bluuebunny/crossref_metadata_2025 huggingface dataset:
Types of Stove in Use and Respiratory and Eye Health of Nepal Rural Housewives: A Cross-Sectional Study
Authors: Han Changwoo , Sanjel Seshananda , Shakya Prabin , Lee Woo-Seok , Kim Woo-Sung , Karmacharya Biraj , Neupane Biraj , Hong Yun-Chul
Published: September 2020

BackgroundsHealth benefits of energy transition from solid fuels to cleaner fuels can be evaluated in field study of developing countries. Even a simple cross-sectional studies may be useful for estimation of the health benefits. This study was conducted in rural Nepal with the hypothesis that the gas stove and clean fuel users may have better respiratory and eye health compared to traditional stove and solid fuel users due to the low household air pollution levels.MethodsFrom July to August 2018, we recruited 90 housewives who resided in a rural Nepal village (Nuwakot District, Likhu Municipality). We conducted a questionnaire survey, physical examination, blood test, and 24-hour monitoring of particulate matter less than 2.5 μm in diameter (PM2.5) levels in kitchen. Logistic regression analysis was used to evaluate the association of types of stove used in kitchens with respiratory and eye symptoms in housewives.ResultsOf 90 participants, 42 and 43 used traditional and gas stove as their primary stove, respectively. Over 28% and 75% of participants experienced mild to moderate airway obstruction and watery eye symptoms during cooking. The odds ratios (95% confidence interval) of chronic cough [0.30 (0.05, 1.86)], wheezing [0.30 (0.06, 1.49)], phlegm [0.36 (0.08, 1.53)], shortness of breath [0.81 (0.31, 2.09)], high chronic obstructive pulmonary disease assessment test scores [0.36 (0.10, 1.30)], and watery eye symptoms during cooking [0.14 (0.04, 0.51)] were lower in gas stove users compared to the traditional stove users. The average 24-hour kitchen PM2.5 concentrations were lower in gas stove user houses (11 μg/m3) than in traditional stove user houses (33 μg/m3).ConclusionsGas stove and clean fuel use may be beneficial for reducing eye discomfort during cooking. Further longitudinal and intervention studies are needed to conclude whether the transition from solid fuels to cleaner fuels will be beneficial for the respiratory and eye health of Nepalese housewives.
Molecular detection of Rickettsia in fleas from micromammals in Chile
Authors: Salas Lucila Moreno , Carniglia Mario Espinoza , Schmeisser Nicol Lizama , Fuentes Luis Gonzalo Torres , Fuente María Carolina Silva de la , Lareschi Marcela , Acuña Daniel González
Published: September 2020

Background: Rickettsial diseases are considered important in public health due to their dispersal capacity determined by the particular characteristics of their reservoirs and / or vectors. Among the latter, fleas play an important role, since the vast majority of species parasitize wild and invasive rodents, so their detection is relevant to be able to monitor potential emerging diseases. The aim of this study was to detect, characterize, and compare Rickettsia spp. from the fleas of micromammals in areas with different human population densities in Chile.Methods: The presence of Rickettsia spp. was evaluated by standard polymerase chain reaction (PCR) and sequencing in 1,315 fleas collected from 1,512 micromammals in 29 locations, with different human population densities in Chile. A generalized linear models (GLM) was used to identify the variables that may explain Rickettsia prevalence in fleas. Results: DNA of Rickettsia spp. was identified in 13.2% (174 of 1,315) of fleas tested. Fifteen flea species were found to be Rickettsia-positive. The prevalence of Rickettsia spp. was higher in winter, semi-arid region and natural areas, and the infections in fleas varied between species of fleas. The prevalence of Rickettsia among flea species ranged from 0%–35.1%. Areas of lower human density have the highest prevalence of Rickettsia. The phylogenetic tree shows two well-differentiated clades. Rickettsia bellii is positioned as basal in a clade. Another clade is subdivided into two subclades, and are related to Rickettsia of spotted fever group.Conclusions: To our knowledge, this is the first report of the occurrence and molecular characterization of Rickettsia spp. in 15 species of fleas of micromammals in Chile. In this study, fleas were detected carrying Rickettsia DNA with zoonotic potential, mainly in villages and natural areas of Chile. Considering that there are differences in the prevalence of Rickettsia in fleas associated with different factors, more investigations are needed to further understand the ecology of Rickettsia in fleas and their implications for human health.
DjinniChip: Evaluation of a novel molecular rapid diagnostic device for the detection of Chlamydia trachomatis in trachoma-endemic areas
Authors: Derrick Tamsyn R , Sandetskaya Natalia , Pickering Harry , Kölsch Andreas , Ramadhani Athumani , Mafuru Elias , Massae Patrick , Malisa Aiweda , Mtuy Tara , Burton Matthew J , Holland Martin J , Kuhlmeier Dirk
Published: September 2020

Background

The clinical signs of active trachoma are often present in the absence of ocular Chlamydia trachomatis infection, particularly following mass drug administration. Treatment decisions following impact surveys and in post-control surveillance for communities are currently based on the prevalence of clinical signs, which may result in further unnecessary distribution of mass antibiotic treatment and the increased spread of macrolide resistance alleles in ‘off-target’ bacterial species. We therefore developed a simple, fast, low cost diagnostic assay (DjinniChip) for diagnosis of ocular C. trachomatis for use by trachoma control programmes.

Methods

The study was conducted in London, Germany and Tanzania. For clinical testing in Tanzania, specimens from a sample of 350 children between the ages of 7 to15 years, which were part of a longitudinal cohort that began in February 2012 were selected. Two ocular swabs were taken from the right eye. The second swab was collected dry, kept cool in the field and archived at -80 o C before sample lysis for DjinniChip detection and parallel nucleic acid purification and detection/quantification by qPCR assay.

Results

Djinnichip was able to reliably detect >10 copies of C. trachomatis per test and correctly identified 7/10 Quality Control for Molecular Diagnostics C. trachomatis panel samples, failing to detect 3 positive samples with genome equivalent amounts >10 copies. Djinnichip performed well across a range of typical trachoma field conditions and when used by lay personnel using a series of mock samples. In the laboratory in Tanzania, using clinical samples the sensitivity and specificity of DjinniChip for C. trachomatis was 66% (95% CI 51–78) and 94.8 (95% CI 91–97%) with an overall accuracy of 90.1 (95% CI 86.4 – 93).

Conclusions

DjinniChip performance is extremely promising, particularly its ability to detect low concentrations of C. trachomatis and its usability in field conditions. The DjinniChip requires further development to reduce inhibition and advance toward a closed system. DjinniChip results did not vary between local laboratory results and typical trachoma field settings, illustrating its potential for use in low-resource areas to prevent unnecessary rounds of MDA and to monitor for C. trachomatis recrudescence.
Metabolic characterization of aggressive breast cancer cells exhibiting invasive phenotype: Impact of non-cytotoxic doses of 2-DG on diminishing invasiveness
Authors: Fujita Mayumi , Imadome Kaori , Somasundaram Veena , Kawanishi Miki , Karasawa Kumiko , Wink David A.
Published: September 2020

Background

Metabolic reprogramming is being recognized as a fundamental hallmark of cancer, and efforts to identify drugs that can target cancer metabolism are underway. In this study, we used human breast cancer (BC) cell lines and established their invading phenotype (INV) collected from transwell inserts to compare metabolome differences and evaluate prognostic significance of the metabolome in aggressive BC invasiveness.

Methods

The invasiveness of seven human BC cell lines were compared using the transwell invasion assay. Among these, INV was collected from SUM149, which exhibited the highest invasiveness. Levels of metabolites in INV were compared with those of whole cultured SUM149 cells (WCC) using CE-TOFMS. The impact of glycolysis in INV was determined by glucose uptake assay using fluorescent derivative of glucose (2-NBDG), and significance of glycolysis, or tricarboxylic acid (TCA) and electron transport chain (ETC) in the invasive process were further determined in aggressive BC cell lines, SUM149, MDA-MB-231, HCC1937, using invasion assays in the presence or absence of inhibitors of glycolysis, TCA cycle or ETC.

Results

SUM149 INV sub-population exhibited a persistent hyperinvasive phenotype. INV were hyper-glycolytic with increased glucose (2-NBDG) uptake; diminished glucose-6-phosphate (G6P) levels but elevated pyruvate and lactate, along with higher expression of phosphorylated-pyruvate dehydrogenase (pPDH) compared to WCC. Notably, inhibiting of glycolysis with lower doses of 2-DG (1 mM), non-cytotoxic to MDA-MB-231 and HCC1937, was effective in diminishing invasiveness of aggressive BC cell lines. In contrast, 3-Nitropropionic acid (3-NA), an inhibitor of succinate dehydrogenase, the enzyme that oxidizes succinate to fumarate in TCA cycle, and functions as complex II of ETC, had no significant effect on their invasiveness, although levels of TCA metabolites or detection of mitochondrial membrane potential with JC-1 staining, indicated that INV cells originally had functional TCA cycles and membrane potential.

Conclusions

Hyper-glycolytic phenotype of invading cells caters to rapid energy production required for invasion while TCAcycle/ETC cater to cellular energy needs for sustenance in aggressive BC. Lower, non-cytotoxic doses of 2-DG can hamper invasion and can potentially be used as an adjuvant with other anti-cancer therapies without the usual side-effects associated with cytotoxic doses.
Two Stepped Majority Voting for Efficient EEG based Emotion Classification
Authors: Ismael aras Masood , Alçin Ömer F , Abdalla Karmand H , sengur Abdulkadir k
Published: September 2020

In this paper, a novel approach that is based on two-stepped majority voting is proposed for efficient EEG based emotion classification. Emotion recognition is important for human-machine interactions. Facial-features and body-gestures based approaches have been generally proposed for emotion recognition. Recently, EEG based approaches become more popular in emotion recognition. In the proposed approach, the raw EEG signals are initially low-pass filtered for noise removal and band-pass filters are used for rhythms extraction. For each rhythm, the best performed EEG channels are determined based on wavelet-based entropy features and fractal dimension based features. The k-nearest neighbor (KNN) classifier is used in classification. The best five EEG channels are used in majority voting for getting the final predictions for each EEG rhythm. In the second majority voting step, the predictions from all rhythms are used to get a final prediction. The DEAP dataset is used in experiments and classification accuracy, sensitivity and specificity are used for performance evaluation metrics. The experiments are carried out to classify the emotions into two binary classes such as high valence (HV) vs low valence (LV) and high arousal (HA) vs low arousal (LA). The experiments show that 86.3% HV vs LV discrimination accuracy and 85.0% HA vs LA discrimination accuracy is obtained. The obtained results are also compared with some of the existing methods. The comparisons show that the proposed method has potential in the use of EEG based emotion classification.
Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection
Authors: Maguire Donogh , Woods Marylynne , Richards Conor , Dolan Ross , Veitch Jesse Wilson , Sim Wei MJ , Kemmett Olivia EH , Milton David C , Randall Sophie LW , Bui Ly D , Goldmann Nicola , Cameron Allan , Laird Barry , Talwar Dinesh , Godber Ian , Davidson Alan , McMillan Donald C
Published: September 2020

BackgroundSevere COVID-19 infection results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure. MethodsElectronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020 - 1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age, sex, BMI and documented evidence of COVID-19 infection at time of discharge or death certification were considered minimal criteria for inclusion.ResultsOf the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure (75%) and multiorgan failure (12%) were the commonest causes of death recorded. Age>70 years (p<0.001), past medical history of cognitive impairment (p<0.001), previous delirium (p<0.001), clinical frailty score>3 (p<0.001), hypertension (p<0.05), heart failure (p<0.01), national early warning score (NEWS) >4 (p<0.01), positive CXR (p<0.01), and subsequent positive COVID-19 swab (p<0.001) were associated with 30-day mortality. CRP>80 mg/L (p<0.05), albumin <35g/L (p<0.05), peri-operative Glasgow Prognostic Score (poGPS) (p<0.05), lymphocytes <1.5 109/l (p<0.05), neutrophil lymphocyte ratio (p<0.001), haematocrit (<0.40 L/L (male) / <0.37 L/L (female)) (p<0.01), urea>7.5 mmol/L (p<0.001), creatinine >130 mmol/L (p<0.05) and elevated urea: albumin ratio (<0.001) were also associated with 30-day mortality.On multivariate analysis, age >70 years (O.R. 3.9, 95% C.I. 1.4 – 8.2, p<0.001), past medical history of heart failure (O.R. 3.3, 95% C.I. 1.2 – 19.3, p<0.05), NEWS >4 (O.R. 2.4, 95% C.I. 1.1 – 4.4, p<0.05), positive initial CXR (O.R. 0.4, 95% C.I. 0.2-0.9, p<0.05) and poGPS (O.R. 2.3, 95% C.I. 1.1 – 4.4, p<0.05) remained independently associated with 30-day mortality. Among those patients who tested PCR COVID-19 positive (n=122), age >70 years (O.R. 4.7, 95% C.I. 2.0 - 11.3, p<0.001), past medical history of heart failure (O.R. 4.4, 95% C.I. 1.2 – 20.5, p<0.05) and poGPS (O.R. 2.4, 95% C.I. 1.1- 5.1, p<0.05) remained independently associated with 30-days mortality.ConclusionAge > 70 years and severe systemic inflammation as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection.
Prevalence, predictors, and mortality of bloodstream infections due to methicillin-resistant Staphylococcus aureus in patients with malignancy: systemic review and meta-analysis
Authors: Li Zhouqi , Zhuang Hemu , Wang Guannan , Wang Hui , Dong Ying
Published: September 2020

Background: Cancer patients are more likely to develop and die of bloodstream infection (BSI) than noncancer patients. Methicillin-resistant Staphylococcus aureus (MRSA), which is associated with immense mortality and economic burden worldwide, is not covered by the recommended initial antibiotic therapy for cancer patients with BSI. This systemic review was performed to estimate the global methicillin-resistant Staphylococcus aureus (MRSA) prevalence among bacteremia in patients with malignancy, and further study the predictors and mortality of cancer patients with MRSA bacteremia.Methods: The PubMed and EMBASE databases were searched for studies published from Jan. 2000 to Mar. 2020 that provided primary data on the prevalence, predictors, or mortality of MRSA bacteremia in cancer patients. A random-effects model meta-analysis was performed to estimate the pooled prevalence of MRSA with 95% confidence intervals (95% CIs).Results: The pooled prevalence of MRSA was 3% (95% CI 2–5%) among all bloodstream infections (BSIs) and 44% (95% CI 32–57%) among S. aureus bacteremia in cancer patients. Based on geographical stratification, the pooled prevalence was 5% in Africa (95% CI 1–14%), 1% in Americas (95% CI 1–2%), 2% in Europe (95% CI 1–4%), 4% in Western Pacific (95% CI 2–7%), 8% in South-east Asia (95% CI 4–14%) and 0% in Eastern Mediterranean (95% CI 0–3%). No significant temporal change in MRSA rates was detected in this analysis (R2 = 0.06; P=0.24). Predictors for MRSA BSIs among cancer patients were identified by comparison with their methicillin-susceptible counterparts, and they were mainly related to healthcare-associated infections and immunosuppression. Finally, the 60-day mortality in adult cancer patients with MRSA BSIs was reported to be 12%, and the 6-month overall mortality was 43.2%, with community-onset infection, secondary BSI, and vancomycin MIC≥2g/mL being the risk factors for mortality.Conclusions: Although the prevalence of MRSA BSIs among cancer patients is relatively low, it did not decline over time as MRSA BSIs in the general hospital population and the high mortality rate was related to MRSA BSIs in patients with malignancy.
Extracellular vesicles from the apoplastic fungal wheat pathogen Zymoseptoria tritici
Authors: Hill Erin H , Solomon Peter
Published: September 2020

Background: The fungal pathogen Zymoseptoria tritici is a significant constraint to wheat production in temperate cropping regions around the world. Despite its agronomic impacts, the mechanisms allowing the pathogen to asymptomatically invade and grow in the apoplast of wheat leaves before causing extensive host cell death remain elusive. Given recent evidence of extracellular vesicles (EVs) – secreted, membrane-bound nanoparticles containing molecular cargo – being implicated in extracellular communication between plants and fungal pathogen, we have initiated an in vitro investigation of EVs from this apoplastic fungal wheat pathogen. We aimed to isolate EVs from Z. tritici broth cultures and examine their protein composition in relation to the soluble protein in the culture filtrate and to existing fungal EV proteomes.Results: Zymoseptoria tritici EVs were isolated from broth culture filtrates using differential ultracentrifugation (DUC) and examined with transmission electron microscopy (TEM) and nanoparticle tracking analysis (NTA). Z. tritici EVs were observed as a heterogeneous population of particles, with most between 50 – 250 nm. These particles were found in abundance in the culture filtrates of viable Z. tritici cultures, but not heat-killed cultures incubated for an equivalent time and of comparable biomass. Bottom-up proteomic analysis using LC-MS/MS, followed by stringent filtering revealed 240 Z. tritici EV proteins. These proteins were distinct from soluble proteins identified in Z. tritici culture filtrates, but were similar to proteins identified in EVs from other fungi, based on sequence similarity analyses. Notably, a putative marker protein recently identified in Candida albicans EVs was also consistently detected in Z. tritici EVs.Conclusion: We have shown EVs can be isolated from the devastating fungal wheat pathogen Z. tritici and are similar to protein composition to previously characterised fungal EVs. EVs from human pathogenic fungi are implicated in virulence, but the role of EVs in the interaction of phytopathogenic fungi and their hosts is unknown. These in vitro analyses provide a basis for expanding investigations of Z. tritici EVs in planta, to examine their involvement in the infection process of this apoplastic wheat pathogen and more broadly, advance understanding of noncanonical secretion in filamentous plant pathogens.
Epidemiological Survey of the Elderly Removable Denture Subsidy Program in Taiwan, 2015–2018: A Cross-sectional Study
Authors: CHU KUAN-YU
Published: September 2020

Background: Taiwan’s population is aging rapidly. Elderly adults with missing teeth require dental rehabilitation to maintain good oral health, which is important for proper nutrition and overall health and life quality. Removable dentures are an economical option for these individuals, for which many county and municipal governments in Taiwan provide subsidies. In this cross-sectional study, we investigated the demographic characteristics of older Taiwanese adults who received a removable denture subsidy, as well as the type of denture obtained and related factors. Methods: We administered a survey and conducted oral examinations among elderly patients of the Geriatric Dentistry clinic of Taoyuan Hospital who had participated in a removable prosthesis subsidy program during 2015–2018. We investigated patients’ demographic characteristics using descriptive statistics and used logistic regression to determine whether age and sex were independent predictors of edentulous status and a need for complete dentures. We also examined the relationships between denture type and related factors. Results: In total, 423 participants (mean age 76.3 years, standard deviation 7.55; 54.4% men) completed the subsidy application process and obtained a removable dental prosthesis. In total, 150 (35.5%) participants applied for single-arch restoration. A removable partial denture (RPD) was the most common type for single jaws, and an RPD and full dentures were the most common for both arches. Logistic regression indicated an effect of age, but not sex, on denture type and edentulous status among 273 subsidy applicants for both arches (odds ratio: 1.041 per year of age, 95% confidence interval: 1.004–1.080, P=0.032). Conclusions: This study confirms that there is a great need for dental rehabilitation among elderly Taiwanese adults. County and municipal governments in Taiwan should regularly review and improve dental subsidy programs, to lift barriers to obtaining removable dentures among older people who need them.
The Changing Epidemiology of Dog Bite Injuries in the United States, 2005-2018
Authors: Tuckel Peter , Milczarski William
Published: September 2020

Background: In 2018, the most recent year for which data are available, dog bites ranked as the 13th leading cause of nonfatal emergency department visits in the United States. As dog ownership spirals upwards in the United States, it is important to continue to monitor the epidemiology of dog bite injuries. This study provides contemporary data on the incidence of dog bites injuries in the United States and in New York and profiles individuals who have been treated for dog bites in emergency departments. The study also examines the demographic correlates of the rate of injuries at the neighborhood level in New York City and maps the rate in each neighborhood.Methods: At the national level, the study examines longitudinal data on dog bite injuries from 2005-2018 gathered by the Centers for Disease Control and Prevention. For New York, the study analyzes data for 2005-2018 collected by the New York State Department of Health. A negative binomial regression analysis was performed on the state data to measure the simultaneous effects of demographic variables on the incidence of dog-related injuries. A thematically shaded map of the rate of dog bite injuries in New York City’s neighborhoods was created to identify neighborhoods with higher-than-average concentration of injuries. Results: In both the United States and New York the rate of dog-bite injuries increased from 2005 to 2011 and then underwent a significant decline. Injuries due to dog bites, however, still remain a sizable public health problem. Injuries are more prevalent among school-age children, inhabitants of less-densely populated areas, and residents of poorer neighborhoods. In New York City, poorer neighborhoods are also associated with fewer dogs being spayed or neutered. Conclusions: To reduce the rate of dog bite injuries, prevention programs – particularly those which center on teaching the dangers of canine interactions with humans – should be targeted at children. Dog bite injuries tend to be clustered in identifiable neighborhoods. Dog bite prevention programs and stricter enforcement of dog laws can target these neighborhoods.
Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics
Authors: Mremi Irene , George Janeth , Rumisha Susan F. , Sindato Calvin , Mboera Leonard E.G. , Kimera Sharadhuli I.
Published: September 2020

Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: A search for eligible articles was done through HINARI, PubMed, and advanced Google Scholar databases. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. Using the key search descriptors, 1,809 articles were identified and screened at two stages and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions while 42 studies assessed the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilized and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.
Prevalence and Socio-Demographic Correlates of Tobacco and Alcohol Use in Four Sub-Saharan African Countries: A Cross-Sectional Study of Middle-Aged Adults
Authors: Boua Palwende Romuald , Soo Cassandra Claire , Debpuur Cornelius , Maposa Innocent , Nkoana Shai , Mohamed Shukri F , Choma Solomon , Oduro Abraham , Asiki Gershim , Mickelsfield Lisa K , Gómez-Olivé Francesc Xavier , Sorgho Hermann , Mall Sumaya , Ramsay Michele
Published: September 2020

Background: Substance misuse is a global public health problem. In addition to social and economic concerns; consumption of tobacco and alcohol is associated with susceptibility to cardiovascular, respiratory, and infectious diseases, and cancers, as well as risk of transitioning to substance use disorders. African data suggest regional differences in the prevalence and patterns of substance use, but there is limited data from African countries. This cross-sectional population study of middle-aged adults, aims to examine prevalence and socio-demographic correlates of substance use in four sub-Saharan African countries, in rural and urban settings. Methods: Participants aged between 40 and 60 years were recruited from six research centres as part of the Africa Wits-INDEPTH partnership for Genomic Research study. Data on patterns of tobacco and alcohol consumption was captured by questionnaire, and alcohol consumption was further assessed using the CAGE (cut-annoyed-guilty-eye) questionnaire. Results: Data from 10703 participants suggested that more men (68.4%) than women (33.3%) were current substance users. The prevalence of current smoking was significantly higher in men than in women (34.5% vs 2.1%, p<0.001). Smokeless tobacco was used more by women than men (14.4% vs 5.3%, p<0.001). Current smoking was associated with alcohol consumption, and smoking cessation in men was associated with being a former drinker, higher socioeconomic status, and if married or cohabiting. Current alcohol consumption was higher in men, compared to women (60.3% vs 29.3%), and highest in men from Soweto (70.8%) and women from Nanoro (59.8%). The overall prevalence of problematic alcohol consumption among men was 18.9%, and women 7.3%. Men were significantly more likely to consume alcohol, and to develop drinking problems. Problematic drinking was more common in men, in divorced or widowed individuals, and in current smokers.Conclusions: Regional variation in the patterns and prevalence of substance use was observed across study sites, and in rural and urban settings. The high levels of substance use recorded in this study are of concern due to the increased risk of associated morbidities. Further longitudinal data will be valuable in determining trends in substance misuse in Africa.
The Complete Mitochondrial Genome of The American Palm Cixiid, Haplaxius Crudus (Hemiptera: Cixiidae)
Authors: Komondy Lidia , Huguet-Tapia Jose , Ascunce Marina S. , Helmick Ericka , Goss Erica M. , Bahder Brian
Published: September 2020

The authors have withdrawn this preprint due to author disagreement.
CT Measurement of Proximal Femoral Medullary Cavity Morphology in Healthy Subjects from Northern China
Authors: Zhao Ran , Cai Hong , Zhang Ke , Tian Hua
Published: September 2020

Purpose: In total hip arthroplasty (THA), optimal stability and fixation is achieved via tight adaptation of the prosthesis to the bone. This study aimed to analyze the proximal femoral medullary cavity morphology of Chinese subjects on three-dimensional reconstructed imagery to explore the factors influencing these parameters.Methods: CT was performed on 63 healthy subjects from northern China (94 hips; 31 men, 63 women). Three-dimensional CT reconstruction of the proximal femoral medullary cavity was performed using Mimics 22.0 software. The anatomical parameters related to THA were measured to examine the relationships between sex, age, and femoral length. These parameters were compared with previously published data.Results: The internal and external coronal diameters of the femoral medullary cavity, and the anterior and posterior sagittal diameters had different contracting trends. There were correlations between the femoral length, femoral head diameter, and coronal diameter, and between the sagittal diameter and cross-sectional area of the medullary cavity. Age was negatively correlated with the CFI(canal flare index). Sex was correlated with the cross-sectional coronal/sagittal diameters, but not with the canal flare index. The proximal end of the medullary cavity was similar to that reported in Caucasians, but the Asian medullary cavity was narrower distal to the level of the lesser trochanteric line.Conclusions: THA-related anatomy was affected by sex, age, and subpopulation. Compared with sex, age had a greater effect on the fit of the stem to the femoral canal. Each patient must be treated individually, as the anatomical structure varied between individuals.
The effect of melatonin on interleukins 22 and 13 in patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass: A Clinical Trial
Authors: Jouybar Reza , Jannati Mansour , Khademi Saeed
Published: September 2020

Objective: Coronary artery bypass graft surgery with cardiopulmonary bypass (CABG) is one treatment for patients with coronary artery disease. After CABG, a series of inflammatory processes occur which affect other organs of the body and even cause severe organ damage and subsequently a worse prognosis. The purpose of this study was to evaluate the effect of pre-surgically administered melatonin on interleukins 22 and 13 in patients undergoing CABG.Results: In this study, 22 patients were evaluated, 10 patients (45.5%) in the Melatonin group, and 12 patients (54.5%) in the control group. The mean level of IL-22 at all time-points in T2, T3, and T4 was significantly lower in the Melatonin group (P <0.05). There was also a significant increase in IL-22 in both groups at T4 compared to T1. There was no significant difference between the two groups in IL-13 at any time, but the Melatonin group at T2 had a significant decrease in IL-13 compared to T1. This study showed that preoperative melatonin administration could prevent the increase of IL-22 but not IL-13.
Accuracy of a Bedside Swallow Test After Extubation in ICU: A Prospective Validation of a Clinical Test Compared to a Fiberoptic Endoscopy.
Authors: Maamar Adel , Parent Valentine , Guérot Emmanuel , Berneau Pauline , Frérou Aurélien , Tulzo Yves Le , Laviolle Bruno , Jégoux Franck , Gacouin Arnaud , Tadié Jean-Marc
Published: September 2020

Background: Swallowing disorders (SDs) are frequent after extubation in intensive care unit (ICU) exposing patients to aspiration pneumonia. There is no validated bedside swallowing evaluation (BSE) after extubation. We aimed to evaluate the accuracy of our BSE in comparison with fiberoptic endoscopic evaluation of swallowing (FEES) in critically ill patients after extubation, and to identify the incidence and risk factors of SD.Methods: After a preliminary study in a first center, we conducted a 1-year prospective study as a validation cohort in a second center. Patients intubated for longer than 48 hours were included. Exclusion criteria were a known laryngeal pathology, a preexisting SD and an admission for stroke. FEES of the larynx and BSE were assessed within 24 hours after extubation to compare the accuracy of the BSE to the FEES procedure.Results: One hundred and twenty eight patients were included, respectively 69 and 79 in the preliminary study and the validation cohort. Thirteen of 69 (19%) and 33/79 (42%) had SD assessed by FEES. The area under curve (AUC) reached respectively 0.86 (95% CI 0.73-0.98) and 0.83 (95% CI 0.74-0.92). Sensitivities were 77% (95% CI 0.54-0.99) and 85% (95% CI 0.73-0.94), specificities 94% (95% CI 0.87-0.98) and 80% (95% CI 0.7-0.91), and negative predictive values (NPV) were 95% and 90% in respectively preliminary study and validation cohort. Independent risk factors for SD were duration of intubation (OR=1.08; 95% CI 1.02-1.17, p=0.03) and hemodynamic failure (OR=4.46; 95% CI 1.27-21, p=0.03).Conclusion: Our BSE is accurate to detect SDs after extubation in critically ill patients and can easily be implemented in an ICU setting.
Modified Kocher-Langenbeck Approach for the Treatment of Posterior Wall or Column Acetabular Fractures: The One-Incision Two-Window Method
Authors: Yang Tien-Yu , Chuang Po-Yao , Huang Tsan-Wen , Huang Kuo-Chin
Published: September 2020

Background: The Kocher-Langenbeck (K-L) approach is the standard method for the treatment of posterior wall or column acetabular fractures. This approach allows direct access to the posterior structures of the acetabulum, but is limited cranially and caudally by the neurovascular bundle. The present study was conducted to assess the quality of reduction and the incidence of complications in patients who underwent the modified “one-incision two-window” K-L approach.Methods : This is a Retrospective case series with recruited thirteen consecutive patients from 2015 to 2017 who sustained an acute, displaced posterior wall or column acetabular fracture. All patients were treated with modified “one-incision two-window” K-L approach.Results: The mean operation time, mean intraoperative blood loss, and mean incision wound length were estimated to be 103.8 min (60-120 min), 373.1 mL (100-700 mL), and 9.7 cm (8.0-13.0 cm), respectively. The radiographic quality of reduction was graded as anatomical reduction (maximum residual displacement [MRD] ≤ 2 mm) in all cases, according to Matta’s criteria. Concerning the incidence of complications, there were no iatrogenic neurovascular injury, no surgical site infections, and no osteonecrosis of the femoral head or heterotopic ossification in this cohort. One patient with transverse posterior wall fracture (group 1) experienced deep vein thrombosis in the lesion leg. Another two patients with solitary posterior wall fracture (group 2) developed posttraumatic osteoarthritis, with one diagnosed as Tonnis grade I lesion and the other as Tonnis grade III lesion. With respect to the clinical treatment outcome, the mean visual analogue scale (VAS), mean modified Harris Hip Score (mHHS) and subjective satisfaction rate were 1.7 (1.0-2.0), 90.6 (81-100), and 84.6% (80%-90%), respectively. Although there was no significant difference in the satisfaction rate (82.9% vs. 87.0%, P = 0.941) at 12 months after surgery, group 1 patients had more increased VAS score (2.0 vs. 1.2, P = 0.016) and more decreased mHHS (87.7 vs. 94.6, P = 0.014) than group 2 patients. Conclusions: Our pilot study confirmed that the “one-incision two-window” K-L approach is a simple, safe, reliable, and effective way to manage acute, displaced posterior wall or column acetabular fractures.Level of evidence: Therapeutic study, level IV.
A Novel Neutralizing Antibody Targeting Receptor Binding Domain of SARS-CoV-2
Authors: Lee Soo-Young , Kim Cheolmin , Ryu Dong-Kyun , Lee Jihun , Kim Young-Il , Seo Ji-Min , kim Yeon-Gil , Jeong Jae-Hee , Kim Minsoo , Kim Jong-In , Kim Pankyeom , Bae Jin Soo , Shim Eun Yeong , Lee Min Seob , Kim Man Su , Noh Hanmi , Park Geun-Soo , Park Jae Sang , Son Dain , An Yongjin , Lee Jeong No , Kwon Ki-Sung , Lee Joo-Yeon , Lee Hansaem , Yang Jeong-Sun , Kim Kyung-Chang , Kim Sung Soon , Woo Hye-Min , Kim Jun-Won , Park Man-Seong , Yu Kwang-Min , Kim Se-Mi , Kim Eun-Ha , Park Su-Jin , Jeong Seong Tae , Yu Chi Ho , Song Youngjo , Gu Se Hun , Oh Hanseul , Koo Bon-Sang , Hong Jung Joo , Ryu Choong-Min , Park Wan Beom , Oh Myoung-don , Choi Young Ki
Published: September 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the current COVID-19 global pandemic. Vaccines and therapeutics are urgently needed for this highly transmissible virus. In this study, we screened human monoclonal antibodies (mAbs) targeting the receptor binding domain (RBD) of the SARS-CoV-2 spike protein from an antibody library constructed from peripheral blood mononuclear cells of a COVID-19 convalescent patient. A potent neutralizing antibody, termed CT-P59, was identified and found to be effective against various SARS-CoV-2 isolates including the D614G spike protein variant without antibody-dependent enhancement effect. Complex crystal structure of CT-P59 Fab/SARS-CoV-2 RBD showed that CT-P59 blocks interaction regions of SARS-CoV-2 RBD for its cellular receptor, angiotensin converting enzyme 2 (ACE2). The binding orientation of CT-P59 is notably different from the previously reported neutralizing mAbs targeting SARS-CoV-2 RBD suggesting that CT-P59 can be a novel binder to SARS-CoV-2 RBD. Therapeutic effects of CT-P59 were evaluated in three animal models (ferret, hamster, and rhesus monkey), and a substantial reduction in viral titre along with alleviation of clinical symptoms was observed. These findings suggest that the human monoclonal antibody, CT-P59, is a promising therapeutic candidate for treatment of COVID-19.
Interfaces of Occupational Health Management and Corporate Social Responsibility: A multi-Centre Qualitative Study from Germany
Authors: Kuhn Eva , Müller Sebastian , Teusch Christoph-Daniel , Tanner Grit , Schümann Marlies , Baur Carolin , Bamberg Eva , Heidbrink Ludger , McLennan Stuart , Buyx Alena
Published: September 2020

Background: The workplace has been identified as a priority setting for health promotion. There are potential advantages of systematically integrating Occupational Health Management (OHM) and Corporate Social Responsibility (CSR). However, OHM and CSR are usually overseen by different management branches with different sets of values, and there is a lack of empirical research regarding interfaces between OHM and CSR. Germany offers a particularly useful setting due to legislation requiring health to be promoted in the workplace. This study aims to examine key stakeholders’ views and experiences regarding interfaces between OHM and CSR in German companies. Methods: Individual semi-structured qualitative interviews were conducted with a sample of 77 German stakeholders from three different groups: experts in occupational health and corporate social responsibility from various companies (n=35), business partners (n=19) and various non-business partners (n=23). Transcripts were analysed using qualitative content analysis. Results: Participants identified several areas in which OHM and CSR are already interacting at strategic, structural and cultural levels, but has also highlighted several barriers that undermine a more meaningful interaction. Participants reported difficulties in articulating the underlying ethical values that are relevant to both OHM and CSR at the strategic level. Several structural barriers were also highlighted, including a lack of resources (both financial and knowledge), and OHM and CSR departments not being fully developed or being undertaken at entirely different operational levels. Finally, the missing practical implementation of corporate philosophy was identified as a key cultural barrier to interfaces between OHM and CSR, with existing guidelines and companies’ philosophies that already connect OHM and CSR not being embraced by employees and managers.Conclusions: There is already significant overlap in the focus of OHM and CSR, at the structural, strategic and cultural levels in many German companies. The potential is there, both in theory and practice, for the systematic combination of OHM and CSR. The insights from this study will be useful to ensure that closer integration between both management branches are set up in a socially sustainable and ethical manner.
The Effect of Psycho-education Program on Resilience in the Caregivers of Clients with Bipolar Disorder
Authors: Khalifi Talieh , Bahrami Raheleh
Published: September 2020

BACKGROUND: Resilience in family refers to the flexible and developed behavioral pattern in the caregivers of clients with mental disorders that face challenges during the caring process. The aim of this study was to investigate the effect of psychoeducation program on resilience in the caregivers of clients with bipolar disorder. METHODS: This is a quasi-experimental study with a control and an experimental group. The participants of the study were 64 caregivers of clients with bipolar disorder in Sanandaj. The experimental group received the intervention for 4 weeks. The control group did not receive any intervention. The instrument of this study included a demographic questionnaire and a Connor-Davidson (CD-RISC) Resilience Scale. The data analysis was performed using descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (independent t-test, paired t-test and repeated measures analysis of variance) using SPSS-22 software. RESULTS: The results showed that there is no difference between the experimental and control groups in terms of the distribution of contextual variables. There was no statistically significant difference between the mean and standard deviation of the resilience score before the intervention in the control group and in the experimental group (P = 0.059). However, after the intervention, the difference was statistically significant (P <0.001) and showed an increase in the experimental group. CONCLUSION: This Quasi-experimental study indicates that psychoeducation is an effective way for the resilience in the caregivers of clients with bipolar disorder and it can be promote resilience in the caregivers.
Comparison of Loop-Mediated Isothermal Amplification and conventional PCR for Diagnosis of common Brucella species
Authors: Moeini-Zanjani Ali , Pournajaf Abazar , Ferdosi-Shahandashti Elaheh , Gholami Mehrdad , Masjedian Faramarz , Khafri Soraya , Rajabnia Ramazan
Published: September 2020

Objective: Rapid, reliable, and affordable detection of Brucella species via the molecular methods remains a challenge. In recent years, loop-mediated isothermal amplification (LAMP) is a functional nucleic acid amplification technique offering a substitute to polymerase chain reaction (PCR). So, we compared the LAMP assay with the conventional PCR for the identification of common Brucella species in Iran. In this study, LAMP assay was comprehensively evaluated against the common PCR method. A group of specific LAMP primers were used to amplify a highly specific fragment from the sequence of the Brucella abortus BCSP31 gene. Sensitivity and specificity values of tests were done with a set of 78 (50 Brucella and 28 non-Brucella) strains. Results: A dilution series of Brucella abortus DNA indicated that the LAMP reaction could reliably detect 10 (fg/µl) DNA target copies per reaction within 36 minute, which is 10 times greater than the PCR assay. In summary, we conclude that LAMP assay provide accurate and fast test results to identify of common Brucella species in low-complexity labs, mainly in low and lower middle income countries.
Admission Exam and Preparatory Year Scores’ Association with Performance in Basic Science Courses in Health Science Colleges
Authors: Alamoudi Aliaa Amr , Falattah Hind Ibrahim , Eldakhakhny Basmah Medhat , kamel Fatemah Omar , AlSawwa Lana Adey , Elsamanoudy Ayman Zaky
Published: September 2020

Background: In King Abdulaziz University, medical and health science schools depend on admission exams (Aptitude and Achievement) and Preparatory year scores in their students’ selection. However, with the growing number of applicants and the drastic changes in teaching and assessment in these colleges continuous assessment and development of admission criteria are needed. In this study, we aimed to evaluate the correlation of admission exam scores, in addition to the Preparatory year GPA, with academic performance in the basic science subjects such as Clinical Biochemistry and Clinical Pharmacology in health science colleges.Methods: The study was conducted on four cohort studies, two faculty of nursing cohorts; Nursing students (2017-2018,n=146) Nursing students (2018-2019,n=81), and two faculty of applied medical sciences cohorts, C.Nutrition students (2017-2018,n=33), C.Nutrition students (2018-2019,n=28) .The students’ scores of GAT, SAAT, and preparatory year GPA were all recorded at the beginning of each semester before the beginning of courses. Clinical Biochemistry and Clinical Pharmacology exam results were recorded at the end of the semester. Correlation was done for each cohort and all cohorts pooled. Results: Results showed that there was no significant correlation between admission exams scores and the students ‘academic achievement in Clinical Pharmacology, and with only a weak correlation detected between SAAT and the overall achievement in Clinical Biochemistry ( r= 0.192*, P= 0.042) in Nursing students (2017-2018). On the other hand Clinical Pharmacology exam results showed a significant positive correlation with Clinical Biochemistry results (r=0.688, P=0.000). Conclusion: Our results could indicate the need to revisit the admission criteria for these colleges. Furthermore, specific preparatory year tracks for health science colleges can ensure that students improve the specific skills and knowledge required for their future college years.