bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic Analysis of Technology and Properties of Legendre-Fenchel Transformations
Authors: Vrankić Ilko , Šohinger Jasminka , Krpan Mira
Published: January 2020

This paper examines a two-way relationship between convex analysis and microeconomic theory. Motivation for this paper are the observed similarities in the structure of the theory of consumer behavior and production theory. The fact that the behavior of variables is not determined by their nature but, rather, by their relationships is best illustrated and explained by using convex sets and convex analysis, which occupy central place in microeconomic theory. This paper is the result of efforts to make complex results of convex analysis and its application in microeconomic theory more transparent.
Starting with the well-known economic phenomenon of profit maximization the authors derive in a novel way general results within the framework of convex analysis. From those results follow, directly and indirectly, the conclusions of the theory of consumer and producer behavior. The authors show that applying the Fundamental Theorems of Calculus opens up a new perspective in which the marginal cost curve can be interpreted as the marginal profit curve. This enables the derivation of Hotelling's lemma in a new way. Using the new interpretation of Hotelling's lemma, the authors reconstruct the cost function and confirm the Conjugate Duality Theorem of Legendre-Fenchel transformations. Relaxing the assumption of differentiability by describing the graph of the cost function as the envelope of its tangents, the authors rederive the properties of Legendre-Fenchel transformations and show that they hold in general. The path from the well-known economic facts to completely general conclusions of convex analysis is continued by applying the Conjugate Duality Theorem of Legendre-Fenchel transformations to the profit function. The essence of the dual characterization of technology by the profit function is illustrated by the graphical representation of linear homogeneity of the profit function. It results in the possibility to reconstruct the production function while using only the First Order Conditions to rederive Hotelling's lemma. It is this inductive-deductive approach used to examine the properties of Legendre-Fenchel trasformations and their application in the theory of consumer and producer behavior that establishes a two-way relationship between convex analysis and microeconomic theory.
Análise de viabilidade econômico-financeira, pelo método de Monte Carlo, de um sistema fotovoltaico para geração distribuída
Authors: De Andrade Helder Maia , Brandalise Nilson
Published: January 2020

Apesar do desenvolvimento tecnológico promover maior eficiência energética dos equipamentos e dispositivos, a demanda por energia aumenta com o crescimento da população e pela busca por mais conforto e bem-estar do ser humano. O crescimento sustentável passa por fontes de energias renováveis e de baixo custo. A posição geográfica do Brasil evidencia um alto potencial para energia solar fotovoltaica favorecendo a geração distribuída, porém, os investimentos iniciais são considerados limitantes para que haja uma maior participação na matriz elétrica brasileira. O objetivo deste trabalho é analisar a viabilidade econômico-financeira de um sistema fotovoltaico para geração distribuída. A metodologia científica para este estudo considerou um cenário real, aplicando-se técnicas de análise de investimentos e simulação de Monte Carlo, usando distribuições probabilísticas para os principais parâmetros de entrada envolvidos na análise. O resultado para o caso adotado apresentou uma discreta viabilidade do projeto, caracterizando-se como a principal contribuição científica do trabalho. Melhores resultados serão obtidos na medida em que os custos dos sistemas fotovoltaicos se tornem mais atrativos através de economia de escala, desenvolvimento tecnológico e regulações de maior incentivo.
Modelagem da geração de biogás aplicando metodologia CDM para redução de emissões de gases de efeito estufa: estudo de caso do Aterro MTR Santa Maria Madalena, RJ, Brasil
Authors: Lattanzi Iasmim Esteves , Prata Filho Dario de Andrade , Quelhas Osvaldo Luiz Gonçalves
Published: January 2020

A grande quantidade de gases de efeito estufa (GEE) emitida por ação antropogênica torna-se um desafio que requer iniciativas para a sua mitigação, como parcerias público-privadas. Nos países em desenvolvimento, essa questão é ainda mais problemática, pois o crescente desenvolvimento econômico não é acompanhado por legislação e iniciativas que regulam o metano liberado na atmosfera. Este trabalho tem como objetivo medir a redução de GEE, aplicando uma metodologia de projeto Clean Development Mechanism (CDM) da Organização das Nações Unidas (ONU) a um aterro real. Os métodos utilizados foram um estudo de caso de um aterro sanitário no estado do Rio de Janeiro, Brasil, com aplicação do modelo LandGem da United States Environmental Protection Agency (EPA) para o dimensionamento dos gases produzidos e, finalmente, análise de projetos CDM para definir uma metodologia que se aplica ao caso. Os resultados mostram que, com a simples implementação de flares no aterro, há uma grande redução das emissões de metano, mas ainda é necessário maior interesse do poder público e privado pela aplicação de metodologias de mitigação de gases. A principal limitação desta pesquisa é o fato de haver poucas publicações na área de metodologias de projetos CDM, e que os dados usados para dimensionar os gases no modelo LandGem foram estimados através de previsões de população e resíduos. Por fim, este estudo pode ser amplamente aplicado em aterros sanitários de diferentes localidades, não restritos ao Brasil.
Development and Validation of a Brief Self-Assessed Wisdom Scale
Authors: Fung Sai-fu , Chow Esther Oi-wah , Cheung Chau-kiu
Published: January 2020

Background: This longitudinal study aimed to develop a nine-item Brief Self-Assessed Wisdom Scale (BSAWS) derived from the original 40-item Self-Assessed Wisdom Scale (SAWS). Methods: The psychometric properties of the shortened scale were evaluated based on a sample of 157 older adults. The factor structure and dimensionality of the original SAWS were examined using confirmatory factor analysis. Subsequent explorative factor analysis of the BSAWS supported the construct validity of the shortened scale. Results: The internal consistency, convergent validity and construct validity of the shortened scale were also evaluated and the results indicated that the BSAWS possesses good psychometric properties and is comparable with the full version. Conclusions: This scale refinement may help researchers and practitioners conduct epistemological surveys or clinical research related to wisdom.
Comparative genomics and association analysis identifies virulence genes of Cercospora sojina in soybean
Authors: Gu Xin , Ding Junjie , Liu Wei , Yang Xiaohe , Yao Liang liang , Gao Xuedong , Zhang Maoming , Yang Shuai , Wen Jingzhi
Published: January 2020

Background: Recently, a new strain of Cercospora sojina (Race15) has been identified, which has caused the breakdown of resistance in most soybean cultivars in China. Despite this serious yield reduction, little is known about why this strain is more virulent than others. Therefore, we sequenced the Race15 genome and compared it to the Race1 genome sequence, as its virulence is significantly lower. We then re-sequenced 30 isolates of C. sojina from different regions to identifying differential virulence genes using genome-wide association analysis (GWAS).Results: The 40.12-Mb Race15 genome encodes 12,607 predicated genes and contains large numbers of gene clusters that have annotations in 11 different common databases. Comparative genomics revealed that although these two genomes had a large number of homologous genes, their genome structures have evolved to introduce 245 specific genes. The most important 5 candidate virulence genes were located on Contig 3 and Contig 1 and were mainly related to the regulation of metabolic mechanisms and the biosynthesis of bioactive metabolites, thereby putatively affecting fungi self-toxicity and reducing host resistance. Our study provides insight into the genomic basis of C. sojina pathogenicity and its infection mechanism, enabling future studies of this disease.Conclusions: Via GWAS, we identified five candidate genes using three different methods, and these candidate genes are speculated to be related to metabolic mechanisms and the biosynthesis of bioactive metabolites. Meanwhile, Race15 specific genes may be linked with high virulence. The genes highly prevalent in virulent isolates should also be proposed as candidates, even though they were not found in our SNP analysis. Future work should focus on using a larger sample size to confirm and refine candidate gene identifications and should study the functional roles of these candidates, in order to investigate their potential roles in C. sojina pathogenicity.
Forecasting the 2017/2018 seasonal influenza epidemic in England using multiple dynamic transmission models: a Case Study
Authors: Birrell Paul , Zhang Xu-Sheng , Corbella Alice , Leeuwen Edwin van , Panagiotopoulos Nikolaos , Hoschler Katja , Elliot Alex J , McGee Maryia , de Lusignan Simon , Presanis Anne M , Baguelin Marc , Zambon Maria , Charlett André , Pebody Richard G , De Angelis Daniela
Published: January 2020

Background: Since the 2009 A/H1N1 pandemic, Public Health England have developed a suite of real-time statistical models utilising enhanced pandemic surveillance data to nowcast and forecast a future pandemic. Their ability to track seasonal influenza and predict heightened winter healthcare burden in the light of high activity in Australia in 2017 was untested. Methods: Four transmission models were used in forecasting the 2017/2018 seasonal influenza epidemic in England: a stratified primary care model using daily, region-specific, counts and virological swab positivity of influenza-like illness consultations in general practice (GP); a strain-specific (SS) model using weekly, national GP ILI and virological data; an intensive care model (ICU) using reports of ICU influenza admissions; and a synthesis model that included all data sources. For the first 12 weeks of 2018, each model was applied to the latest data to provide estimates of epidemic parameters and short-term influenza forecasts. The added value of pre-season population susceptibility data was explored. Results: The combined results provided valuable nowcasts of the state of the epidemic. Short-term predictions of burden on primary and secondary health services were initially highly variable before reaching consensus beyond the observed peaks in activity between weeks 3–4 of 2018. Estimates for R0 were consistent over time for three of the four models until week 12 of 2018, and there was consistency in the estimation of R0 across the SPC and SS models, and in the ICU attack rates estimated by the ICU and the synthesis model. Estimation and predictions varied according to the assumed levels of pre-season immunity. Conclusions: This exercise successfully applied a range of pandemic models to seasonal influenza. Forecasting early in the season remains challenging but represents a crucially important activity to inform planning. Improved knowledge of pre-existing levels of immunity would be valuable.
The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension
Authors: Liu Yang , Lin Yao , Zhang Ming-Ming , Zheng Tong , Li Xiao-Hui , Liu Yan-Yan , Zhao Jing , Shi Lin
Published: January 2020

Background To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension. Methods A case-control study was conducted on 132 children diagnosed with essential hypertension(103 males and 29 females with the mean age of 11.8 ± 2.4 years). The plasma RAAS levels were measured using the enhanced chemiluminescence method, the ambulatory blood pressure was monitored for 24 h, and then the average real variability (ARV) was calculated. Data on indicators were used for assessing cardiac and renal damages. The correlations of plasma renin, angiotensin, and aldosterone (RAAS) levels to blood pressure variability (BPV) and target organ damage (TOD) were studied. A comparison between the groups was conducted using SPSS 20． Results Among the 132 children, 55 cases had target organ damage. The 24-h ARV and the daytime ARV of the systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.175, P = 0.031; t = 2.672, P = 0.009). Plasma AT II and aldosterone levels were significantly associated with the left ventricular mass index (r = 0.329, P= 0.0001; r = 0.175, P = 0.045). Linear regression analysis showed that AT II [ β± s.e.= 0.025±0.006, 95% CI ( 0.013–0.038), P = 0.0001] and aldosterone [ β± s.e.= 0.021±0.007, 95% CI( 0.008–0.034), P = 0.002] were risk factors for LVH. Conclusions The AT II level in children with essential hypertension affected the variability of the 24-h and the daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage. Results from this study indicated that AT II and aldosterone are risk factors for LVH in childhood hypertension and are of great significance for improving the clinical prognosis of pediatric patients with hypertension.
Professional support during the postpartum period: Primiparous mothers' views on professional services, their expectations, and barriers to mobilizing professional help
Authors: Nan Yiping , Zhang Jingjun , Nisar Anum , Huo Lanting , Yang Lei , Yin Juan , Wang Duolao , Rahman Atif , Gao Yan , Li Xiaomei
Published: January 2020

Background: Primiparous mothers who lack experience and knowledge of child caring, are usually overwhelmed with multifarious stressors and challenges. Although support from professionals is needed for new mothers, there is indeed a gap between the necessary high-quality service and the currently provided poor services. This study aimed to explore Chinese primiparous mothers' views on professional services, identify barriers to mobilizing professional support, and further understand mothers' expectations of and preferences for the delivery of professional services. Method: A descriptive phenomenological study design was utilized in this study, and semi-structured interviews were conducted with 28 primiparous mothers selected from two community health centres in Xi' an city, Shannxi province, northwest part of China and who had given birth within one year before the interview. Each conversation lasted between 20-86 minutes. Colaizzi' s seven-step phenomenological approach was used for data analysis. Results: Three major themes were identified: (a) dissatisfying with current professional services for postpartum mothers, (b) likelihood of health care professional help- seeking behaviour, (c) highlighting demands for new health care services. Seven related subthemes including disappointment with hospital services, distrusting services provided by community health centres, private institutes and online platforms; seeking help from professional was not the first choice, hesitating to express their inner discourse to professionals, and considering practical factors prohibited mothers from seeking professional help; urgent needs for new baby-care-related services, and importance of mothers' self-needs. The necessity of professional support in the first month of confinement was highly emphasized by participants. Online professional guidance and support were perceived to be the best way to receive services in this study. Conclusion: The results of this descriptive phenomenological study suggested that the current maternal and child health care services were insufficient and could not meet the needs of primiparous mothers. The identified barriers should be analysed and highlighted by enhancing education and eliminating stigma. The results also indicated that providing service focused on mothers' needs may be an effective strategy to enhance primiparous mothers' well-being, and also suggested that feasibility, convenience, and the cultural adaptability of health care service should be considered during the delivery of postpartum interventions.
Characterization of Visceral leishmaniasis Outbreak, Marsabit County, Kenya, 2014
Authors: Kanyina Evalyne Jaquelyne Wambui
Published: January 2020

Background : Visceral leishmaniasis (VL) is caused by protozoa of the Leishmania donovani complex. Annually, an estimated 500,000 cases of VL are reported globally posing a public health challenge. The objectives of our study were to confirm and determine the magnitude of VL outbreak, characterize the outbreak clinically and epidemiologically and evaluate the county preparedness and response in Marsabit County, Kenya.
Methods : A retrospective review of laboratory registers and patients’ clinical notes was done at Marsabit County Hospital. Cases were persons with confirmed VL diagnosis either by microscopy, serology or molecular technique coming from Marsabit County from May to October 2014. Cases were interviewed using structured questionnaire to collect clinical and epidemiologic information. Blood samples were collected from cases for laboratory confirmation.
Results : A total of 136 cases were confirmed of which 77% (105) were male with a median age of 17 (IQR: 22) years and 9.6% (13) case fatality rate. All cases were admitted at Marsabit County Referral Hospital, Kenya. Medical records of 133 cases were retrieved. Of the 133 cases, 102 (77%) presented with fever, 43 (32%) with splenomegaly, 26 (20%) with hepatomegaly and 96 (72%) were managed with Sodium stibogluconate (SSG) monotherapy. Thirty four cases (26%) received Full haemogram (FHG) test and none had more than one Liver Function Tests (LFTs) in a span of six months. No VL case management training had been conducted nor VL treatment guidelines distributed among health care workers (HCWs) in the last one year.
Conclusions: VL cases were confirmed. Inadequate case monitoring and management was evident. VL case management sensitization training was conducted. The County health department should put in place one health VL surveillance and facilitate periodic case management trainings.
Total words : 275
Key words : Visceral leishmaniasis (VL), Kala-azar, VL case management, Marsabit County, Kenya
Transcriptome analysis of lateral buds from Phyllostachys edulis rhizome during germination and early shoot stages
Authors: Shou Yuting , Zhu Yihua , Ding Yulong
Published: January 2020

Background: The vegetative growth is an important stage for plants when they conduct photosynthesis, accumulate and collect all resources needed and prepare for reproduction stage. Bamboo is one of the fastest growing plant species. The rapid growth of Phyllostachys edulis results from the expansion of intercalary meristem at the basal part of nodes, which are differentiated from the apical meristem of rhizome lateral buds. However, little is known about the major signaling pathways and players involved during this rapid development stage of bamboo. To study this question, we adopted the high-throughput sequencing technology and compared the transcriptomes of Moso bamboo rhizome buds in germination stage and late development stage.Results: We found that the development of Moso bamboo rhizome lateral buds was coordinated by multiple pathways, including meristem development, sugar metabolism and phytohormone signaling. Phytohormones have fundamental impacts on the plant development. We found the evidence of several major hormones participating in the development of Moso bamboo rhizome lateral bud. Furthermore, we showed direct evidence that Gibberellic Acids (GA) signaling participated in the Moso bamboo stem elongation.Conclusion: Significant changes occur in various signaling pathways during the development of rhizome lateral buds. It is crucial to understand how these changes are translated to Phyllostachys edulis fast growth. These results expand our knowledge on the Moso bamboo internodes fast growth and provide research basis for further study.
Window phase analysis of nutrient losses from a typical rice-planting area in the Yangtze river delta region of China
Authors: He Shuang , Li Fayong , LIANG XINQIANG , Li Hua , Wang Sheng , Jin Yingbing , Liu Boyi , Tian Guangming
Published: January 2020

Background: Rice paddy wetlands may serve as a nutrient source or sink in agricultural ecosystems. However, the pattern of nutrient loss on a watershed scale is not clear. A year-round on-site observation study based on 6-h intervals was conducted. Rainfall, temperature, runoff nutrient concentrations, and adjacent stream water samples were automatically monitored to uncover the temporal changes in the runoff losses of the predominant nutrient proxies (total N and total P) from a typical rice-planting area (120 ha) in the Yangtze delta region of China. Results: A high total N concentration in the rice-planting area was observed during the rice-planting season; however, significant fluctuation in the total P was evident throughout the year. The Δtotal N (drainage minus stream) parameter showed negative values with a mean of −0.25 mg L -1 , while Δtotal P showed positive values with a mean of 0.06 mg L −1 . The annual average N and P runoff from paddy field were 11.6 kg ha −1 and 1.5 kg ha −1 , respectively. The window phases for the total N loss were mainly concentrated in the rice-growing season. However, the window phase for the total P loss was more dispersive throughout the year. No apparent relationships were found between rainfall and N and P concentrations by self-organizing map analysis. Conclusions: The high-resolution monitoring, in this study, suggested that nutrient loss loading rather than nutrient concentration, was strongly related to surface runoff Therefore, fertilization before high-intensity rainfall should be avoided to mitigate the nutrient runoff losses and maintain the rice wetland eco-function.
Application of alkaline Pulping to Pruned Branches of Citrus limon from Sudan
Authors: Khider Tarig , Omer Safaa Hassan , Elzaki Osman Taha , Mohieldin Salaheldin Dafalla , Shomeina Suhair Kamal
Published: January 2020

The aim of this study to utilize the pruned branches of Citrus limon in pulping with alkaline pulping methods and to determine the suitability of guar gum to improve the strength properties of pulps. The physical properties of these branches exhibited high medium density and very low percentages of bark to wood ratio. The whole chemical components of these raw materials indicated the suitability to pulp with alkaline cooking methods. Alkaline sulfite anthrquinone with methanol methods gave very good screened yield (60.1%), negligible rejects and bleachable Kappa number 19.5 and best strength properties especially tensile and strengths. Alkaline sulfite with anthraquinone gave very good screened yield with small percentage of rejects and bleachable Kappa number. On the other hand soda cooking produced pulps with acceptable yield (41.9%), rejects (3%) and suitable strengths. The soda anthraquinone pulping methods produced pulp with good yields (56 -59.7%).It is obvious the effect of anthraquinone in preserving carbohydrates specifically hemicelluloses which increase the yields and strengths. Guar gum improved the physical properties of pulps when added during beating with (0.25% on oven dry Soda-AQ pulps) It clear the suitability of Citrus limon branches with age of two years in cooking with all alkaline pulping methods applied.
Altered Gut Microbiota in Infants is Associated with Respiratory Syncytial Virus Disease Severity
Authors: Harding Jeffrey , Siefker David , Vu Luan , You Dahui , Devincenzo John , Pierre Joseph , Cormier Stephania A
Published: January 2020

Rationale Respiratory syncytial virus (RSV) is the number one cause of lower respiratory tract infections in infants. There are still no vaccines or specific antiviral therapies against RSV, mainly due to the inadequate understanding of RSV pathogenesis. Recent data suggest a role for gut microbiota community structure in determining RSV disease severity.Objectives Our objective was to determine the gut microbial profile associated with severe RSV patients, which could be used to help identify future at-risk patients and develop therapeutically protective microbial assemblages that may stimulate immuno-protection.Methods We enrolled 58 infants hospitalized with RSV, 5 were admitted to the pediatric intensive care unit and thus considered severe, 53 were admitted to the pediatric ward and considered moderate, and 37 healthy controls collected from infants during “well-baby checkups” from 2012 to 2015. We evaluated the composition of gut microbiota within 72 hours of enrollment in these patients via 16s sequencing of fecal DNA.Measurements and Main Results There was a significant enrichment in S24_7, Clostridiales, Odoribacteraceae, Lactobacillaceae, and Actinomyces in RSV vs. controls. Patients with severe RSV disease had slightly lower alpha diversity (richness and evenness of the bacterial community) of the gut microbiota compared to patients with moderate RSV and healthy controls. Beta diversity (overall microbial composition) was significantly different between all RSV patients (severe and moderate) compared to controls and had significant microbial composition separating all three groups (control, moderate RSV, and Severe RSV). Conclusions Collectively, these data indicate that a unique gut microbial profile that is associated with severe RSV disease. More mechanistic experiments are needed to determine whether the differences observed in gut microbiota are the cause or consequences of severe RSV disease.
Latest trends in L. infantum infection in dogs in Spain (Part II): current clinical management and control according to a national survey in practitioners
Authors: Montoya Ana , Gálvez Rosa , Checa Rocio , Sarquis Juliana , Plaza Alexandra , Barrera Juan Pedro , Marino Valentina , Miró Guadalupe
Published: January 2020

Background Canine leishmaniosis (CanL) is a parasitic zoonotic disease, endemic in the Mediterranean basin including Spain. While knowledge about CanL, its management, treatment, prevention and control mounts, it remains unclear whether all clinical veterinarians follow the same international recommendations, such as those of the LeishVet group. This study was thus designed to assess recent trends in the clinical management of CanL in veterinary clinics across Spain through a questionnaire-based survey. Results were compared with those of our prior national multicenter questionnaire administered by our research team in 2005. Methods A questionnaire consisting of 28 questions about CanL was developed using Google Forms and distributed by email to 1428 veterinary clinics in Spain. Questions were designed to obtain data on common clinical signs, techniques and complementary exams used to diagnose the disease, and on its monitoring, treatment and control measures. Data were collected in a database for statistical analysis. Results Completed questionnaires were returned by 295 clinics. Compared to the situation in 2005, replies indicate that clinical signs of CanL have not changed significantly, cutaneous lesions being still the most prevalent sign observed by practitioners. Quantitative serological techniques are considered an adequate approach to diagnosis, provided their results are supported by the findings of a thorough physical exam, as well as complementary tests (complete blood count (CBC), biochemical profile, plasma protein electrophoretogram and complete urinalysis). Treatment protocols and check-ups follow international recommendations. Finally, a multimodal approach is being endorsed to adequately control CanL including preventive measures such as: annual serological check-ups and the combination of repellents and vaccines. Besides, owners are being better informed about CanL by veterinarians, which translates to the improved control of this zoonosis. Conclusions The clinical management of CanL has recently undergone significant changes owing to improvements in clinical knowledge of the disease, more unified international criteria, improved diagnostic techniques and their adequate interpretation, as well as a greater awareness of the disease transmitted to owners.
Exploring the Necessity of the Establishment of Doctor of Nursing Practice Program from expertise’s view; A Qualitative Study
Authors: rivaz mozhgan
Published: January 2020

Background Complex healthcare landscape increasingly demands leaders who are adept at managing change in health care environments. The doctor of nursing practice (DNP) prepares nurses for the most advance level of clinical nursing practice. The aim of this study was to explore the necessity of the establishment of the DNP program in Iran from expertise’s view.Methods This study was conducted using a qualitative approach. The participants included thirteen faculty members and PhD candidates who were selected through a purposive sampling. Data were collected through focus group and semi-structured interviews, and analyzed using qualitative content analysis.Results Qualitative data analysis resulted in two main categories: “provide infrastructures” and “DNP: as an opportunity to drive positive changes” with two categories respectively.Conclusion The findings showed although DNP as an opportunity to drive positive changes is necessary in the nursing education, but inadequate resources, cultural, social, and economic differences in the developing countries especially in Iran, are important limitations of the implementation of the DNP. Therefore, a multidisciplinary collaboration to provide a well-integrated means of meeting the needs of the patients recommended for better designing of the DNP and break down the obstacles.
Developing core competencies for pharmacy graduates: The Lebanese Experience
Authors: Sacre Hala , Hallit Souheil , Hajj Aline , Zeenny Rony M , Akel Marwan , Raad Elie , Salameh Pascale
Published: January 2020

Objectives Nowadays, new roles are emerging in the pharmacy profession, all increasingly focused on competencies and skills. Adopting competency-based educational designs prepares pharmacists for their societal role, ultimately leading to improvement of health care and patient safety. The Lebanese Order of Pharmacists (OPL, the official pharmacy association in Lebanon) took the initiative of developing a pharmacy competency framework with the ultimate goal of standardizing pharmacy education at all universities, and appointed a subcommittee within the scientific committee – the Academic Board – to achieve this task.Methods The work started using a primer developed by a group of academic instructors, who drafted the competencies for Lebanese pharmacists based on international reference documents from various parts of the world. The Academic board reviewed, streamlined and validated the suggested primer.Results Our work distributed competencies over seven axes: fundamental knowledge, professional practice, personal skills, supply of medications, safe and rational use of medications, pharmaceutical public health competencies, and organization and management competencies. These results are expected to homogenize basic pharmacy skills, improve the level of pharmacy graduates, and start a dialogue and a partnership between academic institutions, health care organizations and other pharmacy practice institutions, to address the training needs of the healthcare workforce.Conclusion The results of this project are a first step towards providing information on human resource planning and professional development of the pharmacy workforce, and pave the way for future studies to gather new evidence in this area. This initiative is expected to ensure high-quality, team-based delivery of care by pharmacists that is imperative for improving patient care.
Correlation of Macular Sensitivity Measures and Visual Acuity to Vision-related Quality of Life in Patients with Age-related Macular Degeneration
Authors: Forshaw Thomas , Parpounas Alexandra Kalia , Sørensen Torben Lykke
Published: January 2020

Background: Visual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant. Methods: Fifty-six consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-eight patients with AMD were included in the study: thirty-three patients with late AMD (exudative AMD and/or geographic atrophy) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity. Results: There was a higher correlation between vision-related quality of life and macular sensitivity (rho=0.371; p=0.034) than between vision-related quality of life and visual acuity (rho=0.334; p=0.058) in patients with late AMD. These correlations were not statistically significant in patients with early AMD. Composite score (rho=0.405; p=0.019) and near-distance activities score (rho=0.469; p=0.006) correlated highest with the nasal inner macular sub-region in patients with late AMD. Correlations between composite score and macular sub-regions in patients with early AMD were not significant, but near-distance activities score correlated highest with the nasal outer macular sub-region in these patients (rho=0.735; p=0.002). Conclusions: Macular sensitivity as measured using microperimetry correlates significantly better with vision-related quality of life than visual acuity, showing it to be a more patient-relevant outcome measure in patients with late AMD. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD. Trial registration: This study, registration number SJ-618, was registered with the Region Zealand Ethics Committee on 3 rd July 2017.
The incremental prognostic value of sIL-2R and HGF in acute ischemic stroke
Authors: Zhao Haiping , Li Fangfang , Huang Yuyou , Zhang Sijia , Li Lingzhi , Yang Zhenhong , Wang Rongliang , Tao Zhen , Han Ziping , Fan Junfen , Zheng Yangmin , Ma Qingfeng , Luo Yumin
Published: January 2020

Background: Inflammation affect long-term neurological outcome after acute ischemic stroke (AIS). Comprehensive and insightful understanding of correlation of inflammatory mediators and stroke outcome may offer new biomarkers or therapeutic approaches for AIS.Methods: We collected plasma from in 204 AIS patients and 76 healthy controls, and ten cytokines (HGF, IL-1β, IL-2, sIL-2R, IL-5, IL-10, IL-16, MIP-3α, CD40L and MMP1) screened out by Immune Monitoring 65-Plex Human ProcartaPlex Panel were measured. Functional outcome 3 months after stroke was assessed using the modified Rankin Scale. To assess the prognostic ability of inflammatory mediators, we applied multivariate logistic regression and construction of multimarker score.Results: HGF, IL-10, IL-1β, MIP-3α, IL-2, sIL-2R, and IL-5 were significantly upregulated in AIS patients compared to control. After multivariable adjustment, sIL-2R (OR, 1.138; 95% CI, 1.028-1.259; P=0.012) and HGF (OR, 1.121; 95% CI, 1.030-1.218; P=0.008) remained individually associated with unfavorable outcomes at 3 months (p < 0.05). Furthermore, adding sIL-2R and HGF to the conventional model significantly improved risk reclassification for unfavorable outcomes (continuous net reclassification improvement 32.18%, p < 0.001; integrated discrimination improvement 10.21%, p < 0.001).Conclusions: Higher plasma sIL-2R was a new independent predictor of unfavorable outcomes in AIS, and incorporation of sIL-2R and HGF into the conventional model significantly improved risk stratification for unfavorable outcomes.
Metagenomic analysis of gut microbiota in Parkinson's disease patients from Central China
Authors: Zhang Fan , Zhao Qiang , Fang Xing , Xu Meiling , Tang Jie , Zhang Yu , Gao Ping , Sun Xiaodong , Sang Ming , Wang Puqing
Published: January 2020

Background: Studies have shown that gut microbiota may be involved in the occurrence and progression of Parkinson's disease (PD). Nevertheless, the alterations in fecal microbiome in PD patients from Central China have not been previously investigated, and the way in which these microbes influence PD remain unclear.Methods: We performed metagenomic shotgun analyses to investigate the gut microbiota composition of 46 Central China PD patients and their healthy spouses. The relationships between microbiota and PD clinical features were analyzed, and functional pathways were compared for further understaning the contributions of gut microbiota in PD. We also explored potential biomarker for PD diagnosis.Results: Microbial communities in the feces of PD patients were notably different from those of healthy spouses at species level. Gut microbiota of patients was characterized by depletion of Subdoligranulum_unclassified and Prevotella_copri, while the Bacteroides_stercoris and Escherichia_coli were markedly elevated. Correlation analysis found that most identified species were negatively correlated with disease clinical features. In particular, Prevotella_copri was negatively correlated with age, H-Y stage, UPDRS total score and UPDRS Ⅲ score. Random forest model indicated that 6 species including Prevotella_copri had good predictive value for disease. Functional analyses of the metagenomes revealed differences in microbiota metabolism. Pathways associated with superpathway of thiamin diphosphate biosynthesis, 4-aminobutanoate degradation, glucose-1-phosphate degradation and methylphosphonate degradation were significant increase in patients, while pathways associated with aromatic amino acid biosynthesis, chorismate biosynthesis, thiamin formation and pyrimidine deoxyribonucleosides salvage were significantly decrease. Functional pathways of Prevotella_copri were mainly concentrated in UMP biosynthesis, S-adenosyl-L-methionine cycle and guanosine ribonucleotides de novo biosynthesis. Conclusion: This study revealed the differences of gut microbiota between PD patients and their healthy spouses. Altered microbiota had correlation with the clinical characteristics of the disease, and maybe used as potential biomarkers for disease status prediction. We also observed differenct functional pathways of gut microbiota in PD patients,which may help to reveal the mechanism of disease occurrence and progression.
A practical staging atlas to study embryonic development of Octopus vulgaris under controlled laboratory conditions
Authors: Deryckere Astrid , Styfhals Ruth , Vidal Erica AG , Almansa Eduardo , Seuntjens Eve
Published: January 2020

BackgroundOctopus vulgaris has been an iconic cephalopod species for neurobiology research as well as for cephalopod aquaculture. It is one of the most intelligent and well-studied invertebrates, possessing both long- and short-term memory and the striking ability to perform complex cognitive tasks. Nevertheless, how the common octopus developed these uncommon features remains enigmatic. O. vulgaris females spawn thousands of small eggs and remain with their clutch during their entire development, cleaning, venting and protecting the eggs. In fact, eggs incubated without females usually do not develop normally, mainly due to biological contamination (fungi, bacteria, etc.). This high level of parental care might have hampered laboratory research on the embryonic development of this intriguing cephalopod. ResultsHere, we present a completely parameter-controlled artificial seawater standalone egg incubation system that replaces maternal care and allows successful embryonic development of a small-egged octopus species until hatching in a laboratory environment. We also provide a practical and detailed staging atlas based on bright-field and light sheet fluorescence microscopy imaging for precise monitoring of embryonic development. The atlas has a comparative section to benchmark stages to the different scales published by Naef (1928), Arnold (1965) and Boletzky (2016). Finally, we provide methods to monitor health and wellbeing of embryos during organogenesis. ConclusionBesides introducing the study of O. vulgaris embryonic development to a wider community, this work can be a high-quality reference for comparative evolutionary developmental biology.
Genital chlamydia trachomatis infection: an underestimated sexually transmitted disease in China
Authors: Chen Xinlong , Gan Yanling , Chen Qiu , Ren Zhuo , Li Furong , liu dianchang
Published: January 2020

Background Genital chlamydia trachomatis infection is one of the most prevalent sexually transmitted disease globally. The diagnosis and reporting of genital chlamydia trachomatis infection mainly rely on effective laboratory testing available. The prevalence of genital chlamydia trachomatis infection in China may be largely underestimated, based on the reported data. Methods A survey was conducted among hospitals provided clinical services for STD in Shandong Province in 2018. Basic information on the hospitals, type of laboratory tests provided and cases reported of GCTI were collected and analysed in SPSS 22. Results Among 456 hospitals surveyed, antigen testing, PCR testing, and either antigen or PCR testing were available among 200 (43.9%), 88 (19.3%) and 268 (58.8%) hospitals, respectively. PCR testing was more available among tertiary and secondary hospitals than primary hospitals (X 2 =28.560, P=0.000). Significant differences were observed in the availability of antigen testing, PCR testing, and either antigen or PCR testing among different type of hospitals (X 2 =15.708, P=0.003; X 2 =22.494, P=0.000; X 2 =21.729, P=0.000). In 2018, a total of 1532 cases of GCTI were reported in 99 hospitals. More cases were reported by tertiary and secondary hospitals than primary hospitals (X 2 =24.082, P=0.000). The proportion of different kind of hospitals that reported case of GCTI cases was consistent with that of hospitals provided laboratory testing for GCTI. Conclusion The availability of laboratory testing for GCTI in Shandong province was poor, which may lead to underestimation of prevalence of GCTI. More effort needs to improve the availability of GCTI laboratory testing in order to effectively control of GCTI in Shandong province.
Prolonged hyperlipidemia exposure increases the risk of arteriosclerosis in young adults: a cross-sectional study in a cohort of Chinese
Authors: Chen Haojia , Chen Youren , Wu Weiqiang , Chen Zekai , Cai Zefeng , Chen Zhichao , Yan Xiuzhu , Wu Shouling
Published: January 2020

Background Hyperlipidemia is associated with arteriosclerosis. Herein, We examined the effect of prolonged exposure to hyperlipidemia on the risk of arteriosclerosis in young adults.Methods A study cohort (35−55 years old) that received health check-ups in the Kailuan study (2014−2016) were assessed. Hyperlipidemia was defined as a low-density lipoprotein cholesterol ≥160 mg/dL according to the Chinese Guidelines for the Management of Dyslipidemia in Adults. Subjects were divided into three groups based on the number of years with hyperlipidemia: normal (0 years), low exposure (1−5 years), and high exposure (5−10 years) groups. Arteriosclerosis was assessed with brachial-ankle pulse wave velocity. For all subjects and subjects that did not meet statin treatment criteria under guidelines, logistics regression was used to analyze the effect of prolonged hyperlipidemia exposure on arteriosclerosis in different age groups.Results Among 12,431 subjects, the mean age was 46.42±5.34 years with 9,000 men (72.4%). Brachial-ankle pulse wave velocity gradually increased with increased exposure duration. Logistic regression analysis showed that hyperlipidemia exposure was a risk factor for arteriosclerosis in the low (1.22 times) and high (1.49 times) exposure groups compared with the normal group. In the different age groups, the risk of arteriosclerosis increased with the duration of hyperlipidemia exposure, apart for the 35−40-year-old population. The effect of hyperlipidemia exposure duration on arteriosclerosis in young adults that did not meet statin treatment criteria under guidelines was similar to the general population.Conclusions Prolonged exposure to hyperlipidemia in young adults increases the risk of arteriosclerosis. Young adults with this condition may benefit from more aggressive primary prevention.
Traditional Healers use of Personal Protective Equipment: a qualitative study in rural South Africa
Authors: Audet Carolyn , Gobbo Elisa , Sack Daniel E , Clemens Elise M , Ngobeni Sizzy , Mkansi Mevian , Aliyu Muktar H , Wagner Ryan G
Published: January 2020

Background: Traditional healers are frequently exposed to hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) through the widespread practice of traditional “injections”, in which the healer performs dozens of subcutaneous incisions using a razor blade to rub herbs directly into bloodied tissue. An average healer in Agincourt, a rural northeastern sub-district in Mpumalanga province, South Africa, experiences approximately 1,500 occupational blood exposures over the course of their lifetime. Healers in Agincourt have an HIV prevalence of 30% compared to 19% in the general population, and healers who report exposure to patient blood have an adjusted 2.4-fold higher odds of being HIV-positive than those with no exposure. Although research on appropriate PPE use has been well documented for allopathic care providers, little is known about the practices of traditional healers. Methods: This qualitative study was conducted with 30 traditional healers who practice in the rural Bushbuckridge sub-district of Mpumalanga province, northeastern South Africa. We elicited traditional healer attitudes towards glove use during traditional treatments – including patient baths, injections, or other treatments that exposed healers to patient blood or open sores. Results: While 90% of healers reported using latex gloves during some treatments, the majority do not use them regularly. Most employ a combination of gloves, plastic shopping bags, bread bags, paper, and sticks to prevent blood exposure. Healers reported plastic bags slipping or breaking during procedures, exposing them to patient blood. Only three healers consistently used gloves, regardless of the cost. Conclusions: Inadequate PPE use and high HIV prevalence make traditional healers particularly susceptible to contracting HIV in rural South Africa. Despite positive attitudes, consistent glove use remains low due to financial constraints and glove availability. Addressing issues of accessibility and cost of gloves for traditional healers could have a significant impact on the adherence to PPE and, in turn, reduce new HIV infections among this high-risk group.