bluuebunny/crossref_metadata_2025 huggingface dataset:
Socio-cultural factors favoring home delivery in Afar pastoral community, northeast Ethiopia: A Qualitative Study
Authors: Ahmed Mohammed , Demissie Meaza , Worku Alemayehu , Abrha Araya , Berhane Yamane
Published: November 2019

Background

Despite expanding the number of health facilities, Ethiopia has still the highest home delivery services utilization. Health care service utilization varies between regions within the country. This study explored the socio-cultural factors influencing health facility delivery in a pastoralist region of Afar, Ethiopia.

Methods

An explorative qualitative study was conducted in October–December 2015. A total of 18 focus group discussions were conducted separately with mothers, male tribal leaders and religious leaders. In addition, 24 key informant interviews were conducted with Women’s Affairs Bureau and district health office experts and traditional birth attendants and all were selected purposively. Data were coded and categorized using open code software and analyzed based on a thematic approach.

Results

The social factors that affect the choice of delivery place include workload, lack of independence and decision-making power of women, and lack of substitute for childcare and household chores during pregnancy and childbirth. The cultural and spiritual factors include assuming delivery as natural process ought to happen at home, trust in traditional birth attendants, traditional practices during and after delivery and faithful to religion practice, besides, denial by health facilities to benign traditional and spiritual practices such as prayers and traditional food preparations to be performed over there.

Conclusion

Socio-cultural factors are far more than access to health centers as barriers to the utilization of health facilities for child birth. The provision of a maternity waiting home around the health facilities can alleviate some of these socio-cultural barriers.
The effects of ankle stiffness on mechanics and energetics of walking with added loads: a prosthetic emulator study
Authors: Hedrick Erica A. , Malcolm Philippe , Wilken Jason M. , Takahashi Kota Z.
Published: November 2019

Background

The human ankle joint has an influential role in the regulation of the mechanics and energetics of gait. The human ankle can modulate its joint ‘quasi-stiffness’ (ratio of plantarflexion moment to dorsiflexion displacement) in response to various locomotor tasks (e.g., load carriage). However, the direct effect of ankle stiffness on metabolic energy cost during various tasks is not fully understood. The purpose of this study was to determine how net metabolic energy cost was affected by ankle stiffness while walking under different force demands (i.e., with and without additional load).

Methods

Individuals simulated an amputation by using an immobilizer boot with a robotic ankle-foot prosthesis emulator. The prosthetic emulator was controlled to follow five ankle stiffness conditions, based on literature values of human ankle quasi-stiffness. Individuals walked with these five ankle stiffness settings, with and without carrying additional load of approximately 30% of body mass (i.e., ten total trials).

Results

Within the range of stiffness we tested, the highest stiffness minimized metabolic cost for both load conditions, including a ~ 3% decrease in metabolic cost for an increase in stiffness of about 0.0480 Nm/deg/kg during normal (no load) walking. Furthermore, the highest stiffness produced the least amount of prosthetic ankle-foot positive work, with a difference of ~ 0.04 J/kg from the highest to lowest stiffness condition. Ipsilateral hip positive work did not significantly change across the no load condition but was minimized at the highest stiffness for the additional load conditions. For the additional load conditions, the hip work followed a similar trend as the metabolic cost, suggesting that reducing positive hip work can lower metabolic cost.

Conclusion

While ankle stiffness affected the metabolic cost for both load conditions, we found no significant interaction effect between stiffness and load. This may suggest that the importance of the human ankle’s ability to change stiffness during different load carrying tasks may not be driven to minimize metabolic cost. A prosthetic design that can modulate ankle stiffness when transitioning from one locomotor task to another could be valuable, but its importance likely involves factors beyond optimizing metabolic cost.
A novel avian isolate of hepatitis E virus from Pakistan
Authors: Iqbal Tahir , Rashid Umer , Idrees Muhammad , Afroz Amber , Kamili Saleem , Purdy Michael A.
Published: November 2019

Background

Avian hepatitis E virus (aHEV) has been associated with hepatitis-splenomegaly syndrome (HSS) in chickens along with asymptomatic subclinical infection in many cases. So far, four genotypes have been described, which cause infection in chickens, specifically in broiler breeders and layer chickens. In the present study, we isolated and identified two novel aHEV strains from the bile of layer chickens in Pakistan evincing clinical symptoms related to HSS.

Methodology

Histology of liver and spleen tissues was carried out to observe histopathological changes in these tissues. Bile fluid and fecal suspensions were used for viral RNA isolation through MegNA pure and Trizol method which was further used for viral genome detection and characterization by cDNA synthesis and amplification of partial open reading frame (ORF) 1, ORF2 and complete ORF3. The bioinformatics tools; Molecular Evolutionary Genetics Analysis version 6.0 (MEGA 6), Mfold and ProtScale were used for phylogenic analysis, RNA secondary structure prediction and protein hydropathy analysis, respectively.

Results

Sequencing and phylogenetic analysis on the basis of partial methyltranferase (MeT), helicase (Hel) domain, ORF2 and complete ORF3 sequence suggests these Pakistani aHEV (Pak aHEV) isolates may belong to a Pakistani specific clade. The overall sequence similarity between the Pak aHEV sequences was 98–100%. The ORF1/ORF3 intergenic region contains a conservedcis-reactive element (CRE) and stem-loop structure (SLS). Analysis of the amino acid sequence of ORF3 indicated two hydrophobic domains (HD) and single conserved proline-rich domain (PRD) PREPSAPP (PXXPXXPP) with a single PSAP motif found in C-terminal. Amino acid changes S15 T, A31T, Q35H and G46D unique to the Pak aHEV sequences were found in the N-terminal region of ORF3.

Conclusions

Our data suggests that Pak aHEV isolates may represent a novel Pakistani clade and high sequence homology to each other support the supposition they may belong to a monophyletic clade circulating in the region around Pakistan. The data presented in this study provide further information for aHEV genetic diversity, genotype mapping, global distribution and epidemiology.
The effect of temporary hemiepiphysiodesis in the treatment of skeleton immature posttraumatic genu angular deformity: a retrospective study of 27 cases
Authors: Ding Jing , Zhu Ting , Jin Fang-chun , Wu Zhen-kai , Li Hai
Published: November 2019

Background

The purpose of this study was to evaluate the effect, rate of angular correction, and complications of temporary hemiepiphysiodesis (TH) in the treatment of skeleton immature posttraumatic genu angular deformity.

Methods

We retrospectively reviewed the records of 27 patients undergoing temporary hemiepiphysiodesis for the management of posttraumatic genu angular deformity. Based on the data from these patients, the rate of correction, effect of correction, length of the lower limbs, and complications were used as the outcome measures.

Results

Outcome measurements were obtained from a chart review of medical records that included information about clinical evaluations. Fifteen boys and 12 girls, with an average age of 6.3 years, were included in the study. The average follow-up was 3.8 years (range, 1.9 to 5.9 years) after surgery. Complete correction was obtained in 24 patients, while partial correction was obtained in 3 patients. The mean rate of angular correction was 8.41°/year in distal femur and 15.19°/year in proximal tibia. One patient had recurrence of genu valgum. No leg length discrepancy was found in our patients.

Conclusion

Temporary hemiepiphysiodesis is a simple, effective, reliable, and reproducible method for the treatment of posttraumatic genu angular deformity, with fewer complications than osteotomy. Nevertheless, it is important to follow the rebound patient closely until skeletal maturity in our future work.
Long-term outcomes of a dual-mobility cup and cementless triple-taper femoral stem combination in total hip replacement: a multicenter retrospective analysis
Authors: Cypres Alain , Fiquet Arnaud , Girardin Philippe , Fitch David , Bauchu Philippe , Bonnard Olivier , Noyer Daniel , Roy Christophe
Published: November 2019

Background

The separate design concepts of dual-mobility cups and triple-taper femoral stems were developed to improve survivorship following total hip replacement (THR) by reducing instability/dislocation and enabling enhanced fixation. Successful outcomes at over two decades have been reported with earlier-generation devices based on these concepts. The current study aimed to provide the first long-term results with a unique pairing of later-generation dual-mobility cup and triple-taper cementless femoral stem after a decade of use in patients undergoing THR.

Methods

In this retrospective analysis, records were reviewed for all subjects implanted with this dual-mobility cup/cementless femoral stem combination at three centers between 2002 and 2005. Any subject who had not already had follow-up visit beyond 10 years, was not previously revised, and still living were invited for a single follow-up visit consisting of Merle d’Aubgine Scores, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and standard radiographs.

Results

There were 244 THRs available for analysis. At a mean follow-up of 11.9 years, the Kaplan-Meier survivorship (endpoint: revision for any reason) was 99.1% (95% CI, 97.6–99.7) for the stem and 95.9% (95% CI, 93.1–97.6) for the cup. Merle d’Aubigne Scores were significantly improved from baseline and WOMAC scores were in the satisfactory range at the final follow-up. Radiographic analysis revealed no cases of stem subsidence, no cases of bone hypertrophy, 1 (0.4%) case of bone atrophy, and 3 (1.2%) cases of osteolysis around the stem. No subjects had radiolucent lines greater than 1 mm in any femoral Gruen zone. Evidence of cup migration was seen in 1 (0.4%) subject and 1 (0.4%) subject had evidence of osteolysis that was seen in Gruen zones I, II, IV, and V.

Conclusions

This combination of a later-generation dual-mobility cup and cementless triple-taper stem was associated with excellent survivorship and satisfactory functional outcomes at over 10 years follow-up.

Trial registration

ClinicalTrials.gov, NCT02648152. Date of registration: January 6, 2016. Retrospectively registered.
Clinical outcomes and second-look arthroscopic findings of anterior cruciate ligament reconstruction with autograft, hybrid graft, and allograft
Authors: Zheng Xiaozuo , Hu Yang , Xie Peng , Li Tong , Feng Yu-e , Gu Juyuan , Gao Shijun
Published: November 2019

Background

There is no consensus as to the choice of grafts for primary anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to compare the clinical and second-look arthroscopic outcomes after ACL reconstruction by use of autograft, hybrid graft, and γ-irradiated allograft.

Methods

Ninety-seven patients who underwent second-look arthroscopy after ACL reconstruction with autografts (28 patients, hamstring autograft), hybrid grafts (32 patients, hamstring autograft augmented with γ-irradiated tibialis anterior tendon allograft), or γ-irradiated allografts (37 patients, tibialis anterior tendons) were included in this study. The clinical outcomes were compared by using Lysholm score, International Knee Documentation Committee (IKDC) score, and Tegner activity score, and the side-to-side differences of KT-1000 measurement. Second-look arthroscopic findings were compared in terms of synovial coverage and graft tension.

Results

There were no statistical significances among the three groups in Lysholm score, IKDC score, or Tegner activity score (P > 0.05). The KT-1000 examination showed more anterior laxity in the γ-irradiated allograft group than in the autograft or hybrid graft groups (P = 0.006, and P = 0.013, respectively). Two patients in the autograft group, 2 patients in the hybrid graft group and 4 patients in the allograft group were evaluated as graft failure on second-look arthroscopy. The synovial coverage was superior in the autograft group than that in the hybrid graft group or the allograft group (P = 0.013 and P = 0.010, respectively), and was comparable between the hybrid graft group and allograft group (P = 0.876). With regard to graft tension, the autograft group and hybrid group were comparable (P = 0.883) but showed better results than the allograft group (P = 0.011 and P = 0.007, respectively).

Conclusion

The hamstring autografts and hybrid grafts used for ACL reconstruction produced equal efficacy but provided better knee stability than allografts. In addition, the hamstring autografts showed better synovial coverage than the other two graft types.
Residual hip dysplasia in children: osseous and cartilaginous acetabular angles to guide further treatment—a pilot study
Authors: Merckaert Sophie Rosa , Pierzchala Katarzyna , Bregou Aline , Zambelli Pierre-Yves
Published: November 2019

Purpose

In case of residual hip dysplasia (RHD) in children, pelvic radiographs are sometimes insufficient to precisely evaluate the entire coverage of the femoral head, when trying to decide on the need for further reconstructive procedures.

Methods

This study retrospectively compares the bony and the cartilaginous acetabular angle of Hilgenreiner (HTE) of 60 paediatric hips on pelvic MRI separated in two groups. Group 1 included 31 hips with RHD defined by a bony HTE > 20°. Group 2 included 27 hips with a HTE < 20°. They were compared by introducing a new ratio calculated from the square of cartilaginous HTE above the bony HTE on frontal MRI. The normal upper limit for this acetabular angle ratio was extrapolated from the published normal values of cartilaginous HTE and bony HTE in children.

Results

The acetabular angle ratio was statistically significantly increased in the hips with RHD with a mean value of 7.1 ± 4.7 compared to the hips in the control group presenting a mean value of 2.1 ± 1.9 (p < 0.00001).

Conclusions

This newly introduced ratio seems to be a helpful tool to orientate the further treatment in children presenting borderline RHD.
Preoperative sleep quality affects postoperative pain and function after total joint arthroplasty: a prospective cohort study
Authors: Luo Ze-Yu , Li Ling-Li , Wang Duan , Wang Hao-Yang , Pei Fu-Xing , Zhou Zong-Ke
Published: November 2019

Background

The relationship between preoperative sleep quality and postoperative clinical outcomes after total joint arthroplasty (TJA) is unclear. We performed a prospective cohort study to determine whether preoperative sleep quality was correlated with postoperative outcomes after TJA.

Methods

In this prospective cohort study, 994 patients underwent TJA. Preoperative sleep measures included scores on the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and a ten-point sleep quality scale. The primary study outcome measured was the visual analog scale (VAS) pain score to 12 weeks postoperation. The consumption of analgesic rescue drugs (oxycodone and parecoxib) and postoperative length of stay (LOS) were recorded. We also measured functional parameters, including range of motion (ROM), Knee Society Score (KSS), and Harris hip score (HHS).

Results

The mean age for total knee and hip arthroplasties was 64.28 and 54.85 years, respectively. The PSQI scores were significantly correlated with nocturnal and active pain scores and ROM and functional scores from postoperative day 1 (POD1) to POD3. In addition, significant correlation was noted between the correlation between the active pain scores and ESS scores in the TKA group at postoperative 3 months. The consumption of analgesics after joint arthroplasty was significantly correlated with the PSQI scores. Moreover, significant correlations were noted between the sleep parameters and postoperative length of hospital stay (LOS).

Conclusion

Preoperative sleep parameters were correlated with clinical outcomes (i.e., pain, ROM, function, and LOS) after TJA. Clinicians should assess the sleep quality and improve it before TJA.
Muscle-tendon weakness contributes to chronic fatigue syndrome in Gaucher’s disease
Authors: Roca-Espiau Mercedes , Andrade-Campos Marcio , Cebolla Jorge J. , López de Frutos Laura , Medrano-Engay Blanca , López-Royo Maria-Pilar , Giraldo Pilar
Published: November 2019

Background

Chronic fatigue (CFg) is a prevalent symptom in Gaucher disease (GD) at diagnosis (79%) and remains in a quarter of patients after years of therapy. Bone abnormalities are present in over 70% and peripheral neuropathy in about 11% of the patients, which contributes to the disabling and debilitating complications. Our hypothesis is that other factors such as muscle-tendinous weakness could have influence in the development of CFg.

Methods

We have evaluated the fiber structure and elasticity of muscle-tendinous unit by strain-elastography (S-ELA) and analyzed their influence in the CFg. S-ELA study was performed in Achilles tendon in 25 type 1 and two type 3 GD patients, all of them with fatigue and were on enzymatic replacement therapy for mean 13 years; simultaneously, bone marrow burden by MRI and calcaneus ultrasound densitometry were evaluated. Blood cell counts, plasma biomarkers, GBA1 genotyping, and SF36 quality of life scale (QoL) were also performed. Statistical analysis: descriptive and comparative test.

Results

All patients showed a normal Achilles tendinous structure. Abnormal stiff grade 2–3 was found in 17/27 (62.9%); in 11/27 (40.7%) of patients, the alteration was bilateral. There were no correlations between the S-ELA results to other variables; nevertheless, a significant correlation between the degree of tendon hardness and the low score on the QoL scales (p = 0.0035) was found. The S-ELA is a sensitive painless, fast, and low cost method to detect muscle-tendinous subclinical dysfunction that could contribute to CFg in GD. The identification of subclinical tendon alteration would be a sign of alarm, focused on the risk of development of bone complications.

Conclusion

Intratendinous alteration in strain-elastography is an independent variable in GD patients with persistent fatigue.
China’s pathway to a low carbon economy
Authors: Yang Wenjuan , Zhao Rongqin , Chuai Xiaowei , Xiao Liangang , Cao Lianhai , Zhang Zhanping , Yang Qinglin , Yao Lunguang
Published: November 2019

Climate change has emerged as one of the most important environmental issues worldwide. As the world’s biggest developing country, China is participating in combating climate change by promoting a low carbon economy within the context of global warming. This paper summarizes the pathways of China’s low carbon economy including the aspects of energy, industry, low carbon cities, circular economy and low carbon technology, afforestation and carbon sink, the carbon emission trading market and carbon emission reduction targets. There are many achievements in the implementation of low carbon policies. For example, carbon emission intensity has been reduced drastically along with the optimizing of energy and industry structure and a nationwide carbon trading market for electricity industry has been established. However, some problems remain, such as the weakness of public participation, the ineffectiveness of unified policies for certain regions and the absence of long-term planning for low carbon cities development. Therefore, we propose some policy recommendations for the future low carbon economy development in China. Firstly, comprehensive and long-term planning should be involved in all the low carbon economy pathways. Secondly, to coordinate the relationship between central and local governments and narrow the gap between poor and rich regions, different strategies of carbon emission performance assessment should be applied for different regions. Thirdly, enterprises should cooperate with scientific research institutions to explored low carbon technologies. Finally, relevant institutions should be regulated to realize comprehensive low carbon transition through reasonable and feasible low carbon pathways in China. These policy recommendations will provide new perspectives for China’s future low carbon economy development and guide practices for combating climate change.
Microbiological quality of mink feed raw materials and feed production area
Authors: Lyhs Ulrike , Frandsen Henrik , Andersen Birgitte , Nonnemann Bettina , Hjulsager Charlotte , Pedersen Karl , Chriél Mariann
Published: November 2019

Background

The quality of mink feed and raw ingredients affect health and growth. The objectives of this study were to examine the microbiological quality of ready-to-eat mink feed and its raw ingredients, screen the plant part of the feed for mycotoxins, and determine the hygiene of the production environment in the feed processing facilities. The results of the study are important for identification of critical steps in the feed production and for formulation of recommendations for improvements of production processes to obtain better quality feed. Feed and swab samples were taken at three Danish mink feed producers October 2016 and May 2017, respectively. Viable counts, detection of methicillin-resistantStaphylococcus aureus(MRSA), influenza virus and filamentous fungi were performed together with qualitative chemical analyses for bioactive fungal metabolites and mycotoxins. Swab samples were analyzed for total viable counts.

Results

Viable counts varied between 7.2 × 102and 9.3 × 107 cfu/g in raw ingredients and between 107and 109 cfu/cm2on different surfaces at the feed production facilities. A pork meat product, pork haemoglobin, pork liver and a poultry mix was found positive for MRSA, while monophasicSalmonella[4,5,12:i:-] was detected in a pork meat product. Neither MRSA norSalmonellawas detected in any ready-to-eat feed. Influenza A virus was not detected in any sample. Filamentous fungi were detected in all analysed samples of ready-to-eat feed while dihydro-demethyl-sterigmatocystin was found in almost 50% of all ready-to-eat feed samples and in 80% of the sugar beet pulp. Fumonisins and otherFusariumtoxins were found especially in corn gluten meal and extruded barley and wheat.

Conclusions

Mink feed contained a cocktail of mycotoxins and bacteria, which may not per se cause clinical disease, but may affect organ function and animal performance and well-being.
Mortality and health survey, Walikale, Democratic Republic of the Congo, 2017: an example of the use of survey data for humanitarian program planning
Authors: Robinson Eve , Crispino Vittoria , Ouabo Adelaide , Soung Iballa Francklin Brice , Kremer Ronald , Serbassi María Eugenia , van Lenthe Marit , Carrion Martin Antonio Isidro
Published: November 2019

Background

During humanitarian crises, health information systems are often lacking and surveys are a valuable tool to assess the health needs of affected populations. In 2013, a mortality and health survey undertaken by Médecins Sans Frontières (MSF) in the conflict affected Walikale territory of North Kivu, Democratic Republic of the Congo (DRC), indicated mortality rates exceeding humanitarian crisis thresholds and a high burden of mortality and morbidity due to malaria. In late 2017, after a period of relative stability, MSF reassessed the health status of the population through a second survey to guide ongoing operations.

Methods

A two-stage cluster survey, selecting villages using probability proportional to size and households using random walk procedures, was conducted. Household members were interviewed on morbidity and mortality, healthcare use, vaccination status, and bednet availability.

Results

The sample included 5711 persons in 794 households. The crude mortality rate (CMR) and under-five mortality rate (U5MR) were 0.98 per 10,000 persons/day (95% confidence interval (CI) 0.78–1.2) and 1.3 per 10,000 persons/day (95% CI): 0.82–2.0), respectively. The most frequently reported causes of death were fever/malaria (31%), diarrhoea (15%) and respiratory infections (8%). In 89% of households at least one person was reported as falling ill in the previous 2 weeks, and 58% sought healthcare. Cost was the main barrier amongst 58% of those who did not seek healthcare. Coverage of measles-containing-vaccine was 62% in under-fives. Sufficient bednet coverage (1 bednet/2 people) was reported from 17% of households.

Conclusion

The second survey illustrates that although mortality is now just below crisis thresholds, the area still experiences excess mortality and has substantial health needs. The study results have supported the further expansion of integrated community case management to improve access to care for malaria, diarrhoea and respiratory infections. Such surveys are important to orient operations to the health needs of the population being served and also highlight the ongoing vulnerability of populations after humanitarian crises.
Pre-metastatic niche triggers SDF-1/CXCR4 axis and promotes organ colonisation by hepatocellular circulating tumour cells via downregulation of Prrx1
Authors: Tang Yujun , Lu Yishi , Chen Yuan , Luo Lei , Cai Lei , Peng Bangjian , Huang Wenbin , Liao Hangyu , Zhao Liang , Pan Mingxin
Published: November 2019

Background

Circulating tumour cells (CTCs), especially mesenchymal CTCs, are important determinants of metastasis, which leads to most recurrence and mortality in hepatocellular carcinoma (HCC). However, little is known about the underlying mechanisms of CTC colonisation in pre-metastatic niches.

Methods

Detection and classification of CTCs in patients were performed using the CanPatrol™ system. A lentiviral vector expressing Prrx1-targeting shRNA was constructed to generate a stable HCC cell line with low expression of Prrx1. The effect of Prrx1 knockdown on stemness, migration, and drug resistance of the cell line was assessed, including involvement of SDF-1/CXCR4 signalling. Promising clinical applications of an inhibitor of STAT3 tyrosine phosphorylation, C188–9, and specific blockade with CXCR4 antibody were explored.

Results

The number of mesenchymal CTCs in blood was closely associated with tumour recurrence or metastasis. Pre-metastatic niche-derived SDF-1 could downregulate Prrx1, which induced the stemness, drug resistance, and increased expression of CXCR4 in HCC cells through the STAT3 pathway in vitro. In vivo, mice bearing tumours of Prrx1 low-expressing cells had significantly shorter survival. In xenograft tumours and clinical samples, loss of Prrx1 was negatively correlated with increased expression of CXCR4 in lung metastatic sites compared with that in the primary foci.

Conclusions

These findings demonstrate that decreased expression of Prrx1 stimulates SDF-1/CXCR4 signalling and contributes to organ colonisation with blood CTCs in HCC. STAT3 inhibition and specific blockade of CXCR4 have clinical potential as therapeutics for eliminating organ metastasis in advanced HCC.
The effectiveness of an interactive organ donation education intervention for Dutch lower-educated students: a cluster randomized controlled trial
Authors: Steenaart Esther , Crutzen Rik , Candel Math J. J. M. , de Vries Nanne K.
Published: November 2019

Background

Organ donation registration rates remain low, especially among people with lower educational levels. An interactive educational intervention was developed to prepare lower-educated students in the Netherlands for making a well-informed decision about organ donation. This article reports on the effects of this intervention on the intention to register (i.e., the primary outcome in the study at hand) and beliefs regarding organ donation.

Materials and methods

The effectiveness was investigated in a post-test-only cluster randomized controlled trial, in which the intervention was offered to the experimental group and after measurement also to the control group. Randomization to the experimental and control groups took place at a class level. Teachers of schools for Intermediate Vocational Education who taught a course on Citizenship delivered three intervention elements (i.e., video fragments and discussion, quizzes with tailored feedback and exercise filling out a registration form) to their students during two 50-min lessons.

Results

A total of 1170 students participated in the trial and filled out a questionnaire (45 experimental and 43 control classes). Compared to the control group, students in the experimental group had higher odds of having positive registration intentions (OR = 1.81; 95%CI [1.10–2.96]), their perceived knowledge was higher (B = 0.62; 95%CI [0.23–1.01]) and they had higher intentions to talk to family members (B = 0.68; 95%CI [0.28–1.08]) and friends (B = 0.36; 95%CI [0.07–0.66]) about organ donation. There were no effects on the choice students intended to register (OR = 1.08; 95%CI [0.67–1.73]).

Conclusions

Providing education in a classroom setting is an effective tool in increasing registration intentions. Despite uncertainties about the effects on actual registration behavior, a larger-scale dissemination of this intervention is recommended. Providing clear information and opening the discussion about organ donation is an important and promising first step towards higher registration rates.

Trial registration

The Dutch Trial Register, ID: NTR6771. Registered on 24 October 2017.https://www.trialregister.nl/trial/6557
Prevalence of pathogens in ticks collected from humans through citizen science in Belgium
Authors: Lernout Tinne , De Regge Nick , Tersago Katrien , Fonville Manoj , Suin Vanessa , Sprong Hein
Published: November 2019

Background

In order to evaluate the risk of human exposure to tick-borne pathogens in Belgium, a study on the prevalence of several pathogens was conducted on feeding ticks removed from humans in 2017.

Methods

Using a citizen science approach based on an existing notification tool for tick bites, a sample of ticks was collected across the country. Collected ticks were screened by PCR for the presence of the following pathogens:Anaplasma phagocytophilum,Babesiaspp.,Borrelia burgdorferi(sensu lato),Borrelia miyamotoi,Neoehrlichia mikurensis,Rickettsia helveticaand tick-borne encephalitis virus (TBEV).

Results

In total, 1599 ticks were included in the sample. The great majority of ticks belonged toIxodes ricinus(99%); other tick species were identified asIxodes hexagonus(0.7%) andDermacentor reticulatus(0.3%).Borrelia burgdorferi(s.l.) was detected in 14% of nymphs and adult ticks. Adult ticks (20%) were more likely to be infected than nymphs (12%). The most common genospecies wereB. afzelii(52%) andB. garinii(21%). Except for TBEV, the other tick-borne pathogens studied were all detected in the tick sample, although at a lower prevalence: 1.5% forBabesiaspp.; 1.8% forA. phagocytophilum; 2.4% forB. miyamotoi; 2.8% forN. mikurensis; and 6.8% forR. helvetica.Rickettsia raoultii, the causative agent of tick-borne lymphadenopathy, was identified for the first time in Belgium, in two out of fiveD. reticulatusticks. Co-infections were found in 3.9% of the examined ticks. The most common co-infection wasB. burgdorferi(s.l.) + N. mikurensis.

Conclusions

Although for most of the tick-borne diseases in Belgium, other than Lyme borreliosis, no or few cases of human infection are reported, the pathogens causing these diseases were all (except for TBEV) detected in the tick study sample. Their confirmed presence can help raise awareness among citizens and health professionals in Belgium on possible diseases other than Lyme borreliosis in patients presenting fever or other non-characteristic symptoms after a tick bite.
Correction to: Involvement of gut microbiome in human health and disease: brief overview, knowledge gaps and research opportunities
Authors: Liang Dachao , Leung Ross Ka‑Kit , Guan Wenda , Au William W.
Published: November 2019

Following publication of the original article in Gut Pathogens [1], it was brought to our attention that Dr. Ross Ka Kit Leung’s affiliation was incomplete. Dr. Leung is appointed as an Adjunct Professor of Guangzhou Medical University from January 1st 2017 to December 31st 2019. He would like to correct here the affiliation and acknowledge his role at the Guangzhou Medical University when this article was published.
Effects of individualized follow-up with a smartphone-application after cardiac rehabilitation: protocol of a randomized controlled trial
Authors: Lunde Pernille , Bye Asta , Bergland Astrid , Nilsson Birgitta Blakstad
Published: November 2019

Background

Cardiac rehabilitation (CR) programs are evidence-based and widely recommended. However, benefits from CR are likely lost among individuals who discontinue their regular exercise routines and healthy habits. One possible approach to enhance adherence to lifestyle advice after completion of CR, may be individualized follow-up enabled by a smartphone application (app).

Methods

A protocol of a single-blinded, pragmatic randomized controlled trial. The study will take place in the eastern part of Norway, and will include heart patients who have completed CR. Participants will be recruited from two CR centers. Based on power calculation, 113 participants will be included. The intervention group will receive individualized follow-up through an app on a weekly basis throughout a year. The app will be set up with the participant’s own goals, and the follow-up will be based on these individual goals. The control group will receive usual care, including general advice regarding physical activity, exercise and diet. The participants will be assessed at baseline (at completion of CR) and 12 months after baseline. Primary outcome of the study will be peak oxygen uptake. Secondary outcomes include exercise performance, quality of life, health status, health literacy, self-perceived goal achievement, exercise habits, body weight, blood pressure as well as lipids and triglycerides.

Discussion

To our knowledge, this will be the first study to examine the effects of individualized follow-up with an app for one year, in patients completing CR. Hence, it is reasonable to assume that the study may be groundbreaking. Due to the large sample size and the theoretically based intervention, the study has the potential to generate new knowledge that may improve the design of future technology-based follow-up interventions of patients that have completed rehabilitation.

Trial registration

ClinicalTrials.gov. NCT03174106. First registration, 19/05/2017.
Predictors of enrollment in a health protection scheme among informal sector workers in Kumasi Metropolis of Ghana
Authors: Adei Dina , Agyemang-Duah Williams , Mensah Anthony Acquah
Published: November 2019

Objective

Informal sector workers are exposed to occupational hazards which could escalate their healthcare expenditures. Thus, enrollment in a health protection scheme among informal sector workers is useful for reducing their catastrophic healthcare expenditures. However, there is scant information on factors predicting their enrollment in the National Health Insurance Scheme (NHIS) in Ghana, a gap this quantitative study aims to fill. A sample of 350 informal sector workers was involved in a cross-sectional survey.

Results

Approximately 17% of the participants were enrolled in NHIS. Respondents who had worked between 5 and 7 years were significantly more likely to enroll in NHIS compared with those who had worked below 2 years (AOR = 13.159, CI 1.135–152.596, p = 0.039). The study further found that apprentices (AOR = 0.72, CI 0.353–1.056, p = 0.005) were less likely to enroll in NHIS compared with their masters. Participants who were exposed to electrical hazards (AOR = 2.93, CI 1.56–5.10, p = 0.013) and suffered from occupational diseases (AOR = 2.75, CI 1.743–5.17, p = 0.001) were significantly more likely to enroll in NHIS. Also, respondents who were non-Christians were significantly less likely to enroll in NHIS compared with their respective counterparts (AOR = 0.726, CI 0.067–2.503, p = 0.011). The findings are useful for increasing the NHIS enrollment rate among informal sector workers in Ghana.
Magnitude of overweight and associated factors among type 2 diabetes mellitus patients at Mekelle public hospitals, Tigray, Ethiopia: a cross-sectional study
Authors: Kiros Kbrom Gemechu , Abyu Gebre Yitayih , Belay Desta Siyoum , Goyteom Mekonnen Haftom , Welegebriel Tensay Kahsay
Published: November 2019

Objective

To assess magnitude of overweight and associated factors among type 2 diabetes mellitus patients at Mekelle public hospitals, Tigray, Ethiopia.

Results

A total of 365 participants were enrolled in this study. One hundred ninety-eight (54.2%) of the participants were males and 288 (78.9%) of the study participants were from an urban residence. In this study 161 (44.1%) and 12 (3.3%) of the study subjects were alcohol consumers and smokers respectively. Besides, 166 (45%) of the study participants had poor dietary intake and around 302 (82.7%) had low level of vigorous physical activity. The proportion of individuals who were overweight using body mass index as a measure was 149 (40.8%) and the proportion of individuals who had central obesity using waist circumference as a measure was 194 (53.2%). The magnitude of overweight among study participants from urban residence and alcohol consumers was 138 (92.6%) and 93 (62.4%) respectively. Residence area, alcohol consumption, physical activities, central obesity and dietary intake were the determinant factors for overweight among type 2 diabetes mellitus patients.
Antibiotic resistance patterns of Staphylococcus aureus, Escherichia coli, Salmonella, Shigella and Vibrio isolated from chicken, pork, buffalo and goat meat in eastern Nepal
Authors: Bantawa Kamana , Sah Shiv Nandan , Subba Limbu Dhiren , Subba Prince , Ghimire Arjun
Published: November 2019

Objective

Food-borne pathogens are a major cause of illnesses, death and expenses. Their occurrence in meat and other food is considered a global health problem. The burden of food-borne disease is increasing due to antimicrobial resistance which represents a greater risk of treatment failure. However, very little is known about the antibiotic resistance profile of food-borne pathogens in Nepal. This study was conducted to examine the antibiotic resistance profile of common food-borne bacterial pathogens isolated from raw meat sold in Nepal. A total of 83 meat samples were collected from the market and analyzed.

Results

The prevalence of Staphylococcus aureus, Escherichia coli, Salmonella, Shigella, and Vibrio were 68%, 53%, 35%, 6%, and 6% respectively. The resistance of Salmonella was most frequently observed to amoxicillin (100%), tetracycline (24%), chloramphenicol (11%), and nalidixic acid (11%). S. aureus was resistant to amoxicillin (100%) followed by tetracycline (63%), nalidixic acid (17%), and cefotaxime (13%) respectively. Vibrio isolates resisted amoxicillin (100%), tetracycline (40%) and chloramphenicol (20%). Shigella expressed the highest resistance to amoxicillin (100%), followed by chloramphenicol (80%), tetracycline (60%) and nalidixic acid (20%). E. coli exhibited the highest resistance to amoxicillin (100%), followed by tetracycline (93%), nalidixic acid (25%) and cefotaxime (19%).
Methodological evaluation of human research on asthmagenicity and occupational cleaning: a case study of quaternary ammonium compounds (“quats”)
Authors: LaKind Judy S. , Goodman Michael
Published: November 2019

In this paper, we review methodological approaches used in studies that evaluated the association between occupational exposure to quaternary ammonium compounds (quats) and occupational asthma. This association is of interest because quats are a common active ingredient of disinfectants and have been linked to work-related asthma in some circumstances. However, any evidence-based assessment of an exposure-outcome association needs to consider both strengths and limitations of the literature. We focus on publications cited by various US and international organizations. Eighteen investigations included in the review fall into two broad categories: case reports and challenge studies of individual patients and population studies that examined the association between quats and asthma occurrence in groups of subjects. We evaluated these studies guided by questions that address whether: exposure data on specific quat(s) and other agents that may cause asthma were included, new asthma cases were differentiated from asthma exacerbation, and information on respiratory sensitivity versus irritation was given. We also assessed consistency across studies. Studies of individual patients, particularly those that provided detailed information on challenge test results, document cases of asthma induced by exposure to quats. By contrast, studies of occupational groups with the highest potential for quats exposure (e.g., cleaners and farmers) do not consistently report increased incidence of asthma due specifically to quats. The unresolved methodological issues include: poor understanding of exposure pathways considering that quats are non-volatile, lack of quantitative data allowing for identification of an asthmagenicity threshold, insufficient information on whether quats are sensitizers or act via dose-dependent irritation or some other mechanism, and inability to quantify risk of new-onset asthma attributable to quats. Another important area of uncertainty is the lack of information on the specific quats being used. There is also a lack of data capable of distinguishing the effects of quats from those of other chemical and biological workplace exposures. The current state-of-the-science does not allow a proper assessment of the potential link between quats and occupational asthma.
Efficient learning of non-autoregressive graph variational autoencoders for molecular graph generation
Authors: Kwon Youngchun , Yoo Jiho , Choi Youn-Suk , Son Won-Joon , Lee Dongseon , Kang Seokho
Published: November 2019

With the advancements in deep learning, deep generative models combined with graph neural networks have been successfully employed for data-driven molecular graph generation. Early methods based on the non-autoregressive approach have been effective in generating molecular graphs quickly and efficiently but have suffered from low performance. In this paper, we present an improved learning method involving a graph variational autoencoder for efficient molecular graph generation in a non-autoregressive manner. We introduce three additional learning objectives and incorporate them into the training of the model: approximate graph matching, reinforcement learning, and auxiliary property prediction. We demonstrate the effectiveness of the proposed method by evaluating it for molecular graph generation tasks using QM9 and ZINC datasets. The model generates molecular graphs with high chemical validity and diversity compared with existing non-autoregressive methods. It can also conditionally generate molecular graphs satisfying various target conditions.
Position-only synthesis of uniformly excited elliptical antenna arrays with minimum element spacing constraint
Authors: Guo Hua , Jing Guangrui , Dong Mian , Zhang Lijian , Zhang Xiaodan
Published: November 2019

Pattern synthesis of non-uniform elliptical antenna arrays is presented in this paper. Only the element positions of the antenna arrays are optimized by the combination of differential evolution (DE) and invasive weed optimization (IWO) to reduce the peak side lobe level (PSLL) of the radiation pattern. In order to avoid the overlap of the array elements, the minimum spacing of the adjacent elements is constrained. Also, the beam width of the radiation pattern can be constrained effectively. Three elliptical antenna arrays that have 8, 12, and 20 elements are investigated. The synthesis results show that the introduced method can present a good side lobe reduction for the radiation pattern. Compared with other optimization methods, the method proposed in this paper can obtain better performance.
Infinitely many solutions for hemivariational inequalities involving the fractional Laplacian
Authors: Xi Lijing , Zhou Yuying
Published: November 2019

In the paper, we consider the following hemivariational inequality problem involving the fractional Laplacian:
$$ \textstyle\begin{cases} (-\Delta )^{s}u+\lambda u\in \alpha (x) \partial F(x,u) & x \in \varOmega , \\ u=0 & x\in \mathbb{R} ^{N} \backslash \varOmega , \end{cases} $${(−Δ)su+λu∈α(x)∂F(x,u)x∈Ω,u=0x∈RN∖Ω, where Ω is a bounded smooth domain in $\mathbb{R} ^{N}$RN with $N\geq 3$N≥3, $(-\Delta )^{s}$(−Δ)s is the fractional Laplacian with $s\in (0,1)$s∈(0,1), $\lambda >0$λ>0 is a parameter, $\alpha (x): \varOmega \rightarrow \mathbb{R} $α(x):Ω→R is a measurable function, $F(x, u):\varOmega \times \mathbb{R} \rightarrow \mathbb{R} $F(x,u):Ω×R→R is a nonsmooth potential, and $\partial F(x,u)$∂F(x,u) is the generalized gradient of $F(x, \cdot )$F(x,⋅) at $u\in \mathbb{R} $u∈R. Under some appropriate assumptions, we obtain the existence of a nontrivial solution of this hemivariational inequality problem. Moreover, when F is autonomous, we obtain the existence of infinitely many solutions of this problem when the nonsmooth potentials F have suitable oscillating behavior in any neighborhood of the origin (respectively the infinity) and discuss the properties of the solutions.
Neural networks-based adaptive finite-time control of switched nonlinear systems under time-varying actuator failures
Authors: Liu Xikui , Shi Xiurong , Li Yan
Published: November 2019

This paper is dedicated to neural networks-based adaptive finite-time control design of switched nonlinear systems in the time-varying domain. More specifically, by employing the approximation ability of neural networks system, an integrated adaptive controller is constructed. The main aim is to make sure the closed-loop system in arbitrary switching signals is semi-global practical finite-time stable (SGPFS). A backstepping design with a common Lyapunov function is proposed. Unlike some existing control schemes with actuator failures, the key is dealing with the time-varying fault-tolerant job for the switched system. It is also proved that all signals in the system are bounded and the tracking error can converge in a small field of the origin in finite time. A practical example is presented to illustrate the validity of the theory.
New criteria for oscillation of nonlinear neutral differential equations
Authors: Moaaz Osama
Published: November 2019

The aim of this work is to offer sufficient conditions for the oscillation of neutral differential equation second order$$ \bigl( r ( t ) \bigl[ \bigl( y ( t ) +p ( t ) y \bigl( \tau ( t ) \bigr) \bigr) ^{\prime } \bigr] ^{\gamma } \bigr) ^{\prime }+f \bigl( t,y \bigl( \sigma ( t ) \bigr) \bigr) =0, $$(r(t)[(y(t)+p(t)y(τ(t)))′]γ)′+f(t,y(σ(t)))=0,where$\int ^{\infty }r^{-1/\gamma } ( s ) \,\mathrm{d}s= \infty $∫∞r−1/γ(s)ds=∞. Based on the comparison with first order delay equations and by employ the Riccati substitution technique, we improve and complement a number of well-known results. Some examples are provided to show the importance of these results.