analysis. The overall pooled estimated prevalence of food insecurity was 63.44% (95% CI: 46.33-80.54%). A higher pooled prevalence of food insecurity was observed among females (68.85%, 95% CI (57.88%, 79.81%)) compared to males (31.15%, 95% CI (20.19%, 42.12%)).Conclusion

The review demonstrates a high prevalence of food insecurity among people living with HIV in Ethiopia, with evidence of greater vulnerability among women. Interventions should be culture and context specific to address regional and gender disparities in the prevalence of food insecurity.
Sex Differences of the Brain Structural Adaptation to Hypoxic Environment
Authors: Fan Cunxiu , Zhao Cunhua , Zhao Yuhua , Yin Wu , Lin Jianzhong , Zhang Jiaxing
Published: August 2019

Background Different physiological and pathological patterns have been found in the two sexes at high altitude. However, sex differences in brain remain unknown. Methods T1-weighted MRI scanned in 61 Tibetan males and 68 Tibetan females aged 17-23, and Freesurfer was used to detect brain structures. Neuropsychological tests were also performed. One hundred and twenty-seven matched lowland Han subjects were controls. Results Both Tibetan and Han males had larger global gray matter (GM) volume and white matter volume than females, while Tibetan but not Han female brains contained a larger proportion of GM than male brains. Tibetan females had significant smaller regional GM volume in the left rostral middle frontal gyrus, pars opercularis, and right caudal middle frontal gyrus and moreover, GM volume in the left pars opercularis positively correlated with performance in digit span. However, Tibetans females had significantly thicker cortices in the left rostral middle frontal gyrus, left pars triangularis, right rostral middle frontal gyrus, and right pars triangularis than males and cortical thickness in these regions negatively correlated with altitude. In Tibetan females but not males, the negative correlation of cortical thickness with altitude has been testified by global analysis. Conversely, Han subjects showed discrepant sex differences in brains with Tibetans, showing larger regional GM volume and thicker cortices in different brain areas. Conclusion Sex differences exist between Tibetan and Han brains. Female brains may be more susceptible to hypoxia. Sex differences in the brains of Tibetans may be related to different neuropsychiatric performances in the two sexes.
Determining the feasibility and effectiveness of brief online mindfulness training for rural medical students: a pilot study
Authors: Moore Sarah Jane , Barbour Rita , Ngo Hanh , Sinclair Craig , Chambers Richard , Auret Kirsten , Hassed Craig , Playford Denese
Published: August 2019

Background

We sought to determine the feasibility and effectiveness of a mindfulness training program, delivered online to medical students at a Rural Clinical School.Methods

An 8-week online training program was delivered to penultimate-year medical students at an Australian Rural Clinical School during 2016. Using a mixed methods approach, we measured the frequency and duration of participants’ mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion and compassion levels, as well as personal and professional attitudes and behaviours.Results

47 participants were recruited to the study. 50% of participants were practising mindfulness meditation at least weekly by the end of the 8-week program, and 32% reported practising at least weekly 4 months following completion of the intervention. There was a statistically significant reduction in participants’ perceived stress levels and a significant increase in self-compassion at 4-month follow-up. Participants reported insights about the personal and professional impact of mindfulness meditation training as well as barriers to practice.Conclusions

The results provide preliminary evidence that online training in mindfulness meditation can be associated with reduced stress and increased self-compassion in rural medical students. More rigorous research is required to establish concrete measures of feasibility of a mindfulness meditation program.
Effect of advanced simulation training with digital feedback on dental faculty’s competency in tooth preparation: A pre-post design
Authors: Xu Xiaoxiang , Xie Qiufei , Zhou Yongsheng , Wu Lei , Cao Ye
Published: August 2019

Background： Crown preparation is one of the most essential techniques in dentistry and represents a very important topic in preclinical dental education. It is obligatory for prosthodontic faculty to master this technique and demonstrate it during live operation for preclinical simulation training. Standardized tooth preparation training in simulated environment should be provided for preclinical instructors to improve their teaching performance. This study aimed to investigate the effect of advanced simulation training with digital feedback on dental faculty’s competency in tooth preparation.

Methods： Fifty prosthodontic faculty from 49 dental schools in China participated in this training program. Prior to the training course, all trainees were required to prepare the maxillary right central incisor (11#) for a ceramo-metal crown and the mandibular left first molar (36#) for a metal crown with the standard typodont tooth. Training started with the same preparations using on-site simulation facilities with 30 minutes provided for each preparation. These were graded by a digital evaluation system and adopted as pre-training competency. Then, a didactic instruction and a live demonstration about standardized tooth preparation was delivered by a senior fixed prosthodontic specialist. This was followed by three rounds of practice. All the preparations were digitally evaluated and feedback was provided to the corresponding operators. Finally, a summative examination was conducted, and the final preparations were digitally graded as post-training competency.

Results： Total scores of 11# and 36# preparations in the final test were significantly increased compared to the pre-training scores. Marks deducted for amount of reduction and margin line of prepared 11# and 36#, and taper of prepared 36#, were significantly decreased compared to that before training.

Conclusions： Advanced simulation training can effectively enhance the faculty’s competency in tooth preparation. Such training may be provided in the prosthodontic faculty development program to improve their tooth preparation competence before they begin preclinical teaching.