bluuebunny/crossref_metadata_2025 huggingface dataset:
To Choose or not to Choose? -User Perspectives on Medication Free Treatment for Persons With Psychosis: a Qualitative Study
Authors: Oedegaard Christine Henriksen , Davidson Larry , Stige Brynjulf , Veseth Marius , Blindheim Anne , Garvik Linda , Sørensen Jan-Magne Tordenhjerte , Søraa Øystein , Engebretsen Ingunn Marie Stadskleiv
Published: August 2019

Abstract: Background: Norway recently changed national policies in psychiatry emphasizing the right for persons with psychosis to choose medication-free treatment. Long-term anti-psychotic medication is debated, in terms of effectiveness and side effects. New guidelines generate increased treatment options for patients with severe mental illness. Methods: This study explore users’ experiences with treatment choices in this unique context. We interviewed eleven patients diagnosed with psychosis about their experiences of choosing treatment, analysing the transcribed data team based and stepwise. Results: Findings show how choosing treatment appears to be a complicated process with many influencing factors. Emerging themes were about the dialogue between patient and therapist, the importance of having a treatment choice, difficulties choosing the unknown not knowing what helps, choice influenced by the level of experience with in particular medication, and coercive measures contrasting the freedom of choice. Conclusion: The freedom to choose was perceived important, but the complexity of choosing showed how optimal care might not always equal the freedom to choose. Aiming for optimal care, we need to consider how involuntary admission and other coercive measures are used, and possibly improved, in order to care without further traumatizing people who are already in extreme distress. Ethical approval: The Regional Ethics Committee for Medical Health Research (REK southeast 2017/736) defined this study as health service research and hence according to the Norwegian health research legislation, the study was to be approved by the local data protection officer. The data protection officer for Health Bergen approved the study in July 2017 (2017/8692).
The strategy of coping with stress and selected health related behavioural patterns of demobilized battle participants
Authors: Ortenburger Dorota , Wąsik Jacek , Andriejczuk Olga
Published: August 2019

Background: The aim of the herein paper is to express knowledge of the role of ties (relations) between mental factors such as trust in your own possibilities of coping with pain and availing of the active strategies of coping with stress, while also the degree of readiness to limit stress with the aid of the use of alcohol. Methods: The research covered the group of 38 demobilized ATO participants (21-46 years) undergoing treatment and rehabilitation in the Hospital. A measurement was conducted with the aid of certified psychological questionnaires and from medical documentation. Results: A correlation occurred between the active strategy of coping with the stress felt and the strategy of coping with pain of the ICS type – Internal control of pain (r=0.71; p<0.05), as well as the negative correlation between the readiness to utilize stimulants with the aim of easing stress and the strategy of coping with pain of the ICS type (r=-0.58; p<0.05). Conclusion: The ways of coping with stress and pain by the hospitalized participants of combat action may be significant factors (of a psychological nature) that have an impact on their readiness to undertake behaviour that is significant for their health (such as alcohol and others) with the aim of reducing the symptoms of nervous tension felt.
Caffeine citrate improves outcomes of apnea of prematurity based on gestational ages
Authors: Zhao Dongchi , Lijun Li , Xia Wang , Pu Yang , Junwen Zheng
Published: August 2019

ObjectiveThis study aimed to evaluate the therapeutic effect of caffeine citrate on early premature infants with apnea of prematurity (AOP), and the impact on movement and neurobehavioral development in their early lives.Study designAmongst 397 premature infants whose gestational age (GA) were less than 32 weeks, 172 premature infants were eligible for this study from January 2014 to May 2017. 94 infants received caffeine citrate intervention, 20 infants were given aminophyline and the rest 58 infants didn't received any methylxanthines. According to the incidence of apnea, caffeine using was divided into two situations of therapeutic and preventive administration. The primary clinical outcomes were recorded which included length of stay (LOS), duration of mechanical ventilation, the incidence of complications and outcomes.Results62 cases (66%) were assigned to receive caffeine within 3 days after birth, and 69 cases (74%) received caffeine less than one month. Caffeine could reduce LOS, duration of MV and nasal continues positive airway pressure (nCPAP), the incidence of nosocomial infection and bronchial pulmonary dysplasia (BPD) (p<0.05). There was no significant difference in the incidence of abdominal distension, necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA) and intraventricular hemorrhage (IVH) compared with aminophylline and conservative groups (P >0.05). Caffeine showed different effects on clinical outcomes in early premature infants based on their GAs, and premature infants with larger GA could benefit more from the intervention (p<0.001), and caffeine didn’t affect their early lives in short-term prognosis by follow-up.Conclusion Caffeine can improve AOP clinical outcomes in those premature infants with larger GA, and didn't have side effects on the movement and neurobehavioral development in short-term prognosis.
Neonatal Mortality And Associated Factors In A Pastoral Region, Afar, Ethiopia: A Health Facility Based Study
Authors: Woday Abay , Mekuria Yohannes , Denis Christine St
Published: August 2019

Abstract

Background: Neonatal mortality is public health issue in developing countries, such as Ethiopia. Unfortunately, the issue is noticeably under-reported and underestimated, so the true gravity of the situation cannot be acknowledged. Subsequently, Afar in Ethiopia contributes the largest burden of under-five mortality when compared to other regions in the country. Regrettably, there is no current information to the rates and predictors of neonatal mortality for the region. Thus, this study aims to assess neonatal mortality and associated factors in pastoral communities residing in Afar, Ethiopia.

Methods: A health facility based retrospective cross sectional study was conducted on 403 neonates admitted to the neonatal intensive care unit (NICU) from May 1 st 2015 - May 2nd 2019. Medical records were reviewed and audited for both mothers and neonates to collect data using standardized data extraction checklist. The medical records were selected using a systematic random sampling technique. Binary logistic regression with odds ratio and 95% Confidence interval was calculated to assess the association between neonatal mortality and associated factors. Finally, the statistical significance level was declared at a p-value <0.05.

Results: 391 medical records of newborns were included with data complete rate of 97.02%. The prevalence of neonatal mortality was 14.6% (95% CI 11.0%-18.4%). Lack of antenatal care (ANC) follow up (AOR = 4.69: 95%CI 1.77, 12.47), giving birth through cesarean section (AOR 3.59, 95%CI 1.22, 10.55), having a temperature less than 36.5 o C within the first hour of admission (AOR 10.75, 95%CI 3.75, 30.80), perinatal asphyxia (AOR 7.16, 95%CI 2.22, 23.10) and/or having a length of stay greater than five days in the hospital (AOR 0.23, 95%CI 0.08, 0.66) were signiﬁcantly associated with neonatal mortality.

Conclusion: This study revealed that the rate of neonatal mortality is still too high compared to the national data. Antenatal care, cesarean section delivery, length of stay in the hospital, low temperature with in the first hour of admission and perinatal asphyxia were factors associated with neonatal mortality. Thus, the health facilities should give due attention for improving antenatal cares, intra-partum cares and standardized cares for admitted neonates. Additional prospective studies are recommended.
Impact of chronic kidney disease and anemia on health-related quality of life and work productivity: Analysis of multinational real-world data
Authors: Haalen Heleen van , Jackson James , Spinowitz Bruce , Milligan Gary , Moon Rebecca
Published: August 2019

Background. Reductions in health-related quality of life (HRQoL) in patients with chronic kidney disease (CKD) are thought to be exacerbated by the low hemoglobin (Hb) levels that define anemia, a common complication of CKD. The current analysis evaluated the impact of anemia on HRQoL and work productivity in patients with non-dialysis dependent and dialysis dependent CKD using real‑world data.Methods. Data were collected in France, Germany, Italy, Spain, the UK, the USA and China in 2012–2018 in the Adelphi Real World Disease Specific Programme™ (DSP) for CKD, a large, cross-sectional, survey of physicians and their patients. Patients completed three patient-reported outcomes (PRO) instruments: the EuroQol 5-Dimension 3-level (EQ-5D-3L), the Kidney Disease Quality of Life (KDQOL-36) instrument and the Work Productivity and Activity Impairment (WPAI) questionnaire. PROs were assessed by CKD stage and Hb levels, and regression analyses were performed with CKD stage and Hb level as independent variables and PROs as outcome variables, while adjusting for age, sex, CKD stage, comorbidities and CV risk.Results. Overall, 5276 patients participated in the survey, including 28% stage 4 and 36% dialysis patients. Patients with lower Hb levels more often reported problems/issues on all EQ-5D-3L domains (p<0.0001). Regression analyses showed significant associations between lower Hb levels and the probability of low (<0.8) EQ-5D-3L utility scores (p<0.0001) and low visual analog scale (VAS) scores (p<0.05), indicating poorer health status. Associations were seen even when adjusting for CKD stage and other potential confounding factors. Significant associations were observed between Hb level and the 12-Item Short-Form Health Survey (SF‑12) Physical Component Summary (PCS), SF-12 Mental Component Summary (MCS) and the three KDQOL-36 subscales (all p<0.0001), and were confirmed using linear regression analyses adjusting for CKD stage and other potential confounders. Numerically greater work productivity losses and greater activity impairment were observed with lower Hb levels.Conclusions. Lower Hb levels worsen the impact of CKD on HRQoL, and are associated with lower work productivity in patients with CKD. Assessment and treatment of anemia should be recognized as a key component of integral CKD management throughout all stages of the disease.
Contraceptive utilization and associated factors among women in the extended post-partum period in wukro town, Tigray, Ethiopia: a community based cross sectional study
Authors: Assefa Natnael Etsay , Berhe Yodit Zewdie , Werid Weldu Mammo , Mengesha Meresa Berewo , Tekola Kidanemariam Berhe , Abady Gdiom Gebreheat , Gebru Tesfay Tsegay , Berhe Lidya Zewdie , Weldemariam Mulu Gebretsadik
Published: August 2019

Background: The extended post-partum period is the twelve months after delivery, which is a very critical time for mothers to ensure a safe birth interval. Many women do not realize that they are at risk of pregnancy during the postpartum period and the importance of birth interval. Birth interval more than two years reduces maternal and child mortality and give a better health for the mother and the child. Because of this assessing post-partum contraceptive utilization and the determining factors is crucial. Hence, the study was conducted to determine contraceptive utilization and identify factors which affect post -partum contraceptive utilization Methods: A community based cross sectional study was implemented among 422 women who gave birth one year prior to the study period in wukro town. The total sample size was allocated to the three kebeles proportionally. Systematic random sampling technique was used to select study subjects. Data were collected by interviewer administered structured questionnaire. The data were coded and entered using EpiData version 3.1 and transported to Statistical Package for Social Science version 20 for analysis. Binary and multivariable logistic regressions were fitted. Odds ratio with 95% confidence interval was used to measure strength of association. Results: A total of 422 women were enrolled in this study. Nearly half (48.6%) of the women were using contraceptive. Multivariable logistic regression showed that prenatal counseling [AOR 3.06(95% CI; 1.30, 7.22)], menses returned [AOR 3.99(95% CI; 1.96, 8.11)] and resuming sexual activity [AOR 5.96(95% CI; 2.67, 13.3)] were positively associated with utilization of postpartum contraceptive. Conclusions: Postpartum contraceptive use was low. Strengthening prenatal family planning counseling and improving women’s awareness about the return of their fertility after childbirth are suggested to improve family planning utilization in extended postpartum period.
Retrospective Development of a Novel Resilience Scale using Existing Cohort Data: The Adolescent to Adult Health Resilience Instrument
Authors: Montoya-Williams Diana , Passarella Molly , Lorch Scott A
Published: August 2019

Background: Cohort studies represent rich sources of data that can be used to link components of resilience to a variety of health-related outcomes. The Adolescent to Adult Health (Add Health) cohort study represents one of the largest data sets of the health and social context of adolescents transitioning into adulthood. It did not however use validated resilience scales in its data collection process. This study aimed to retrospectively create and validate a resilience scale using existing data from the cohort to better understand the resilience of its participants.

Methods: Questions asked of participants during one Add Health data collection time period (N=9852) were matched to items on a well-known and widely validated resilience scale called the Connor Davidson Resilience Scale. Factor analysis and psychometric analyses were used to refine and validate this novel Adolescent to Adult Health Resilience Instrument. Construct validity utilized participants’ answers to the 10 item Center for Epidemiologic Studies Depression Scale, which has been used to validate other resilience scales.

Results: Factor analysis yielded an instrument with 13 items that showed appropriate internal consistency statistics. Resilience scores in our study were normally distributed with no ceiling or floor effects. Our instrument had appropriate construct validity, negatively correlating to answers on the depression scale (r = -0.64, p<0.001). We also found demographic differences in mean resilience scores: lower resilience scores were seen among women and younger participants. Resilience scores increased with increasing education and household income.

Conclusions: It is possible to retrospectively construct a resilience scale from existing cohort data and achieve good psychometric properties. The Adolescent to Adult Health Resilience Instrument can be used to better understand the relationship between resilience, social determinants of health and health outcomes among young adults using existing data, much of which is publicly available.

Keywords: resilience, validation, Add Health, scale development
Back pain as reported in survey and claims data – comparison of prevalences and concordance by data linkage
Authors: Feißel Annemarie , Robra Bernt-Peter , Stallmann Christoph , Swart Enno , March Stefanie
Published: August 2019

Objectives

Back pain is a burden for those suffering from it as well as for the economy and social insurance system. This explains the great interest in collecting data on back pain in population studies to estimate for instance its prevalence. As part of the lidA study, the agreement between self-reported information on back pain (self-reported prevalence) and health claims data (administrative prevalence) has been examined.

Methods

In two waves of CAPI, employees (years 1959, 1965) were asked about aspects of health, inter alia, if they experience any symptoms or pain in “upper back or thoracic spine” and “lower back or lumbar region” during the past 12 months. With present informed consent, the CAPI data were individually linked with health claims data (n=1,031). Due to the lack of a gold standard, both data sources were cross-validated. Back pain is logged in claims data across sectors based on two different definitions (2009-2013): Def1) at least one “M54” (ICD-10 coded) entry; Def2) present in at least two quarters within a period of four consecutive quarters.

Results

The difference between self-reported prevalence (57.8%) and administrative prevalence (58.3%) based on Def1 is minimal in contrast to Def2 (34.6%). Despite almost identical prevalence percentages, Cohen’s Kappa for Def1 indicates a low level of agreement between both data sources (0.23 [95%-CI: 0.17-0.29]). Although prevalence differs significantly based on Def2, Cohen’s Kappa still shows low agreement (0.18 [95%-CI: 0.13-0.24]).

Conclusions

The low level of agreement between both data sources suggests that each data source identifies a certain group of individuals having few overlaps with one another. Therefore, aiming in identifying the target population for disease-specific health prevention, a combination of both data sources, the prevalence of back pain can be estimated more accurately.
How does the WHO Surgical Safety Checklist fit with existing perioperative risk management strategies? An ethnographic study across surgical specialities in Norway
Authors: Wæhle Hilde Valen , Haugen Arvid Steinar , Wiig Siri , Søfteland Eirik , Sevdalis Nick , Harthug Stig
Published: August 2019

Background

The World Health Organization (WHO) Surgical Safety Checklist (SSC) has demonstrated beneficial impacts on a range of patient- and team outcomes, though variation in SSC implementation and staff`s perception of it remain challenging. Precisely how frontline personell integrate the SSC with pre-existing perioperative clinical risk management remains underexplored – yet likely an impactful factor on how SSC is being used and its potential to improve clinical safety. This study aimed to explore how members of the multidisiplinary perioperative team integrate the SSC within their risk management strategies.

Methods

An ethnographic case study including observations (40h) in operating theatres and in-depth interviews of 17 perioperative team members was carried out at two hospitals in 2016. Data were analysed using content analysis.

Results

We identified three themes reflecting the integration of the SSC in daily surgical practice: 1) Assessing utility; implying an intuitive advantage assessment of the SSC`s practical utility in relation to relevant work; 2) Customising implementation; reflecting performance variability of SSC on confirmation of items due to precence of team members; barriers of performance; and definition of SSC as performance indicator, and 3) Interactive micro-team communication; including formal- and informal micro-team formations where detailed, specific risk communication unfolded.

Conclusion

When the SSC is not integrated within existing risk management strategies, but perceived as an “add on”, its fidelity is compromised, hence limiting its potential clinical effectiveness. Implementation strategies for the SSC should thus integrate it as a risk-management tool and include it as part of risk-management education and training. This can improve team learning around risk comunication, foster mutual understanding of safety perspectives and enhance SSC implementation.
Oral cancer stem cells drive tumourigenesis through activation of stromal fibroblasts
Authors: Al-Magsoosi Mohanad J.N , Lambert Daniel W , Khurram Syed Ali , Whawell Simon A
Published: August 2019

Background: Cancer stem cells (CSC) are a subpopulation of cells within a tumour that are primarily responsible for tumour progression and resistance to therapy. Fibroblasts in the stromal tissue surrounding a tumour are also involved with its progression and fibroblast ‘activation’ is an independent prognostic marker in oral cancer. We hypothesise that CSCs can be isolated from oral cancer cell lines using functional assays and that they may drive tumour progression through communication with stromal fibroblasts.
Methods: CSCs were isolated from oral cancer cell lines (H357 and SCC4) by their rapid adherence to fibronectin or resistance to cisplatin. Conditioned medium from both CSC and unsorted H357 and SCC4 cell lines were applied to cultures of NOFs for 24 hours. The gene and protein expression of the activation markers alpha smooth muscle action (αSMA) and interleukin-6 was assessed using qPCR and immunofluorescence. Expression of CSC markers and αSMA were examined in OSCC tissue using immunohistochemistry.
Results: Cells isolated using both methods expressed significantly increased levels of stem cell markers CD24, CD44 and CD29 compared to unsorted cells. Adherent cells exhibited lower growth rate, higher colony forming efficiency and increased cisplatin resistance compared to unsorted cells. Conversely, the cisplatin-resistant cells adhered to fibronectin in greater numbers than unsorted cells. Expression of αSMA and IL-6 was increased in NOFs following exposure to either H357 or SCC4 CSC conditioned medium. In OSCC tissue there was a positive correlation between expression of αSMA and both CD24 and CD44.
Conclusions: Rapid adherence to fibronectin and chemo-resistance effectively isolates a sub-population of cells from cell lines which show stem cell-like characteristics. Our data also suggests that factors released by CSC can activate fibroblasts towards a CAF-like phenotype, which together with evidence of correlation between markers of both in vivo, provides evidence of a mechanism by which such cells can drive tumour progression.
Red LED light promotes hair follicle development to improve fibre quality in Su line Angora rabbit
Authors: Qin Feng , Wang Jing , Shao Le , Pan Xiaoqing , Yang Jie , Zhu Cigeng , Zhang Xia , Li Jian , Li Sheng , Zhai Pin
Published: August 2019

Background: Light has crucial roles in animal physiological activities. This study aimed to investigate the effects of different colours of light-emitting diodes (LEDs) on rabbit fibre quality and hair follicle development. 50 three-month-old Su line Angora rabbits were randomly assigned to five groups. Treatment groups were exposed to same intensities of red, green and blue LED light under 16 h light:8 h dark photoperiod regimes. Control groups were exposed to white light and black. The trial spanned 73 days.
Results: Results showed that LED colours exerted different effects on wool yield, fibre quality, hormones and hair follicle development. The wool yield of red group was higher than that of white, green and black groups (P<0.05). The shoulder fibre length of red group was higher than that of white and green groups (P<0.05). The coarse fibre diameter of white group was lower than that of green and black groups (P<0.05). The fibre diameter of red group was the lowest and was lower by 13.9% than that of control group (P>0.05). The coarse fibre ratio of green group was higher (13.31%) than that of red group (3.81%, P<0.05). The follicle groups of white, green and black groups consisted of 1 primary follicle associated with 3 or 4 secondary follicle groups and those of blue group consisted of 1 primary follicle associated with 5–10 secondary follicle groups. The follicle of red group consisted of numerous secondary follicles and a few primary follicles. In same magnification, the numbers of follicle groups of white, red, green, blue and black groups were 14.0, 16.5, 10.0, 11.67 and 11.0, respectively. The numbers of follicle groups of red and green groups significantly differed (P<0.05). Serum melatonin (MT) of red group was highest than that of white and green groups (P<0.01), higher than that of black group (P<0.05), serumTriiodothyronine (T 3 ) of red group was higher than that of white and black groups (P<0.05).
Conclusions: Thus, the data reveal that red LED light can improve fibre quality, this may be due to red LED light which can enhance the secretion of melatonin to promote hair follicle development .
Magnitude and factors associated with anemia among pregnant women attending antenatal care at st. Paul's Hospital Millennium Medical college, Addis Ababa, Ethiopia, July, 2019
Authors: Umuro Desta Samuel , Asres Yared Lasebew , Muluneh Gezahegn Mamo
Published: August 2019

Background: This study aimed to assess magnitude and factors associated with anemia among pregnant women attending antenatal clinic at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Methods: Institution based cross sectional study design was conducted from December 1, 2018 to January 15, 2019 on 405 pregnant women attending antenatal clinic. All pregnant women visiting the Antenatal care clinic during the study period and who fulfilled the eligibility criteria were included in the study. Secondary data was collected from clients register and personal files on hemoglobin, HIV, stool, and other variables. Descriptive statistics was used to analysis some variables by using SPSS. Logistic regression was carried out to identify factors associated with anemia in pregnancy. Adjusted odds ratio with their 95% of confidence interval and p<0.05 are consider to have significant association.
Results: The magnitude of Anemia in pregnant women in this study was 19.8 %, (95% CI 16.00-23.70). HIV infection (AOR=6.12(95% CI 2.19, 17.08) parasitic infestation (AOR= 11.88 (95% CI 5.60, 25.20) and history of not taking fruit after meal during pregnancy (AOR=3.12(95% CI 1.72, 5.67) were the major determinants of anemia.
Conclusion: This study showed that the magnitude of anemia among pregnant women was high especially at third trimester. Living with HIV /AIDS, parasitic infestation and no history of taking fruits after meal were the main factors.
Key words: Magnitude, Anemia, Pregnant women
Moderation effect of emotion regulation on the relationship between social anxiety, drinking motives and alcohol related problems
Authors: Kim Sojung , Kwon Jung-Hye
Published: August 2019

Abstract Background: Accumulated evidence suggests that individuals with social anxiety disorder (SAD) are at particular risk of developing alcohol use disorder (AUD). Yet, little is known about the mechanisms under this high comorbidity. This study aimed to elucidate the process of development of alcohol related problems (ARP) among individuals with elevated social anxiety (SA). We examined the moderation effect of difficulties in emotion regulation (DER) on the relationship between cognitive-behavioral-physiological symptoms of SA, coping and conformity motives and ARP. Methods: In a sample of university students (N = 647) in South Korea, the proposed model in which fear of negative evaluation (FNE), social avoidance, and concerns over physiological symptoms (CPS) were supposed to affect ARP with the mediation of coping and conformity motives was tested. Furthermore, DER was hypothesized to moderate each meditational path. Results: Results showed that FNE and CPS predicted ARP with the mediation of conformity and coping motives, respectively. As hypothesized, each path was moderated by DER. Conclusions: Findings suggest that coping and conformity motives to cope with cognitive and physiological symptoms of SA were related to ARP. In addition, individuals with high levels of DER were prone to exhibit more ARP.
Medical career expectations of academically talented high school students: A nationwide cross-sectional study in China
Authors: Wu Hongbin , Pei Leisi , Li Shan , Jiang Cheng
Published: August 2019

Background: Academically talented high school students (ATHSSs), an exceptional cohort, are not well studied for their career expectations, especially for those with medical career expectation (MCE). Nowadays, the public perception of the medical profession is changing in China. The purpose of this study was to answer questions about ‘is medicine attractive for ATHSSs and ‘what factors affect medical career expectations (MCE) for ATHSSs’ in China.
Methods: A total of 16,479 representative ATHSSs in senior three completed a questionnaire and four different academic tests. Frequency statistics showed the proportion of ATHSSs with MCE. Unpaired t-tests were performed to find out the differences in demographics, family background, and academic performance between students with and without MCE. The logit models analysis were applied to explore the potential factors that affected the MCE of this exceptional group of students.
Results: ATHSSs with MCE accounted for 20.6% (ranking 7/18) of the respondents. They were more likely to be female, came from relatively poorer families, lived in a rural area, and performed significantly worse in all academic tests except for mathematics, compared with those without MCE. In addition, the results revealed that gender (β=-0.436, p<0.01), region of hometown (β=-103, p<0.1), mother’s years of schooling (β=-0.019, p<0.05), and father’s occupational status (β=-0.005, p<0.01) contributed significantly to the MCE of academically talented students. Better performance in mathematics affected the MCE of ATHSSs taking the liberal arts and science tests differently.
Conclusions: We found the medical career is becoming unattractive to academically talented students and the medical career may be loosing their aura in China. Students who have medical career expectations are likely to be females and to have a weak family background. We discuss implications for medical education.
Analysis of Fundus Photography and Fluorescein Angiography in Chinese patients with different stages of non-arteritic anterior inschemic optic neuropathy
Authors: Wang Liping , Li Ying
Published: August 2019

ABSTRACT
Purpose: The aim of this study was to characterize the different stages of non-arteritic anterior inschemic optic neuropathy (NAION) features by Fundus Photography (FP) and Fluorescein Aniography (FA) in a Chinese Population.
Methods: The retrospective observation study included 30 patients (36 eyes) with acute phase, 20 patients (27 eyes) with subacute phase and 30 patients (52 eyes) with chronic phase. Macular, optic nerve and disc were investigated by FP and FA. Categorical variables were evaluated by Fisher’s exact test.
Results: Macular edema, papilloedema, disc hemorrhage and exudation from FP were more common in the acute and subacute stage groups than chronic stage group with optic atrophy in contrast (all p<0.01). Compared to chronic stage, acute and subacute stages were more likely to appear macular fluorescence accumulation and peripapillary choroid filling delay (all p<0.01). However, chronic stage tended to have retinal artery filling delay and disc filling defects in the early phase from FA (all p<0.01).
Conclusion: The data showed that NAION had different fundus performances at different clinical stages. They may help to record the disease progression for accurate diagnosis and treatment.
Increasing the Effectiveness and Adoption of Agricultural Phosphorus Management Strategies to Minimize Water Quality Impairment
Authors: Osmond D. L. , Shober A. L. , Sharpley A. N. , Duncan E. W. , Hoag D. L. K.
Published: August 2019

Phosphorus (P) is essential for optimum agricultural production, but it also causes water quality degradation when lost through erosion (sediment‐attached P), runoff (soluble reactive P; SRP), or leaching (sediment‐attached P or SRP). Implementation of conservation practices (CP) affects P at the source (avoiding), during transport (controlling), or at the water resource edge (trapping). Trade‐offs often occur with CP implementation. For instance, multiple researchers have shown that conservation tillage reduces total P by over 50%, while increasing SRP by upward of 40%. Conservation tillage may increase water quality degradation as SRP is more bioavailable than is particulate P. Conservation practices must be implemented as a system of practices to increase redundancy and to address all loss pathways, such as P management with conservation tillage and a riparian buffer. Further, planning and adoption must be at a watershed scale to ensure practices are placed in critical source areas, thereby providing the most treatment for the least price. Farmers must be involved in watershed planning, which should include financial backstopping and educational outreach. It is imperative that CPs be used more effectively to reduce and retard off‐site P losses. New and innovative CPs are needed to improve control of P leaching, address legacy stores of soil test P, and mitigate increased P losses expected with climate change. Without immediate changes to CP implementation, P losses will increase due to climate change, with a concomitant degradation of water quality. These changes must be made at a watershed scale and in an intentional and transparent manner.

Core Ideas

Phosphorus‐reducing conservation practices must control all P pathways.

Phosphorus‐reducing conservation practices must be utilized as systems.

New and innovative conservation practices are needed to improve control of P.

Farmer decision‐making must be considered when implementing conservation practices.

Watershed planning and conservation practice implementation must be intentional.
The Latitudes, Attitudes, and Platitudes of Watershed Phosphorus Management in North America
Authors: Smith D. R. , Macrae M. L. , Kleinman P. J. A. , Jarvie H. P. , King K. W. , Bryant R. B.
Published: August 2019

Phosphorus (P) plays a crucial role in agriculture as a primary fertilizer nutrient—and as a cause of the eutrophication of surface waters. Despite decades of efforts to keep P on agricultural fields and reduce losses to waterways, frequent algal blooms persist, triggering not only ecological disruption but also economic, social, and political consequences. We investigate historical and persistent factors affecting agricultural P mitigation in a transect of major watersheds across North America: Lake Winnipeg, Lake Erie, the Chesapeake Bay, and Lake Okeechobee/Everglades. These water bodies span 26 degrees of latitude, from the cold climate of central Canada to the subtropics of the southeastern United States. These water bodies and their associated watersheds have tracked trajectories of P mitigation that manifest remarkable similarities, and all have faced challenges in the application of science to agricultural management that continue to this day. An evolution of knowledge and experience in watershed P mitigation calls into question uniform solutions as well as efforts to transfer strategies from other arenas. As a result, there is a need to admit to shortcomings of past approaches, plotting a future for watershed P mitigation that accepts the sometimes two‐sided nature of Hennig Brandt's “Devil's Element.”

Core Ideas

North American P mitigation experiences spanning 26 degrees of latitude are explored.

Uncertainty and lag times create schisms in mitigation programs.

One‐size‐fits‐all approaches cannot account for management trade‐offs.

Acknowledging shortcomings in messages and approaches is imperative to moving on.

Unified P mitigation provides a framework and eliminates solution singularities.
QTL Mapping of Wheat Stripe Rust Resistance in Relation to Epidermal Flavonoids Measured Using a Leaf‐Clip, Optical Sensor
Authors: Emebiri Livinus , Taylor Kerry , Hildebrand Shane
Published: August 2019

Epidermal flavonoids have long been suggested as targets for selection in stress‐adaptive crop breeding, but routine selection is neither practicable nor cost effective because of the time‐consuming process involved in phenotyping. In this research, we found that the content of epidermal flavonoids, measured using the chlorophyll fluorescence excitation ratio method, was inversely related to stripe rust (Puccinia striiformis f. sp. tritici [Pst]) response in wheat (Triticum aestivum L.). We investigated the genetic basis by conducting quantitative trait locus (QTL) mapping with a 9K single nucleotide polymorphism (SNP) array in a cross of ‘Drysdale’ × ‘Waagan’ segregating for adult‐plant stripe rust resistance. Data from 3 yr of field experimental trials were analyzed, and heritability estimates for epidermal flavonoids varied from 0.16 to 0.47 across the experiment‐years. In contrast, heritability for stripe rust response varied from 0.79 to 0.84. Eleven QTL were identified for epidermal flavonoids, with a major locus on chromosome 4D, explaining between 19.5 and 47.3% of the phenotypic variation across years. Thirteen QTL were identified for stripe rust response, with the major locus explaining 68% of the phenotypic variation. Quantitative trait loci associated with epidermal flavonoids and stripe rust response were colocated on chromosomes 2B and 3B, but other genetic loci detected for the respective traits were independent. The study has established a genetic basis for epidermal flavonoids measured using the nondestructive, leaf‐clip sensor in wheat, which will encourage further research on the possible exploitation of the compound by breeding and selection.
The Ionome of a Genetically Diverse Set of Wild Soybean Accessions
Authors: Taliercio Earl , Scaboo Andrew , Baxter Ivan , Locke Anna M.
Published: August 2019

Soybean [Glycine max (L.) Merr.] provides oil and protein for fuel, food, and feed around the world. The limited genetic diversity of domesticated soybean threatens future yield and limits breeders' ability to optimize the nutrient composition of soybean. Glycine soja (L.) Merr. is a wild relative of soybean that is substantially more genetically and phenotypically diverse than domesticated soybean. Breeding advances have overcome many of the challenges of breeding with G. soja. Genomics and publicly available marker data facilitated the identification of a genetically diverse core set from the USDA G. soja germplasm collection and allowed the identification of progeny that capture the valuable genetic diversity present in the wild germplasm. Valuable seed composition traits have been identified among wild soybean accessions. We extend these observations to include the seed ionome of 84 wild soybean accessions. Measurement of the concentrations of 19 elements from wild soybean seeds and 13 G. max accessions from multiple environments show that 17 of the element levels have a range of heritabilities and are substantially influenced by the environment. The average concentrations of many elements were higher in the wild soybean than domesticated soybean and also varied among maturity groups. Genetic markers potentially associated with improved mineral composition of Glycine seed have also been identified. This variation may be sufficient to improve mineral content of soy meal. Notably, S concentrations were higher in G. soja, and S levels correlate with total protein levels and S‐containing amino acids. These observations may be used by breeders to improve seed composition of soybean.
Using Carbon Isotope Discrimination to Assess Genotypic Differences in Drought Resistance of Parental Lines of Common Bean
Authors: Sanz‐Saez Alvaro , Maw Michael J.W. , Polania Jose A. , Rao Idupulapati M. , Beebe Stephen E. , Fritschi Felix B.
Published: August 2019

Accurate assessment of crop water uptake (WU) and water use efficiency (WUE) is not easy under field conditions. Carbon isotope discrimination (Δ13C) has been used as a surrogate of WUE to examine crop yield responses to drought and its relationship with WU and WUE. A 2‐yr study was conducted (i) to characterize genotypic variation in Δ13C, grain yield, and other physiological parameters in common bean (Phaseolus vulgaris L.) parental lines, and (ii) to examine the relationships between grain Δ13C, shoot Δ13C, and grain yield under well‐watered and terminal drought stress conditions. All measured plant traits were strongly influenced by water availability, and genotypic differences in grain yield, shoot Δ13C, and grain Δ13C were found in both watered and terminal drought stress environments. The parental lines were classified into two drought adaptation groups, drought resistant and drought sensitive, based on a yield drought index. High yields under drought conditions were related to (i) greater water uptake, as indicated by high Δ13C in genotypes previously shown to have deeper roots (e.g., SEA 5 and BAT 477), and (ii) increased WUE, denoted by lower Δ13C and greater pod harvest index (PHI) (e.g., SER 16). Coupling of Δ13C measurements with measured yield and yield components analyses, such as PHI, provided an avenue to distinguish different physiological traits among drought resistant genotypes underlying adaptation to water deficit stress.
Comparing Yield, Quality, Water Use Efficiency, and Value between Fodder and Grain Produced Using Ridge‐Furrow Rainwater Harvesting in a Semiarid Region
Authors: Wang Qi , Zhang Dengkui , Zhou Xujiao , Liu Jianrong , Liu Qinglin , Li Xiaoling , Sample David J. , Zhang Yongsheng , Zhang Rui
Published: August 2019

Agriculture production in study areas benefits from the use of ridge‐furrow rainwater harvesting (RFRH) to supplement rainfall in the absence of irrigation from imported sources. However, it is necessary to select suitable fodder plants for use with RFRH in this climate. In this paper, 10 treatments (3 ridge widths × 3 ridge‐mulching materials + flat planting [FP] as control) in a complete random design were applied in a 3‐yr field experiment for alfalfa (Medicago sativa L.) and oat (Avena sativa L.) production, respectively. Ridges mulched with plastic film (PF) and ridges mulched with biodegradable film (BF) had positive effects on fodder, grain yields, and water use efficiency (WUE), but ridges with manually compacted soil (MCS) had a negative effect on yield and WUE in the most cases. Fodder, grain yields, and WUE decreased as ridge width increased. For oats, the decrease of WUE of MCS was 1.31 kg ha−1 mm−1, but the increase of WUE of BF and PF was 0.83 and 1.25 kg ha−1 mm−1, respectively, compared with that of FP over 3 yr. For alfalfa, the increase of WUE of MCS, BF, and PF was, respectively, 0.22, 5.62, and 6.33 kg ha−1 mm−1. The RFRH systems, especially PF and BF, produced oat and alfalfa fodders with increased crude protein content and decreased acid and neutral detergent fiber content. The average alfalfa fodder yield was 1.37 times greater than that of oats, whereas the average WUE of alfalfa was 2.62 times greater than that of oats. Alfalfa fodder contained higher crude proteins and lower neutral detergent fiber content than oat fodder and had similar acid detergent fiber. It is more economic to harvest oat fodder than to harvest oat grain, and it is more economic to produce alfalfa than to produce oats.
Using Normalized Difference Red Edge Index to Assess Maturity in Cotton
Authors: Thompson Corey N. , Guo Wenxuan , Sharma Bablu , Ritchie Glen L.
Published: August 2019

Temporal remote sensing measurements of plant growth may give breeders a better understanding of crop growth habits, yield, fiber quality, and maturity in cotton (Gossypium hirsutum L.) genotypes. The objective of this research was to derive a spectral index maturity scoring method based on the normalized difference red edge (NDRE) index. Seasonal NDRE measurements were collected from 2015 to 2017. A growth inflection point (GIP) was generated based on a quadratic fit of the NDRE growth curves for nine commercial cotton cultivars under three irrigation treatments. This GIP was the number of heat units associated with the inflection point of the NDRE values during the season. It was compared with manual measurements of crop maturity, including nodes above white flower (NAWF), percentage open boll (POB), and end‐of‐season plant mapping indices. Each year had environmental conditions that changed growth habits and maturity of the cultivars. Cultivar and irrigation affected maturity in all 3 yr. The GIP correlated with each maturity assessment, with the highest correlations found with NAWF (r2 from 0.38 to 0.88) by irrigation. In most cases, the relationship between NAWF and GIP was not cultivar specific, suggesting that GIP may be used across multiple cotton genotypes within multiple growing environments. The GIP method provides a method to more rapidly and objectively evaluate maturity characteristics of cotton cultivars, as well as the effects of management on these characteristics.
Location and Seasonal Effects on Irrigated Sugarcane Breeding for Yield and Sucrose Content in South Africa
Authors: Zhou Marvellous
Published: August 2019

Breeding programs conduct multienvironment trials to evaluate the adaptability and performance of genotypes across variable agroecological regions. Genotype × environment interaction (G×E) results in the genetic values varying across environments. When G×E is large, greater genetic gains can be achieved through developing specific genotypes for each environment. The objective of this study was to investigate the location and seasonal effects on genotype performance for cane yield and sucrose content and their implication on breeding varieties for the irrigated regions of South Africa. Data were collected from a series of variety trials planted in 2009, 2010, and 2011 at Mpumalanga and Pongola locations in the early and late seasons. Randomized complete block designs with three replications were used, and data for cane yield and sucrose content were collected in the plant and three ratoon crops. Data were analyzed using the mixed procedure of SAS. Seasonal effects were larger than location effects, whereas genotype × season was larger than genotype × location, indicating the importance of considering seasons when breeding for irrigated regions. Seasonal effects were larger for sucrose content than cane yield. Genotype × ratooning effects was nonsignificant indicating ratooning ability was not important in irrigated regions. High cane yield and low sucrose in the early season and low cane yield and high sucrose in the late season indicated the uniqueness of the early and late seasons. Establishing early and late season breeding programs in the irrigated region would enhance genetic gains for yield and quality.
Recursos hídricos y derecho al agua en la Comunidad Andina
Authors: Lozano Carlos
Published: August 2019

La integración es un proceso complejo que no se agota en el aspecto económico y debe incorporar diversas variables que consideren las particularidades propias de las diferentes naciones que toman parte en ella. El diseño de una política subregional consensuada sobre las directrices que debe observar la gestión del recurso hídrico, con inclusión de los principios de la democracia ambiental y del agua y la perspectiva del derecho humano al agua potable, representa una importante apuesta para la profundización de la integración andina, fortaleciendo la capacidad de negociación del bloque, reforzando la construcción incluyente de ciudadanía andina y robusteciendo así las democracias andinas.
Bioética y acción social cómo afrontar los conflictos éticos en la intervención social
Authors: Castillo Ordoñez Elsy Yaneth
Published: August 2019

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