bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-sectional analysis of self-reported sedentary behaviors and chronic knee pain among South Korean adults over 50 years of age in KNHANES 2013-2015
Authors: Lee Sook-Hyun , Son Chihyoung , Yeo Sujung , Ha In-Hyuk
Published: October 2019

Background

An increasing amount of evidence supports an association between sedentary behaviors and chronic knee pain. However, the association between the total daily duration of sedentary behavior and chronic knee pain in the general population remains unclear. We aimed to analyze the association between sedentary behavior and chronic knee pain in a study population representative of the general Korean population aged > 50 years while also considering the physical activity or body mass index (BMI).

Methods

This cross-sectional study used data from the 6th Korean National Health and Nutrition Examination Survey (KNHANES VI) of 2013–2015, which was completed by 22,948 Korean adult participants aged > 50 years. The participants were divided into two groups based on the status of the chronic knee pain. Data were analyzed using multivariable logistic regression after adjustment for age, sex, and individual factors.

Results

Longer sedentary behavior was correlated with chronic knee pain (p for trend = 0.02). Sedentary behavior exceeding 10 h/day was significantly associated with chronic knee pain (adjusted odds ratio, 1.28; p = 0.03). Participants with high levels of physical activity were less likely to suffer from chronic knee pain (adjusted odds ratio, 0.78; p = 0.00), and women with over 10 daily hours of sedentary behavior with high levels of physical activity were more likely to have chronic knee pain. A significant association was noted between chronic knee pain and obesity (≥30.0 kg/m2) individuals (adjusted odds ratio, 3.48; p = 0.04).

Conclusions

Longer duration of sedentary behaviors was correlated with chronic knee pain. Our study suggests the need to encourage reductions in overall sedentary behavior to < 10 h daily. A high physical activity level is recommended, particularly for women > 50 years and those with obesity.
Trends in working conditions and health across three cohorts of older workers in 1993, 2003 and 2013: a cross-sequential study
Authors: van der Noordt M. , Hordijk H. J. , IJzelenberg W. , van Tilburg T. G. , van der Pas S. , Deeg D. J. H.
Published: October 2019

Background

Over the past decades, the number of older workers has increased tremendously. This study examines trends from 1993 to 2013 in physical, cognitive and psychological functioning among three successive cohorts of Dutch older workers. The contribution of the changes in physical and psychosocial work demands and psychosocial work resources to change in functioning is examined. Insight in health of the older working population, and in potential explanatory variables, is relevant in order to reach sustainable employability.

Methods

Data from three cohorts (observations in 1993, 2003 and 2013) of the Longitudinal Aging Study Amsterdam (LASA) were used. Individuals aged 55–65 with a paid job were included (N = 1307). Physical functioning was measured using the Timed Chair Stand Test, cognitive functioning by a Coding Task and psychological functioning by the positive affect scale from the CES-D. Working conditions were deduced from a general population job exposure matrix. Linear and logistic regression analyses were performed.

Results

From 1993 to 2013, time needed to perform the Timed Chair Stand Test increased with 1.3 s (95%CI = 0.89–1.71), to a mean of 11.5 s. Coding Task scores increased with 1.7 points (95%CI = 0.81–2.59), to a mean of 31 points. The proportion of workers with low positive affect increased non-significantly from 15 to 20% (p = 0.088). Only the improvement in cognitive functioning was associated with the change in working conditions. The observed decrease of physically demanding jobs and increase of jobs with higher psychosocial resources explained 8% of the improvement.

Conclusions

Changes in working conditions may not contribute to improved physical and psychological functioning, but do contribute to improved cognitive functioning to some extent. Further adjustment of physical work demands and psychosocial work resources may help to reach sustainable employability of older workers.
Associations between occupational factors and self-rated health in the national Brazilian working population
Authors: Oenning Nágila Soares Xavier , de Goulart Bárbara Niegia Garcia , Ziegelmann Patrícia Klarmann , Chastang Jean-François , Niedhammer Isabelle
Published: October 2019

Background

The literature remains seldom on the topic of self-rated health (SRH) among the national working populations of emerging countries. The objectives of the study were to examine the associations of occupational factors with SRH in a national representative sample of the working population in Brazil.

Methods

This study relied on a cross-sectional sample of 36,442 workers, 16,992 women and 19,450 men. SRH was the studied health outcome. Sixteen occupational factors related to four topics were studied: employment characteristics, working time/hours, psychosocial work factors and physical and chemical work exposures. The associations between occupational factors and SRH were studied using logistic regression models with adjustment for sociodemographic characteristics (age, ethnicity and marital status). The analyses were performed for each gender separately and using weights.

Results

The prevalence of poor SRH was 26.71%, this prevalence being higher among women (29.77%) than among men (24.23%). The following risk factors for poor SRH were found among men and women: working as a self-employed worker, clerk/service worker, manual worker, part-time (≤ 20 h/week), exposure to work stress, exposure to high physical activity and exposure to sun. The risk factors for poor SRH among women only were: working as a domestic worker and exposure to noise, and among men, working in the agriculture sector.

Conclusions

Our study suggested that occupational factors related to both physical and psychosocial work environment may be associated with SRH in the working population in Brazil. Improving working conditions may be beneficial for health at work in Brazil.
Community-based aftercare following an emergency department presentation for attempted suicide or high risk for suicide: study protocol for a non-randomised controlled trial
Authors: Bliokas Vida V. , Hains Alex R. , Allan Jonathan A. , Lago Luise , Sng Rebecca
Published: October 2019

Background

Suicide is a major public health issue worldwide. Those who have made a recent suicide attempt are at high risk for dying by suicide in the future, particularly during the period immediately following departure from a hospital emergency department. As such the transition from hospital-based care to the community is an important area of focus in the attempt to reduce suicide rates. There is a need for evaluation studies to test the effectiveness of interventions directed to this stage (termed ‘aftercare’ interventions).

Methods

A controlled non-randomised two group (intervention vs treatment-as-usual control) design, using an intention-to-treat model, will evaluate the effectiveness of a suicide prevention aftercare intervention providing follow-up after presentations to a hospital emergency department as a result of a suicide attempt or high risk for suicide. The intervention is a community-based service, utilising two meetings with a mental health clinician and follow-up contacts by peer workers via a combination of face-to-face and telephone for four weeks, with the option of extension to 12 weeks. Seventy-five participants of the intervention service will be recruited to the study and compared to 1265 treatment-as-usual controls. The primary hypotheses are that over 12 months, those who participate in the aftercare follow-up intervention are less likely than controls to present to a hospital emergency department for a repeat suicide attempt or because of high risk for suicide, will have fewer re-presentations during this period and will have lower all-cause mortality. As a secondary aim, the impact of the intervention on suicide risk factors for those who participate in the service will be evaluated using pre- and post-intervention repeated measures of depression, anxiety, stress, hopelessness, belongingness, burdensomeness, and psychological distress. Enrolments into the study commenced on 1 November 2017 and are anticipated to cease in November 2019.

Discussion

The study aims to contribute to the understanding of effective interventions for individuals who have presented to a hospital emergency department as a result of a suicide attempt or at high risk for suicide and provide evidence in relation to interventions that incorporate peer-workers.

Trial registration

ACTRN12618001701213. Registered on 16 October 2018. Retrospectively registered.
Use of the kojA promoter, involved in kojic acid biosynthesis, for polyketide production in Aspergillus oryzae: implications for long-term production
Authors: Tamano Koichi , Kuninaga Mahoko , Kojima Naoshi , Umemura Myco , Machida Masayuki , Koike Hideaki
Published: October 2019

Background

Aspergillus oryzae, a useful industrial filamentous fungus, produces limited varieties of secondary metabolites, such as kojic acid. Thus, for the production of valuable secondary metabolites by genetic engineering, the species is considered a clean host, enabling easy purification from cultured cells. A. oryzae has been evaluated for secondary metabolite production utilizing strong constitutive promoters of genes responsible for primary metabolism. However, secondary metabolites are typically produced by residual nutrition after microbial cells grow to the stationary phase and primary metabolism slows. We focused on a promoter of the secondary metabolism gene kojA, a component of the kojic acid biosynthetic gene cluster, for the production of other secondary metabolites by A. oryzae.

Results

A kojA disruptant that does not produce kojic acid was utilized as a host strain for production. Using this host strain, a mutant that expressed a polyketide synthase gene involved in polyketide secondary metabolite production under the kojA gene promoter was constructed. Then, polyketide production and polyketide synthase gene expression were observed every 24 h in liquid culture. From days 0 to 10 of culture, the polyketide was continuously produced, and the synthase gene expression was maintained. Therefore, the kojA promoter was activated, and it enabled the continuous production of polyketide for 10 days.

Conclusions

The combined use of the kojA gene promoter and a kojA disruptant proved useful for the continuous production of a polyketide secondary metabolite in A. oryzae. These findings suggest that this combination can be applied to other secondary metabolites for long-term production.
Rationale and protocol for the Assessment of Impact of Real-time Continuous Glucose Monitoring on people presenting with severe Hypoglycaemia (AIR-CGM) study
Authors: Avari Parizad , Ramli Rozana , Reddy Monika , Oliver Nick , Fothergill Rachael
Published: October 2019

Background

Severe hypoglycaemia carries a significant risk of morbidity and mortality for people with type 1 diabetes. Economic costs are also high, estimated at approximately £13 million annually in England, UK. Continuous glucose monitoring (CGM) has been shown to reduce hypoglycaemia and associated fear, improve overall glycaemia and quality of life, and is cost-effective. Despite effective pathways in place with high levels of resource utilization, it has been reported there are low levels of follow-up, therapy change and specialist intervention after severe hypoglycaemia. This study is designed to assess the impact of providing real-time CGM to people with type 1 diabetes, who have had a recent episode of severe hypoglycaemia (within 72 h), compared to standard care.

Methods/design

Fifty-five participants with type 1 diabetes and a recent episode of severe hypoglycaemia, who are CGM naïve, will be recruited to the study. Participants will be randomised to CGM or standard care. The primary outcome is percentage time spent in hypoglycaemia (< 3.0 mmol/L, 55 mg/dL). Secondary outcomes include other measures of hypoglycaemia, time in euglycaemia, overall glucose status and patient reported qualitative measures.

Discussion

This study assesses the impact of providing continuous glucose monitoring at the outset in individuals at highest risk of hypoglycaemia. Changing demand means that novel approaches need to be taken to healthcare provision. This study has the potential to shape future national standards.

Trial registration

NCT03748433, November 2018 (UK).
Luteolin supports osteogenic differentiation of human periodontal ligament cells
Authors: Quan He , Dai Xiaopeng , Liu Meiyan , Wu Chuanjun , Wang Dan
Published: October 2019

Background

Previous research revealed that luteolin could improve the activation of alkaline phosphatase (ALP) and osteocalcin in mouse osteoblasts. We aimed to determine the effect of luteolin on osteogenic differentiation of periodontal ligament cells (PDLCs).

Methods

Cultured human PDLCs (HPDLCs) were treated by luteolin at 0.01, 0.1, 1, 10, 100 μmol/L, Wnt/β-catenin pathway inhibitor (XAV939, 5 μmol/L) alone or in combination with 1 μmol/L luteolin. Immunohistochemical staining was performed to ensure cells source. Cell activity and the ability of osteogenic differentiation in HPDLCs were determined by MTT, ALP and Alizarin Red S staining. Real-time Quantitative PCR Detecting System (qPCR) and Western blot were performed to measure the expressions of osteogenic differentiation-related genes such as bone morphogenetic protein 2 (BMP2), osteocalcin (OCN), runt-related transcription factor 2 (RUNX2), Osterix (OSX) and Wnt/β-catenin pathway proteins members cyclin D1 and β-catenin.

Results

Luteolin at concentrations of 0.01, 0.1, 1, 10, 100 μmol/L promoted cell viability, ALP activity and increased calcified nodules content in HPDLCs. The expressions of BMP2, OCN, OSX, RUNX2, β-catenin and cyclin D1 were increased by luteolin at concentrations of 0.01, 0.1, 1 μmol/L, noticeably, 1 μmol/L luteolin produced the strongest effects. In addition, XAV939 inhibited the expressions of calcification and osteogenic differentiation-related genes in HPDLCs, and 1 μmol/L luteolin availably decreased the inhibitory effect.

Conclusion

1 μmol/L luteolin accelerated osteogenic differentiation of HPDLCs via activating the Wnt/β-catenin pathway, which could be clinically applied to treat periodontal disease.
Palliative care training addressed to hospital healthcare professionals by palliative care specialists: a mixed-method evaluation
Authors: Artioli Giovanna , Bedini Gabriele , Bertocchi Elisabetta , Ghirotto Luca , Cavuto Silvio , Costantini Massimo , Tanzi Silvia
Published: October 2019

Background

Despite the great advances in the concept of palliative care (PC) and its benefits, its application seems to be delayed, leaving unfulfilled the many needs of patients and family members. One way to overcome this difficulty could be to develop a new training programme by palliative care specialists to improve PC primary skills in healthcare professionals. The aim of this study was to evaluate the training’s impact on trainees within a hospital setting using Kirkpatrick’s and Moore’s models.

Methods

We adopted a mixed-method evaluation with concurrent triangulation. The evaluation followed the first three steps of Kirkpatrick’s and Moore’s models and included a pre- and post-training evaluation through self-administered questionnaires and focus groups. We used the McNemar statistical test.

Results

The results highlighted the significant amount of knowledge acquired by the hospital professionals after training, in terms of increasing their knowledge of palliative care and in terms of the change in meaning that they attributed to phenomena related to chronicity and incurability, which they encounter daily in their professional practice. In both quantitative and qualitative research, the results, in synthesis, highlight:

(i) the development of a new concept of palliative care, centred on the response to the holistic needs of people;

(ii) that palliative care can also be extended to non-oncological patients in advanced illness stages (our training was directed to Geriatrics and Nephrology/Dialysis professionals);

(iii) the empowerment and the increase in self-esteem that healthcare professionals gained, from learning about the logistical and structural organization of palliative care, to activate and implement PC;

(iv) the need to share personal aspects of their professional life (this result emerges only in qualitative research);

(v) the appreciation of cooperation and the joining of multiple competences towards a synergistic approach and enhanced outcomes.

Conclusion

It is necessary to further develop rigorous research on training evaluation, at the most complex orders of the Kirkpatrick and Moore models, to measure primary PC skills in health care professionals. This will develop the effectiveness of the integration of I- and II-level palliative care competencies in hospitals and improve outcomes of patients’ and families’ quality of life.
The relationship between Iranian patients’ perception of holistic care and satisfaction with nursing care
Authors: Rajabpour Sahar , Rayyani Masoud , Mangolian shahrbabaki Parvin
Published: October 2019

Background

Holistic care is comprehensive care that emphasizes the interaction of human existential dimensions and has a significant role in accelerating the recovery process. Since nurses interact and communicate with patients more than other health care providers, the current study aimed to determine the Iranian patients’ perceptions of holistic care and overall satisfaction with nursing care.

Methods

It is a descriptive-correlational study done on patients admitted to the oncology wards of hospitals in southeastern Iran. The holistic caring inventory and patient satisfaction instrument were used to measure the patients’ perceptions of holistic care and their satisfaction, respectively. SPSS 19 was used to analyze the data.

Results

The results showed that there is a significant positive correlation between patients’ perception of holistic care and overall satisfaction with nursing care (P < 0.01,r = 032), which means that the higher the patients’ perception of holistic care, the greater their overall satisfaction. Based on the regression model, type of hospital, Patient’s perception of holistic care, education, previous experience of hospitalization, age and marriage are respectively predictors of overall satisfaction with nursing care (P < 0.05).

Conclusion

The present study showed that patients’ overall satisfaction with nursing care depends on holistic nursing care, meaning that nurses should pay attention to patients’ physical, mental, emotional aspects and increase the quality of care.
How executives’ expectations and experiences shape population health management strategies
Authors: Steenkamer Betty M. , Drewes Hanneke W. , van Vooren Natascha , Baan Caroline A. , van Oers Hans , Putters Kim
Published: October 2019

Background

Within Population Health Management (PHM) initiatives, stakeholders from various sectors apply PHM strategies, via which services are reorganised and integrated in order to improve population health and quality of care while reducing cost growth. This study unravelled how stakeholders’ expectations and prior experiences influenced stakeholders intended PHM strategies.

Methods

This study used realist principles. Nine Dutch PHM initiatives participated. Seventy stakeholders (mainly executive level) from seven different stakeholder groups (healthcare insurers, hospitals, primary care groups, municipalities, patient representative organisations, regional businesses and program managers of the PHM initiatives) were interviewed. Associations between expectations, prior experiences and intended strategies of the various stakeholder groups were identified through analyses of the interviews.

Results

Stakeholders’ expectations, their underlying explanations and intended strategies could be categorized into four themes: 1. Regional collaboration; 2. Governance structures and stakeholder roles; 3. Regional learning environments, and 4. Financial and regulative conditions. Stakeholders agreed on the long-term expectations of PHM development. Differences in short- and middle-term expectations, and prior experiences were identified between stakeholder groups and within the stakeholder group healthcare insurers. These differences influenced stakeholders’ intended strategies. For instance, healthcare insurers that intended to stay close to the business of care had encountered barriers in pushing PHM e.g. lack of data insight, and expected that staying in control of the purchasing process was the best way to achieve value for money. Healthcare insurers that were more keen to invest in experiments with data-technology, new forms of payment and accountability had encountered positive experiences in establishing regional responsibility and expected this to be a strong driver for establishing improvements in regional health and a vital and economic competitive region.

Conclusion

This is the first study that revealed insight into the differences and similarities between stakeholder groups’ expectations, experiences and intended strategies. These insights can be used to improve the pivotal cooperation within and between stakeholder groups for PHM.
Post-donation satisfaction in kidney transplantation: a survey of living donors in Japan
Authors: Kobayashi Sayaka , Akaho Rie , Omoto Kazuya , Shirakawa Hiroki , Shimizu Tomokazu , Ishida Hideki , Tanabe Kazunari , Nishimura Katsuji
Published: October 2019

Background

No studies using a valid, standardized method to measure post-donation satisfaction levels among living kidney donors (LKDs) have been published.

Methods

Donor satisfaction levels were measured using the Japanese version of the Client Satisfaction Questionnaire-8 (CSQ-8), a validated, self-report questionnaire. To identify factors related to post-donation satisfaction levels, we compared donors’ sociodemographic and psychological characteristics and health-related quality of life (HRQoL), using the Short Form-36 Health Survey (SF-36), as well as recipients’ clinical characteristics and SF-36 scores between donors with and without low satisfaction. In addition, donors’ perceptions of the donation results and transplant procedure were assessed using measures that we developed.

Results

The mean (standard deviation [SD]) CSQ-8 score for the 195 participants was 26.9 (3.4). Twenty-nine (14.9%) respondents with total scores < 1 SD below the mean CSQ-8 score were placed into the low satisfaction group. Multiple logistic regression analysis demonstrated that lower perceptions of receiving adequate information prior to transplantation (odds ratio [OR] = 0.17; 95% confidence interval [CI] = 0.079–0.379; p < 0.001), lower optimism according to the Life Orientation Test (OR = 1.24; 95% CI = 1.045–1.470; p = 0.014), and increased serum creatinine levels in the paired recipient (OR = 0.05; 95% CI = 0.250–1.011; p = 0.054) independently increased the odds of having less satisfaction with donation.

Conclusions

Our findings suggest that careful pre-donation education and more detailed informed consent may be needed, especially in LKDs with low constitutional optimism.
Improving quality of life in cancer patients through higher participation and health literacy: study protocol for evaluating the oncological social care project (OSCAR)
Authors: Frick Johann , Schindel Daniel , Gebert Pimrapat , Grittner Ulrike , Schenk Liane
Published: October 2019

Background

Cancer patients experience psychological and social distress due to their medical treatment and social issues. However, continuous and specialized social support is still lacking. In Germany, a group of company health insurance funds has developed an approach to support cancer patients with monthly structured interviews conducted by specially trained Social Care Nurses. The nurses will identify patient needs in order to provide help with medical, personal, and social matters. One aim of the scientific evaluation is to analyze the effect of the consultations on various patient-reported outcomes, especially quality of life. The evaluation concept will be described in this study protocol.

Methods/design

The evaluation is a non-randomized, controlled, multi-center intervention study with a mixed-method design. It consists of three research modules which include primary data from questionnaires, and claims data from the health insurance funds. In Module 1, cancer patients will be recruited to form an intervention group (OSCAR, n = 150) and a control group (n = 200) in four study centers for a period of 1 year. One baseline and three follow-up questionnaires will be conducted to survey the patient-reported outcomes. Relevant secondary outcomes are health literacy, participation, and physician-patient communication. In Module 2, claims data will be used to analyze cost effects and thereby assess effectivity and hospitalization. Module 3 will involve a qualitative analysis of project diaries kept by the Social Care Nurses. The diaries will record the nurses’ practical experiences and the benefits of deploying OSCAR across the German healthcare system.

Discussion

OSCAR is an innovative way of providing cancer patients with continuous support to improve their quality of life. The evaluation concept aims to assess the effects of the monthly consultations by the Social Care Nurses on the patients, and will use a mixed-method design. The results are important for assessing the transferability of OSCAR to the healthcare system as a whole.

Trial registration

German Clinical Trials Register (DRKS-ID: DRKS00013640). Registered 29 December 2017.
Horizontal return to work coordination was more common in RTW programs than the recommended vertical coordination. The Rapid-RTW cohort study
Authors: Skarpaas Lisebet Skeie , Haveraaen Lise Aasen , Småstuen Milada Cvancarova , Shaw William S. , Aas Randi Wågø
Published: October 2019

Background

In return-to-work (RTW) programs, coordinators are often provided in order to integrate services. However, models of coordinating services vary widely internationally, and across different programs, where one distinction is between vertical and horizontal integration (i.e. between levels/institutions, or within one service/level). The aim of this study was therefore to explore and describe if and how a coordinator was provided in RTW-programs, and whether the provision of a coordinator was associated with certain personal or intervention characteristics.

Methods

The study was designed as a cohort study following employees participating in a variety of Rapid-RTW-programs in Norway (n = 39). Employees (n = 494) answered a self-administered questionnaire, which was linked to register-data on diagnoses and sickness-absence. Employees who replied yes/no to the question “Did the program provide a person who tailored or coordinated your services?” were included in this analysis. Associations for being provided with a coordinator were tested in adjusted logistic regression models.

Results

Sixty-nine percent of the employees reported having a coordinator. These coordinators were mainly responsible for coordinating treatment within own programs (i.e. horizontal coordination, 68%). As expected, rehabilitation programs more often provided a coordinator compared to treatment programs (OR 3.87 95% CI 2.42–6.24). The odds for being provided with a coordinator were reduced for each additional year of age of the employee (OR 0.97, 95% CI 0.96–0.99). More professions were involved in programs that provided coordinators, also more contact with other stakeholders like leaders and social insurance services (NAV), but only contact with supervisor remained statistically significant in adjusted analysis (OR 1.69 95% CI 0.31–9.27). The programs with a coordinator more often provided adaptations at the workplace for the individual employee (OR 0.08 95% CI 0.01–0.60). However, these signs of vertical integration were only evident for a limited number of employees.

Conclusion

In this study, seven of ten employees reported to have a coordinator, which was associated with more professions and stakeholder involvement in the RTW-process. Most of these coordinators did not coordinate vertically between the service levels and types of intervention arenas for sick listed employees (i.e. workplace, social security, and health care services), as recommended in earlier research.
Implementation fidelity of village health and nutrition days in Hardoi District, Uttar Pradesh, India: a cross-sectional survey
Authors: Johri Mira , Rodgers Louis , Chandra Dinesh , Abou-Rizk Cybil , Nash Eleanor , Mathur Alok K.
Published: October 2019

Background

Village Health and Nutrition Days (VHNDs) are a cornerstone of the Government of India’s strategy to provide first-contact primary health care to rural areas. Recent government programmes such as the Janani Suraksha Yojana (JSY) and Mission Indradhanush (MI) have catalysed important changes impacting VHNDs. To learn how VHNDs are currently being delivered, we assessed the fidelity of services provided as compared to government norms in a priority district of Uttar Pradesh.

Methods

We fielded a cross-sectional study of VHNDs to provide a snapshot of health services functioning. Process evaluation data were collected via administrative sources, non-participant observation using a standardised form, and structured questionnaires. Questionnaires were designed using a framework to assess implementation fidelity. Key respondents were VHND participants, front-line workers involved in VHND delivery, and VHND non-participants (pregnant women due for antenatal care or children due for vaccination as per administrative records). Results were summarised as counts, frequencies, and proportions.

Results

In the 30 villages randomly selected for inclusion, 36 VHNDs were scheduled but four (11.1%) were cancelled and one VHND was not surveyed. Vaccination and antenatal care were offered at 96.8% (30/31) and child weighing at 83.9% (26/31) of VHNDs. Other normed services were infrequently provided or completely absent. Health education and promotion were particularly weak; institutional delivery was the only topic discussed in a majority of VHNDs. The true proportion of any serious problem impeding vaccine delivery was 47.2% (17/36), comprising 4 VHND cancellations and 13 VHNDs experiencing vaccine shortages. Of the 13 incidents of vaccine shortage, 11 related to an unexpected global shortage of injectable polio vaccine (IPV). Over the 31 VHNDs, 37.8% (171 of the 452 scheduled beneficiaries) did not participate. Analysis of missed opportunities for vaccination highlighted inaccuracies in beneficiary identification and tracking and demand side-factors.

Conclusions

The transformative potential of VHNDs to improve population health is only partially being met. A core subset of high-priority services for antenatal care, institutional delivery, and vaccination associated with high-priority government programmes (JSY, MI) is now being provided quite successfully. Other basic health promotion and prevention services are largely not provided, constituting a critical missed opportunity.
Leptospira spp. and Toxoplasma gondii in stranded representatives of wild cetaceans in the Philippines
Authors: Obusan Marie Christine M. , Villanueva Ren Mark D. , Siringan Maria Auxilia T. , Rivera Windell L. , Aragones Lemnuel V.
Published: October 2019

Background

The stranding events of cetaceans in the Philippines provide opportunities for gathering biological information and specimens, especially from the pelagic forms. As part of an effort to monitor the health of wild cetaceans, this study detected Leptospira spp. and Toxoplasma gondii, causative agents of the emerging zoonotic diseases leptospirosis and toxoplasmosis respectively, in their stranded representatives. From October 2016–August 2018, 40 cetaceans (representing 14 species) that stranded nationwide were sampled for brain, cardiac muscle, skeletal muscle, kidney, and blood tissues, urine, and sera. These were subjected to molecular, serological, culture, and histopathological analyses to detect the target pathogens.

Results

T. gondii was detected in 20 (71%) of the 28 cetaceans with biological samples subjected to either molecular detection through RE gene amplification or IgG antibodies detection through agglutination-based serological assay. On the other hand, Leptospira was detected in 18 (64%) of 28 cetaceans with biological samples subjected to bacterial culture, molecular detection through 16S rDNA amplification, or IgM antibodies detection through ELISA-based serological assay.

Conclusions

There is the plausibility of toxoplasmosis and leptospirosis in cetacean populations found in the Philippines, however, acute or chronic phases of infections in sampled stranded individuals cannot be confirmed in the absence of supporting pathological observations and corroborating detection tests. Further studies should look for more evidences of pathogenicity, and explore the specific mechanisms by which pelagic cetacean species become infected by Leptospira spp. and T. gondii. As there is growing evidence on the role of cetaceans as sentinels of land-sea movement of emerging pathogens and the diseases they cause, any opportunity, such as their stranding events, should be maximized to investigate the health of their populations. Moreover, the role of leptospirosis or toxoplasmosis in these stranding events must be considered.
Preliminary study on the effects of enrofloxacin, flunixin meglumine and pegbovigrastim on Mycoplasma bovis pneumonia
Authors: Dudek Katarzyna , Bednarek Dariusz , Ayling Roger D. , Kycko Anna , Reichert Michał
Published: October 2019

Background

Mycoplasma bovis is a causative agent of disease in cattle causing many clinical conditions. Currently there are no commercial M. bovis vaccines in Europe and treatment is difficult with decreased antimicrobial susceptibility of M. bovis field isolates. Using an M. bovis calf infection model the effectiveness of enrofloxacin given alone; in combination with flunixin meglumine, a nonsteroidal anti-inflammatory drug; and a group with an additional treatment of pegbovigrastim, an immunostimulator, was evaluated.

Results

Enrofloxacin given alone stimulated a strong immune response, reduced the clinical manifestation and lung lessions of the M. bovis infection. In contrast the combination therapy appeared ineffective.

Conclusions

In this experiment enrofloxacin given alone appeared to be the most effective treatment of the M. bovis affected calves, whereas co-administration with flunixin meglumine, and pegbovigrastim was not beneficial in this trial.
High ectoine production by an engineered Halomonas hydrothermalis Y2 in a reduced salinity medium
Authors: Zhao Qi , Li Shannan , Lv Peiwen , Sun Simian , Ma Cuiqing , Xu Ping , Su Haijun , Yang Chunyu
Published: October 2019

Background

As an attracted compatible solute, 1,4,5,6-tetrahydro-2-methyl-4-pyrimidinecarboxylic acid (ectoine) showed great potentials in various field. However, lower productivity and high saline medium seriously hinder its wide applications.

Results

The entire ectoine metabolism, including pathways for ectoine synthesis and catabolism, was identified in the genome of an ectoine-excreting strain Halomonas hydrothermalis Y2. By in-frame deletion of genes encoding ectoine hydroxylase (EctD) and (or) ectoine hydrolase (DoeA) that responsible for ectoine catabolism, the pathways for ectoine utilization were disrupted and resulted in an obviously enhanced productivity. Using an optimized medium containing 100 g L−1 NaCl in a 500-mL flask, the double mutant of Y2/ΔectD/ΔdoeA synthesized 3.13 g L−1 ectoine after 30 h cultivation. This is much higher than that of the wild type strain (1.91 g L−1), and also exceeds the production of Y2/ΔectD (2.21 g L−1). The remarkably enhanced accumulation of ectoine by Y2/ΔectD/ΔdoeA implied a critical function of Doe pathway in the ectoine catabolism. Furthermore, to reduce the salinity of fermentation medium and overcome the wastewater treatment difficulty, mutants that lacking key Na+/H+ antiporter, Mrp and (or) NhaD2, were constructed based on strain Y2/ΔectD/ΔdoeA. As a result, the Mrp-deficient strain could synthesize equal amount of ectoine (around 7 g L−1 or 500 mg (g DCW) −1) in the medium containing lower concentration of NaCl. During a fed-batch fermentation process with 60 g L−1 NaCl stress, a maximum 10.5 g L−1 ectoine was accumulated by the Mrp-deficient strain, with a specific production of 765 mg (g DCW)−1 and a yield of 0.21 g g−1 monosodium glutamate.

Conclusion

The remarkably enhanced production of ectoine by Y2/ΔectD/ΔdoeA implied the critical function of Doe pathway in the ectoine catabolism. Moreover, the reduced salinity requirement of Mrp-deficient strain implied a feasible protocol for many compatible solute biosynthesis, i.e., by silencing some Na+/H+ antiporters in their halophilic producers and thus lowering the medium salinity.
Unravelling the diversity of glycoside hydrolase family 13 α-amylases from Lactobacillus plantarum WCFS1
Authors: Plaza-Vinuesa Laura , Hernandez-Hernandez Oswaldo , Moreno F. Javier , de las Rivas Blanca , Muñoz Rosario
Published: October 2019

Background

α-Amylases specifically catalyse the hydrolysis of the internal α-1, 4-glucosidic linkages of starch. Glycoside hydrolase (GH) family 13 is the main α-amylase family in the carbohydrate-active database.Lactobacillus plantarumWCFS1 possesses eleven proteins included in GH13 family. Among these, proteins annotated as maltose-forming α-amylase (Lp_0179) and maltogenic α-amylase (Lp_2757) were included.

Results

In this study, Lp_0179 and Lp_2757L. plantarumα-amylases were structurally and biochemically characterized. Lp_2757 displayed structural features typical of GH13_20 subfamily which were absent in Lp_0179. Genes encoding Lp_0179 (Amy2) and Lp_2757 were cloned and overexpressed inEscherichia coliBL21(DE3). Purified proteins showed high hydrolytic activity onpNP-α-D-maltopyranoside, being the catalytic efficiency of Lp_0179 remarkably higher. In relation to the hydrolysis of starch-related carbohydrates, Lp_0179 only hydrolysed maltopentaose and dextrin, demonstrating that is an exotype glucan hydrolase. However, Lp_2757 was also able to hydrolyze cyclodextrins and other non-cyclic oligo- and polysaccharides, revealing a great preference towards α-1,4-linkages typical of maltogenic amylases.

Conclusions

The substrate range as well as the biochemical properties exhibited by Lp_2757 maltogenic α-amylase suggest that this enzyme could be a very promising enzyme for the hydrolysis of α-1,4 glycosidic linkages present in a broad number of starch-carbohydrates, as well as for the investigation of an hypothetical transglucosylation activity under appropriate reaction conditions.
Lower than average HDL cholesterol efflux capacity in Lithuanian population
Authors: Kutkiene Sandra , Petrulioniene Zaneta , Karciauskaite Dovile , Laucevicius Aleksandras , Matuzevicienė Gabija , Staigyte Justina , Mikulskiene Akvilė Saulyte , Gargalskaite Urte , Skiauteryte Egle , Kovaite Milda
Published: October 2019

Background

The aim of our study was to evaluate high-density lipoprotein cholesterol (HDL-C) efflux capacity in healthy controls and patients with severe dyslipidemia. Evaluation of HDL function may be beneficial for better understanding of cardiovascular diseases, as well as for taking actions to minimize residual cardiovascular risk.

Methods

During 2016–2017 a total of 93 participants – 48 (51.6%) women and 45 (48.4%) men – were included in this cross-sectional study. Data of 45 (48.4%) participants with severe dyslipidemia (SD) and 48 (51.6%) controls without dyslipidemia was used for statistical analysis. Total lipid panel, concentration of lipoprotein (a) and apolipoproteins were measured, data about cardiovascular risk factors were collected and detailed evaluation of HDL-C quality was performed for all patients.

Results

Increased HDL-C concentration was associated with higher ApoA1 (r = 0.866 in controls, r = 0.63 in SD group), ApoA2 (r = 0.41 in controls, r = 0.418 in SD group) and LDL-C concentrations (r = − 0.412 in SD group), lower ApoE (r = − 0.314 in SD group) and TG concentrations (r = − 0.38 in controls, r = − 0.608 in SD group), lower ApoB/ApoA1 ratio (r = − 0.567 in control group), below average HDL-C efflux capacity (r = − 0.335 in SD group), lower BMI (r = − 0.327 in controls, r = − 0.531 in SD group) and abdominal circumference (r = − 0.309 in women with SD). Below-average HDL-C efflux capacity was found in 67.7% (N = 63) of participants. It was more often found among patients with normal weight or BMI 30–31 kg/m2. HDL-C efflux capacity was inversely associated with HDL-C concentration (r = − 0.228).

Conclusion

Abnormal HDL function may be associated with residual cardiovascular risk in Lithuanian population.
DEMQOL and DEMQOL-Proxy: a Rasch analysis among those diagnosed with dementia
Authors: Hendriks A. A. Jolijn , Smith Sarah C. , Black Nick
Published: October 2019

Background

In previous work we concluded that DEMQOL and DEMQOL-Proxy can provide robust measurement of HRQL in dementia when scores are derived from analysis using the Rasch model. As the study sample included people with mild cognitive impairment, we undertook a replication study in the subsample with a diagnosis of dementia (PWD). PWD constitute the population for whom DEMQOL and DEMQOL-Proxy were originally developed.

Methods

We conducted a Rasch model analysis using the RUMM2030 software to re-evaluate DEMQOL (441 PWD) and DEMQOL-Proxy (342 family carers). We evaluated scale to sample targeting, ordering of item thresholds, item fit to the model, and differential item functioning (sex, age, severity, relationship), local independence, unidimensionality and reliability.

Results

For both DEMQOL and DEMQOL-Proxy, results were highly similar to the results in the original sample. We found the same problems with content and response options.

Conclusions

DEMQOL and DEMQOL-Proxy can provide robust measurement of HRQL in people with a diagnosis of dementia when scores are derived from analysis using the Rasch model. As in the wider sample, the problems identified with content and response options require qualitative investigation in order to improve the scoring of DEMQOL and DEMQOL-Proxy.
Angioedema quality of life questionnaire (AE-QoL) - interpretability and sensitivity to change
Authors: Kulthanan Kanokvalai , Chularojanamontri Leena , Rujitharanawong Chuda , Weerasubpong Puncharas , Maurer Marcus , Weller Karsten
Published: October 2019

Background

The Angioedema Quality of Life (AE-QoL) is the first patient reported outcome measure developed for the assessment of quality of life (QoL) impairment in patients with recurrent angioedema (RAE). This study aimed to evaluate the clinimetric properties of the AE-QoL in Thai patients and to establish categories of QoL impairment assessed by the AE-QoL.

Methods

The validated Thai version of the Dermatology Life Quality Index (DLQI) and Patient Global Assessment of Quality of Life (PGA-QoL) were used to comparatively evaluate the Thai version of AE-QoL. Spearman correlations between the Thai AE-QoL and two other standard measurements (DLQI and PGA-QoL) were investigated to determine convergent validity. The Thai DLQI and PGA-QoL were used to categorize patients according to their QoL. Known-group validity of the Thai AE-QoL was later analyzed. The reliability of the Thai AE-QoL was investigated using Cronbach’s alpha and intraclass correlation. Three different approaches including the distribution method, receiver operating characteristic curve analysis, and the anchor based-method were used for the interpretability.

Results

A total of 86 patients with RAE with a median age of 38.0 ± 15.1 years (range 18–76) were enrolled. Of those, 76 patients (88%) had RAE with concomitant wheals, and 10 patients (11.6%) had RAE only. The AE-QoL assessed RAE-mediated QoL impairment with high convergent validity and known-groups validity, high internal consistency and test-retest reliability, and good sensitivity to change. Although the AE-QoL did not differentiate between patients with moderate and large effect as measured by PGA-QoL or DLQI in this study, AE-QoL total values of 0–23, 24 to 38, and ≥ 39 could define patients with “no effect”, “small effect”, and “moderate to large effect” of RAE on their QoL, respectively.

Conclusions

This study supports the validity and reliability of the Thai version of the AE-QoL, which is a very different language from the original version. Categories allow to classify the effect of RAE on patients’ QoL as “none”, “small”, and “moderate to large”. Further studies are needed to confirm the applicability of AE-QoL in other Asian populations”.
The PPAR-γ antagonist T007 inhibits RANKL-induced osteoclastogenesis and counteracts OVX-induced bone loss in mice
Authors: Li Xiang , Ning Lei , Ma Jianjun , Xie Ziang , Zhao Xiangde , Wang Gangliang , Wan Xinyu , Qiu Pengcheng , Yao Teng , Wang Haoming , Fan Shunwu , Wan Shuanglin
Published: October 2019

Background

Osteoclasts are key determinant cellular components implicated in the development and progression of disorders driven by bone damage. Herein, we studied the upshot of T007, an antagonist of peroxisome proliferator-activated receptor-gamma (PPARγ), on osteoclastogenesis using cell and animal models.

Results

The in vitro assays revealed that T007 hindered the osteoclastogenesis caused by the treatment with the receptor activator of nuclear factor-κB ligand (RANKL) through inhibiting the levels of PPARγ in cells. The PPARγ siRNA partially reproduced the inhibitory action of T007. The opposite findings were produced after PPARγ overexpression. Furthermore, T007 prevented from bone loss in a mouse model of osteoporosis induced by ovariectomy (OVX). These findings implied that T007 is a potential efficient drug for the prophylaxis and cure of osteoclast-related disorders.

Conclusions

Taken together, our findings demonstrated that T007 impedes osteoclastogenesis and will be useful for the therapy of bone related diseases, essentially osteoporosis.
Effect of induced dNTP pool imbalance on HIV-1 reverse transcription in macrophages
Authors: Shepard Caitlin , Xu Joella , Holler Jessica , Kim Dong-Hyun , Mansky Louis M. , Schinazi Raymond F. , Kim Baek
Published: October 2019

Background

Terminally differentiated/nondividing macrophages, a key target cell type of HIV-1, harbor extremely low dNTP concentrations established by a host dNTP triphosphohydrolase, SAM domain and HD domain containing protein 1 (SAMHD1). We tested whether the induction of dNTP pool imbalance can affect HIV-1 replication in macrophages. For this test, we induced a large dNTP pool imbalance by treating human primary monocyte derived macrophages with either one or three of the four deoxynucleosides (dNs), which are phosphorylated to dNTPs in cells, to establish two different dNTP imbalance conditions in macrophages.

Results

The transduction efficiency and 2-LTR circle copy number of HIV-1 GFP vector were greatly diminished in human primary macrophages treated with the biased dN treatments, compared to the untreated macrophages. We also observed the induced dNTP bias blocked the production of infectious dual tropic HIV-1 89.6 in macrophages. Moreover, biochemical DNA synthesis by HIV-1 reverse transcriptase was significantly inhibited by the induced dNTP pool imbalance. Third, the induced dNTP bias increased the viral mutant rate by approximately 20–30% per a single cycle infection. Finally, unlike HIV-1, the single dN treatment did not significantly affect the transduction of SIVmac239-based GFP vector encoding Vpx in macrophages. This is likely due to Vpx, which can elevate all four dNTP levels even with the single dN treatment.

Conclusion

Collectively, these data suggest that the elevated dNTP pool imbalance can induce kinetic block and mutation synthesis of HIV-1 in macrophages.