bluuebunny/crossref_metadata_2025 huggingface dataset:
An In Vitro Intestinal Model Captures Immunomodulatory Properties of the Microbiota in Inflammation
Authors: Lock Jaclyn Y. , Caboni Mariaelena , Strandwitz Philip , Morrissette Madeleine , DiBona Kevin , Joughin Brian A. , Lewis Kim , Carrier Rebecca L.
Published: October 2020

BackgroundThere is a growing appreciation for the significance of the gut microbiome in health and disease. Specifically, considerable effort has been put forth to understand mechanisms by which the microbiota modulates and responds to inflammation. Here, we explored whether oxidation metabolites produced by the host during inflammation, sodium nitrate and trimethylamine oxide, impact the composition of a human stool bacterial population in a gut simulator. We then assessed whether an immune-competent in vitro intestinal model responded differently to spent medium from bacteria exposed to these cues compared to spent medium from a control bacterial population. ResultsThe host-derived oxidation products were found to decrease levels of Bacteroidaceae and overall microbiota metabolic potential, while increasing levels of pro-inflammatory Enterobacteriaceae and lipopolysaccharide in bacterial cultures, reflecting shifts that occur in vivo in inflammation. Spent medium, with or without sodium nitrate and trimethylamine oxide, induced elevated intracellular mucin levels and reduced intestinal monolayer integrity as reflected in trans-epithelial electrical resistance relative to fresh medium controls. However, multiplexed cytokine analysis revealed markedly different cytokine signatures from intestinal cultures exposed to spent medium with added oxidation products relative to spent control medium, while cytokine signatures of cultures exposed to fresh media were similar regardless of addition of host-derived cues. Further, the presence of immune cells in the intestinal model was required for this differentiation of cytokine signatures. ConclusionsThis study indicates that simple in vitro immune-competent intestinal models can capture bacterial-mammalian cross-talk in response to host-derived oxidation products and supports utility of these systems for mechanistic studies of interactions between the gut microbiome and host in inflammation.
Responses of Cyanobacterial Aggregate Microbial Communities to Algal Blooms
Authors: Zhu Congmin , Zhang Junyi , Wang Xin , Yang Yuqing , Chen Ning , Lu Zuhong , Ge Qinyu , Jiang Rui , Zhang Xuegong , Yang Yunfeng , Chen Ting
Published: October 2020

BackgroundFreshwater lakes are threatened by harmful cyanobacterial blooms; whose basic unit is Cyanobacterial Aggregate (CA). Community variations of CA-attached bacteria are substantial during different blooming stages. However, little is known about their transcriptional and metabolic variations. Most bacterial genomes in CA were not constructed in existing database, which limits our understanding of the bacterial variations as responses to cyanobacterial blooms. ResultsIn this longitudinal study, 16 CA samples were collected from Lake Taihu, one of the largest freshwater lakes in China, from April of 2015 to February of 2016. By sequencing the V4 region of 16S rRNA genes, full metagenomes (MG) and metatranscriptomes (MT), we generated 424 Mb of 16S rRNA gene data, 122 Gb of high-quality MG data and 160 Gb of high-quality MT data. We analyzed the taxonomic, functional and transcriptional variations of microbes in CAs along three blooming stages, and constructed metagenome-assembled genomes (MAGs) by binning analysis. First, 55 OTUs, 456 genes and 37 transcripts mainly associated with pathways of transporters, photosystem and energy metabolism showed significantly different abundance among the three stages. Second, 161 high-quality MAGs in CAs were achieved, with 19 of which significantly shifted in relative abundance among three stages. The most abundant MAGs have gene capacities to synthesize flagella and divers of transporters, and participate in metabolic pathways of nitrogen, phosphorus and sulfur. Finally, 22 high-quality cyanobacterial MAGs were constructed and can be divided into four functional clusters, which showed significant differences on the energy pathways, transporters and prokaryotic defense system.ConclusionOverall, these results demonstrated the taxonomic, functional and transcriptional variations of microbes in CAs among three different blooming stages. Genome construction and metabolic analysis of cyanobacteria and their attached bacteria suggested that the material exchange and signal transmission do, indeed, exist among them. Our understanding of the underlying molecular pathways for cyanobacterial blooms could potentially lead to the control of blooms by interventional strategies to disrupt the expression of critical microbes.
Evaluation of algorithms using administrative health and structured electronic medical record data to determine breast and colorectal cancer recurrence in a Canadian province
Authors: Decker Kathleen , Lambert Pascal , Pitz Marshall , Singh Harminder
Published: October 2020

Background: Algorithms that use administrative health and electronic medical record (EMR) data to determine cancer recurrence have the potential to replace chart reviews. This study evaluated algorithms to determine breast and colorectal cancer recurrence in a Canadian province with a universal health care system.Methods: Individuals diagnosed with stage I-III breast or colorectal cancer diagnosed from 2004 to 2012 in Manitoba, Canada were included. Pre-specified and conditional inference tree algorithms using administrative health and structured EMR data were developed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) correct classification, and scaled Brier scores were measured.Results: The weighted pre-specified variable algorithm for the breast cancer validation cohort (N=1181, 167 recurrences) demonstrated 81.1% sensitivity, 93.2% specificity, 61.4% PPV, 97.4% NPV, 91.8% correct classification, and scaled Brier score of 0.21. The weighted conditional inference tree algorithm demonstrated 68.5% sensitivity, 97.0% specificity, 75.4% PPV, 95.8% NPV, 93.6% correct classification, and scaled Brier score of 0.39. The weighted pre-specified variable algorithm for the colorectal validation cohort (N=693, 136 recurrences) demonstrated 77.7% sensitivity, 92.8% specificity, 70.7% PPV, 94.9% NPV, 90.1% correct classification, and scaled Brier score of 0.33. The conditional inference tree algorithm demonstrated 62.6% sensitivity, 97.8% specificity, 86.4% PPV, 92.2% NPV, 91.4% correct classification, and scaled Brier score of 0.42. Conclusions: Algorithms using administrative health and structured EMR data to determine breast and colorectal cancer recurrence had moderate sensitivity and PPV, high specificity, NPV, and correct classification, but low accuracy. Algorithms for determining cancer recurrence must improve before replacing chart reviews.
Metabolic Alterations in Meningioma Reflect Clinical Course
Authors: Masalha Waseem , Daka Karam , Woerner Jakob , Pompe Nils , Weber Stefan , Delev Daniel , Krueger Marie T. , Schnell Oliver , Beck Jürgen , Heiland Dieter Henrik , Grauvogel Juergen
Published: October 2020

BackgroundMeningiomas are common brain tumors, defined by an innocent clinical course. However, some meningiomas reveal a malignant transformation and recur within a short time period regardless of their WHO grade. The current study aims to identify potential markers, which can discriminate between benign and malignant meningioma courses. MethodsFor this purpose, we profiled the metabolites of 43 patients with low- and high-grade meningiomas. Tumor specimens were analyzed by NMR analysis; 270 metabolites were identified and clustered with the AutoPipe algorithm. ResultsWe observed two distinct clusters marked by alterations in the glycine-serine, choline or tryptophan metabolism. Both clusters showed significant differences between WHO graduation and proliferation index.ConclusionOur findings suggest that alterations of glycine-serine are associated with a lower proliferation and frequencies of recurrent tumors. Alterations of the choline-tryptophan metabolism causes increased proliferation and recurrence is more common. Our results suggest, that tumor malignancy is reflected by metabolic alterations, which can support histological classifications in order to predict the clinical outcome of patients with meningiomas.
S-1 plus leucovorin and oxaliplatin versus S-1 plus cisplatin as first-line therapy in patients with advanced gastric cancer: a cost-effectiveness analysis
Authors: Feng Mingyang , Liao Weiting , Yang Yang , Li Qiu
Published: October 2020

Background: A multicenter, open-label, randomized, phase 3 trial (SOLAR) conducted in 62 centers across Japan and South Korea showed that S-1 plus leucovorin and oxaliplatin showed improved overall response rate, progression-free survival (PFS), and overall survival (OS) compared with S-1 plus cisplatin. This study aimed to investigate whether S-1 plus leucovorin and oxaliplatin is cost-effective compared with S-1 plus cisplatin as the first-line therapy of advanced gastric cancer from the perspective of Chinese society.Materials and methods: The clinical data for this model was derived from the SOLAR trial. Costs and utility were either derived from the standard fee database or extracted from previously published literature. A Markov model was developed to simulate the disease process of patients with advanced gastric cancer. One-way sensitivity analyses were conducted to investigate the impact of variables on the analysis model. A second-order probabilistic sensitivity analysis was performed based on 1,000 Monte-Carlo simulations.Results: S-1 plus leucovorin and oxaliplatin cohort provided an incremental 0.02 QALYs with an incremental cost of $1,527.31, compared with the S-1 plus cisplatin cohort, resulting in the incremental cost-effectiveness ratio (ICER) of $61,331.63/QALY, which beyond the willingness to pay threshold. Costs of drugs in the PFS state in both cohorts and utility of PFS state were the most influential factors in this study.Conclusion: S-1 plus leucovorin and oxaliplatin is not cost-effective compared with S-1 plus cisplatin as first-line therapy in patients with advanced gastric cancer from the Chinese society perspective.
Chiropractic Student Perspectives on The Use of Virtual Radiography Simulation An Observational Study Reporting on Chiropractic Students’ Perception on The Use of Virtual Radiography as A Clinical Learning Tool
Authors: Shanahan Madeleine , Molyneux Tom , Vindigni Dein
Published: October 2020

Background Virtual radiography provides students with an opportunity to practise their clinical skills in patient positioning and evaluating radiographic images. The purpose of this pilot study was to introduce Projection VR™, a software radiography simulation program, into a student chiropractic program and evaluate its potential application as a teaching and learning tool. Methods Undergraduate chiropractic students, enrolled in a radiographic course (unit within the chiropractic program), were invited to attend a scheduled laboratory where they were introduced to, and undertook purposefully designed activities using the radiography simulation. At the end of this activity, students were asked to complete an online survey to describe their perceptions of the educational value of the software program. Descriptive and inferential statistics were used to evaluate outcomes.Results Responses were received from 44 out of the 47 students who attended the scheduled laboratory (response rate 92%). Overall students were positive about this simulation identifying that it was easy to use (95%) and that they could control the equipment as needed (95%). The main reported benefits included students being enabled to repeat tasks until they were satisfied with the results (98%) and being able to quickly assess images and determine if changes needed to be made (98%). Participants reported improvement in their understanding of the effect of exposure factors on patient radiation dose (93%) as well as their technical image evaluation (84%) and problem-solving skills (80%).Conclusions The results of this study suggest that virtual radiography is a valuable complementary resource in providing chiropractic students with radiographic knowledge and skills.
Individual Dosimetry System for Targeted Alpha Therapy Based on PHITS Coupled with Microdosimetric Kinetic Model
Authors: Sato Tatsuhiko , Furuta Takuya , Liu Yuwei , Naka Sadahiro , Nagamori Shushi , Kanai Yoshikatsu , Watabe Tadashi
Published: October 2020

Background: An individual dosimetry system is essential for the evaluation of precise doses in nuclear medicine. The purpose of this study was to develop a system for calculating not only absorbed doses but also EQDX(α/β) from the PET-CT images of patient for targeted alpha therapy (TAT), considering the dose dependence of the relative biological effectiveness, the dose-rate effect, and the dose heterogeneity. Methods: A general-purpose Monte Carlo particle transport code PHITS was employed as the dose calculation engine in the system, while the microdosimetric kinetic model was used for converting the absorbed dose to EQDX(α/β). PHITS input files for describing the geometry and source distribution of a patient are automatically created from PET-CT images, using newly developed modules of DICOM2PHITS. We examined the performance of the system by calculating several organ doses using the PET-CT images of four healthy volunteers after injecting 18F-NKO-035. Results: The deposition energy map obtained from our system seems to be a blurred image of the corresponding PET data because annihilation γ-rays deposit their energies rather far from the source location. The calculated organ doses agree with the corresponding data obtained from OLINDA 2.0 within 20%, indicating the reliability of our developed system. Test calculations by replacing the labeled radionuclide from 18F to 211At suggest that large dose heterogeneity in a target volume is expected in TAT, resulting in a significant decrease of EQDX(α/β) for higher-activity injection. Conclusions: An individual dosimetry system including the function for calculating EQDX(α/β) was developed based on PHITS coupled with the microdosimetric kinetic model. It enables us to predict the therapeutic and side effects of TAT based on the clinical data largely available from conventional external radiotherapy.
Using Dynamic Time Warping Self-Organizing Maps to Characterize Diurnal Patterns in Environmental Exposures
Authors: Li Kenan , Sward Katherine , Deng Huiyu , Morrison John , Habre Rima , Franklin Meredith , Chiang Yao-Yi , Ambite Jose-Luis , Wilson John P. , Eckel Sandrah P.
Published: October 2020

BackgroundAdvances in measurement technology are producing increasingly time-resolved environmental exposure data. We aim to gain new insights into exposures and their potential health impacts by moving beyond simple summary statistics (e.g., means, maximums) to characterize more detailed features of high-frequency time-series data. MethodsThis study proposes a novel variant of the Self-Organizing Map (SOM) algorithm called Dynamic Time Warping Self-Organizing Map (DTW-SOM) for unsupervised pattern discovery in time series. This algorithm uses DTW, a similarity measure for sequential data that optimally aligns interior patterns, both as the similarity measure and for training the neural network.ResultsWe applied DTW-SOM to a panel study monitoring indoor and outdoor residential environmental exposures for 10 patients with asthma from 7 households near Salt Lake City, Utah; each patient was followed for up to 373 days. Compared to other SOM algorithms using Euclidean distance, the DTW-SOM algorithm maintained the topological properties of the input time series and generated more detailed diurnal patterns. We observed seasonal patterns in outdoor temperature and distinct patterns of indoor peak PM2.5 exposure, which was likely linked to both combustion sources and days with increased inhaler usage. ConclusionsThe new algorithm, DTW-SOM, better preserved the topology relationship of time-series data and better summarized time-series patterns as compared to the original version of SOM.
In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh
Authors: Akhtar Zubair , Aleem Mohammad Abdul , Ghosh Probir Kumar , Islam A.K.M. Monwarul , Chowdhury Fahmida , MacIntyre C Raina , Fröbert Ole
Published: October 2020

Background: There is a paucity of data regarding acute phase (in-hospital and 30-day) major adverse cardiac events (MACE) following ST-segment elevation myocardial infarction (STEMI) in Bangladesh. This study aimed to document MACE during the acute phase post-STEMI to provide information.Methods: We enrolled STEMI patients of the National Institute of Cardiovascular Disease, Dhaka, Bangladesh, from August 2017 to October 2018 and followed up through 30 days post-discharge for MACE, defined as the composite of total death, myocardial infarction, and coronary revascularization. Demographic information, cardiovascular risk factors, and clinical data were registered in a case report form. The Cox proportional hazard model was used for univariate and multivariate analysis to identify potential risk factors for MACE.Results: A total of 601 patients, mean age 51.6±10.3 years, 93% male, were enrolled. The mean duration of hospital stay was 3.8±2.4 days. We found 37 patients (6.2%) to experience an in-hospital event, and 45 (7.5%) events occurred within the 30 days post-discharge. In univariate analysis, a significantly increased risk of developing 30-day MACE was observed in patients with more than 12 years of formal education, diabetes mellitus, or a previous diagnosis of heart failure. In a multivariate analysis, the risk of developing 30-day MACE was increased in patients with heart failure (hazard ratio = 4.65; 95% CI, 1.64–13.23).Conclusions: A high risk of in-hospital and 30-day MACE in patients with STEMI exists in Bangladesh. Additional resources should be allocated providing guideline-recommended treatment for patients with myocardial infarction in Bangladesh.
Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: Multiple effects of social support on quality of life
Authors: Qi Xinye , Xu Jiao , Chen Guiying , Liu Huan , Liu Jingjing , Wang Jiahui , Zhang Xin , Hao Yanhua , Wu Qunhong , Jiao Mingli
Published: October 2020

Objective: Elderly patients with type 2 diabetes mellitus are highly vulnerable due to serious complications. Thus far, there is little research on the relationship between social support and quality of life, which warrants further exploration of the internal mechanism. This study assessed quality of life and its interfering factors in this patient population.Methods: In total, 571 patients with type 2 diabetes mellitus over 60 years old were recruited from two community clinics in Heilongjiang province, China. We collected data on health status, quality of life, self-management behavior, fasting plasma glucose (FPG) level, and social support. Structural equation modeling and the bootstrap method were used to analyze the data. Results: The average quality of life score was -29.25 ± 24.41. Poorly scored domains of quality of life were “Psychological feeling” (-8.67), “Activity” (-6.36), and “Emotion” (-6.12). Of the 571 patients, 65.32% had normal FPG, 9.8% had high-risk FPG, 15.94% had good self-management behavior, and 22.07% had poor social support. Significant correlations among social support, self-management behavior, FPG level, and quality of life were noted. A multiple mediator model revealed that social support influenced quality of life in three ways: (i) directly (c´ = 0.6549); (ii) indirectly through self-management behavior (a1*b1 = 0.2596); and (iii) indirectly through FPG control (a2*b2 = 0.2825). Self-management behavior influenced quality of life directly and indirectly through FPG control. Conclusion: Improving self-management behavior and monitoring hypoglycemia should become priority targets for future intervention. Scheduled social support to self-management projects should be put into the standardized management procedure. Physicians should provide substantial and individualized support to elderly patients with type 2 diabetes mellitus regarding medication, blood glucose monitoring, and physical exercise.
What do the General Public Believe About the Causes, Prognosis and Best Management Strategies for Low Back Pain? A Cross Sectional Study
Authors: Hall Amanda , Coombs Danielle , Richmond Helen , Bursey Krystal , Furlong Bradley , Lawrence Rebecca , Kamper Steven
Published: October 2020

Background: Low back pain (LBP) is one of the most common reasons for seeking health care and is costly to the health care system. Recent evidence has shown that LBP care provided by many providers is divergent from guidelines and one reason may be patient’s beliefs and expectations about treatment. Thus, examining the nature of patient beliefs and expectations regarding low back pain treatment will help coordinate efforts to improve consistency and quality of care. Methods: This study was a cross-sectional population-based survey of adults living in Newfoundland, Canada. The survey included demographic information (e.g. age, gender, back pain status and care seeking behaviors) and assessed outcomes related to beliefs about the inevitable consequences of back pain with the validated back beliefs questionnaire as well as six additional questions relating beliefs about imaging, physical activity and medication. Surveys were mailed to 3000 households in July-August 2018 and responses collected until September 30th, 2018.Results: 428 surveys were returned (mean age 55 years (SD 14.6), 66% female, 90% had experienced an episode of LBP). The mean Back Beliefs Questionnaire score was 27.3 (SD 7.2), suggesting that people perceive back pain to have inevitable negative consequences. Large proportions of respondents held the following beliefs that are contrary to best available evidence: (i) having back pain means you will always have weakness in your back (49.3%), (ii) it will get progressively worse (48.0%), (iii) resting is good (41.4%) and (iv) x-rays or scans are necessary to get the best medical care for LBP (54.2%). Conclusions: A high proportion of the public believe LBP to have inevitable negative consequences and hold incorrect beliefs about diagnosis and management options, which is similar to findings from other countries. This presents challenges for clinicians and suggests that considering how to influence beliefs about LBP in the broader community could have value. Given the high prevalence of LBP and that many will consult a range of healthcare professionals, future efforts could consider using broad reaching public health campaigns that target patients, policy makers and all relevant health providers with specific content to change commonly held unhelpful beliefs.
Central Lymph Node Metastasis is Predictive of Survival in Advanced Gastric Cancer Patients Treated with D2 Lymphadenectomy
Authors: Lu Huiwen , Zhao Bochao , Huang Rui , Sun Yimeng , Zhu Zirui , Xu Huimian , Huang Baojun
Published: October 2020

BackgroundThe number of positive lymph nodes, which was defined as “N stage”, is mostly used to predict the survival of D2-resected gastric cancer patients, not the location. A “central lymph node” (CnLN) was defined by Ikoma et al, included common hepatic, celiac and proximal splenic artery LNs. CnLNs located in the extraperigastric area are included in the D2 LN station for gastric cancer. We speculate that CnLNs can be regarded as a predictor of survival.Methods Eligible advanced gastric cancer patients who underwent curative resection and D2 lymph node dissection between 2004 and 2012 at our institution were identified. The frequency of CnLN metastases and risk factors affecting DFS were examined. Survival differences were assessed by log-rank tests and Kaplan–Meier curves.ResultsThe study identified 1178 patients who underwent curative surgery or D2 or more extensive lymphadenectomy. A total of 342 patients had been proven to have CnLN metastasis. Larger tumor size (p<0.001), more frequent lymphatic vessel invasion (p<0.001), signet ring cell histology (p=0.014), and more advanced pathological T stage (p=0.013) were significantly related to CnLNs metastasis. The patients with CnLN metastasis had a poor prognosis (HR for DFS of 1.366, 95%CI=1.138-1.640, p=0.001). For the pN2/3 patients, CnLN metastasis was associated with shorter 5-year DFS (for pN2 patients: 25.9% vs 39.3%, p=0.017; for pN3 patients: 11.5% vs 23.4%, p=0.005).ConclusionGastric cancer patients with CnLN metastasis who underwent D2 resection had a poor prognosis. With the same N stage, the patients with positive CnLNs had shorter survival. CnLNs metastasis could be a supplement to N stage and a predictor of survival in gastric cancer patients. Large sample, multicenter, randomized clinical trials are still needed in the future.
Effects of Combining Diaphragm Training With TENS on Balance, Pain, and Function in Athletes With Chronic Low Back Pain: A Randomized Clinical Trial
Authors: Otadi Khadijeh , Ansari Noureddin Nakhostin , Sharify Shahriar , Fakhari Zahra , Sarafraz Hadi , Aria Amir , Rasouli Omid
Published: October 2020

Background: there is a lack of evidence about the effects of diaphragm training combined with TENS on balance, pain, and function in athletes with CLBP.Objectives: This study aimed to investigate the effects of combining diaphragm training with electrical stimulation on core stability, dynamic balance, pain, and function in young athletes with nonspecific CLBP.Design: Randomized clinical trialMethod: A total of 24 young adult athletes (12 women, 12 men) with non-specific CLBP were randomly allocated into experimental and control group. The experimental group received diaphragm training plus Transcutaneous Electrical Nerve Stimulation (TENS), while the control group received only TENS. Both groups underwent 12 sessions over a 4-week period. Static stability, dynamic balance, pain, and function were measured pre- and post-intervention.Results: Significant improvements in pain and function scores were found in both groups after completing the interventions. However, only the experimental group showed significant improvements in the static stability and dynamic balance post-intervention. The experimental group showed greater improvements in pain and static stability. No significant differences in function or dynamic balance were observed between the groups. Conclusions: The present study indicates that diaphragm training plus TENS can improve static stability, dynamic balance, function, and pain in young athletes with non-specific CLBP. It seems beneficial to add diaphragm training to rehabilitation programs for athletes with CLBP.The trial was retrospectively registered at the Iranian Registry of Clinical Trials on www.irct.ir (Identification number: IRCT20090228001719N8).
Factors Associated with Delayed Initiation of Breastfeeding in Health Facilities: Secondary Analysis of Bangladesh Demographic and Health Survey 2014
Authors: Raihana Shahreen , Alam Ashraful , Huda Tanvir M , Dibley Michael J
Published: October 2020

Background: Irrespective of the place and mode of delivery, 'delayed' initiation of breastfeeding beyond the first hour of birth can negatively influence maternal and newborn health outcomes. In Bangladesh, 49% of newborns initiate breastfeeding after the first hour. The rate is higher among deliveries at a health facility (62%). Objective: This study investigates the maternal, health service, infant, and household characteristics associated with delayed initiation of breastfeeding among health facility deliveries in Bangladesh. Methods and Study Design: We used data from the 2014 Bangladesh Demographic and Health Survey. We included 1277 last-born children born at a health facility in the two years preceding the survey. 'Delayed' breastfeeding was defined using WHO recommendations as initiating after one hour of birth. We performed univariate and multivariable logistic regression to determine factors associated with delayed initiation. Results: About three-fifth (n=785,62%) of the children born at a health facility delayed initiation of breastfeeding beyond one hour. After adjusting for potential confounders, we found delayed initiation to be common among women, who delivered by caesarean section (aOR:2.93; 95%CI:2.17-3.98), and who were exposed to media less than once a week (aOR:1.53; 95%C:1.07-2.19). Women with a higher body mass index had an increased likelihood of delaying initiation (aOR:1.05; 95%CI:1.01-1.11). Multiparous women were less likely to delay (aOR:0.71; 95%CI:0.53-0.96). Conclusions: Delayed initiation following caesarean deliveries continues to be a challenge. Several other health facility and maternal factors also contribute to the delayed. Interventions to promote early breastfeeding should include strengthening the capacity of healthcare providers to encourage early initiation, especially for caesarean deliveries.
Mentorship on Malaria Microscopy Diagnostic Service in Ethiopia: Baseline Competency of Microscopists and Performance of Health Facilities
Authors: Gidey Bokretsion , Nega Desalegn , Abera Adugna , Abebe Abnet , Mekasha Sindew , Tasew Geremew , Haile Mebrahtom , Dillu Dereje , Mehari Degu , Assefa Ashenafi , Liknew Wondimeneh , G/tsadik Abeba , Mohammed Hussien , Woldie Ermias , Getachew Tsegaye , Ararso Desaelegn , Yenealem Dereje , Kebede Adisu , Etana Kebede , Kedida Gizachew , Solomon Hiwot , Tollera Getachew , Woyessa Adugna , Abate Ebba
Published: October 2020

Background: In Ethiopia, malaria case is declining as a result of proven interventions and the country launched malaria elimination strategy in targeted settings since 2017. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop continuation of the transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. Therefore, this study was carried out toevaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis.Methods: A cross-sectional study was conducted from August 01 to September 30, 2019 in nine Regional States and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked and proficiency of microscopists was tested using WHO certified slides from national slide bank in public health institute. Strength of agreement, sensitivity, specificity and positive and negative predictive values were calculated.Results: In this study, 102 health facilities (84 health centers and 18 hospitals) were included; from which, 202 laboratory professionals participated. In slide re-checking, moderate agreement (Agreement: 76.0%; Kappa: 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the rechecking results were 78.1% and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in detection of malaria parasites was 92.7% and 89.1%, respectively. Furthermore, in identifying species, slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. Conclusion: The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Therefore, implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are the key strategies to improve the overall performance of health facilities in malaria microscopy.
Molecular Surveillance of Antimalarial Resistance Pfcrt, Pfmdr1 and Pfk13 Polymorphisms in African Plasmodium Falciparum Imported Parasites to Wuhan, China
Authors: Weijia Cheng , Song Xiaonan , Tan Huabing , Wu Kai , Li Jian
Published: October 2020

Background: The development of drug resistance in Plasmodium falciparum becomes a severe problem for malaria control globally. Before finding a practical solution, monitoring the susceptibility of P. falciparum resistance-related genes is crucial. It will offer valuable information on the drug resistance in malaria-endemic areas and guides the rational clinical use of antimalarial drugs.Methods：Filter paper blood was taken from patients with positive P. falciparum during 2017-2019 in Wuhan, China. The target fragments from pfcrt, pfmdr1, and k13 propeller (pfk13) genes of P. falciparum were amplified and sequenced. Subsequently, the polymorphisms of pfcrt, pfmdr1, and pfk13 and the haplotypes of Pfcrt and Pfmdr1 were analyzed.Results: Totally, 106 samples were collected. Subsequently, 98.11% (104/106), 100% (106/106), and 86.79% (92/106) of these samples were successfully amplified and sequenced for the pfcrt, pfmdr1, and pfk13 genes, respectively. The prevalence of Pfcrt K76T, Pfmdr1 N86Y, and Pfmdr1 Y184F mutation were 9.62%, 4.72%, and 47.17%, respectively. At codons 72-76 of pfcrt gene locus were showed three haplotypes, including CVMNK (wild-type), CVIET (mutation type), CV M/I N/E K/T (mixed type), with 87.50%, 9.62%, and 2.88% prevalence, respectively. For the pfmdr1 gene, including NY (wild type), NF and YF (mutant type), N Y/F, Y Y/F, and N/Y Y/F (mixed type), accounted for 34.91%, 43.40%, 3.77%, 15.09%, 0.94%, and 1.89%, respectively. A total of eleven Pfcrt/Pfmdr1 combined haplotypes, including six types of combined haplotypes, and five combined haplotypes with mixed-type, For pfk13, no mutation was detected. Conclusions: The wild-type SNPs and haplotypes for the pfcrt, and pfmdr1 genes become predominant in the current study. It indicates these isolates entirely or partly recovery their susceptibility to antimalarial drugs, including chloroquine, amodiaquine, and mefloquine. Moreover, it demonstrates these drugs can continue to be effective drugs for P. falciparum malaria cases treatment in Africa. Although no mutation is detected in pfk13, continuous molecular surveillance is still urgently necessary.
Predictors for the Uptake of Optimal Doses of Sulfadoxine-pyrimethamine for Intermittent Preventive Treatment of Malaria During Pregnancy in Tanzania: Further Analysis of 2015-2016 Tanzania Demographic and Health Survey and Malaria Indicator Survey Data
Authors: Mushi Vivian , Mbotwa Christopher H , Zacharia Abdallah , Ambrose Theresia , Moshi Fabiola V
Published: October 2020

Background: In Tanzania, the uptake of optimal doses (≥ 3) of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria (IPTp-SP) during pregnancy has remained below the recommended target of 80%. Therefore, this study aimed to investigate the predictors for the uptake of optimal IPTp-SP among pregnant women in Tanzania.Methods: This study used data from the 2015-16 Tanzania demographic and health survey and malaria indicator survey (TDHS-MIS). The study had a total of 4,111 women aged 15 to 49 who had live births 2 years preceding the survey. The outcome variable was uptake of three or more doses of IPTp-SP and the independent variables were age, marital status, education level, place of residence, wealth index, occupation, geographic zone, parity, the timing of first antenatal care (ANC), number of ANC visits and type of the health facility for ANC visits. Predictors for the optimal uptake of IPTp-SP were assessed using univariate and multivariable logistic regression.Results: A total of 327 (8%) women had optimal uptake of IPTp-SP doses. Among the assessed predictors, the following were significantly associated with optimal uptake of IPTp-SP doses; education level [primary (AOR: 2.2, 95% CI 1.26–3.67, P = 0.005); secondary or higher education (AOR: 2.1, 95% CI 1.08–4.22, P = 0.029)], attended ANC at the first trimester (AOR: 2.4, 95% CI 1.20–4.96, P = 0.014), attended ≥ 4 ANC visits (AOR: 1.9, 95% CI 1.34–2.83, P <0.001), attended government health facilities (AOR: 1.5, 95% CI 1.07–1.97, P = 0.017) and geographic zone [Central (AOR: 5, 95% CI 2.08–11.95, P <0.001); Southern Highlands (AOR: 2.8, 95% CI 1.15–7.02, P = 0.023); Southwest Highlands (AOR: 2.7, 95% CI 1.03–7.29, P = 0.043); Lake (AOR: 3.5, 95% CI 1.51–8.14, P = 0.004); Eastern (AOR: 1.5, 95% CI 1.88–11.07, P = 0.001)].Conclusions: The uptake of optimal IPTp-SP doses is still low in Tanzania. The optimal uptake of IPTp-SP was associated with attending ANC in the first trimester, attending more than four ANC visit, attending government health facility for ANC, having primary, secondary or higher education level and geographic zone. Therefore, we recommend health education and behavior change interventions with the emphasis on the optimal use of IPTp-SP doses.
Genome-wide analysis of structures and characteristics of the SPL gene family in wheat (Triticum aestivum L.)
Authors: Li Li , Shi Fu , Guan Yanbin , Wang Guoli , Zhang Yufan , Chang Junli , Chen Mingjie , Yang Guangxiao , Wang Yuesheng , He Guangyuan
Published: October 2020

Background: The SQUAMOSA-PROMOTER BINDING PROTEIN-LIKE (SPL) genes encode a family of plant-specific transcription factors that contain a conservative SBP domain. SPL proteins play important roles in plant growth and development, such as plant architecture, flowering regulation, and grain yield. However, the systematic analysis of TaSPL gene family in wheat is lacking.Results: In this study, 56 TaSPL genes were identified from wheat genome and divided into eight groups (G1-G8), according to the phylogenetic analysis of TaSPL proteins among numbers of plant species. Bioinformatics method were applied to analyse the gene structure, motif, chromosome localization, segmental duplication and synteny of total TaSPL genes and the results showed that their characteristics were different among group in the exon-intron constitution, conserved and specific motif. The expansion and evolution of the TaSPL genes occurred within the wheat genome. Total 28 of 56 TaSPL genes were predicted to be putative targets for miR156, which revealed the importance of miR156-mediated regulation in wheat. Moreover, transcript level analysis of TaSPL genes in wheat tissues by qRT-PCR discovered the diversified spatiotemporal expression patterns, based on the comparison with reference RNA-seq data. Some TaSPL genes were subject to various stress treatments including drought and hormones, etc. suggesting that these part genes probably involved in responding to hormone signals during different wheat development stages. Conclusions: Our findings show that TaSPL genes may regulate the development of spike and grain, resistance to abiotic stresses, and involve in responding to hormone signals. These results could provide a fundamentally information to further study of the functions of TaSPL genes in wheat growth and development.
Post-Traumatic Stress Disorder Psychological Interventions in Sub-Saharan Africa: Protocol for a Systematic Review of Literature
Authors: Ntlantsana Vuyokazi , Molebatsi Keneilwe , Mashaphu Sibongile , Chiliza Bonginkosi , Akena Dickens H
Published: October 2020

Background: While untreated post-traumatic stress disorder (PTSD) results in considerable morbidity and higher risk of mortality, little has been done to treat PTSD in low resourced sub-Saharan Africa settings where there is mass exposure of the population to traumatic events. This systematic review aims to summarise available evidence on the efficacy of psychological therapies for PTSD in sub-Saharan Africa (SSA).Methods: A systematic search of literature in the PubMed, PsychInfo, EMBASE and Cochrane Register of Controlled Trials electronic databases will be conducted using keywords related to “PTSD”, “psychological therapies” and “SSA”. Two independent researchers will screen for studies eligible for inclusion if set in SSA and randomised controlled trial study design. Data on intervention types, population, comorbidities, comparison group intervention and PTSD outcomes will be extracted from included studies. Risk of bias will be assessed, qualitative synthesis of data will be conducted, and pooled effect estimates calculated.Discussion: Trauma in SSA occurs within the context of unique conditions necessitating applicable interventions. The results of the systematic review will be important in providing a guide for clinicians and researchers in low resource settings in development of effective interventions. Systematic review registration: PROSPERO (CRD42020181638)
Health System Adaptability at Primary Level Care in the Time of COIVD-19: Experiences From Ethiopia
Authors: Abebe Yared , Beshir Ismael Ali , Tsegaye Zergu Tafese , Desta Binyam Fekadu , Kibret Mengistu Asnake , Equar Awala , Deboch Sisay Meselle , Refissa Abera , Sendeku Agegnheu Gebru , Serbessa Feyissa
Published: October 2020

BackgroundCOVID-19 is a global public health emergency, that has had massive implications on the ability of health systems to avail essential services both during and after the emergency. An effective response thus requires an agile health system that can adjust, reorganize, transform or modify in response to shocks and stress, and to recover quickly in the aftermath. This study aims to identify the major attributes that health systems needed to be adaptable in early stages of the COVID-19 pandemic, as observed in selected primary health care facilities in Ethiopia. MethodsThis study employed a retrospective cross-sectional study design based on the ‘ready, willing and able’ framework for health system resilience. The assessment used two independent, concurrently administrated instruments. A total of 163 health centers were visited from April to June 2020. ResultsThe overall mean score for COVID-19 preparedness was 73.1±16.1 standard deviation (SD) and it ranged from 28.9 to 99.9 out of 100. The mean score for the ‘ready’ dimension of preparedness was 75.1±19.1 SD, for the ‘willing’ dimension it was 61.6±24.6 SD and for the ‘able’ dimension the score was 82.8±21.0 SD. Multivariable linear regression analysis showed that levels of functionality of governing, and management systems, integration of emergency responses into the routine system, and prior experience of implementing quality improvement efforts were positively associated with COVID-19 preparedness. ConclusionHealth system resilience is a result of investments made prior to any incidents to ensure that the system is prepared for unpredicted shocks. Early adaptation required to contain the effects of COVID-19 may be considered as a litmus test to understand the capacity of primary health care facilities in Ethiopia to withstand future health system stressors.
Characterizing the bacterial community in bioflocs, culture water and intestines of GIFT tilapia (Oreochromis niloticus) reared in a biofloc technology (BFT) system
Authors: Zhang Yang , Cao Baoxin , Abakari Godwin , Tan Hongxin , Luo Guozhi
Published: October 2020

GIFT Oreochromis niloticus was cultured in a bio-floc technology (BFT) system to identify the floral structure of the biofloc water and in the intestine of the fish. High-throughput sequencing technology was used to detect the microbes in the culture water, in the intestines and gills of farmed fish. The effective sequence coverage rate of each sample exceeded 99% and the sequencing results were true and reliable. The results show that according to Chao1 and Simpson indices, the microbial richness and diversity of flocs increase with the increase of culture time. Flocs initially favoured the thick-walled bacterium ( Firmicutes ) as the dominant fungi with abundance of 86%, whiles the rest were all less than 10% in abundance. At the end of the experiment the abundance of Chlorofiexi was 43% , Proteobacteria 26%, and Bacteroidetes 12%. During the early stages, Bacillus was the most dominant group of about 86% abundance. However, this declined towards the end of the breeding period and the abundance was recorded to reduce to about 3%. The highest abundance was associated with the bacterial described as unclassified species called N orank-f-caldilineaceae representing 40% and the abundance of Flavobacterium found to be 2%. The dominant bacteria in the intestinal tract of fish were Proteobacteria (35%), Bacillus (16%) and Cetobacterium (13%). The main heterotrophic assimilation functions in the BFT system were bacillus and chlorocampylobacter . However, flavobacterium was found in the BFT system indicating the presence of on-going denitrification
F. prausnitzii and Its Supernatant Increase SCFAs-producing Bacteria to Restore Gut Dysbiosis in TNBS-Induced Colitis
Authors: Zhou Youlian , Xu Haoming , Xu Jing , Zhao Hailan , Chen Ye , Zhou Yongjian , Nie Yuqiang
Published: October 2020

An increasing number of studies have shown that Faecalibacterium prausnitzii (F. prausnitzii) is a promising anti-inflammatory bacterium that colonizes in the gut and that gut microbiota dysbiosis plays an important role in the pathogenesis of inflammatory bowel disease (IBD). In this study, we report the gut microbiota profile of 2,4,6 trinitrobenzene sulfonic acid (TNBS)-induced colitis mice treated with F. prausnitzii and its supernatant on the basis of high-throughput sequencing. We interestingly found that both F. prausnitzii and its metabolites exerted protective effects against colitis in mice, which ameliorated gut dysbiosis, with an increase in bacterial diversity and the abundance of short-chain fatty acid (SCFA) -producing bacteria and a decrease in serum TNF- α and the abundance of Proteinbacteria, Acidobacteria, and Bacteroidetes. These findings will provide further evidence of the anti-inflammatory effect of F. prausnitzii, which presents therapeutic potential for IBD treatment.
Dietary Purslane (Portulaca Oleracea L.) Promotes the Growth Performance of Broilers by Modulation of Gut Microbiota
Authors: Wang Cong , Liu Qing , Ye Fengchun , Tang Hongbo , Xiong Yanpeng , Wu Yongfei , Wang Luping , Feng Xuanbiao , Zhang Shuiyin , Wan Yongmei , Huang Jianhua
Published: October 2020

Purslane is a widespread wild vegetable with both medicinal and edible properties. It is highly appreciated for its high nutritional value and is also considered as a high-quality feed resource for livestock and poultry. In this study, Sanhuang broilers were used to investigate the effect of feeding purslane diets on the growth performance in broilers and their gut microbiota. A total of 48 birds with good growth and uniform weight were selected and randomly allocated to four treatment groups A (control), B, C and D. Dietary treatments were fed with basal diet without purslane and diets containing 1%, 2% and 3% purslane. The 16S rDNA was amplified by PCR and sequenced using the Illumina HiSeq platform to analyze the composition and diversity of gut microbiota in the four sets of samples. The results showed that dietary inclusion of 2% and 3% purslane could significantly improve the growth performance and reduce the feed conversion ratio. Microbial diversity analysis indicated that the composition of gut microbiota of Sanhuang broilers mainly included Gallibacterium, Bacteroides and Escherichia-Shigella, etc. As the content of purslane was increased, the abundance of Lactobacillus increased significantly, and Escherichia-Shigella decreased. LEfSe analysis revealed that Bacteroides_caecigallinarum, Lachnospiraceae, Lactobacillales and Firmicutes had significant differences compared with the control group. PICRUSt analysis revealed bacteria mainly enriched in carbohydrate metabolism pathway due to the additon of purslane in the diet. These results suggest that the addition of purslane to feed could increase the abundance of Lactobacillus in intestine, modulate the environment of gut microbiota and promote the metabolism of carbohydrates to improve its growth performance. This study indicates that the effect of purslane on the growth-promoting performance of broilers might depend on its modulation on gut microbiota, so as to provide a certain scientific basis for the application of purslane in the feed industry.