bluuebunny/crossref_metadata_2025 huggingface dataset:
The Rho-Associated Kinase Inhibitor Fasudil can Replace Y-27632 for Use in Human Pluripotent Stem Cell Research
Authors: so Seongjun , Lee Yeonmi , Park Jumi , Lee Ji-yoon , Kim Doin , Hwang Julie , Shin Joosung , Choi Jiwan , Han Yuri , Kang Seoon , Dutton James R. , Seo Eul-Ju , Lee Beom Hee , Kim Chong Jai , Mitalipov Shoukhrat , Oh Soojin , Kang Eunju
Published: November 2019

Poor survival of human pluripotent stem cells (hPSCs) following freezing, thawing, or passaging hinders maintenance and differentiation in stem cell research. Rho-associated kinases (ROCKs) play a crucial role in hPSC survival. To date, a typical ROCK inhibitor, Y-27632, has been the primary agent used in hPSC research. Here, we report that another ROCK inhibitor, fasudil, can be used as an alternative. Fasudil increased hPSC growth due to survival rather than proliferation following thawing and passaging, similar to Y-27632. It did not affect pluripotency and genetic integrity including mitochondrial genome (mtDNA). Notably, the genes related to metabolism, mTORC1, and TP53 have mainly displayed a faster recovery pattern with ROCK inhibitors than control. Furthermore, fasudil was confirmed as useful for the single dissociation of hPSCs and for aggregation. It also increased retinal pigment epithelium (RPE) differentiation and the survival of neural crest cells during differentiation. These findings suggest that fasudil can replace Y-27632 for use in stem cell research.
STUDI PEMBUATAN NUGGET FUNGSIONAL DARI IKAN CAKALANG (KATSUWONUS PELAMIS L.) DENGAN EKSTRAK BUAH MENGKUDU (MORINDA CITRIFOLIA L.)
Authors: Genesa Jalil , Sukendar Nandi K , Regia Shinta
Published: November 2019

Nugget skipjack fish with noni fruit extract is a processed food from fish meat. It is milled with the addition of noni fruit extract as a value added (fuctional) on nugget products. Noni fruit is less favored by people due to the bitter taste and the aroma is sting. Therefore , it was carried out addition of extract from noni fruit on nugget processed products. This research aimed to produce functional nugget product from skipjack fish with noni fruit extract and to know chemical and physical content of nugget and alkaloids content in nugget. The parameters were water content, ash content, fat content, protein content, carbohidrate content, organoleptic test, and alkaloids content. The expremental design was Randomized Block Design with 3 treatments and 3 replications. Alkaloids content was present in all treatments . The best treatment based on physical, chemical, and oreganoleptics test of nugget was F3 treatment (60% fih meat + 7% extract of noni + 23% filler + 10% ice water). Result of organoleptics test texture 3.59 (likes), color 3.48 (rather like), aroma 3.63 (like), and taste 3.77 (like).
STUDI PEMBUATAN BROWNIES KUKUS DENGAN SUBSTITUSI TEPUNG DAUN SINGKONG (MANNIHOT UTILISSIMA)
Authors: Zainal Zainal , Laga Amran , Rahmatiah Rahmatiah
Published: November 2019

Cassava leaves are abundant green leaves and affordable. This research uses cassava leaves of sleedlings type with white, pink stalk with light green leaf colour made into flour to be processed food products. The purpose of this research was to analyze the physical properties and chemical content of brownies steamed by the addition of cassava leaf flour based on a mineral test (Ca, P, Fe), water content, ash content, protein content, fat content, carbohydrate and crude fibre content. A panellist assessment of brownies steamed based on organoleptic test results and determining the formulation of good brownies cake products from the ratio of wheat flour and cassava flour used. This research was designed using Completely Randomized Design (RAL) with three replications such as  A0 (100% wheat flour: 0 (control)), A1 (85% wheat flour: 15% cassava flour), A2 (70% wheat flour: 30% cassava flour) and A3 (55% wheat flour: 45% cassava flour). The parameters observed were proximate tests which included (water content, ash content, protein content, fat content, carbohydrate content), mineral tests (Ca, P, Fe), crude fibrecontent, organoleptic test. The best treatment was A3 which has water content 20,83%, ash content 2,88%, protein content 9,48%, fat content 23,68%, carbohydrate 42,13% and fiber content 1,12%, content mineral calcium 12.56 g / kg, phosphorus 2.06 g / kg, iron 61.06 ppm. The result of the panellist's assessment of the level of preference to steamed brownies was A0 with the average value of organoleptic score is texture 4.08 (like), colour 4,1 (like), taste 4.04 (like), and flavour 4 (like)
POTENSI REMPAH-REMPAH TRADISIONAL SEBAGAI SUMBER ANTIOKSIDAN ALAMI UNTUK BAHAN BAKU PANGAN FUNGSIONAL)
Authors: Helmalia Andi Widya , Putrid Putrid , Dirpan Andi
Published: November 2019

Seiring dengan perkembangan zaman yang semakin maju, masyarakat semakin sering mengkonsumsi makanan cepat saji atau junk food.  Hal inilah yang menyebabkan munculnya penyakit degeneratif berdasarkan pola hidup. Sehingga muncullah konspe pangan fungsional. Pangan fungsional adalah makanan atau minuman yang memiliki fungsi fisiologis terhadap tubuh. Misalnya mengkonsumsi antioksidan untuk dapat menangkal radikal bebas yang terjadi pada tubuh. Sumber antioksidan alami ini dapat berasal dari berbagai jenis tumbuhan seperti buah-buahan, sayur-sayuran, rempah-rempah, teh, ataupun enzim dan protein Seperti yang telah kita ketahui, Indonesia merupakan negara yang kaya akan rempah-rempah. Rempah-rempah ini dapat digunakan sebagai sumber antioksidan alami yang memiliki banyak manfaat bagi tubuh. Jenis-jenis rempah yang ada di Indonesia yaitu jahe, kunyit, kayu manis, secang, dan andaliman. Jahe mengandung senyawa antioksidan yaitu metil ester, 9-oktadekonik dan nortraselogenin. Penelitian ekstrak bubuk kunyit dan asam tersebut memiliki perbandingan ekstrak kunyit 55% dan ekstrak daun asam 45% sehingga menghasilkan nilai 4,844%. Kayu manis dapat menjadi sumber antioksidan karena mengandung banyak senyawa seperti eugenol, safrole, sinamaldehid, tannin, dan kalsium oksalat. Komponen aktif yang terkandung di dalam secang yaitu flavonoid. Buah andaliman memiliki potensi sebagai antioksidan dan inhibitor a-glukosidase.
The Impact of Modeling Instruction Based on System Toward Work-Energy Concept Understanding
Authors: Mustofa Zainul , Sutopo Sutopo , Mufti Nandang , Asmichatin Anik
Published: November 2019

This study aimed to explore the effectiveness of modeling instruction based on a system for improving student’s understanding of energy concepts on high school students. This Research was a mixed-method design with an embedded experimental model. The subject of this study was the 62 students of 11th grade, at Senior High School in Nganjuk, Indonesia. Modeling instruction based on system learning could significantly improve students' understanding of concepts better than conventional learning. Based on the calculation of the effectiveness of learning using N-gain obtained for 0.33 (medium or low medium category) for the treatment class and 0.18 (low category) for the control class. It concluded that improved students' conceptual understanding of the treatment class was better than the control class. This research also was identified student’s difficulties especially in differentiating forces and work. Students propensity to use p-prime in solving problems rather than using energy theorems.
A Novel Classification System for Slipped Capital Femoral Epiphysis Based on the Radiographic Relationship of the Epiphyseal Tubercle and the Metaphyseal Socket
Authors: Maranho Daniel A. , Bixby Sarah , Miller Patricia E. , Novais Eduardo N.
Published: November 2019

Background:

Recent studies have suggested that the epiphyseal tubercle serves as a fulcrum for rotation in slipped capital femoral epiphysis (SCFE). However, radiographic evidence of the rotational mechanism is limited. In this study, we describe a novel radiographic staging system for SCFE based on the anatomic relationship between the epiphyseal tubercle and the metaphyseal socket.

Methods:

We reviewed the cases of 469 patients with SCFE who were treated at our institution between 2000 and 2017. SCFE was classified according to our proposed staging system using the preoperative lateral radiograph. Normal hips were considered to be Stage 0. In Stage 1, the tubercle is concentric within its metaphyseal socket, which is enlarged and may present peritubercle radiolucency. In Stage 2, there is evidence of eccentricity of the tubercle, which remains in contact with the posterior wall of the socket. In Stage 3, the tubercle and metaphyseal lucency reach the posterior cortex of the femoral neck. A complete dislodgment of the tubercle from the metaphysis is present in Stage 4. Intra- and interobserver agreement, and correlations between the staging system and the traditional classifications of severity, stability, and chronicity, were estimated.

Results:

The distribution by stage was as follows: 2% of the hips were classified as Stage 0, 19% were Stage 1, 48% were Stage 2, 15% were Stage 3, and 16% were Stage 4. The staging system had excellent intraobserver (κ = 0.89 [95% confidence interval (CI) = 0.83 to 0.96]) and interobserver agreement (κ = 0.87 [95% CI = 0.72 to 1.00]). There was a high correlation between the staging system and SCFE severity as assessed by the Southwick angle (r = 0.77 [95% CI = 0.73 to 0.82]; p < 0.001). There was a moderate correlation between the staging system and the Loder classification of stability (r = 0.55 [95% CI = 0.48 to 0.62]; p < 0.001) and a negligible correlation with the classification of chronicity (r = 0.19 [95% CI = 0.10 to 0.28]; p < 0.001).

Conclusions:

The proposed staging system for SCFE is highly reliable and correlates well with the severity of SCFE based on the degree of displacement, with moderate correlation shown for stability. This new staging system helps in understanding the rotational mechanism of SCFE, warranting further investigation to determine its clinical application.

Clinical Relevance:

The novel classification has the potential for the identification of hips that demonstrate subtle SCFE or are at pre-slip stage, or those at risk for osteonecrosis of the femoral head, failure of fixation, or slip progression.
Comparing Effect of Auricular Acupressure and Body Acupressure on Pain and Duration of First Stage of Labor: Study Protocol for a Randomized Controlled Trial
Authors: Alimoradi Zainab , Kazemi Farideh , Valiani Mahboubeh , Gorji Maryam
Published: November 2019

Background Labor pain is one of the leading causes for fear of childbirth. Acupressure is a non-pharmacological pain relief method which showed promising results. Comparing the effect of body acupressure at multiple points and auricular acupressure on the pain and duration of labor, the present study is designed. Methods/Design In a randomized controlled trial, 90 primigravida women who attend for childbirth would be randomly assigned to three groups (interventions: body acupressure and auricular acupressure, control: routine care). In order to determine the allocation sequence with 1:1:1 ratio, the computer-generated 6-block randomization techniques would be used. To hide the allocation, the type of intervention will be written based on the generated sequence and put in opaque enveloped pockets; then, the pockets as well as questionnaires are encoded respectively. The pain score of all the participants would be measured at the peak uterine contraction at the 4cm cervical dilation and at 10 cm dilation based on visual analog scale (VAS). Duration of the active phase of labor in these groups are recorded too. Data are imported into SPSS-16 software. First, normality of the data distribution will be investigated. To compare the labor duration among the research groups, ANOVA would be used, which will be followed, in case of significance, by the Scheffe post-hoc test. Furthermore, Chi-squared test would be used to compare the categorized demographic variables and ANOVA or Kruskal-Wallis tests will be used to compare the quantitative variables in the studied groups. significance level of 0.05 is considered significant. Discussion In this study the effect of auricular acupressure and body acupressure on pain and duration of first stage of labor will be compared.
Seven-day services in surgery and weekend effect at a Japanese teaching hospital: a retrospective cohort study
Authors: Matoba Masaaki , Suzuki Takashi , Ochiai Hirotaka , Shirasawa Takako , Yoshimoto Takahiko , Minoura Akira , Sano Hitomi , Ishii Mizue , Kokaze Akatsuki , Otake Hiroshi , Kasama Tsuyoshi , Kamijo Yumi
Published: November 2019

The authors have withdrawn this preprint from Research Square
Willingness to adopt wearable devices with behavioral and economic incentives by health insurance wellness programs: results of a US cross-sectional survey with multiple consumer health vignettes
Authors: Soliño-Fermández Diego , Ding Alexander , Bayro-Kaiser Esteban , Ding Eric L.
Published: November 2019

Background: The number of health-related wearable devices is growing but it is not clear if Americans are willing to adopt health insurance wellness programs based on wearables and the incentives with which they would be more willing to adopt. Methods: In this cross-sectional study we used a survey methodology, usage vignettes and a dichotomous scale to examine U.S. residents’ willingness to adopt wearables (WTAW) in six use-cases where it was mandatory to use a wearable device and share the resulting data with a health insurance company. Each use-case was tested also for the influence of additional economic incentives on WTAW. Results: A total of 997 Americans across 46 states participated in the study. Most of them were 25 to 34 years old (40.22%), 57.27% were female, and 74.52% were white. On average, 69.5% of the respondents were willing to adopt health-insurance use-cases based on wearable devices, though 77.8% of them were concerned about issues related to economic benefits, data privacy and to a lesser extent, technological accuracy. WTAW was 11-18% higher among consumers in use-cases involving health promotion and disease prevention. Furthermore, additional economic incentives combined with wearables increased WTAW overall. Notably, financial incentives involving providing healthcare credits, insurance premium discount, and/or wellness product discounts had particularly greater effectiveness for increasing WTAW in the consumer use-cases involving participation: for health promotion (RR=1.06 for financial incentive, 95% CI: 1.01-1.11; P=0.018); for personalized products and services (RR=1.11 for financial incentive, 95% CI: 1.01-1.21; P=0.018); and for automated underwriting discount at annual renewal (RR=1.28 for financial incentive, 95% CI: 1.20-1.37; P<0.001). Conclusions: Under the adequate economic, data privacy and technical conditions, 2 out of 3 Americans would be willing to adopt health insurance wellness programs based on wearable devices, particularly if they have benefits related to health promotion and disease prevention, and particularly with financial incentives. Keywords: Diffusion of innovation; wearable electronic devices; health insurance; United States
Risk of multi-drug resistant Campylobacter spp. and residual antimicrobials at poultry farms and live bird markets in Bangladesh
Authors: Neogi Sucharit Basu , Islam Md. Mehedul , Islam SK Shaheenur , Akhter A.H.M. Taslima , Sikder Md. Mahmudul Hasan , Yamasaki Shinji , Kabir S. M. Lutful
Published: November 2019

Background: This study systematically examined potential risks and associated socio-environmental factors of MDR Campylobacter spp. in poultry farms and live bird markets (LBMs) of Bangladesh. Methods: Microbial culture and PCR-based methods were applied to examine the occurrence and MDR patterns of Campylobacter spp. at hatcheries (n = 33), broiler farms (n = 122) and LBMs (n = 69). Antimicrobial residues in broiler meat and liver samples (n = 50) were detected by advanced chromatographic techniques. A questionnaire based cross-sectional survey was conducted on socio-environmental factors. Results: In poultry farms, Campylobacter spp. was primarily found in cloacal swab (21/49, 43%), followed by drinking water (8/24, 33%), and meat (8/28, 29%) samples of broilers. Remarkably, in live bird markets, Campylobacter spp. was detected in higher prevalence in broiler meat (14/26, 54%), which could have an association with bacterial contamination in drinking water sources (11/21, 52%) and floor (9/21, 43%). Representative isolates (n = 71) were differentiated into two species: Campylobacter jejuni (66%) and Campylobacter coli (34%). Majority of C. jejuni (33/47, 70%) and C. coli (14/24, 58%) strains were observed to be MDR, predominantly showing resistance to amoxycilin, tetracycline and erythromycin, and additionally to ciprofloxacin, norfloxacin, streptomycin, and azithromycin. Residual antimicrobials, including oxytetracycline, ciprofloxacin and enrofloxacin, were detected in majority of broiler liver (79%) and meat (62%) samples. Alarmingly, 33% and 19% of the liver and meat samples, respectively, contained residual antimicrobial concentration above acceptable limit. Inadequate personal and environmental hygiene, unscrupulously use of antimicrobials, improper waste disposal, and lack of health surveillance and quarantine facilities of diseased birds were distinguishable anthropogenic risk factors, with local diversity and compound influences on MDR pathogens. Conclusion: The observed large-scale occurrence of MDR C. jejuni and C. coli and residual antimicrobials in poultry value chain reflects an alarming situation for public health in Bangladesh. Potential contamination sources of MDR Campylobacter and the combined influences of diverse socio-environmental risk factors, noted in this study, would aid in developing interventions to minimize the increasing risks of poultry-associated MDR pathogens under ‘One Health’ banner that includes poultry, human and environment perspectives.
The trend of full vaccination coverage in infants and inequalities by wealth quintile and maternal education: Analysis from four recent Demographic and Health Surveys in Nepal
Authors: Acharya Kiran , Paudel Yuba Raj , Dharel Dinesh
Published: November 2019

Background Despite policy intention to reach disadvantaged populations, inequalities in child health care use and health outcomes persist in Nepal. The current study aimed to investigate the trend of full vaccination coverage among infants and its equity gaps between Nepal Demographic and Health Surveys (NDHS) 2001 and 2016.Methods Using data from NDHS conducted in 2001, 2006, 2011 and 2016, we investigated the trend of coverage of six antigens:Bacille Calmette Guerin (BCG), Diptheria, Pertussis, Tetanus (DPT), Polio, and Measles during their infancy among children aged 12-23 months. We presented trends and correlates of vaccination coverage by different socio-demographic factors. We measured inequalities in full vaccination coverage by wealth quintile and maternal education using absolute measure (slope index of inequality) and relative measures (Relative index of inequality, concentration index) of inequalities.Results Full immunization coverage among infants steadily increased from 65.6% in 2001 to 87.0% in 2011; however, it decreased to 77.8% in 2016. Province 2 had a significantly lower full vaccination coverage compared to Province1.Although decreasing over time, there were significant inequalities by household wealth quintiles and maternal educational status. The slope index of inequality (SII) for wealth quintiles decreased from -32.3 [-45.5,-19.1] in 2001 to an SII of-8.4 [-18.6,-1.7] in 2016. Similarly, the SII for education decreased from -61.8 [-73.5,-50.1] in 2001 to an SII of -30.5 [-40.7,-20.2] in 2016. Similarly, the relative index of inequality (RII) also showed an improvement over time, indicating the narrowing equity gap. Additionally, concentration index on full immunization coverage by wealth quintiles dropped from 0.21 (0.12-0.28) in 2001 to 0.054 (-0.01-0.12) in 2016. Absolute and relative inequalities were persistently larger by maternal educational status compared to household wealth quintiles throughout the study period.Conclusion Full vaccination coverage in Nepal increased from 2001 until 2011 but saw a significant decrement away from the national target after 2011. However, the equity gap by household wealth quintile and maternal education status has narrowed over time. However, immunization programs need to give higher emphasis to infants born to mothers with less education, those born in the poorer wealth quintile households, and those living in Province 2.
Determinants of late antenatal care follow up among pregnant women in Easter zone Tigray, Northern Ethiopia, 2018. Unmatched case- control study
Authors: Gebremariam Gebrehiwot , Teklehaimanot Berhane Fseha , Gebru Hirut Teame , Gebrezgi Znabu Asfaw , Tekola Kidanemaryam Berhe , Baraki Mulu Ftiwi
Published: November 2019

Objective: The purpose of the study was to identify determinants of late antennal care at first visit in health facilities of eastern zone of Tigray, Northern Ethiopia 2018. Result: Women with unplanned pregnancy (AOR= 4.03, 95%, CI: 1.56-5.67), Participants whose previous first antenatal care was after 16 weeks (AOR= 3.9, 95% CI: 1.98-7.68), Participants did not accompanied by their partner for antenatal visit (AOR= 1.29,95%, CI: 1.05-4.67), women recognized their current pregnancy at three months or late ( AOR= 4.7,95%,CI: 2.49-9.04) and participants provided adequate time for their previous antenatal care by health professionals ( AOR = 0.461, 95% CI 0.342- 0.875) were found the determinant factors of late antenatal care at first Visit. Hence family planning utilization, times of first visit antenatal, information flow and supporting by partners have a great role in improving antenatal care at first visit. There for responsible bodies should give focuses on utilization of family planning, increasing awareness of pregnancy symptoms and health provisional provide adequate time during visits.
Whole Exome Sequencing in Idiopathic Short Stature: rare mutations affecting growth
Authors: Noorian Shahab , Rohani Farzaneh , Savad Shahram , Kabir Kourosh , Khonsari Nami Mohammadian , Ghanipour Nima , Gholami Mehri , Zaimkohan Hooshang
Published: November 2019

Introduction: one of the most common causes of referrals to paediatricians is short stature (ISS), some pathogenic mutations may present exactly similar to non-pathogenic causes, our goal is to identify and treat these patients labelled ISS with these mutations and hopefully treat them correctly. Materials and Methods: We assessed All children under the age of fifteen years labelled as ISS. Fourteen of them were confirmed to be ISS and thus were allowed in our study. Afterwards, we pooled their blood specimens and ordered a whole-exome sequencing (WES) test. Results: five patient had normal WES results. Four patients had rare motions that were not studied in the previous literature but due to the functions of the genes, and our patients’ phenotypes it is highly possible that these mutations caused our patients’ short stature. Four patients had known genetic mutations causing short stature. One patient had a mutation with no effect on height. With the help of WES, some rare mutations were found, with the patients’ phenotype and evaluation we identified their function, we diagnosed some other patients’ rare genetic disorders and assessed the possible effect of their mutation on their height and phenotype we aimed to determine how many children labelled as ISS are correctly diagnosed. By WES most of our patient achieved the correct diagnosis which would be impossible to diagnose without WES; thus the reason for their short stature was identified, with the correct diagnosis now we can aim for the proper treatment.
Factors associated with seeking post-abortion care among women in Guangzhou, China
Authors: Wang Hui , Liu Yan , Xiong Ribo
Published: November 2019

Background: Post-abortion care(PAC) service in China relies on integrating post-abortion family planning (PAFP) services into existing abortion services in hospital settings where the vast majority of induced abortion is performed. This study aims to assess post-abortion care (PAC) utilization and identify factors affecting PAC uptake among clients on the day of abortion in Guangzhou, China. Methods: A cross-sectional study was conducted involving a total of 423 abortion clients in the selected hospitals of Guangzhou From June to September, 2018. The anonymous, self-reported questionnaires regarding associated factors were administered to all participants. Multivariate logistic regression model was used to determine associated factors of PAC utilization. Results: The magnitude of PAC counseling before they leave the health care facilities was 42.1%. Multivariate logistic regression showed that unmarried women, women with local household registration, knowing fertility could return sooner after abortion and women themselves as the main decider on PAC use were significantly associated with PAC utilization. Conclusions: The utilization rate of PAC was low in Guangzhou, China. There’s an urgent need to improve the awareness of regular use of PAC and provide better access for migrants. Partners should be involved during counseling after obtaining women’s consent. Women empowerment through enhancing health education on own decision making in PAC utilization should also be strengthened.
Neutrophil Count as a Reliable Marker of Diabetic Kidney Disease in Autoimmune Diabetes
Authors: Yu Yao , Lin Qiuqiu , Ye Dewei , Wang Yanfei , He Binbin , Li Yanhua , Huang Gan , Zhou Zhiguang , Xiao Yang
Published: November 2019

Background A growing body of evidence supports neutrophils as an active player in the development of diabetic kidney disease (DKD). However, the clinical relevance of neutrophils and DKD in autoimmune diabetes remains unknown. This study aims to investigate the relationship between circulating neutrophils and DKD in autoimmune diabetes.Methods Patients with type 1 diabetes (T1D, n=226) and latent autoimmune diabetes in adults (LADA, n=79) were enrolled and stratified according to the urinary albumin to creatinine ratio (ACR). Circulating levels of white blood cells (WBCs), including neutrophils, were measured in a central laboratory, and the neutrophil-to-lymphocyte ratio (NLR) was calculated. The risk factors associated with DKD were analysed by logistic regression.Results In T1D and LADA patients, the peripheral neutrophil counts increased in parallel with DKD advancement. The neutrophil counts in the patients with macroalbuminuria were significantly higher than those in the patients with normoalbuminuria for each type of diabetes. Furthermore, neutrophil counts positively correlated with the ACR. In addition, neutrophils were independently associated with DKD in T1D in the logistic regression analysis, when various well-known risk factors, including disease duration, sex, and smoking status, were adjusted as continuous variables.Conclusions Neutrophil counts are closely associated with DKD in patients with autoimmune diabetes, suggesting neutrophil-mediated inflammation may be involved in the pathogenesis of DKD in patients with autoimmune diabetes.
The procurement and supply chain strengthening project: Improving public health supply chains for better access to HIV medicines, Uganda 2011-2016
Authors: Muyingo Sowedi , Etoori David , Lotay Paul , Malamba Samuel Sewava , Olweny James , Keesler King , Jjemba Pito , Settaala Rashid
Published: November 2019

With countries moving towards reaching the UNAIDS 90-90-90 goal to achieve HIV epidemic control, there are going to be an unprecedented number of persons tested, treated, and regularly monitored for viral suppression. However, most of the countries with the greatest burden of HIV/AIDS experience regular stock outages which could be detrimental to reaching these targets. Antiretroviral therapy and other commodities such as HIV test kits and laboratory supplies need to be readily and consistently available in order to achieve these targets.
Medical Access Uganda Limited implemented several interventions as part of a procurement and supply chain strengthening project with the ultimate goal of supply chain improvement for access to HIV medicines. These interventions were evaluated using performance-monitoring-indicators from 2011-2016. We tested for the significance in the change in scores of performance-monitoring-indicators using the test for difference in proportions. Health facilities were scored on six categories and accredited as bronze, silver, or gold based on their total scores. Kaplan Meier estimates were computed for time to silver and gold ranking and Cox proportional hazards models were computed for time to gold ranking.
The 13 sites with a baseline score <50 achieved a final score of (Unranked=0,Bronze(50-69)=2,Silver(70-89)=8,Gold(≥90)=3), 44 sites with a baseline score 50-69 achieved a final score of (U=0,B=0,S=26,G=18), 106 sites with a baseline score 70-89 achieved a final score of (U=0,B=3,S=62,B=41) and 31 sites with a baseline score ≥90 achieved a final score of (U=0,B=1,S=10,G=20). We observed a significant reduction in reported stock outs from 46%-4% (p<0.001). Accurate stock card inventory rose from 79%-91% (p<0.001); adequate stock levels from 54%-71% (p=0.002) and stock reporting rates from 91%-100% (p<0.001). The stock order fill rate improved from 93%-97% (p=0.375). Patient load (medium vs low adjusted hazard ratio (aHR):2.19,p=0.026; high vs low aHR:2.97,p=0.034) and number of support supervision visits (6-10 aHR:3.33,p=0.024; >10 aHR:5.78,p= 0.003) were associated with better stock management ranking scores.
Improvements in supply chain management in countries committed to achieving the 90-90-90 goals are crucial to achieving HIV epidemic control. Health system strengthening and mentorship investments in Uganda were feasible and are essential for sustainable disease control efforts.
DNA barcode trnH-psbA is a promising candidate for efficient identification of forage legumes and grasses
Authors: Loera-Sánchez Miguel , Studer Bruno , Kölliker Roland
Published: November 2019

Objective Grasslands are widespread ecosystems that fulfil many functions. Plant species richness (PSR) is known to have beneficial effects on such functions and monitoring PSR is crucial for tracking the effects of land use and agricultural management on these ecosystems. Unfortunately, traditional morphology-based methods are labor-intensive and cannot be adapted for high-throughput assessments. DNA barcoding could aid increasing the throughput of PSR assessments in grasslands. In this proof-of-concept work, we aimed at determining which of three plant DNA barcodes ( rbcLa , matK and trnH-psbA ) best discriminates 16 key grass and legume species common in temperate sub-alpine grasslands. Results Barcode trnH-psbA had a 100% correct assignment rate (CAR) in the five analyzed legumes, followed by rbcLa (93.3%) and matK (55.6%). Barcode trnH-psbA had a 100% CAR in the grasses Cynosurus cristatus , Dactylis glomerata and Trisetum flavescens . However, the closely related Festuca, Lolium and Poa species were not always correctly identified, which led to an overall CAR in grasses of 66.7%, 50.0% and 46.4% for trnH-psbA , matK and rbcLa , respectively. Barcode trnH-psbA is thus the most promising candidate for PSR assessments in permanent grasslands and could greatly support plant biodiversity monitoring on a larger scale.
Spatial-temporal mapping of hand, foot and mouth disease in relation to climate factors in Xinjiang, China from 2008 to 2016
Authors: xie ling , Huang Ruifang , Wang Hongwei , Xiao Zhengqing
Published: November 2019

[Objectives]: The study mainly aims to depict the epidemiological characteristics of hand, foot and mouth disease (HFMD) in Xinjiang, China and evaluate the effects of meteorological factors (temperature & precipitation) on its dynamics through spatiotemporal analysis. This study provides substantial evidences for disease HFMD control and prevention.
[Methods]: With the data from the national surveillance data of HFMD and meteorological parameters in the study area from 2008 to 2016, the correlation between meteorological factors and HFMD incidence was explored through kernel density analysis. Furthermore, the spatial autocorrelation of HFMD in each year was analyzed by the Spatial Autocorrelation (Global Moran's I) tool.
[Results]: The relationship between monthly mean temperature (T) and HFMD cases fit best in the following logarithmic equation: y=4.8176ln(T)-19.773, (R2 = 0.5194). The relationship between monthly mean precipitation (P) and HFMD fit best in the following quadratic equation, y=-1E-06×P2+0.0108×P+5.9867, (R2 = 0.5319). HFMD was mainly distributed in northern Xinjiang. Global spatial autocorrelation analysis indicated the spatial dependency on the incidence of HFMD in 2008, 2010, 2012, 2014 and 2015. The spatial dependency is the negative spatial autocorrelation in 2009. The incidence of HFMD in Xinjiang presented a random distribution pattern in 2011 and 2016.
[Conclusion]: Our findings show that meteorological (air temperature & precipitation) variables had important effects on HFMD occurrence and transmission. This study provides a basis for the early warning of HFMD.
The Impact of Supply-side and Demand-side Interventions on Use of Antenatal and Maternal Services in Western Kenya: A Qualitative Study
Authors: Hirai Mitsuaki , Morris Jamae , Ouda Rosebel , Atieno Nancy , Quick Robert
Published: November 2019

Background : Antenatal care (ANC) and delivery by skilled providers have been well recognized as effective strategies to prevent maternal and neonatal mortality. ANC and delivery services at health facilities, however, have been underutilized in Kenya. One potential strategy to increase the demand for ANC services is to provide health interventions as incentives for pregnant women. In 2013, an integrated ANC program was implemented in western Kenya to promote ANC visits by addressing both supply- and demand-side factors. Supply-side interventions included nurse training and supplies for obstetric emergencies and neonatal resuscitation. Demand-side interventions included SMS text messages with appointment reminders and educational contents, group education sessions, and vouchers to purchase health products.

Methods : To explore pregnant mothers’ experiences with the intervention, ANC visits, and delivery, we conducted focus group discussions (FGDs) at pre- and post-intervention. A total of 19 FGDs were held with pregnant mothers, nurses, and community health workers (CHWs) during the two assessment periods. We performed thematic analyses to highlight study participants’ perceptions and experiences.

Results : FGD data revealed that pregnant women perceived the risks of home-based delivery, recognized the benefits of facility-based delivery, and were motivated by the incentives to seek care despite barriers to care that included poverty, lack of transport, and poor treatment by nurses. Nurses also perceived the value of incentives to attract women to care but described obstacles to providing health care such as overwork, low pay, inadequate supplies and equipment, and insufficient staff. CHWs identified the utility and limitations of text messages for health education.

Conclusions : Future interventions should ensure that adequate workforce, training, and supplies are in place to respond to increased demand for maternal and child health services stimulated by incentive programs.
Reference values and correlations for multiple physical performance measures: a prospective cross-sectional study among independently mobile older men in Japan
Authors: Ishii Yoshinori , Noguchi Hideo , Sato Junko , Ishii Hana , Ishii Ryo , Kobayashi Seiya , Iwamura Takashi , Toyabe Shin-ichi
Published: November 2019

Background: As the most rapidly aging country in the world, Japan is one of few countries with a male life expectancy over 80 years. The gap between the healthy life span and the total life expectancy is large, highlighting the importance of maintaining physical performance (e.g., walking speed, grip strength, and standing balance) in later life, which is also negatively associated with mortality among older adults. The present study aimed to establish reference values for multiple physical performance measures among high-functioning oldest-old Japanese men and to investigate the correlations among these measurements to understand how these variables are related in a more detailed and objective way, compared with previous studies. Methods: This single-center prospective cross-sectional study was conducted from September 2018 to August 2019 with 120 male orthopedic patients in Japan who were able to walk independently. Seven measures of physical performance were assessed: handgrip strength, quadriceps strength, static balance ability (one-legged stance), dynamic balance ability (Functional Reach Test; FRT), walking ability (5-m walking time test), combined movement ability (Timed Up & Go test), and bone quality. Cognitive function was also measured (Mini-Mental State Examination; MMSE). Spearman’s rank correlation was used to evaluate correlations between the variables. Results: Specific reference values are reported for each physical performance measurement explored in this study. Only six participants were classified as cognitively impaired, and 16 had mild cognitive impairment. There were significant correlations of varying levels among all of the measures of physical performance. Age was significantly correlated with all performance measures except FRT, and there was no correlation between age and MMSE. MMSE was weakly correlated with FRT and unrelated to the other performance measures. Conclusions: The reference ranges from this study among a high-functioning cohort of men aged 80 years or older can be used by older men who have not yet reached this age and their health care providers as physical performance targets to facilitate the maintenance of independent mobility in later life. There is an urgent need for the establishment of exercise interventions that will allow these men to achieve the desired targets, potentially lengthening their healthy life span.
Oropharyngeal dysphagia and quality of life in elderly patients after stroke.
Authors: Oliveira Leticia Sampaio de , Cardenas Jonan Emi Valencia , Mituuti Claudia Tiemi , Rosa Raquel Rodrigues , Andrade Eduardo Carvalho de , Berretin-Felix Giédre
Published: November 2019

Objective To verify the association between oropharyngeal dysphagia and quality of life in elderly individuals, at the late stage of stroke.Methods Retrospective cross-sectional study, whose results were obtained by analysis of the databank of a project that analyzed 30 elderly individuals affected by stroke in the late stage. All were submitted to clinical and instrumental evaluation (fiberoptic endoscopic) of swallowing, testing foods of solid, liquid and pudding textures. The degree of dysphagia was classified according to data from clinical examination and images of videoendoscopy examinations using the DOSS scale (Dysphagia Outcome and Severity Scale). The quality of life related to swallowing was analyzed by the SWAL-QOL protocol (Quality of Life in Swallowing Disorders), previously applied to the elderly individuals. Data were submitted to descriptive statistical an analysis and the Spearman correlation test.Results The clinical evaluation evidenced that most individuals presented mild oropharyngeal dysphagia, while the DOSS scale demonstrated swallowing with functional limitations. Mild impact or lack of impact was observed on the quality of life related to swallowing. There was positive correlation between burden, wish to feed, duration of feeding and mental state with the severity of oropharyngeal dysphagia, both by clinical and instrumental evaluations; and between the frequency of symptoms and severity of dysphagia by clinical evaluation (p<0.01).Conclusion There was association between the severity of oropharyngeal dysphagia and quality of life of elderly individuals in the late stage of stroke, demonstrating the importance of longitudinal follow-up of these individuals concerning the feeding aspects.
Physical activity and risk of dementia in community-dwelling older people: the Three-City cohort.
Authors: Dupré Caroline , Bongue Bienvenue , Helmer Catherine , Dartigues Jean François , Hupin David , Roche Frédéric , Berr Claudine , Carriere Isabelle
Published: November 2019

Background Physical activity may decrease the risk of dementia; however, previous cohort studies seldom investigated the different types of physical activity and household activities. Our objective was to analyze the links between two physical activity types and dementia in older people.Methods The study used data from the prospective observational Three-city cohort and included 1550 community-dwelling individuals aged 72 to 87 without dementia at baseline. Physical activity was assessed with the Voorrips questionnaire. Two sub-scores were calculated to assess household/transportation activities and leisure/sport activities. Restricted cubic spline and proportional hazard Cox models were used to estimate the non-linear exposure-response curve for the dementia risk and the appropriate activity level thresholds. Models were adjusted for possible confounders, including socio-demographic variables, comorbidities, depressive symptoms and APOE genotype.Results The median age was 80 years, and 63.6% of participants were women. After a median follow-up of 4.6 years, dementia was diagnosed in 117 participants (7.6%). An inverse J-shaped association was found between household/transportation physical activity sub-score and dementia risk. The results remained significant when this sub-score was categorized in three classes (low, moderate, and high), with hazard ratios (95% confidence interval) of 0.55 (0.35-0.87) and 0.62 (0.38-1.01) for moderate and high activity levels, respectively. No significant protective effect was found for leisure/sport activities.Conclusions The 5-year risk of dementia was significantly and negatively associated with the household/transportation activity level, but not with the leisure and sport activity sub-score. This highlights the importance of considering all physical activity types in 72 years or older people.
The Effect of Otago Exercise Program Training on Balance and Fear of Falling in Elderly Individuals
Authors: Arzhane Saeide Solati Dasht , Hazrati Maryam , Ashraf Alireza
Published: November 2019

Background Balance is an index to determine the independence level of elderly individuals in their daily activities. This study aimed to examine the effects of Otago Exercise Program (OEP) on balance and fear of falling among elderlies.Methods This clinical trial with pre/posttest design was conducted on 88 individuals aged 60 years and over who had referred to Imam Reza geriatric clinic and Kholdebarin retirement center in Shiraz. The participants were selected through simple random sampling. In the pretest, the two groups were assessed via 30-second chair stand, timed up and go, and four-stage balance tests to determine their balance status. Their fear of falling was also evaluated using the Fall Efficacy Scale-International (FES-I). The OEP was administered to the intervention group over one month in form of two 1.5-hour sessions per week. However, the control group received no trainings. The exercises were performed by the participants in their houses 5-6 times a week each lasting for 40-60 minutes over eight weeks. The participants were also followed up via telephone contacts weekly to ensure the performance of the exercises. The data were analyzed using the SPSS 21.Results The results showed that the implementation of OEP had a significant effect on improvement of balance among the elderly participants. Furthermore, the results revealed the effectiveness of OEP in reducing the fear of falling among the participants. The mean score of fear of falling was 18.88 in the intervention group and 30.30 in the control group. However, no significant differences were found between the pretest and posttest scores in the control group.Conclusion The study results indicated that OEP could be effective in improving postural stability as well as dynamic and static balance and declining the fear of falling. Trial Registration: Registration number of this study is IRCT20131117015426N7 and the date of registration is 2019.06.17.
Drought and flood occurrences in the Lancang River Basin during the last 60 years: their variations and teleconnections with monsoons
Authors: Tang Jian , Cao Huiqun
Published: November 2019

Understanding the inconsistency in the effects of monsoon changes on drought and flood occurrences would allow scientists to identify useful indicators in the prediction and early warning of regional drought and flood. Based on the calculation of the Standardized Precipitation Index, monsoon indices, and water vapor fluxes from 1956 to 2015, the relationships between drought–flood occurrences and monsoons in different regions of the Lancang River Basin were investigated. Drought and flood occurrences had spatial differences. Areas located in the lower basin had high drought and flood occurrences. The frequencies of drought and flood occurrences have no obvious regional differences and mainly varied periodically at 3–5, 8–15, and 20–25 years. Because the impact and strength of the Tibetan Plateau Monsoon (TPM) and South Asian monsoon (SAM) are limited, the TPM and SAM are the key factors that affect the occurrences of drought and flood in the upstream and downstream regions of the Lancang River Basin, respectively. The TPM and SAM are potentially useful indicators in the prediction of drought and flood occurrences. These results are of great scientific merit in developing an effective mitigation strategy to reduce the impacts of drought–flood disasters in the Lancang River Basin.
Biosorption of Cd2+ from aqueous solution by Ca2+/Mg2+ type Citrus paradisi Macf. peel biosorbents
Authors: Sun Hongyan , Wang Xiaoyun , Wang Rui , Zhang Yuezhong , Wang Xiaoxiao
Published: November 2019

Grape fruit (Citrus paradisi Macf.) peel (GP) was used as raw material to prepare two novel biosorbents: CaGP (Ca2+ type) and MgGP (Mg2+ type). Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and N2 adsorption–desorption isotherms were used to characterize prepared adsorbents. Cd2+ biosorption by CaGP, MgGP and GP was investigated systematically by studying the effects of pH, biosorption time and initial concentration on the biosorption of Cd2+. The results showed that biosorption efficiencies of Cd2+ on CaGP and MgGP increased with increase in pH, and the highest removal of Cd2+ was occurred at pH 6.0. Meanwhile, Cd uptake capacity increased with contact time, and could reach equilibrium within 20 min. The rates of biosorption of Cd2+ on three prepared biosorbents were found to best-fit pseudo-second-order equation. Experimental isotherms were well fitted by Langmuir and Freundlich isotherms models. Moreover, according to the Langmuir equation, the maximum biosorption capacities (qm) of Cd2+ on CaGP and MgGP were found to be increased by 46.3% and 27.0%, respectively, compared with GP. The present study demonstrated that the waste grape fruit peel after simple Ca2+ or Mg2+ treatment could be used as a potential biosorbent for Cd2+, which indicated modified novel inactive/dead biological materials could remove Cd2+ from water.