bluuebunny/crossref_metadata_2025 huggingface dataset:
Seizure Impact on the School Attendance in Children with Epilepsy: Prospective Study in the Pediatrics Neurology Clinic at Tikur Anbessa Specialized Hospital,Addis Ababa, Ethiopia
Authors: Hassen Oumer , Beyene Ayalew moges
Published: October 2019

Abstract Background: Epilepsy is the most common chronic neurological disease seen in Pediatrics Neurology Units in developing countries and like other chronic disorders it has been found to negatively affect school attendance and academic performance influencing school life of children. An educational underachievement can also be due to comorbid learning and behavioral problems in these children. The impact of epilepsy on school attendance may also contribute to the academic difficulties of children with epilepsy. The purpose of this study is to assess school absenteeism and determine which factors influence school absenteeism in school aged children and adolescents with epilepsy. Methods: A hospital based prospective study was conducted among school aged children and adolescents with epilepsy between the ages of 7-18 years attending at the Paediatric Neurology Clinic and their primary caretakers. A sample of 183 children and adolescents were included in the study. The participants (children and their parents/caregivers) gave information concerning the socio-demographic data, primary caregiver’s information like educational status, information concerning child’s seizure and epilepsy status disclosures to teachers and peer. And medical cards were thoroughly reviewed. Descriptive statistics and bi-variate logistic regression analysis was done to assess determinants of school absenteeism. Results: The prevalence of school absenteeism among children aged 7-18years at PNC follow up was 69.4%.Among other factors female sex with AOR 2.19(95% CI 1.03-4.84), having symptomatic seizure AOR 2.51(95% CI 1.09-5.86), having seizure at school and having longer duration of seizure were statistically significant association with school absenteeism. Conclusion: This study demonstrated the school absenteeism is very common among children aged 7-18 years at PNC follow up (69.4%) and that seizure has a significant impact on children’s school attendance. Keywords: Epilepsy; School; Childhood; Absenteeism; Ethiopia Trial registration: N/A
Diagnostic accuracy of multi-slice computed tomography in Children with Abernethy malformation
Authors: Guo Chen , Zhong Yumin , Wang Qian , Hu Liwei , Gu Xiaohong , Shao Hong , Wu Wei , Cao Jianfeng , Qiu Haisheng
Published: October 2019

Background ：Abernethy malformation is a rare congenital abnormality. Imaging examination is an important method for the diagnosis. The purpose of this study was to demonstrate manifestations of multi-slice computed tomography (MSCT) in Abernethy malformation and its diagnostic accuracy.

Methods ：Fourteen children with Abernethy malformation were admitted to our center in China between July 2011 and January 2018. All 14 patients (eight males and six females) received MSCT and digital subtraction angiography (DSA) while eight patients also received ultrasound. The patients’ age ranged from 1 to 14 (median age 8 years old). The clinical records of the patients were retrospectively reviewed. MSCT raw data were transferred to an Advantage Windows 4.2 or 4.6 workstation (General Electric Medical Systems, Waukesha, WI). We compared the findings of MSCT with DSA and surgical results in order to ascertain diagnostic accuracy.

Results ：Three cases had type Ib Abernethy malformation and eleven cases had type II. Two cases of type II Abernethy malformation were misdiagnosed as type Ib using MSCT. Comparing the findings of MSCT with DSA and surgical results, the accuracy of MSCT was 85.7% (12/14), in which 100.0% (3/3) were type Ib and 81.8% (9/11) were type II. Clinical information included congenital heart disease, pulmonary hypertension, diffuse pulmonary arteriovenous fistula, abnormal liver function, hepatic nodules, elevated blood ammonia, and hepatic encephalopathy. Eleven cases were treated after diagnosis. One patient with Abernethy malformation type Ib(1/3) underwent liver transplantation. Seven patients with Abernethy malformation type II (7/11) were treated by shunt occlusion, received laparoscopy, or were treated with open surgical ligation. Another three patients (3/11) with Abernethy malformation type II were treated by interventional portocaval shunt occlusion under DSA.

Conclusion ：MSCT attains excellent capability in diagnosing type II Abernethy malformation and further shows the location of the portacaval shunt. DSA can help when it is hard to determine diagnosis between Abernethy type Ib and II using MSCT.

Key words: Abernethy malformation; Angiography; Tomography
Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: a systematic review and meta-analysis
Authors: Liu Jing , Dong Yi , Wang Yan
Published: October 2019

Background : This study aims to evaluate the efficacy and safety of extended depth of focus (EDOF) intraocular lenes (IOLs) in cataract surgery.
Methods: All comparative clinical trials that involved bilaterally implanting EDOF IOLs in patients with cataract were retrieved from the literature database. We used random effects models to pool weighted mean differences (WMD) and risk ratio (RR) for continuous and dichotomous variables, respectively.
Results: Nine studies with a total of 1336 eyes were identified. The subgroup analysis was conducted according to the type of IOLs used in the control group. Compared with monofocal IOLs, EDOF IOLs produced better uncorrected intermediate visual acuity (WMD: -0.17, 95% CI: -0.26 to -0.08, P = 0.0001) and uncorrected near visual acuity (WMD: -0.17, 95% CI: -0.21 to -0.12, P < 0.00001). EDOF IOLs resulted in reduced contrast sensitivity, more frequent halos, however, higher spectacle independence (RR: 2.81, 95% CI: 1.06 to 7.46, P = 0.04) than monofocal IOLs. Compared with trifocal IOLs, EDOF IOLs produced worse near visual acuity (MD: 0.10, 95% CI: 0.07 to 0.13, P<0.0001). EDOF IOLs performed better than trifocal IOls in contrast sensitivity, and there were no significant difference in halos and spectacle independence. Serious postoperative complications were rare, with no adverse events were reported in most studies.
Conclusions: Increasing the risk of contrast reduction and more frequent halos, EDOF IOLs provided better intermediate and near VAs than monofocal IOLs. At the expense of near vision, patients receiving EDOF IOLs have better contrast sensitivity than those receiving trifocal IOLs. Halo incidence and spectacle independence of EDOF IOLs were similar to those of trifocal IOLs.
Adenocarcinoma with mixed subtypes is a rare but aggressive histologic subtype in colorectal cancer
Authors: Sheng Hui , Wei Xiaoli , Mao Minjie , He Jincan , Luo Tianqi , Lu Shilin , Zhou Liye , Huang Zhixin , Yang Anli
Published: October 2019

Background: Although numerous studies have investigated the clinicopathologic and prognostic relevance of mucinous adenocarcinoma (MAC) and signet-ring cell carcinoma (SRCC) compared with classic adenocarcinoma (CA), little is known about the prognosis of adenocarcinoma with mixed subtypes (AM) and the differences among these four subtypes.

Methods: The statistics of colorectal cancer registered in the Surveillance, Epidemiology and End Results (SEER) database were retrieved and analyzed. We also compared the clinicopathologic and prognostic relevance between CA, SRCC, MAC, and AM.

Results: The frequencies of these four subtypes were 69.9% (CA, n=15,812), 25.1% (MAC, n=5,689), 3.6% (SRCC, n=814) and 1.4% (AM, n=321), respectively. All of MAC, SRCC, and AM were significantly related with aggressive features. Only SRCC and AM were identified as independent poor prognostic markers for overall survival by multivariate analysis. The aggressiveness of AM was between MAC and SRCC according to the clinicopathologic associations. The prognosis of AM was significantly worse than MAC but comparable with SRCC.

Conclusion s: We confirmed the clinicopathologic relevance with aggressive features of MAC and SRCC, as well as poor prognostic relevance of SRCC by analyzing a large study population data set. Furthermore, we identified AM as a rare but aggressive histologic subtype in colorectal cancer, to which particular attention should be given in clinical practice.
Deaths From Surgical Conditions In Malawi A Randomised Cross-sectional Nationwide Household Survey
Authors: Varela Carlos Gomes , Young Sven , Groen Reinou , Banza Leonard Ngoe , Mkandawire Nyengo , Elisabeth Moen Bente , Viste Asgaut
Published: October 2019

Back ground The prevalence of untreated surgical conditions in Malawi has been estimated at 35% with 24% of the deaths associated with untreated surgical conditions. In SSA, the primary emphasis for health research has been on communicable diseases, and relatively little is known about deaths from surgical conditions in most middle- to low-, income African countries, including Malawi. This study aimed to address this knowledge gap by quantifying and describing the deaths from surgical conditions in Malawi. Methods To access the deaths associated with surgical conditions in Malawi, a randomised multi-stage cross-sectional national household survey was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48 233 settlements, using 50 villages from each district as data collection sites. Two to four household were randomly selected from each village. Two members of each selected household were interviewed. 1487 households were involved in the survey. Data collection was done using an electronic questionnaire. Results The total number of reported deaths from all causes was 616 in the 1479 households, ranging from 0 to 9 dead household members. Further data related to the deaths were available for 558 persons, with 294 (52.7%) males and 259 (46.4%) females. A total of 13 women died during pregnancy (5% of deceased women). Non-surgical conditions accounted for 408 (73.5%) of all the total deaths. Symptoms such as body swelling, abdominal distension and injuries were among the common associations of deaths: (6.0%, 5.3% and 4.6%). Almost half of the deaths occurred at home (234 persons - 41.9%) while 288 (51.6%) died at a health facility. Thirty persons died on their way to a health facility. Seventy-two persons (12.9%) who died had sought care from a traditional herbalist prior to attending a health facility. Conclusion In Malawi, body swelling, abdominal distension and injuries were the main conditions reported to be related to surgical causes of death. These occurred while the patients were either waiting at home or at health centre. Some patients initially consult a traditional herbalist prior to seeking modern health care. This delayed the possibility of timely surgical intervention.
Risk factors associated with Hepatitis B virus infection among pregnant women attending antenatal clinic at Felegehiwot referral hospital, Northwest Ethiopia, 2018: An institution based cross sectional study
Authors: Gedefaw Getnet , Waltengus Fikadu , Akililu Almaz , Gelaye Kihinetu
Published: October 2019

Objective

This study aimed to determine the magnitude of serum HBsAg and the risk factors for Hepatitis B virus infection among pregnant women in Bahir Dar. An institution based cross sectional study was implemented from February 1 to May 1, 2018 among 338 pregnant women attending antenatal care clinic at Felegehiwot referral hospital, Bahir Dar, 2018. Systematic random sampling technique was implemented. Blood sample was taken from 338 study participants and serum was tested for Hepatitis B surface antigen (HBsAg) using Enzyme Linked ImmunoSorbent Assay.Results

The overall prevalence of hepatitis B virus infection among pregnant women were 16(4.7%) (95% CI= 2.7, 7.7). Having a history of blood transfusion (AOR=5.2; 95% CI=1.2-22.3), having a history of multiple sexual partners (AOR=4.6; 95% CI=1.1-19.6) and having a history tonsillectomy (traditional surgical procedure) AOR=3.4; 95% CI=1.1-10.1) were the significant risk factors for Hepatitis B virus infection.
MicroRNA Expression Profiles Analysis in Sperm Reveals hsa-mir-191 is an Auspicious Omen of in Vitro Fertilization
Authors: Xu Hua , Wang Xin , Wang Zhikai , Li Jianhui , Xu Zhiming , Miao Maohua , Chen Guowu , Lei Xiangdong , Wu Jun , Shi Huijuan , Wang Ke , Zhang Tiancheng , Sun Xiaoxi
Published: October 2019

Background : MicroRNAs (miRNAs) are a class of noncoding small RNAs that play important roles in many physiological processes by regulating gene expression. Previous studies have shown that the expression levels of total miRNAs increase during mouse embryonic development, and some miRNAs control the regulatory network in development progression. However, few studies have focused on the effects of miRNAs on early human embryonic development. The relationship between miRNAs and early human embryogenesis is still unknown.
Results: In this study, sperm samples from 102 patients with a normal sperm index but treated with assisted reproductive technology (ART) were collected for small RNA sequencing, and the relationships between differentially expressed small RNAs and the fertilization rate (FR), blastocyst rate and high-quality embryo rate (HQER) were analyzed. The sperm samples with high hsa-mir-191 expression had a higher FR, effective embryo rate (EER) and HQER. hsa-mir-191 was used as a single indicator to predict the HQER. The receiver operating characteristic (ROC) curve had an area under the ROC curve (AUC) of 0.686. We also found that hsa-mir-191 expression is correlated with an abnormal sperm rate (cor = 0.29, p < 0.01). We also evaluated the relationship between hsa-mir-34c and early human embryo development in these 102 sperm samples and obtained negative results.
Conclusions: These findings suggest that high hsa-mir-191-5p expression is associated with improved early human embryonic development and that hsa-mir-191-5p could be used as a potential marker to screen high-quality sperm to improve the success rates of in vitro fertilization (IVF).
“I wouldn’t have hit you, but you would have killed your baby:” Exploring Midwives’ Perspectives on Disrespect and Abusive Care in Ghana.
Authors: Author) Millicent Veronica Dzomeku(New Corresponding , Bemah Boamah Mensah Adwoa , Nakua Emmanuel Kweku , Author) Pascal Agbadi(Former Corresponding , Lori Jody R. , Donkor Peter
Published: October 2019

Background: Quality maternal health reduces maternal and neonatal mortality and morbidity. Healthcare professionals, including midwives, are significant agents for the promotion of quality maternal health. Frequents reports of disrespect and abuse of childbearing women by midwives during intrapartum care are becoming common, suggesting that many of these agents are engaging in care practices that compromise quality maternal health. Thus, understanding midwives’ descriptions and experiences of the phenomenon is critical to addressing the threat. on this common emerging public health issue of disrespect and abusive care (D&AC) have been explored, except for midwives. This paper, therefore, explored the understanding of midwives on D&AC and their occurrence in professional practice in a tertiary health facility in Kumasi, Ghana.
Method: An exploratory descriptive qualitative research design using an interpretative approach was employed in the study. Data were generated through individual in-depth interviews. Data saturation was reached with fifteen midwives. The interviews were audio-recorded and transcribed verbatim. Open Code 4.03 was used to manage and analyse the data.
Findings: The midwives understood D&AC. They also confirmed meting out or witnessing colleagues engage in D&AC in their professional practice. The midwives described D&AC as the provision of inadequate care and the overlooking of patient-centred care, and verbal, physical, and psychological abuse. The themes revealed that socio-economic inequalities, provider perception and victim blaming, and health system related factors facilitate D&AC. It emerged that the following marginalized groups were at high risk for D&AC: the non-compliant, mentally ill, HIV/AIDs+, teenagers, poor, and childbearing women on admission at the general labour ward.
Conclusion: The midwives understood D&AC and revealed that it frequently occurred in their professional practice. Frequent in-service training on respectful maternity care and monitoring of care provision in healthcare facilities are needed to eliminate the incidence of D&AC.
Assessing medical impoverishment and associated factors in health care in Ethiopia
Authors: Obse Amarech Guda , Ataguba John E.
Published: October 2019

Background

About 5% of the global population, predominantly in low- and middle-income countries, is forced into poverty because of out-of-pocket (OOP) health spending. In most countries in sub-Saharan Africa, the share of OOP health spending in current health expenditure exceeds 35%, increasing the likelihood of impoverishment. In Ethiopia, OOP payments remained high at 37% of current health expenditure in 2016. This study aims to assess impoverishment resulting from OOP health spending in Ethiopia and examine the factors associated with this impoverishment.Methods

This paper uses data from the Ethiopian Household Consumption Expenditure Survey (HCES) 2010/11. The HCES covered 10,368 rural and 17,664 urban households. OOP health spending includes spending on various outpatient and inpatient services. Impoverishing impact of OOP health spending was estimated by comparing poverty estimates before and after OOP health spending. A probit model was used to assess factors that are associated with impoverishment.Results

Using the Ethiopian national poverty line of Birr 3,781 per person per year (equivalent to US$2.10 per day), OOP health spending pushed about 1.19% of the population (i.e. over 957,169 individuals) into poverty. Living in rural areas (highland, moderate, or lowland) increased the likelihood of impoverishment compared to residing in an urban area. Households headed by males and adults with formal education are less likely to be impoverished by OOP health spending, compared to their counterparts.Conclusion

In Ethiopia, OOP health spending impoverishes a significant number of the population. Although the country had piloted and initiated many reforms, e.g. the fee waiver system and community-based health insurance, a significant proportion of the population still lacks financial protection. The estimates of impoverishment from out-of-pocket payments reported in this paper do not consider individuals that are already poor before paying out-of-pocket for health services. It is important to note that this population may either face deepening poverty or forgo healthcare services if a need arises. More is therefore required to provide financial protection to achieve universal health coverage in Ethiopia, where the informal sector is relatively large.
Effect of Continuation of Antiplatelet Therapy on Survival in Patients Receiving Physician Home Visits
Authors: Osugi Yasuhiro , Ino Teruo , Kobayashi Daiki , Iwata Mitzunaga , Asai Kanici
Published: October 2019

Background: Little is known about the effects of continued antiplatelet therapy in patients who receive physician home visits. This study aimed to evaluate the association of survival with the continuation of antiplatelet drugs in patients who received physician home visits.
Methods: A retrospective cohort study was conducted in a teaching hospital in Toyota, Japan, from April 2015 to October 2018. All patients who received home visits by physicians from the department of Family Medicine of the hospital were included. The primary outcome was the difference in all-cause mortality between patients who were taking antiplatelet drugs and those who were not. The Cox proportional hazards model was applied, adjusted for the patient’s demographic features, activities of daily living, comorbidities, and primary disease requiring home care.
Results: A total of 833 patients were included, of whom 61 received antiplatelet drugs (n = 42 for aspirin, n = 17 for clopidogrel, and n = 8 for cilostazol) and 772 received no antiplatelet drugs. The mean age of the patients was 78.3 years, 409 (49.1%) were male, and 314 (37.7%) had end-stage cancer. During a median follow-up period of 120 days (interquartile range, 29–364), 54.3% of the patients died. Compared with patients not taking antiplatelet drugs, patients taking antiplatelet drugs had a better outcome (p < 0.01, log-rank test) and a significantly lower hazard ratio (0.34; 95% confidence interval, 0.17–0.65; Cox proportional hazards regression).
Conclusions: The continuous prescription of antiplatelet drugs may have beneficial effects on mortality among patients who receive physician home visits.
Ultrasound Assessment of Tensile Stress in Carotid Arteries of Healthy Human Subjects with Varying Age
Authors: Luo Xianghong , Wu Rong , Du Lianfang , Li Zhaojun
Published: October 2019

Background: Arterial remodeling is thought to reflect the adaptation of the vessel wall to mechanical and hemodynamic stimuli and contributes to the progression of cardiovascular and cerebrovascular diseases. Tensile stress (TS) is one of the mechanical properties of the artery wall. The purpose of this study was to investigate the tensile stress change (TS) of carotid artery with varying viscoelasticity in healthy subjects within two groups of different ages. Methods: Forty-five subjects were recruited and randomly assigned into the group at the age above 50 years and below 50 years. The carotid arteries were examined by ultrasonography, using the techniques of shear wave elastography (SWE), shear wave dispersion (SWD) and radiofrequency (RF) -based ultrasound. The following values, including elastic modulus (SWER) and viscous index (SWDR), as well as the peak and mean TS of the left and right carotid arteries (L-PTS, R-PTS, L-MTS and R-MTS) were measured. The correlations between SWER, SWDR and tensile stress were evaluated by using what correlation method.Results: The SWER and SWDR of carotid arteries are lower in the subjects ≥50 years old than the subjects younger than 50 years (SWER, 10.29±9.57 kPa VS 17.24±14.07 kPa; SWDR, 11.99±3.51 (m/s)/kHz VS 13.97±3.71 (m/s)/kHz, P< 0.05). The R-PTS was lower in the group with younger age (P<0.05). Pearson correlation analysis showed that SWER of carotid artery was positively correlated with the parameters of tensile stress，R-PTS, R-MTS, L-PTS and L-MTS( r=0.218, r=0.359, r=0.209 and r=0.369, respectively, P<0.05). However, SWDR of carotid arteries was not significantly associated with TS.Conclusion: Ultrasonic shear wave imaging could be used to quantitatively assess carotid viscoelasticity. The carotid TS was related to its elasticity while little related to its viscosity, suggesting that mechanical properties of the arterial wall might be better revealed.
Comparison of three surgical approaches for thoracolumbar junction (T12-L1) tuberculosis: a multicentre, retrospective study
Authors: Zeng Yanping , Cheng Peng , Tan Jiulin , Li Zhilin , Chen Yuan , Li Li Tao , Zheng Yonghong , Wang Gaoju , Xu Jianzhong , Zhang Zehua
Published: October 2019

Background: The surgical approaches to thoracolumbar junction (T12-L1) tuberculosis were controversial. We aimed to compare the safety and efficacy of three different procedures through a multicentre retrospective study.
Methods: The medical records of thoracolumbar junction tuberculosis patients (n = 177) from January 2005 to January 2015 were collected and reviewed. 45 patients underwent anterior debridement and instrumented fusion (Group A), 52 underwent anterior combined with posterior debridement and instrumented fusion (Group B) and 80 underwent posterior-only debridement and instrumented fusion (Group C). Patients with neurological deficit were 10 in Group A, 23 in Group B, 36 in Group C. All patients had a standard preoperative and postoperative anti - tuberculous therapy regimen. Clinical outcomes, laboratory indexes and radiological evaluation of the three groups were compared. Operations at each centre were performed by the respective senior medical teams of the six different hospitals.
Results: All three surgical approaches achieved bone fusion and pain relief. Cases with neurological deficits had different degrees of improvement after surgery. The operative time was 330.2±45.4min, 408.0±54.3min, 227.9±58.5min, and the blood loss was 744.0±193.8ml, 1134.6±328.2ml, 349.8±289.4ml in groups A, B and C respectively.
The average loss of correction was 5.5±3.7° in group A, 1.6±1.9° in group B, 1.7±2.2° in group C, and the difference between groups except B vs C were of statistically significant (P < 0.05).
Conclusions: For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only procedure is the better than the anterior-only procedure in the correction of kyphosis and maintenance of spinal stability. The posterior-only procedure is recommended because it achieves the same efficacy as combined procedure with shorter operation time, less blood loss and trauma.
Hydro-alcoholic extract of Otostegia integrifolia Benth (Lamiacae) produces peripheral antinociception and central analgesia in mice models
Authors: Woldesenbete Abel Degu , Tesfaye Rediet
Published: October 2019

Objective Pain and inflammatory conditions are the commonest health problems reported to this date. The advent of numerous pharmacologic agents cannot still abated the demand due to the associated side effects, the search for satisfactory new molecule particularly from herbal sources is the main endeavor as experience shows. Thus, this study evaluated the analgesic activity of the 80% methanol leaf extract of Otostegia integrifolia in mice models of pain.Results Analgesic effect of various oral doses of the hydro-alcoholic extract (100, 200 and 400 mg/kg) was determined in hot plate and acetic acid induced writhing methods. In all models, the higher doses of the extract (400mg/kg) exhibited significant central and peripheral analgesic activities without significant difference compared to the standard drugs morphine and aspirin respectively. However, the lowest dose of the extract lacks central analgesic activity. The experimental finding from this study corroborates perhaps the presence of similar constituents within the genus Otostegia that might be responsible for the analgesic effects observed on other species. Thus, Otostegia integrifolia could be potential source for development of new analgesics.
Effects of Comprehensive Sexuality Education on the comprehensive knowledge and attitude to condom use among first-year students in Arba Minch University: a quasi-experimental study
Authors: Boti Negussie , Hussen Sultan , Shegaze Mulugeta , Shibru Simon , shibiru Tamiru , Zerihun Eshetu , Godana Wanzahun , Abebe Sintayehu , Gebretsadik Woyinshet , Desalegn Nathan , Temtime Zebene
Published: October 2019

ABSTRACT
Objective: To assess the effect of comprehensive sexuality education on the comprehensive knowledge and attitude to condom use among first-year students at Arba Minch University .
Results: A total of 832 students participated at a baseline, and 820 students participated at the posttest. This study found that there was a significant effect on changing students’ knowledge and attitude towards a condom. In the education group, the students’ average change of comprehensive condom knowledge score was 0.229 higher than the average score of students' in the control group (ATE=0.229, 95% CI, 0.132 to 0.328; p < 0.001). The average change of attitude toward condom score of students’ in the education group was 1.834 higher than the average change score of students’ in the control group (ATE=1.834, 95% CI, 1.195 to 2.772; p < 0.001).This study provides further evidence on the effectiveness of comprehensive sexuality education in terms of knowledge and attitude towards a condom. Therefore, the implementation of this education should be strengthened in order the prevent youths from STI/HIV and unintended pregnancies.
Prediction of Ebola Virus Disease (EVD) infestation trends across fruit bats migratory seasons
Authors: NAMAHORO Jean Pierre , Haijun Xiao
Published: October 2019

Background : The majority of the rural populace of West and Central Africa participate actively in bushmeat commodity trade. The peak of this trade usually occurs during the migration of massive flocks of fruit bats. Unfortunately, this commercial period happens to coincides with the most conducive time for the spread of Ebola Virus Disease (EVD) which is transmitted by these fruit bats. We, therefore, conducted this study to predict EVD infestation trend among individuals who might be vulnerable and/or infected (hunters, vendors, and consumers of bushmeat) as a result of this seasonal bats migration. Methods: A secondary data collected in Ghana and semi-structured questionnaires were administered to international students from 7 countries (Democratic Republic of Congo (DRC), Ghana, Liberia, Zambia, Gabon, Guinea, and Ivory-Coast) and responses collated were used in this study. Bivariate correlation, probabilistic transmission rate of EVD, and probabilistic model (P-SIR) were employed to predict susceptible and infected individuals. Results : In all affected countries, it was observed that; there was a yearly bats’ migration pattern. 80 % of all interviewees confirmed that hunting, trading and consuming of bats influenced the rapid spread of EVD. The bivariate correlation between fruit bats and people involved in the bushmeat commodity chain was significant (p < 0.05) and the probability of infected bats were equally significant across the sampled countries. The estimated probabilistic rate was between 0.0099 and 0.01120, while individuals susceptible to EVD were predicted to be approximately between 5 and 45 (hunters), 0-18 f(vendors), and 25-90 (consumers). Conclusion : The migratory season of fruit bats contributes to EVD transmission in the most affected countries. People should avoid bushmeat consumption or eradicate all activities leading to the interaction with fruit bats to reduce the spread of EVD (Ebola) especially during the migratory seasons. Policy-makers and government agencies should also put in mechanisms that will protect their citizens during the fruit bats season. Keywords : bushmeat commodity chain, Ebola, migration season, EVD, fruit bats
Evaluation of a sitting light volleyball intervention: a social-ecological approach
Authors: Leung Ka Man , Chung Pak-Kwong , Chu William
Published: October 2019

Background This study was part of a 15-week sitting light volleyball (SLVB) intervention programme which examined the effectiveness of the intervention on physical and psychological attributes of people with physical disabilities (PWPD) in Hong Kong. Gaining an in-depth understanding of the perceptions and experiences of PWPD in the SLVB intervention is critical to further develop SLVB as a PA intervention and sport. This qualitative study explored and examined the association between the SLVB intervention elements and outcomes. Methods Using a social–ecological model (SEM), the participants’ experiences regarding the intervention were assessed and the suitability and feasibility of the SLVB intervention elements were examined. Twenty participants (mean age = 53.52 years standard deviation (SD = 9.02), 60% female participants; 25% had at least a college degree) attended our semi-structured interviews. Results Using thematic analysis, their experiences at the individual or intrapersonal level (improved health and well-being, enjoyment, novelty, competence autonomy, and self-regulation when playing SLVB); relationship or interpersonal levels (teamwork, social support, socialization, and communication); perceived environment level (comfort, privacy, spaciousness, and accessibility concerns); community or organizational level (safety, dissemination of information, and community facilities); and policy level (resources allocation by the government) were obtained. The participants also commented on the suitability of the SLVB intervention for PWPD, contents and coaching, modified rules, duration of session and scheduling, and number of participants and coaches. Conclusion This qualitative study identified several primary drivers and barriers for engaging PWPD in SLVB, and demonstrated that adopting a multilevel approach to our SLVB intervention has positive outcomes. Our results can facilitate the development of the experiential aspects of SLVB and indicate the suitability and feasibility of organizing SLVB-related activities in a community setting in the future.
The Need for a Telemedicine Strategy for Botswana? A Scoping Review and Situational Assessment
Authors: Ncube Benson , Mars Maurice , Scott Richard E
Published: October 2019

Background: Health, healthcare, and healthcare system problems within the developing world are well recognised. eHealth, the use of Information and Communications Technologies (ICT) for health, is frequently suggested as one means by which to ameliorate such problems. However, to identify and implement the most appropriate ehealth solutions requires development of a thoughtful and broadly evidence-informed strategy. Most published strategies focus on health informatics solutions, neglecting the potential for other aspects of ehealth (telehealth, telemedicine, elearning, and ecommerce). This study examined the setting in Botswana to determine the need for a telemedicine-specific strategy.Methods: A situational assessment of ehealth activities in Botswana was performed through a scoping review of the scientific and grey literature using specified search terms, an interview with the project manager of the major mhealth stakeholder, and benchtop review of policies and other relevant Government documents including the country’s current draft eHealth Strategy. Results: Thirty-nine papers were reviewed. Various ehealth technologies have been applied within Botswana. These include Skype for educational activities, instant messaging (WhatsApp for telepathology; SMS for transmission of laboratory test results, patient appointment reminders, and invoicing and bill payment), and robotics for dermatopathology. In addition health informatics technologies have been used for surveillance, monitoring, and access to information by healthcare workers. The number of distinct health information systems has been reduced from 37 to 12, and 9 discrete EMRs remain active within the public health institutions. Many infrastructural issues were identified. A critical assessment of the current draft ehealth strategy document for Botswana showed limitations. Many telemedicine services have been introduced over the years (addressing cervical cancer screening, teledermatology, teleradiology, oral medicine and eye screening), but only one project was confirmed to be active and being scaled up with the intervention of the Government.Conclusions: Botswana’s draft ‘ehealth’ strategy will not, in and of itself, nurture innovative growth in the application of telemedicine initiatives, which currently are fragmented and stalled. This lack of focus is preventing telemedicine’s recognised potential from being leveraged. A specific Telemedicine Strategy, aligned with and supportive of the pre-existing ehealth strategy, would provide the necessary focus, stimulus, and guidance.
BRAF mutant colorectal cancer: ErbB2 expression levels as predictive factor for the response to combined BRAFi/ErbB1 inhibitors
Authors: Miele Evelina , Abballe Luana , Spinelli Gian Paolo , Mersini Besharat Zein , Catanzaro Giuseppina , Chiacchiarini Martina , Vacca Alessandra , Po Agnese , Capalbo Carlo , Ferretti Elisabetta
Published: October 2019

Background: Colorectal cancer (CRC) is a heterogeneous disease with a complex biology and has a wide number of altered genes such as BRAF, KRAS and PIK3CA. Advances with new-targeted therapies have been achieved and available treating options have prolonged patient’s survival. However, BRAF-mutated CRC patients remain unresponsive to available therapies with RAF inhibitors (RAFi) alone or combined with ErbB inhibitors (ErbBi). These unmet needs require further exploitation of oncogenic signaling in order to set up individualized treatments. Methods: To this end, we tested the efficacy of single agent or combined treatments using the BRAFi, vemurafenib and two different ErbBi: panitumumab and afatinib in CRC cells characterized by different molecular phenotypes. Results: Combination strategies with BRAFi and ErbBi achieved a better response in BRAF V600E mutated cells expressing high levels of ErbB2. Conclusions: In conclusion our findings allow us to indicate that high ErbB2 expression levels is a positive predictor factor since those patients are responsive to BRAFi/ErbBi combination.
Non breathing-related sleep fragmentation and imaging markers in patients with atherosclerotic cerebral small vessel disease (CSVD), a cross-sectional case-control study
Authors: Wang Jihui , Chen Xiaodong , Liao Jinchi , Zhou Li , Han Hongying , Tao Jiong , Lu Zhengqi
Published: October 2019

Objective Evidence of a relationship between non breathing-related sleep fragmentation and imaging markers of the brain in cerebral small vessel disease (CSVD) patients is scarce. The purpose of the present study was to investigate the relationship in CSVD patients living in China, where CSVD is a major pathogenesis underlying stroke. Methods A group of 84 CSVD patients were prospectively recruited along with 24 age and sex matched normal controls. 3.0 T superconducting magnetic resonance imaging and overnight polysomnography were conducted in all the participants. Polysomnography parameters including sleep onset latency, total sleep time; sleep efficiency, wake after sleep onset, percentage of each sleep stage (N1, N2, N3 and REM) and arousal index were compared between the CSVD patients and normal controls, and the relationship between arousal index and CSVD markers was explored in the CSVD group. Results Polysomnography measures showed that CSVD patients had significantly higher arousal index and wake after sleep onset, lower sleep efficiency and N-3 ratio compared to normal controls ( p < 0.05). The results of ordinal logistic regression showed that higher arousal index was positively associated with the severity of periventricular white matter hyperintensity (OR 1.177, 95% CI 0.170 to 2.295) and perivascular space (OR 1.245, 95% CI 0.485 to 2.124) in CSVD patients, after adjusting for all the independent variables. Conclusions These preliminary results indicate that non breathing-related sleep fragmentation is common and related to the pathological markers of CSVD patients. Future prospective research is invited to establish the causal relationship between sleep parameters and CSVD pathology.
Genome-wide association analysis of fiber fineness and yield in ramie (Boehmeria nivea) using SLAF-seq
Authors: Huang Kunyong , Shi Yaliang , Zhong Yicheng , Zhu Aiguo , Sun Zhimin , Niu Juan , Chen Jing , Luan M , Chen Jianhua
Published: October 2019

Background: Ramie is a major natural fiber crop cultivated in East Asia. The improvement of its fiber yield and fineness are important breeding goals. Fiber yield is a complex quantitative trait comprising ramet number, stem diameter, plant height, skin thickness, and ﬁber percentage. The fiber fineness is a crucial trait for ramie fiber quality. However, there are few association studies for fiber yield traits and fiber fineness on ramie, and lack high-density SNP maps in natural ramie population.Results: Here, a panel of 112 core ramie germplasms were genotyped by 215,376 consistent single-nucleotide polymorphisms (SNPs) from specific-locus amplified-fragment sequencing (SLAF-seq), and used for genome-wide association study of fiber fineness and yield. Subsequently, the genetic diversity, linkage disequilibrium (LD), and population structure was conducted based on 215,376 SNPs. Population cluster analysis disclosed five subpopulations. Neighbor-joining (NJ) analysis revealed three major clusters. No obvious relationships were identified between them and their geographic origins. The genome-wide linkage disequilibrium (LD) decayed to r2 = 0.1 was ~11.75 kb in physical distance. One, seven, one, seven, and twenty-seven significant SNP marker associations were detected for fiber fineness (third season), stem diameter (third season), stem skin thickness (third season), fiber percentage (second season), and fiber percentage (third season), respectively. Two promising candidate genes, whole_GLEAN_10029622 and whole_GLEAN_10029638 resided in the significant trait-SNP association for fiber fineness (third season), which annotated as a cotton fiber-expressed protein and an Arabidopsis thaliana homeobox protein ATH1, respectively and validated by qPCR. Conclusions: These results provide information for understanding the population structure, LD decay and genetic variation in ramie natural population. The identified loci or genes for fiber fineness and yield may provide the basis for future research on fiber fineness and yield and marker-assisted selection breeding for ramie.
Genomic signatures of divergent selection for production and adaptation in domestic goats (Capra hircus)
Authors: Mwacharo Joram M , Kim Eui-Soo , Elbeltagy Ahmed R , Aboul-Naga Adel M , Rischkowsky Barbara A , Rothschild Max F
Published: October 2019

Background : Goats are distributed worldwide and include many breeds with marked phenotypic variation. Both natural and human driven processes have shaped their genomes. Here, 52K genome-wide SNP genotypes were used to investigate signatures of divergent selection between indigenous goats from an arid hot environment in Egypt and breeds developed under temperate environments in Europe. Three selection signature approaches were used, the di derivative of F ST , iHS and Rsb.
Results: Out of a total of 36 candidate regions that were detected to be under selection by the three approaches, the analysis detected nine regions with the strongest selection signatures spanning 134 genes of which 68 were the most significantly functionally enriched. In addition to well-known genes affecting dairy traits ( LAP3 , ABCG2 , MEPE , IBSP , MED28 ) and body weight and stature ( LCORL , NCAPG , CCSER1 , DCAF16 ) in several mammalian species, we found evidence for selection in regions spanning genes implicated in the regulation of fatty acid synthesis and metabolic pathways ( PI4K2B and PPARGC1A ), inflammatory gene expression and autoimmune response pathways ( CXCL8 , HERC5 , RGS18 , TROVE2 ) and spermatogenesis ( SPATA18 , LAP3 ). Other genes not reported before in goats included SLIT2 , PACRGL , GRP125 , DHX15 , SOD3 and KCNIP4 which have been associated with thermal nociception in mice. We also detected a paralog of TBC1D12 , namely TBC1D14 , in one of the candidate regions. TBC1D12 has been linked to environmental adaptation in sheep. Gene ontology analysis revealed the 68 candidate genes were highly enriched in two biological processes viz regulation of G protein-coupled receptor signaling pathway (GO:0045744) and cellular response to stress (GO:0033554).
Conclusions: Our results provide evidence that goat genomes have evolved, in part, via diverse positive selection directed at breed formation, at past and recent genetic improvement and adaptation to environments. Based on their uniqueness, these breed-group specific signatures of selection can be considered to be footprints of divergence which may be useful in characterizing genome architecture and diversity in domestic animals and for targeted genetic improvement.
Personal Sun Protection and Counseling Patterns among Primary Care Providers
Authors: Nadelman Daniel Alexander , Heidelbaugh Joel J.
Published: October 2019

Background: Personal sun protection and patient counseling patterns among primary care providers is an important topic that has not previously been studied in great detail. Our report evaluates the relationship between sun protection habits among providers, patterns in discussions with patients about sun protection, and prior education on this topic during medical training.
Methods: An online survey was sent to family medicine faculty and house officers. Four survey questions about personal sun protection and patient counseling habits were provided. Participants were then asked whether they had received formal education concerning sun protection during their medical training.
Results: Our results suggest that providers who received formal education on sun protection during their medical training were more likely to personally use adequate protection and counsel their patients on this topic.
Conclusions: This study highlights the importance of sun protection education among primary care providers. Our findings suggest that improving education on this topic among physicians may lead to increased awareness among both patients and providers. Productive discussions about sun protection in the primary care setting has the potential to improve sun protective habits among patients, which can in turn decrease the incidence of skin cancer.
Age is a predictor for the recurrence of syncope in vasovagal syncope patients with a positive head-up tilt test
Authors: Guo Yongjuan , Chen Xiaomin , Zeng Tianze , Wang Lin , Cen Lvwei
Published: October 2019

BACKROUND Valid predictors of the recurrence of syncope in vasovagal syncope (VVS) patients with a positive head-up tilt test (HUTT) are currently lacking. The goal of this study was to identify the predictive performance of age for the recurrence of syncope in VVS patients with a positive HUTT. METHODS in total, 175 VVS patients with a positive HUTT were followed for 6 to 32 months, and ≥1 syncope episodes during follow-up was considered the recurrence of syncope. The study population was divided into 2 groups, namely, a recurrence of syncope group (44 patients) and a no recurrence of syncope group (131 patients). The baseline clinical data, hemodynamic parameters and classification of the vasovagal syncope on the HUTT were analyzed. Binary logistics regression was used to analyze the effect size and confidence interval of age. A receiver operating characteristic(ROC) analysis was used to assess the predictive performance and investigate the predictive value of age by the area under the curve (AUC). RESULTS The age of recurrence of syncope group 60.0 (47.8, 66.0) years was older than that of no recurrence of syncope group 53.0 (43.0, 62.0) years, and there was a significant difference between the two groups (P < 0.05). The trend of syncope recurrence changed with age and the binary logistics regression model adjusted by sex showed that the elder was an increased risk of syncope recurrence in VVS with positive HUTT [OR value: 1.034, 95% confidence interval(CI) 1.008 to 1.061 p < 0.05].Age was a valid predictor for the recurrence of syncope in VVS patients with a positive HUTT (AUC: 0.688; 95%CI 0.598 to 0.777 p < 0.05) . The cut-off value was 53.5 years, and the sensitivity and specificity were 72.7% and 52.7%, respectively. CONCLUSIONS Age was a valid predictor for recurrence of syncope in VVS patients with positive HUTT. The rate of recurrence of syncope increased with increasing age, especially in old female.