bluuebunny/crossref_metadata_2025 huggingface dataset:
Development & Validation of Attitude Toward Nutrition Counselling Questionnaire for use among Kuwaiti healthcare professionals
Authors: ALMughamis Nouf S , Alayoub Abdullah A. , Meraj Hafsa , Waqas Ahmed
Published: January 2020

Objective
This study aims to report the developmental processes and validation of Attitude Toward Nutrition Questionnaire in Arabic language.
Results
A total of 173 (response rate= 86.93%) participants responded to the survey. There were a total of 92 (53.2%) nutritionists and 81(46.8%) doctors/surgeons. Principal component analyses revealed followed by visualization of Cattell’s scree plot, suggested a four-factor solution for the 36-item Attitude Toward Nutrition Counselling Questionnaire. Itwas found to have an acceptable validity. These four factors cumulatively explained 37.9% of the variance in the factor structure of the ATNQ. Cronbach’s alpha revealed an acceptable level of reliability for each subscale of the ATNQ. The first subscale named “Factual knowledge about nutrition” comprised of nine items. It yielded a Cronbach’s alpha value of 0.78. The second subscale “knowledge about nutrition in morbidities” comprised of seven items and yielded a Cronbach’s alpha value of 0.71. The third subscale “counselling of patients” comprised of 11 items and yielded a Cronbach’s alpha of 0.68. The fourth subscale comprising nine items yielded a Cronbach’s alpha value of 0.64 and was named, “Dietary programs and supplementation”.
Keywords
Nutrition, Questionnaire, Scale, knowledge, Dietician, Arabic, Attitude
Preoperative clinical factors and visual outcomes following orbital decompression with dysthyroid optic neuropathy
Authors: Tagami Mizuki , Honda Shigeru , Azumi Atsushi
Published: January 2020

Background: To investigate preoperative clinical factors and visual outcomes of Japanese patients with dysthyroid optic neuropathy (DON) after urgent orbital decompression.Methods: This retrospective, observational case series study investigated 44 patients who exhibited several preoperative clinical factors that might be associated with the need for urgent orbital decompression due to DON. Additionally, the visual acuity of DON patients was compared between the patients preoperatively and at 1 and 6 months postoperatively.Results: All 44 patients received steroid and with or without radiation therapy, with 27 patients able to avoid undergoing urgent surgery. However, the remaining 17 patients required urgent orbital decompression following a lack of response to the therapy. None of the patients who initially avoided surgery required additional surgery for DON. Factors significantly associated with the need for urgent orbital decompression surgery included: female gender, older age, long disease duration, unilateral significant DON, history of resistance to pulsed steroid therapy, unstable thyroid function, high TRAb(Thyrotrophin receptor antibody )value, poor visual acuity, presence of central diplopia, and presence of corneal problems (P<0.05 each). The results also showed that postoperative visual outcomes of surgery for DON were acceptable.Conclusion: This study revealed several preoperative clinical factors for DON that appear to be associated with the need for urgent orbital decompression surgery in Japanese patients.
Identification of subclinical tuberculosis in household contacts. The relevance of tuberculosis exposure scores and contact investigations.
Authors: Bekken Gry Klouman , Ritz Christian , Selvam Sumithra , Nelson Jesuraj , Hesseling Anneke C , Doherty Timothy Mark , Grewal Harleen MS , Vaz Mario , Jenum Synne
Published: January 2020

Background: The goal of tuberculosis elimination put forward in the End TB Strategy prioritizes diagnosis and treatment of incipient and subclinical TB, recently defined by key stakeholders as “asymptomatic, early pre-clinical disease during which pathology evolves” . Regarded as indicative of a high risk of TB progression, considerable efforts have been made to identify these cases through exploration of biomarkers. The present study aimed to evaluate simple scoring systems for TB exposure as screening tools for subclinical TB, the only identifiable of the incipient and subclinical disease states, in a contact investigation (CI) setting of low HIV-prevalence.
Methods: Nested within a large prospective study in household contacts (HHCs) of smear positive pulmonary TB cases in South-India conducted 2010-2012, we assessed 1) the association between the Tuberculosis Contact Score (TCS) and the Infectivity Score, with established tools for Mycobacterium tuberculosis (Mtb) infection, corrected for established TB risk factors, and 2) the capability of the TB exposure scores to identify subclinical TB defined by Mtb- culture positivity in sputum or gastric aspirate (subjects <5 years) specimen.
Results: Of 525 HHCs, 29 were Mtb -culture positive and 96.6% of these asymptomatic. The TCS and the Infectivity Score associated with positive Tuberculin Skin Test and QuantiFeron TB-Gold In-tube assay (QFT) results in multivariate analyses (TCS: OR TST 1.16, 95%CI: 1.01, 1.33; OR QFT 1.33 95%CI: 1.16, 1.51. Infectivity Score: OR TST 1.39, 95%CI: 1.10, 1.76; OR QFT 1.41 95%CI: 1.16, 1.71). The Infectivity Score showed a moderate capability to identify subclinical TB (AUC of 0.61, 95%CI: 0.52, 0.70).
Conclusions: Although our results did not identify an easily applicable screening tool for subclinical TB, the present study indicates that focusing on TB-related symptoms in CI settings may be of limited value for early identification of HHCs with high risk for TB progression.
Vigorous cool room treadmill training to improve walking ability in people with Multiple Sclerosis who use ambulatory assistive devices: A feasibility study.
Authors: Devasahayam Augustine J , Chaves Arthur R , Lasisi Wendy O , Curtis Marie E , Wadden Katie P , Kelly Liam P , Pretty Ryan , Chen Alice , Wallack Elizabeth M , Newell Caitlin J , Williams John B , Kenny Hannah , Downer Matthew B , McCarthy Jason , Moore Craig S , Ploughman Michelle
Published: January 2020

Background: Aerobic training has the potential to restore function, stimulate brain repair, and reduce inflammation in people with Multiple Sclerosis (MS). However, disability, fatigue, and heat sensitivity are major barriers to exercise for people with MS. We aimed to determine the feasibility of conducting vigorous harness-supported treadmill training in a room cooled to 16°C (10 weeks; 3times/week) and examine the longer-term effects on markers of function, brain repair, and inflammation among those using ambulatory aids.

Methods: Ten participants (9 females) aged 29 to 74 years with an Expanded Disability Status Scale ranging from 6 to 7 underwent training (40 to 65% heart rate reserve) starting at 80% self-selected walking speed. Feasibility of conducting vigorous training was assessed using a checklist, which included attendance rates, number of missed appointments, reasons for not attending, adverse events, safety hazards during training, reasons for dropout, tolerance to training load, subjective reporting of symptom worsening during and after exercise, and physiological responses to exercise. Functional outcomes were assessed before, after, and 3 months after training. Walking ability was measured using Timed 25 Foot Walk test and on an instrumented walkway at both fast and self-selected speeds. Fatigue was measured using fatigue/energy/vitality sub-scale of 36-Item Short-Form (SF-36) Health Survey, Fatigue Severity Scale, modified Fatigue Impact Scale. Aerobic fitness (maximal oxygen consumption) was measured using maximal graded exercise test (GXT). Quality-of-life was measured using SF-36 Health Survey. Serum levels of neurotrophin (brain-derived neurotrophic factor) and cytokine (interleukin-6) were assessed before and after GXT.

Results: Eight of the ten participants completed training (attendance rates >80%). No adverse events were observed. Fast walking speed (cm/s), gait quality (double-support (%)) while walking at self-selected speed, fatigue (modified Fatigue Impact Scale), fitness (maximal workload achieved during GXT), and quality-of-life (physical functioning sub-scale of SF-36) improved significantly after training, and improvements were sustained after 3-months. Improvements in fitness (maximal respiratory exchange ratio and maximal oxygen consumption during GXT) were associated with increased brain-derived neurotrophic factor and decreased interleukin-6.

Conclusion: Vigorous cool room training is feasible and can potentially improve walking, fatigue, fitness, and quality-of-life among people with moderate to severe MS-related disability.
Characterization of the Gh4CL gene family reveals a role of Gh4CL7 in drought tolerance
Authors: Sun Shichao , Xiong Xianpeng , Zhang Xiaoli , Feng Hongjie , Zhu Qianhao , Sun Jie , Li Yanjun
Published: January 2020

Background The function of 4-coumarate-CoA ligases (4CL) under abiotic stresses have been studied in plants, however, limite is known about the upland cotton 4CL genes and their roles in response to drought stress.Results In this study, we performed genome-wide identification of the 4CL genes in G. hirsutum and investigated the expression profiles of the identified genes in various cotton tissues and in response to stress conditions with an aim to identify 4CL gene(s) associated with drought tolerance. We identified 34 putative 4CL genes in G. hirsutum that were clustered into three classes. Genes of the same class usually share a similar gene structure and motif composition. Many cis -elements related to stress and phytohormone responses were found in the promoters of the Gh4CL genes. Of the 34 Gh4CL genes, 26 were induced by at least one abiotic stress and 10 were up-regulated under the PEG simulated drought stress conditions, including Gh4CL7 . Virus-induced gene silencing (VIGS) in cotton and overexpression (OE) in Arabidopsis thaliana were applied to investigate the biological function of Gh4CL7 in drought tolerance. The Gh4CL7 -silencing cotton plants showed more sensitive to drought stress, probably due to decreased relative water content (RWC), chlorophyll content and antioxidative enzyme activity, increased stomatal aperture, and the contents of malondialdehyde (MDA) and hydrogen peroxide (H 2 O 2 ). Arabidopsis lines overexpressing Gh4CL7 , however, were more tolerant to drought treatment, which was associated with improved antioxidative enzyme activity, reduced accumulation of MDA and H 2 O 2 and up-regulated stress-related genes under the drought stress conditions. In addition, compared to their respective controls, the Gh4CL7 -silencing cotton plants and the Gh4CL7- overexpressing Arabidopsis lines had a lower and higher lignin content, respectively. Taken together, these results demonstrated that Gh4CL7 could positively respond to drought stress and therefore might be a candidate gene for improvement of drought tolerance in cotton.Conclusion We comprehensively identified 4CL family genes in upland cotton and provide valuable information on the evolutionary relationship. Gh4CL7 gene is involved in lignin biosynthesis and play a positively role in reponsing drought stress.
The pitfalls of biodiversity proxies: Differences in richness patterns of birds, trees and understudied diversity across Amazonia
Authors: RITTER CAMILA DUARTE
Published: January 2020

It is the protocol I used to collect and extract DNA from organic litter, top 5 cm mineral soil and insect samples in the Amazonia to metabarcoding studies.
Management of Constipation in Long-term Care Hospitals and its Ward Manager and Organization Factors
Authors: Takaoka Manami , Igarashi Ayumi , Futami Asako , Yamamoto-Mitani Noriko
Published: January 2020

Background

Studies examining organizational factors that may influence constipation management in long-term care (LTC) hospitals are lacking. This study aimed to clarify the practice of constipation management in LTC hospitals and to explore its factors, including ward manager’s perception, organizational climate, and constipation assessment.Methods

In this cross-sectional questionnaire survey of ward managers and staff nurses working in LTC wards, we determined daily assessment and practices regarding constipation management. We also conducted multivariate analyses to examine factors related to constipation management.Results

There was a 20% response rate to the questionnaire. Nearly all LTC wards routinely assessed bowel movement frequency; other assessments were infrequent. Laxatives were used, but the use of dietary fiber and probiotic products was implemented in only 20%–30% of wards. The implementation of non-pharmacological management and adequate use of stimulant laxatives were positively associated with the ward manager’s belief and knowledge, organizational climate, the existence of nursing records for constipation assessment, planned nursing care for constipation, and organized conferences and in-hospital study sessions on constipation management.Conclusion

Areas to improve constipation management in LTC hospitals include altering the ward manager’s perception, improving hospital’s organizational climate, and introducing standardized assessment/care planning systems.
IgG antibody response against Anopheles salivary gland proteins in asymptomatic Plasmodium infections in Narino, Colombia
Authors: Montiel Jehidys , Carbal Luisa Fernanda , Tobón-Castaño Alberto , Vásquez Gissella M. , Fisher Michael L. , Londono Berlin L.
Published: January 2020

Background The humoral immune response against Anopheles salivary glands proteins in the vertebrate host can reflect the intensity of exposure to Anopheles bites and the risk of Plasmodium infection. In Colombia, the identification of exposure biomarkers is necessary due to the several Anopheles species circulating. The purpose of this study was to evaluate risk of malaria infection by measuring antibody responses against salivary glands extracts from Anopheles (Nyssorhynchus) albimanus and Anopheles (Nys.) darlingi and also against the gSG6-P1 peptide of Anopheles gambiae in people residing in a malaria endemic area in the Colombian Pacific coast. Methods Dried blood spots samples were eluted to measure the IgG antibodies against salivary gland extracts of An. albimanusstrains STECLA (STE) and Cartagena (CTG) and An. darlingi and the gSG6-P1 peptide by ELISA in uninfected people and microscopic and submicroscopic Plasmodium carriers from the Colombia Pacific Coast. A multiple linear mixed regression model, Spearman correlation, and Mann-Whitney U-test were used to analyse IgG data. Results Significant differences in specific IgG levels were detected between infected and uninfected groups for salivary glands extracts from An. albimanus and for gSG6-P1, also IgG response to CTG and gSG6-P1 peptide were positively associated with the IgG response to Plasmodium falciparum in the mixed model. Conclusion The CTG and STE An. albimanus salivary glands extracts are a potential source of new Anopheles salivary biomarkers to identify exposure to the main malaria vector and to calculate risk of disease in the Colombian Pacific coast. Also, the gSG6-P1 peptide has the potential to quantify human exposure to the subgenus Anopheles vectors in the same area.
Substance P Induces Sympathetic Immune Response in the Contralateral Eye after the First Eye Cataract Surgery in Type 2 Diabetic Patients
Authors: Gong Xianhui , Ren Yueping , Pan Wenjie , Zheng Jingwei , Fang Xiuxiu , Cai Junyong , Song E
Published: January 2020

Background: Substance P (SP) is a nociceptive tachykinin which regulates the immune inflammatory reactions including monocyte chemoattractant protein 1 (MCP-1) production. Sequential second-eye cataract surgery often suffer more pain than the first one partly because of the MCP-1 increase in aquous humor (AH). This study aims to illustrate whether SP involved in the sympathetic inflammatory responses in the contralateral eye in patients with or wihtout type 2 diabetes. Methods: This prospective randomized clinical study included 51 cataract patients (22 with diabetes and 29 without), and bilateral sequential cataract surgeries were conducted with 1-day or 1-week interval randomly. More than 100 µl AH was obtained before surgery and stored for later magnetic Luminex assays to detect interleukin (IL)-1β, IL-1ra,IL-6, IL-8, IL-10, MCP-1, vascular endothelial growth factor, spinal macrophage inflammatory protein (MIP-1a), interferon-inducible protein 10 (IP-10), and regulated on activation, normal T expressed and secreted (RANTES), as well as the enzyme-linked immunosorbent assay for SP. Results: Among the 4 groups with 1-day or 1-week interval of the 51 cataract patients with or without diabetes, no significant differences were found in age, sex distribution, the R/L ration of the first surgery eye, or the lens nucleus hardness (P ≥ 0.802). Over 100 µl AH samples were collected safely in all the cases without intraoperative complications. SP and MCP-1 levels were both increased significantly in the second eye of the diabetic patients with 1-day and 1-week interval ( P ≤ 0.040). The SP increase in the second eye of the diabetic patients were significantly higher than that of the patients without diabetes ( P ≤ 0.030) both in the groups with 1-day and 1-week interval. And the MCP-1 increase was significantly higher in the diabetic patients in the group with 1-week interval (P = 0.042). Conclusions: Substance P and MCP-1 productions elevated in the AH of the contralateral eye after the first-eye cataract surgery in diabetic patients, indicating that SP and MCP-1 were involved in the sympathetic inflammatory responses. Diabetic patients are susceptible to noninfectious inflammation after cataract surgery, and perceive more pain in the second-eye phacoemulsification.
Effects of STIP1 and GLCCI1 polymorphisms on the risk of childhood asthma and inhaled corticosteroid response in Chinese asthmatic children
Authors: Huang Juan , Hu Xiaolei , Zheng Xiangrong , Kuang Jian , Liu Chentao , Wang Xia , Tang Yongjun
Published: January 2020

Background: Asthma is a common chronic lung disease in children. We aimed to determine the associations between stress-induced phosphoprotein 1 (STIP1) and glucocorticoid-induced transcript 1 (GLCCI1) polymorphisms and susceptibility of childhood asthma and inhaled corticosteroid (ICS) response in children. Methods: A total of 263 Chinese Han asthmatic children were recruited from the Xiangya Hospital, Central South University. Pulmonary function tests were performed before the treatment and 3 months after the treatment. 150 non-asthmatic children were recruited. Each participant's DNA was extracted from the peripheral blood and Method of MassARRAY was used to genotype the single-nucleotide polymorphisms (SNPs). Results: STIP1 rs2236647 wild-type homozygote (CC) was associated with increased asthma risk of children (OR=1.858，95% CI：1.205-2.864), but not associated with the onset age of asthma and ICS response. GLCCI1 rs37969, rs37972 and rs37973 polymorphisms were not associated with the risk of childhood asthma. However, rs37969 mutant genotypes (TT/GT) were significantly associated with increased risk of early onset asthma (OR=2.254, 95% CI: 1.068-4.757) and less improvement in PD20 (p = 0.028). We also found significant associations between rs37969, rs37972 and rs37973 mutant genotypes and less improvement in maximal midexpiratory flow (MMEF) after ICS treatment for 3 months (p=0.036, p=0.010 and p=0.003, respectively). Conclusions: STIP1 rs2236647 was associated with asthma risk of children. GLCCI1 rs37969 mutant genotypes were associated with increased asthma risk of early onset and less improvement in airway hyper-responsiveness. GLCCI1 rs37969, rs37972 and rs37973 polymorphisms might be associated with pulmonary function in childhood asthma patients after ICS treatment.
Misoprostol administered sublingually at a dose of 12.5 µg versus vaginally at a dose of 25 µg for the induction of full-term labour: a randomized controlled trial
Authors: Gattas Daniele Sofia de Moraes Barros , de Amorim Melania MR , Feitosa Francisco EL , Junior José R da Silva , Ribeiro Lívia CG , Souza Gustavo FA , Souza Alex S Rolland
Published: January 2020

Background: Labor induction is defined as any procedure that stimulates uterine contractions before labor begins spontaneously. The vaginal and oral routes of administration of misoprostol are those most used for the induction of labor in routine practice, with the recommended dose being 25 μg. Nevertheless, the sublingual route may reduce the number of vaginal examinations required, increasing patient comfort and lowering the risk of maternal and fetal infection. This study aimed to compare the frequency of tachysystole when misoprostol is administered sublingually at the dose of 12.5μg versus vaginally at a dose of 25μg to induce labor in a full-term pregnancy with a live fetus. Methods : A randomized, placebo-controlled, triple-blind clinical trial was conducted at two maternity hospitals in northeastern Brazil. Two hundred patients with a full-term pregnancy, a live fetus, Bishop score ≤6 and an indication for induction of labor were included. Following randomization, one group received 12.5μg misoprostol sublingually and a vaginal placebo, while the other group received a sublingual placebo and 25μg misoprostol vaginally. The primary outcome was the frequency of tachysystole. Student’s t-test, the chi-square test of association and Fisher’s exact test were used, as appropriate. Risk ratios and their 95% confidence intervals were calculated. Results: The frequency of tachysystole was lower in the group using 12.5μg misoprostol sublingually compared to the group using 25μg misoprostol vaginally (RR=0.15; 95%CI: 0.02-0.97; p=0.002). Failure to achieve vaginal delivery within 12 and 24 hours was similar in both groups. Sublingual administration was preferred to vaginal administration by women in both groups; however, the difference was not statistically significant. Conclusion: The effectiveness of labor induction with low-dose sublingual misoprostol was similar to that achieved with vaginal administration of the recommended dose; however, the rate of tachysystole was lower in the sublingual group, and this route of administration may prove a safe alternative.
Treatment success and mortality among adults with tuberculosis in rural eastern Uganda: a retrospective cohort study
Authors: Izudi Jonathan , Tamwesigire Imelda K. , Bajunirwe Francis
Published: January 2020

Background Successful treatment of tuberculosis leads to clinical and public health benefits such as reduction in transmission, complications, and mortality among patients. However, data are limited on treatment outcomes and the associated factors among persons with bacteriologically confirmed pulmonary (BC-PTB) in rural areas of high tuberculosis and Human Immunodeficiency Virus (HIV) burden countries such as Uganda. We investigated factors associated with successful treatment of tuberculosis and mortality among adult persons with BC-PTB in rural eastern Uganda.Methods We constructed a retrospective cohort of patients with BC-PTB from a routine tuberculosis clinic database in eastern Uganda. We performed bivariate and multivariate analysis. Using a 5% level of significance, we used the modified Poisson regression analysis to determine factors independently associated with treatment success and mortality.Results We retrieved 1,123 patient records. Of these, 477(42.5%) had a cure, 323 (28.0%) had treatment completion, 17(1.5%) had failed treatment, 81(7.2%) had died, 89(7.9%) were lost to follow-up, and 136(12.1%) had missing treatment outcome. Overall, 800 (81.1%) of the 987 persons with BC-PTB that had an outcome, were successfully treated. Successful treatment of tuberculosis was less likely to occur among those with HIV infection (Adjusted risk ratio (aRR), 0.88; 95% Confidence Interval (CI), 0.82-0.95), older than 50 years (aRR, 0.89; 95% CI, 0.81-0.97), or male (aRR, 0.92; 95% CI, 0.87-0.98). Mortality was associated with HIV infection (aRR, 4.48; 95% CI, 2.95-6.79), older than 50 years (aRR, 2.93; 95% CI, 1.74-4.92), year of enrollment into treatment from 2015 (aRR, 0.80; 95% CI, 0.66-0.97), and Community-Based Directly Observed Therapy Short Course (aRR, 0.26; 95% CI, 0.13-0.50).Conclusions Treatment success rate among adult persons with BC-PTB in rural eastern Uganda is suboptimal and mortality is high. HIV infection and older age reduce the chance of successful treatment of tuberculosis, and increase risk of mortality. Older and HIV infected persons with BC-PTB will require special consideration to optimize treatment success and reduce risk of mortality.
Screening, cloning and expression patterns of phosphorus-related genes of Burkholderia multivorans WS-FJ9 at different phosphorus levels
Authors: Liu Yuqing , Wang Yahui , Kong Weiliang , Liu Wanhui , Xie Xingli , Wu Xiaoqin
Published: January 2020

As important plant growth promoting rhizobacteria, phosphate-solubilizing bacteria (PSB) fix nitrogen, dissolve potassium, promote growth, improve the soil micro-environment, and enhance soil fertility. A high-efficiency PSB strain from the pine tree rhizosphere, Burkholderia multivorans WS-FJ9, was screened in our laboratory. In this study, using a Bio Screener fully automatic microbial growth curve meter to determine the growth of the WS-FJ9 strain in phosphate-removing medium, the growth and mineral phosphate solubilization of WS-FJ9 were obtained by Mo-Sb colorimetry and organophosphate-degradation plate assays. Second-generation sequencing technology was used to obtain genomic information and analyze possible phosphorus decomposition genes. The related expression of these genes under different phosphorus levels was determined by quantitative real-time PCR. The results showed that WS-FJ9 had strong adaptability and capacity for mineral phosphate solubilization at low phosphorus levels, which is characterized by its low phosphorus induction and high phosphorus inhibition. And the amount of solubilized mineral phosphate could exceed 140 mg/L. The total length of the genome of WS-FJ9 was 7,497,552 bp after splicing, and the GC content was 67.37%. Eight phosphate-related genes were selected to determine their expression patterns at different phosphorus levels. Among them, AP-2, GspE and GspF were only related to organic phosphorus, HlyB was only related to inorganic phosphorus, and PhoR, PhoA, AP-1 and AP-3 were related to both. The WS-FJ9 strain utilizes multiple pathways for mineral phosphate solubilization, and the degradation processes of different phosphorus sources are interrelated and independent, indicating that WS-FJ9 strain can adapt to different phosphorus source environments and has good potential for future applications.
National mapping of soil-transmitted helminth and schistosome infections in Ethiopia
Authors: Leta Gemechu Tadesse , Mekete Kalkidan , Wuletaw Yonas , Gebretsadik Abeba , Sime Heven , Mekasha Sindew , Woyessa Adugna , Shafi Oumer , Vercruysse Jozef , Grimes Jack ET , Gardiner Iain , French Michael , Levecke Bruno , Drake Lesley , Harrison Wendy , Fenwick Alan
Published: January 2020

Background: The geographical distributions of both soil-transmitted helminths (STHs; Ascarislumbricoides, Trichuristrichiura, and the hookworms (Necatoramericanus and Ancylostomaduodenale) and schistosomes (SCH; Schistosomamansoni and S. haematobium) are pivotal to be able to effectively design and implement mass drug administration (MDA) programs. The objective of this mapping was to provide up-to-date data on the distribution of both STH and SCH for Ethiopia to inform the national control program.Methodology: Between 2013 and 2015, we assessed the distributions of STHs and SCH in a nationwide survey covering 153,238 school-aged children (aged five to 15 years), from 786woredas (districts), representing all nine Regional States and two City Administrations of Ethiopia. From these surveys, nationwide disease maps were developed which allow recommendations to be made on the implementation of MDA programs.Principal findings: The prevalence of any STH infection across the study population was 21.7%, with A. lumbricoides (12.8%) the most prevalent, followed by hookworms (7.5%) and T. trichiura (5.9%). The prevalence for any SCH was 3.8%, with S. mansoni (3.5%) the dominant and S. haematobium was less prevalent (0.3%).STHs were more prevalent in southwest Ethiopia, whereas SCH found mostly in the west and northeast of the country. The prevalence of moderate-to-heavy intensity infections was 2% for STHs and 1.6% for SCH. Based on the disease maps and on WHO guidance for STH, 279 woredas were classified as highly endemic and therefore qualify for treatment twice per year and 215 woredas were moderate endemic and qualify for treatment once per year. For SCH, 69 woredas were classified as highly endemic and qualify for treatment once per year and 153 woredas were moderate endemic and qualify for treatment every two years. Conclusions/Significance: the results confirm that Ethiopia is endemic for both STHs and SCH, posing a significant public health problem. Following the WHO recommendations on mass drug administration, 18 and 14 million school-aged children are in need of MDA for STHs and SCH respectively.
Refining sleep measurement using the Motionwatch8©: How many days of monitoring do we need to get reliable estimates of sleep quality for older adults with Mild Cognitive Impairment?
Authors: Falck Ryan S. , Barha Cindy K. , Chan Patrick C.Y. , Liu-Ambrose Teresa
Published: January 2020

BackgroundMild cognitive impairment (MCI) is a transition stage between healthy cognition and dementia, and is linked to poorer sleep. Objective, reliable, and low-burden field methods to measure older adult sleep are also currently needed. The MotionWatch8© (MW8) wrist-worn actigraph provides estimates of sleep with 14 days of observation; however, there may be underlying differences in the reliability of sleep estimates based on MCI status. We therefore investigated the number of MW8 monitoring days required to estimate sleep in older adults with MCI and without. MethodsOlder adults (55+ years; N=151) wore the MW8 for ≥14 days. The Montreal Cognitive Assessment was used to categorize participants with probable MCI (scores of <26/30) and participants without MCI (≥26/30). We calculated intra-class reliability coefficients for 1-, 7-, and 14-days of wear-time, and performed Spearman-Brown predictions to determine the number of monitoring days needed for an ICC=0.80.ResultsOlder adults with MCI were older (p<0.01), more likely to be male (p=0.03), and had shorter sleep duration (p<0.01). Spearman-Brown analyses indicated that the number of monitoring days needed for an ICC=0.80 in older adults with probable MCI was 7 days for sleep duration, 4 days for fragmentation, and 4 days for efficiency; adults without MCI required 4 days for duration, 6 days for fragmentation, and 3 days for efficiency. ConclusionsOur results indicate that while the reliability of MW8 estimates of sleep differs based on cognitive status, 7 days of MW8 monitoring provides reliable estimates of sleep for adults with MCI and those without.
Evaluation of Oxidant and Anti-Oxidant Activity in Rheumatoid Arthritis Patients and Their Effects on Rheumatoid Arthritis Disease Activity
Authors: Toosi Taraneh Dormohammadi , Dehghani Abbas , Rezaei Ramin , Asgardoon Mohammad Hossein , Mirmiranpour Hossein , Rostamian Abdolrahman , Movasseghi Safieh , Pezeshki Shaghayegh , Hashemi Payam , Esteghamati Alireza
Published: January 2020

BackgroundRheumatoid arthritis (RA) is the most common cause of systemic inflammatory arthritis which causes joint destruction. The pathogenesis of RA is not fully understood, but it seems imbalance between oxidant and antioxidant process, plays a significant role on it. As a result, suppression of these mechanisms would be helpful to subside inflammation and eventually control of the disease activity. The aim of this study was to evaluate the level of oxidant and antioxidant and their effects on disease activity in RA patients.MethodsIn the following case-control study, we evaluated the levels of Malondialdehyde (MDA) and oxidized Low-Density Lipoproteins (ox.LDL) as oxidative factors and Catalase (CAT), Glutathione Peroxide (GSH-Px) and Superoxide Dismutase (SOD) as antioxidants. Also tumor Necrosis Factor (TNF)-α, Interleukin (IL) 1β and IL6 were measured as inflammatory factors.Results43 RA patients and 43 healthy people were enrolled. Significant differences were found in the average levels of MDA, ox.LDL, CAT, GPX, SOD, TNFα, IL1beta and IL6 between two groups (p-value < 0.001), but we did not find any significant differences between two groups of patients based on DAS28 (p- value> 0.05).ConclusionThe results of our study showed that there were increased oxidative activities in RA patients in comparison to the control group which indicated the presence of inflammatory process causing cellular damage in the patients group. As a consequence, adding some antioxidant agents to RA treatment might have some advantages for the disease control. Based on our findings, it seems that the oxidative process did not have any effect on the disease severity. We also suggest further observational study to confirm the results.
Relationship between structural and functional changes in glaucomatous eyes: A multifocal electroretinogram study
Authors: Tanaka Hiroki , Ishida Kyoko , Ozawa Kenji , Sawada Akira , Mochizuki Kiyofumi , Yamamoto Tetsuya
Published: January 2020

Background: The association between the structure of the macular region and its function as measured by multifocal electroretinography (mfERG) and the mean thresholds (MT) of the visual field (VF) is not well-understood. Methods: The macular retinal nerve fiber layer (mRNFL) and the ganglion cell and inner plexiform layer (GCIPL) in six regions were measured by optical coherence tomography (OCT). For functional assessment, MT and mfERG scans with parameters of the second-order kernel responses within the central 5°, nasal to temporal amplitudes ratio (N/T), and the multifocal photopic negative response to B-wave ratio (mfPhNR/B) were measured. Forty-one glaucoma patients underwent OCT, mfERG, and MT measurement and 55 healthy subjects underwent mfERG. Results: The mfPhNR/B was significantly smaller ( P < 0.01) and the N/T was significantly larger ( P < 0.01) in glaucoma patients than in normal subjects. In glaucoma patients, the N/T is significantly correlated with the thickness of inferior and inferotemporal GCIPL ( r = -0.317 and -0.360, respectively) and MT of corresponding VF areas ( r = -0.330 and -0.334, respectively) (all P values < 0.05). The mfPhNR/B was significantly correlated with the thickness of mRNFL in the central area ( r = 0.365, P = 0.02) and with the MT of all corresponding VF areas ( r rages between 0.330 and 0.460, all P values < 0.04), except for the inferotemporal area. However, correlation was not observed between the N/T and the mfPhNR/B in any location. Conclusions: Significant differences exist between glaucoma and healthy participants in the N/T and mfPhNR/B. Correlations were observed between two mfERG parameters and OCT parameters or MT in glaucoma patients. Further research should seek to demonstrate whether the N/T and the mfPhNR/B should be applied in a complementary fashion.
Ripasudil alleviated the inflammation of RPE cells by targeting the miR-136-5p/ROCK/NLRP3 pathway
Authors: Gao Zhao , Li Qiang , Zhang Yunda , Li Haiyan , Gao Xiaohong , Yuan Zhigang
Published: January 2020

Introduction Inflammation of RPE cells lead to different kinds of eye diseases and affect the normal function of the retina. Furthermore, higher levels of ROCK1 and ROCK2 induced injury of endothelial cells and many inflammatory diseases of the eyes. Ripasudil which was used for the treatment of glaucoma was one kind of the inhibitor of ROCK1 and ROCK2. But whether the ripasudil could relieved the LPS induced inflammation damage of RPE cells was not clear.Material and methods We used the LPS to stimulate ARPE-19 cells which is the RPE cell line. After that, we detected the levels of ROCK1 and ROCK2 by western-blotting assay after the stimulation of LPS and treatment of ripasudil. Then luciferase reporter assays were used to confirm the targeted effect of miR-136-5p on ROCK1 and ROCK2. At last, the levels of NLRP3, ASC, caspase1, IL-1β and IL-18 were detected with the western-blotting after the knockdown of miR-136-5p.Results The levels of ROCK1, ROCK2 and miR-136-5p in ARPE-19 cells was promoted after the stimulation of LPS. After the treatment of ripasudil, the ROCK1, ROCK2 and miR-136-5p was suppressed. The miR-136-5p targeted and inhibited the expression of ROCK1 and ROCK2. Inflammation related proteins NLRP3, ASC, caspase1, IL-1β and IL-18 was inhibited after the treatment of ripasudil. However, the expression of these proteins was rescued after the knockdown of the miR-136-5p.Conclusion Ripasudil relieved the inflammatory injury of RPE cells by upregulating miR-136-5p and therefore inhibiting the expression of ROCK1, ROCK2, NLRP3, ASC, caspase1, IL-1β and IL-18.
Quality improvement education for medical students: a near-peer pilot study
Authors: McGeorge Elizabeth , Coughlan Charles , Fawcett Martha , Klaber Robert
Published: January 2020

Background Quality improvement (QI) is an essential component of modern clinical practice. Front-line professionals offer valuable perspectives on areas for improvement and are motivated to deliver change. In the UK, all junior doctors are expected to participate in QI in order to advance to the next stage of their training. However, UK undergraduates receive no standardized training in QI methodology. This is perpetuated within medical schools by a lack of teaching capacity and competing priorities, and may lead to tokenistic engagement with future QI projects. Methods We describe a near-peer teaching programme designed to introduce students to QI methodology. This programme was conceived and delivered in full by junior doctors and used existing resources to ensure high quality teaching content. 111 fifth-year medical students from the University of Cambridge were taught in interactive, participative workshops that encourage them to develop their own QI change ideas and projects. Core topics included the model for improvement, driver diagrams, stakeholder engagement, measurement for improvement and analysing and presenting data. Students completed surveys before and immediately after this intervention to assess their understanding of and confidence in utilizing QI methodology. Questionnaires were also completed by junior doctor tutors. Results Analysis of questionnaires completed before and immediately after the intervention revealed statistically significant improvements in students’ self-reported understanding of QI (p<0.05) and confidence in applying techniques to their own work (p<0.05). Students expressed a preference for QI teaching delivered by junior doctors, citing a relaxed learning environment and greater relevance to their stage of training. Tutors reported increased confidence in using QI techniques and a greater willingness to engage with QI in future. Conclusions In this single-centre study, near-peer teaching produced significant improvements in students’ self-reported understanding of QI and confidence in applying QI methodology. Near-peer teaching may constitute a sustainable means of teaching essential QI skills at undergraduate level. Future work must evaluate objective measures of student engagement with and competence in conducting QI.
Diagnostic biomarker candidates for pulpitis revealed by bioinformatics analysis of merged microarray gene expression datasets
Authors: Chen Ming , Zeng Junkai , Yang Yeqing , Wu Buling
Published: January 2020

Background Pulpitis is known as an inflammatory disease classified by the level of inflammation. The existed traditional methods of evaluating status of dental pulp tissue in clinical practice still have some shortages and limitations. Immediate and accurate diagnosis of pulpitis is essential to the choice of treatment. Through integrating different datasets from Gene Expression Omnibus (GEO) database, we analyzed the merged expression matrix of pulpitis, aiming to identified biological pathways and diagnostic biomarker of pulpitis.Methods By integrating two datasets (GSE77459 and GSE92681) in GEO database using sva and limma packages, differentially expressed genes (DEGs) of pulpitis were identified. Then DEGs were used to analyze biological pathways of dental pulp inflammation with Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and the Gene Set Enrichment Analysis (GSEA). Protein–protein interaction (PPI) networks and modules were constructed to identify hub genes with the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) and Cytoscape.Results A total of 472 DEGs consisting of 396 upregulated and 76 downregulated genes were found in pulpitis tissue. DEGs in GO analysis were enriched in biological processes about inflammation and in KEGG pathway analysis were cytokine-cytokine receptor interaction, chemokine signaling pathway and NF-κB signaling pathway. GSEA results provided further functional annotations including complement system, IL6/JAK/STAT3 signaling pathway and inflammatory response pathways. According to the degrees of nodes in PPI network, 10 hub genes were obtained and 8 diagnostic biomarker candidates were screened, including PTPRC, CD86, CCL2, IL6, TLR8, MMP9, CXCL8 and ICAM1.
Evaluation of 24 protocols for the production of platelet-rich fibrin
Authors: Miron Richard J , Chai Jihua , Fujioka-Kobayashi Masako , Sculean Anton , Zhang Yufeng
Published: January 2020

Background The aim of this study was to evaluate 24 protocols for the production of platelet rich fibrin (PRF) produced via horizontal centrifugation to better understand cell separation following protocols at various times and speeds.Methods All protocols were compared utilizing a recent method to quantify cells in PRF in 1 mL sequential layers pipetted from the upper layer downwards until all 10 mL were harvested. In total, 960 complete blood counts (CBCs) were investigated. Both solid and liquid-based PRF protocols were investigated following 24 protocols involving 6 relative centrifugal force (RCF) values (100,200,400,700,1000 and 1200g) at 4 centrifugation times (3,5,8 and 12 minutes).Results In general, platelets could more easily accumulate in the upper 4 layers when compared to leukocytes owing to their lower cellular density. Protocol time seemed to have a greater impact on the final cell layer separation when compared to the effect of speed. Protocols of greater than 8 minutes at 400 g led to no leukocyte accumulation in the upper PRF layers (found specifically within the buffy coat). Protocols at or below 200 g were unable to effectively accumulate platelets/leukocytes. The optimal centrifugation speed and time for solid-PRF ranged between 400 -700 g for 8 minutes. It was noted that variability in patient baseline platelet/leukocyte/erythrocyte counts (hematocrit) significantly affected cell layer separation. This finding was more pronounced at lower centrifugation speeds.Conclusions Within the investigated ranges, a protocol of 700 g for 8 minutes presented the highest yield of platelets/leukocytes evenly distributed throughout the upper PRF layers.
Colorimetric LAMP Molecular Method for Immediate Detection of Three Periodontal Pathogens
Authors: Al-Hamdoni Sumaya A.S.M. , Al-Rawi Amera M.M.
Published: January 2020

Background and Purpose: For enhancing the efficiency of diagnostic tools and overcome drawbacks faced in diagnosis attempt, molecular methods have been developed aid accurate and rapid identification of bacterial species particularly those which are difficult to study with. The current study searched to find a more specific and rapid method serves researchers for the identification of periodontal pathogens and overcome disturbances encountered in study such anaerobic fastidious organisms. Methods and Results: Three periodontal pathogens, Porphyromonas gingivalis , Tannerella forsythia and Treponema denticola were characterized and identified by phenotypic features and Loop- Mediated Isothermal Amplification (LAMP) techniques which involved 4 sets of primers targeted to 16SrRNA genes and loop primers and the Colorimetric Master Mix containing Bst DNA polymerase and Phenol Red for the detection of amplicon formation. There was a variance in phenotypic characters of the isolates of the same species. LAMP, as a novel molecular technique was of usefulness value in identifying the target weather as extracted DNA or whole cells in a high specific and very rapid manner within 30 min. by visual reading of the results. Conclusion: It is strongly recommended the use of the novel LAMP method in researches work with periodontal pathogens as its advantages make it superior to other molecular techniques in respects of a higher specificity, rapidity, sensitivity and overcome DNA extraction step and special equipment in that it can be used at chair- side identification.
The effect of nicotinamide adenine dinucleotide phosphate oxidase 4 on migration and invasion of fibroblast-like synoviocytes in rheumatoid arthritis
Authors: Lee Ha-Reum , Yoo Su-Jin , Kim Jinhyun , Yoo In Seol , Park Chan Keol , Kang Seong Wook
Published: January 2020

Background: Reactive oxygen species (ROS) regulate the migration and invasion of fibroblast-like synoviocytes (FLS), which are key effector cells in rheumatoid arthritis (RA) pathogenesis. Nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) induces ROS generation and consequently, enhances cell migration. Despite the important interrelationship between RA, FLS, and ROS, the effect of NOX4 on RA pathogenesis remains unclear. Methods: FLS isolated from RA (n=5) and osteoarthritis (OA, n=5) patients were stimulated with recombinant interleukin 17 (IL-17; 10 ng/ml) and tumor necrosis factor alpha (TNF-α; 10 ng/ml) for 1 h. Cell migration, invasion, adhesion molecule expression, vascular endothelial growth factor (VEGF) secretion, and ROS expression were examined. The mRNA and protein levels of NOX4 were analyzed by RT-qPCR and western blotting, respectively. The NOX4 inhibitor GLX351322 and NOX4 siRNA were used to inhibit NOX4 to probe the effect of NOX4 on these cellular processes. Results: Migration of RA FLS was increased 2.48-fold after stimulation with IL-17 and TNF-α, while no difference was observed for OA FLS. ROS expression increased in parallel with invasiveness of FLS following cytokine stimulation. When the expression of NOX was examined, NOX4 was significantly increased by 9.73-fold in RA FLS compared to unstimulated FLS. Following NOX4 inhibition, cytokine-induced vascular cell adhesion molecule 1 (VCAM1), VEGF, and migration and invasion capacity of RA FLS were markedly decreased to unstimulated levels. Conclusion: NOX4 is a key contributor to cytokine-enhanced migration and invasion via modulation of ROS, VCAM1, and VEGF in RA FLS.