bluuebunny/crossref_metadata_2025 huggingface dataset:
ANALYSIS OF LEVEL OF PREPAREDNESS COMMUNITY OF DISASTER EARTHQUAKE IN GANGGA SUB-DISTRICT
Authors: Apriyatno Apriyatno , Muryani Chatarina , Yusup Yasin , Nurhadi Nurhadi
Published: March 2020

Natural conditions and geographical situations in Indonesia show that natural disasters are very likely to occur. One of the natural disasters that occurred was an earthquake. The main factor in the occurrence of the earthquake which caused many losses was the lack of knowledge regarding the potential and community preparedness for the earthquake disaster. The purpose of this study was to determine the level of community preparedness in dealing with earthquake disasters. The method used is a qualitative method with sampling using a cluster random sampling of 75 respondents. Analysis of community preparedness uses scoring with the help of Geographic Information Systems on four parameters of preparedness, namely knowledge and attitudes, emergency response plans, disaster warning systems, and resource mobilization. The results of this study are Gangga District community preparedness is divided into two categories, namely the category of moderate preparedness and high preparedness. The category of preparedness is currently found in Bentek, Genggelang, and Rempek villages. Meanwhile, the category of high preparedness is found in Gondang village and Sambik Bangkol village. Considering that the Ganges District is an earthquake-prone area, it is expected that the government, family and community will be able to increase preparedness so that the community can live better in earthquake-prone areas.
Clostridium difficile Infection of a Total Hip Arthroplasty
Authors: Loloi Justin , Mrowczynski Oliver , Claxton Benjamin , Abdulbasit Muhammad , Schade Meredith
Published: March 2020

Case:

We describe the case of an 85-year-old woman who presented with worsening right hip pain after a conversion hip replacement. Subsequent imaging demonstrated a gas-containing collection in the lateral thigh. She was taken to the operating room for irrigation and debridement, where intraoperative cultures returned positive for Clostridium difficile. Surgical management was followed by a prolonged course of antibiotics.

Conclusions:

Clostridium difficile as the etiology of infection in a conversion arthroplasty is exceedingly rare. Orthopaedic surgeons and infectious disease specialists should consider C. diff as a potential cause of infection in conversion hip arthroplasty because management options will need to be tailored.
SPE Strong: Strengthening Our Core: There Is No Silver Bullet: Strengthening the Fundamentals
Authors: Noonan Shauna
Published: March 2020

President's column

“Success is neither magical nor mysterious. Success is the natural consequence of consistently applying the basic fundamentals.” —Jim Rohn, American businessman and author

This month’s column is dedicated to technology evaluation, an area where I have spent the majority of my career. For at least 2 decades, I have been approached almost weekly by either one of my engineers or an inventor who has found the “next best thing that will revolutionize our industry.” While I have been a champion for innovation and technology development, I have also applied critical thinking in forming my opinion of such claims. The first questions I always ask myself are: “Do I need this new technology?” and “Do I understand the root cause of the problem well enough to determine if applying existing technology and accepted practices cannot solve it?” To adequately answer these questions, a good understanding of the fundamentals, such as fluid or mechanical dynamics, is often needed. Is this new tool or method genuinely innovative, or has it been born out of engineering ignorance?

“Being ignorant is not so much a shame, as being unwilling to learn.” —Benjamin Franklin

For context, let me provide an example. The downhole rod-driven reciprocating pump has existed since the late 1800s (Beckwith 2014). For a century, the design practices for deter-mining the optimal tolerance between the downhole plunger and barrel were theoretical equations and often used rules of thumb. Too large of a tolerance would lead to excess fluid slip-page and decreasing efficiency of the pump. Too tight of a tolerance could lead to rod buckling and the inability to handle particulates such as sand. As an industry, we typically erred on the side of caution toward tighter tolerances, and many “gadgets” were invented to prolong the life of the downhole rods and pumps and to counter issues caused by this design practice. It wasn’t until the late 1990s when a group of operators in the Permian Basin began to question the validity of the existing equations and design philosophies.

These Permian operators collectively funded research at Texas Tech University to understand the dynamics of the fluid slippage between a plunger and barrel under a variety of conditions. Through intensive research and experimentation of the fundamentals, they were able to develop a new equation, later named the Patterson Equation, which proved that larger tolerances did not lead to excess slippage (Nickens et al. 2005). The gained understanding of these previously accepted fundamentals had significant implications throughout the industry. Operators began to increase their plunger and barrel tolerances in their designs, and they no longer needed gadgets. As a result, the run life of the downhole equipment increased considerably. The value gained by those operating companies collaborating with the university far exceeded their original investment. However, the industry was the greatest benefactor of the publication of the research.
Evolutionary significance of amino acid permease transporters in 17 plants from Chlorophyta to Angiospermae
Authors: Zhang Chao , Kong Nana , Cao Minxuan , Wang Dongdong , Chen Yue , Chen Qin
Published: March 2020

Background: Nitrogen is an indispensable nutrient for plant growth. It is used and transported in the form of amino acids in living organisms. Transporting amino acids to various parts of plants requires relevant transport proteins, such as amino acid permeases ( AAP s), which were our focus in this study.
Results: We found that 5 AAP genes were present in Chlorophyte species and more AAP genes were predicted in Bryophyta and Lycophytes. Two main groups were defined and group I comprised 5 clades. Our phylogenetic analysis indicated that the origin of clades 2, 3, and 4 is Gymnospermae and that these clades are closely related. The members of clade 1 included Chlorophyta to Gymnospermae. Group II, as a new branch consisting of non-seed plants, is first proposed in our research. Our results also indicated that the AAP family was already present in Chlorophyta and then expanded accompanying the development of vasculature. Concurrently, the AAP family experienced multiple duplication events that promoted the generation of new functions and differentiation of sub-functions.
Conclusions: Our findings suggest that the AAP gene originated in Chlorophyta, and some non-seed AAP genes clustered in one group. A second group, which contained plants of all evolutionary stages, indicated the evolution of AAP s. These new findings can be used to guide future research.
Development of Leishmania (Mundinia) in guinea pigs
Authors: Bečvář Tomáš , Siriyasatien Padet , Bates Paul , Volf Petr , Sádlová Jovana
Published: March 2020

Background: Leishmaniasis is a human and animal disease caused by parasites of the genus Leishmania , which is now divided into 4 subgenera – L. (Leishmania) , L. (Viannia) , L. (Sauroleishmania) and L. (Mundinia) . Subgenus Mundinia, established in 2016, is geographically widely dispersed, its distribution covers all continents, except Antarctica. It consists of 5 species - L. enriettii and L. macropodum are parasites of wild mammals while L. martiniquensis , L. orientalis and unnamed L . sp. from Ghana are infectious to humans. There is very little information on natural reservoir hosts and vectors for any Mundinia species. Methods: Experimental infections of guinea-pigs with all five Mundinia species were performed. Animals were injected intradermally with 10 7 culture-derived promastigotes into both ear pinnae. The courses of infections were monitored weekly; xenodiagnoses were performed at weeks 4 and 8 post infection using Lutzomyia migonei . The distribution of parasites in different tissues was determined post mortem by conventional PCR. Results: No significant differences in weight were observed between infected animals and the control group. Animals infected with L. enriettii developed temporary lesions at the site of inoculation and were infectious to Lu. migonei in xenodiagnoses. Animals infected with L. martiniquensis and L. orientalis developed temporary erythema and dry lesions at the site of inoculation, respectively, but were not infectious to sand flies. Guinea pigs infected by L. macropodum and L . sp . from Ghana showed no signs of infection during experiments, were not infectious to sand flies and leishmanial DNA was not detected in their tissue samples at the end of experiments at week 12 post-inoculation. Conclusions: According to our results, guinea pigs are not an appropriate model organism for studying Mundinia species other than L. enriettii. We suggest that for better understanding of L. (Mundinia) biology it is necessary to focus on other model organisms.
Ripasudil alleviated the inflammation of RPE cells by targeting the miR-136-5p/ROCK/NLRP3 pathway
Authors: Gao Zhao , Li Qiang , Zhang Yunda , Gao Xiaohong , Li Haiyan , Yuan Zhigang
Published: March 2020

Background: Inflammation of RPE cells led to different kinds of eye diseases and affected the normal function of the retina. Furthermore, higher levels of ROCK1 and ROCK2 induced injury of endothelial cell s and many inflammatory diseases of the eyes. Ripasudil, which was used for the treatment of glaucoma , was one kind of the inhibitor of ROCK1 and ROCK2, but whether ripasudil could relieve the LPS-induced inflammation and damage of RPE cells was not clear.
Methods: We used LPS to stimulate ARPE-19 cells, the RPE cell line. After that, we detected the levels of ROCK1 and ROCK2 by western-blotting after the stimulation of LPS and treatment of ripasudil. Then luciferase reporter assays were used to confirm the targeting effect of miR-136-5p on ROCK1 and ROCK2. At last, the levels of NLRP3, ASC, caspase1, IL-1β and IL-18 were detected with the western-blotting after the knockdown of miR-136-5p.
Results: The levels of ROCK1, ROCK2 and miR-136-5p in ARPE-19 cells were promoted after the stimulation of LPS. After the treatment of ripasudil, the expression levels of ROCK1, ROCK2 and miR-136-5p were suppressed. The expression of ROCK1 and ROCK2 was targeted and inhibited by the miR-136-5p. The levels of inflammation related proteins NLRP3, ASC, caspase1, IL-1β and IL-18 was also inhibited after the treatment of ripasudil. However, the expression of these proteins was rescued after the knockdown of miR-136-5p.
Conclusion: Ripasudil relieved the inflammatory injury of RPE cells by upregulating miR-136-5p, therefore inhibiting the expression of ROCK1, ROCK2, NLRP3, ASC, caspase1, IL-1β and IL-18.
Age-dependent involvement of gut mast cells and histamine in post-stroke inflammation
Authors: Blasco Maria Pilar , Chauhan Anjali , Honarpisheh Pedram , Ahnstedt Hilda , d’Aigle John , Ganesan Arunkumar , Ayyaswamy Sriram , Blixt Frank , Venable Susan , Major Angela , Durgan David , Haag Anthony , Kofler Julia , Bryan Robert , McCullough Louise D , Ganesh Bhanu Priya
Published: March 2020

Background

Risk of stroke-related morbidity and mortality increases significantly with age. Aging is associated with chronic, low-grade inflammation, which is thought to contribute to the poorer outcomes after stroke seen in the elderly. Histamine (HA) is a major molecular mediator of inflammation and mast cells residing in the gut are a primary source of histamine.

Methods

Stroke was induced in male C57BL/6J mice at 3 months (young) and 20 months (aged) of age. Role of histamine after stroke was examined using young (Yg) and aged (Ag) mice, mice underwent MCAO surgery and were euthanized at 6h, 24h and 7 days post-ischemia; sham mice received the same surgery but no MCAO. In this work, we evaluated whether worsened outcomes after experimental stroke in aged mice was associated with age-related changes in mast cells, histamine levels, and histamine receptor expression in the gut, brain, and plasma.

Results

We found increased numbers of mast cells in the gut and the brain with aging. Using the middle cerebral artery occlusion (MCAO) model of ischemic stroke, we demonstrate that stroke leads to increased numbers of mast cells and histamine receptors in the gut. These gut-centric changes are associated with elevated levels of HA and other pro-inflammatory cytokines including IL-6, G-CSF, TNF-α, and IFN-γ in the peripheral circulation. Our data also shows that post-stroke gut inflammation led to a significant reduction of mucin-producing goblet cells and a loss of gut barrier integrity. Lastly, gut inflammation after stroke is associated with changes in the composition of the gut microbiota as early as 24 hours post-stroke.

Conclusion

An important theme emerging from our results is that acute inflammatory events following ischemic insults in the brain persist longer in the aged mice when compared to younger animals. Taken together, our findings implicate mast cell activation and histamine signaling as a part of peripheral inflammatory response after ischemic stroke, which are profound in aged animals. Interfering with histamine signaling orally might provide translational value to improve stroke outcome.
A retrospective study of lumbar spine fusion surgery with the Wiltse approach and the traditional approach
Authors: Cheng Weiyi , Zeng Xixi , Gui Tong
Published: March 2020

Background：This study aim to compare the clinical results such as functional improvement, complications, intraoperative parameters etc. between the Wiltse approach and traditional approach in lumbar spine fusion. Methods: In this retrospective controlled study, from May 2016 to May 2017, 70 patients undergone lumbar spine fusion surgery for lumbar disc herniation or lumbar spondylolisthesis within degree II were randomly divided into 2 groups which include Wiltse approach group (N=35, M:F= 1.06:1, mean age= 52 years) and traditional approach group (N=35, M:F= 1.18:1, mean age= 51 years). Actually, all the 70 cases were consisted of 38 lumbar-disc-herniation patients and 32 degree II lumbar-spondylolisthesis patients. In order to specify the clinical curative effects of the two group patients, several indicators including the operation time, the amount of blood loss and post-operation drainage, the ODI, the concentration of peripheral blood creatine phosphokinase (CK) and the cross sectional area (CSA) in magnetic resonance imaging (MRI) were compared. Results: Compared with traditional group, the Wiltse approach group had a statistically significant small figure on operative time, intraoperative blood loss, post-operative drainage and post-operative ODI (p＜0.05).As for the peripheral blood CK levels, the concentration of the Wiltse approach group was lower in 1 day and 3 days after the operation(p＜0.05), while the difference of the CK concentration for 7 days post-operation has no statistical significance(p>0.05). Furthermore, for the MRI CSA three months after the operation , the Wiltse approach side,s was bigger than the traditional side,s in the Wiltse approach group; the Wiltse approach group,s was bigger than the traditional group,s of the two group,s non-decompression side(p＜0.05).Conclusion: For lumbar spinal fusion surgery, the Wiltse approach do have such advantages as shorter operation time, smaller vertebral side muscle injury and better lumbar functional recovery compared with the traditional approach, but as a surgeon, while determining operation program, we should take into account the may influence of the inconsistency of paravertebral muscle anatomy in different levels.
Utilization of clinical practice guideline on antimicrobial in China: An exploratory survey on multilevel determinants
Authors: Deng Qingwen , Liu Wenbin
Published: March 2020

Background: Nowadays, irrational use of antimicrobials has threatened public health. It’s necessary to expand the use of clinical practice guideline (CPG) on antimicrobial for facilitating the proper use of antimicrobial. However, the utilization status of CPG on antimicrobial and the influencing factors, especially the ones at the organizational level, remain largely unknown. Methods: A cross-sectional questionnaire survey was conducted on a sample among physicians from 16 public hospitals in the eastern, central and western parts of China. A multilevel regression model was employed to examine factors associated with physicians’ utilization of CPG on antimicrobial. Results: A total of 815 physicians were included in this study. About 80% of the surveyed physicians reported their adherence to the CPG on antimicrobial. Dimensions of “subjective norm”, “perceived risk” and “behavioral intention” from the domain of physician belief, a dimension of “ease of use” from the domain of CPG traits, and dimensions of “top management support” and “organization & implementation” from the domain of hospital practice were significantly associated with physicians’ utilization of CPG on antimicrobial. And except for working department, most demographics characteristics of the physician were not found to be significantly related to the CPG use. In addition, it also showed that region is a significant factor affecting physicians’ CPG use. Conclusions: This study depicted the current status of CPG on antimicrobial and comprehensively identified its potential determinants not only from the three domains at the individual level, such as physician belief, but also from the location region at the organizational level. The results will provide a direct reference for the implementation of CPG on antimicrobial.
Does Gender Influence the Outcomes of Total Ankle Arthroplasty in Patients with Ankle Osteoarthritis?
Authors: Lee Gun-Woo , Lee Keun-Bae
Published: March 2020

Background Total ankle arthroplasty has progressed as a treatment option for patients with ankle osteoarthritis. However, no studies have been conducted to evaluate the effect of gender on the outcome. The purpose of the present study was to evaluate outcomes, survivorship, and complications rates of total ankle arthroplasty, according to gender differences. Methods This study included 187 patients (195 ankles) that underwent mobile-bearing HINTEGRA prosthesis at a mean follow-up of 7.5 years (range, 4 to 14). The two groups consisted of a men’s group (106 patients, 109 ankles) and a women’s group (81 patients, 86 ankles). Average age was 64.4 years (range, 45 to 83). Results Clinical scores on the Ankle Osteoarthritis Scale for pain and disability, and American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved and were not significantly different between the two groups at the final follow-up. There were no significant differences in complication rates and implant survivorship between the two groups. The overall survival rate was 96.4% in men and 93.4% in women at a mean follow-up of 7.5 years (p=0.621). Conclusions Clinical outcomes, complication rates, and survivorship of total ankle arthroplasty were comparable between men and women. These results suggest that gender did not seem affect outcomes of total ankle arthroplasty in patients with ankle osteoarthritis.
Impact of long-term industrial contamination on the bacterial communities in urban river sediments
Authors: zhang lei , Tu Demei , Li Xingchen , Lu Wenxuan , Li Jing
Published: March 2020

Background: The contamination of the aquatic environment of urban rivers with industrial wastewater has affected the abiotic conditions and biological activities of the trophic levels of the ecosystem, particularly sediments. However, most current research about microorganism in urban aquatic environments has focused on indicator bacteria related to feces and organic pollution. Meanwhile, they ignored the interactions among microorganisms. To deeply understand the impact of industrial contamination on microbial community, we study the bacterial community structure and diversity in river sediments under the influence of different types of industrial pollution by Illumina MiSeq high-throughput sequencing technology and conduct a more detailed analysis of microbial community structure through co-occurrence networks. Results: Although these sediment samples have a similar characteristic profile of high bacterial rank, their relative abundance was different, and there were significant differences among different locations. In addition, redundancy analysis indicated that the structure of the bacterial community in river sediments was influenced by a variety of environmental factors. TN, TP, TOC and metals (Cu, Zn and Cd) were the most important driving factors that determined the bacterial community in urban river sediments (P <0.01). According to PICRUSt analysis, the bacterial communities in different locations had similar overall functional profiles. It is worth noting that the 15 functional genes related to xenobiotics biodegradation and metabolism were the most abundant in the same location. The non-random assembly patterns of bacterial composition in different types of industrially polluted sediments were determined by a co-occurrence network. Among them, Denitratisoma, Anaeromyxobacter, and Candidatus Microthrix in the co-occurrence network were identified as keystone genera. The microbial taxa in the same module had closer ecological connections and involved carbon and nitrogen cycles as well as the repair of metal pollution. Conclusions: Our data indicate that long-term potential interactions between different types of industrial pollution and taxa collectively affect the structure of the bacterial community in urban river sediments.
Dynamic change in lymphocyte count in the early stage is a potential predictor of the severity of COVID-19
Authors: Zhang Xi , Du Yonghao , Shi Lei , Chen Tianyan , Zhao Yingren , Ye Feng , Lin Shumei , Zheng Jie , Niu Gang
Published: March 2020

Background Lymphopenia is associated with COVID-19 severity. Herein we describe the dynamic changes in lymphocyte count during hospitalization and explore a possible association with the severity of COVID-19.Methods In this retrospective study, 13 non-severe COVID-19 patients diagnosed at admission were enrolled. One patient progressed to severe disease. Dynamic changes in lymphocyte count and CT score of all patients were analyzed.Results Lymphocyte count changed significantly in the non-severe patients over time (admission vs day 5, P=0.685; day 5 vs day 15, P<0.001). Lymphocyte count of the severe patient fluctuated, and even decreased within the first 12 days post-admission, before increasing gradually. Chest CT scores of nine (75%) non-severe patients on the 5th day of hospitalization were higher than at admission, but decreased gradually thereafter (admission vs day 5, P<0.001, day 5 vs day 15, P=0.004). In the severe patient, CT score continued to increase for 2 weeks after admission, before decreasing gradually.Conclusions Non-severe COVID-19 patients had significantly increased lymphocyte count and decreased CT score 1 week after illness onset. Dynamic change in lymphocyte count in the early stages of COVID-19 may be helpful to identify the patients who are more likely to develop severe or critical illness.
Primary Ovarian Leiomyoma: A common tumor in rare location and report of eight cases
Authors: zaigui wu , minyue Dong
Published: March 2020

Background: Ovarian Leiomyoma accounts only for 0.5 to 1% of all benign ovarian tumors. Here we present a series of eight patients over a six-year period(2012-2018). The clinico-pathological features, diagnosis and management were discussed. Methods: We had experienced eight cases of ovarian leiomyoma.The clinical features,pathologic findings,diagnosis, treatment were reviewed. Results: The mean age of these patients was 38.5 years. The majority of these patients may be asymptomatic and usually diagnosed incidentally during pelvic examination or pathologic examination after surgery. Six cases presented only with pelvic mass sized from 2 to 20 cm and even some patients persisted for more than twenty years while the other two were diagnosed due to four years of primary infertile or three months of irregular vagina bleeding. Three patients coincident with uterine leiomyoma while the others not. Three had ovarian leiomyoma degenerated and one case had a evidence of atypical 4/10. Conclusions : ovarian leiomyoma was very rare but it should be considered in the diagnosis of pelvic or ovarian solid masses. Magnetic resonance imaging was provital in its different diagnose while fast frozen pathology during operation was very necessary for its surgical decision. A proper surgical decision should be made according to patients age.
M2 Macrophagy-derived Exosomal MiRNA-5106 Induces Bone Mesenchymal Stem Cells towards Osteoblastic Fate by Targeting Salt-inducible Kinase 2 and 3
Authors: Xiong Yuan , Chen Lang , Yan Chenchen , Zhou Wu , Yu Tao , Sun Yun , Cao Faqi , Xue Hang , Hu Yiqiang , Chen Dong , Mi Bobin , Liu Guohui
Published: March 2020

Background Osteoblast differentiation is a vital process for fracture healing, and exosomes are nanosized membrane vesicles that can deliver therapeutic drugs easily and safely. Macrophages participate in the regulation of various biological processes in vivo , and macrophage-derived exosomes (MD-Exos) have recently been a topic of increasing research interest. However, few study has explored the link between MD-Exos and osteoblast differentiation. Herein, we sought to identify miRNAs differentially expressed between M1 and M2 macrophage-derived exosomes, and to evaluate their roles in the context of osteoblast differentiation.Results We found that microRNA-5106 (miR-5106) was significantly overexpressed in M2 macrophage-derived exosomes (M2D-Exos), while its expression was decreased in M1 macrophage-derived exosomes (M1D-Exos), and we found that this exosomal miRNA can induce bone mesenchymal stem cell (BMSC) osteogenic differentiation via directly targeting the Salt-inducible kinase 2 and 3 ( SIK2 and SIK3 ) genes. In addition, the local injection of both a miR-5106 agonist or M2D-Exos to fracture sites was sufficient to accelerate healing in vivo.Conclusions Our study demonstrates that miR-5106 is highly enriched in M2D-Exos, and that it can be transferred to BMSCs wherein it targets SIK2 and SIK3 genes to promote osteoblast differentiation.
Validation of Family Planning tool in the Pastoralist Community
Authors: Alemayehu Mussie , Medhanyie Araya Abrha , Reed Elizabeth , Bezabih Afework Mulugeta
Published: March 2020

Background : Pastoralist community, Afar, women felt that they are embedded in strong cultural and religious perspectives which promotes a high number of children, and discourages family planning (FP) use. They are multifaced factors which hinder women not to use FP and it is time to develop a context-based tool to understand the situation at the ground. However, we have a dearth of evidence on a reliable and valid tool. Therefore, this study aims in developing a reliable and valid tool that considers the women's knowledge, male involvement, attitude, and belief about whether most people approve or disapprove of the behavior to use or not use of FP. Methods : A total of 891 married women participated in the study. Reviewing the literature, piloting, pretesting and collecting the actual data were the steps we used to develop a reliable and valid tool. We used the integrated behavioral model (IBM) as a conceptual framework for developing the tool. The developing tool consists of 1) knowledge 2) perceived male involvement and 3) constructs of integrated behavioral model (IBM); expressional and instrumental attitude, subjective norm, self-efficacy, perceived control and intention to use of FP. The IBM items composed of direct and indirect measurement. In the analysis of the data, exploratory and confirmatory factor analysis was done. Independent t. test with cohen’s d was used to calculate the effect size. The correlation coefficient was carried between the direct and indirect measurements of the items of the integrated behavioral model (IBM). Results : A total of 891 pastoralist married women were included in the analysis of the reliability and validity of the tool. The mean age of the participants was 26.74(±6.45). The KMO value for all items was greater than 0.83 with a Bartlett test of sphericity of (p<0.00). Thirteen items were used to measure the knowledge of the respondent towards FP use. The tool had 64.92 variances explained and Cronbach alpha of 0.85. Acceptable values of the fitness indices were obtained in the confirmatory factor analysis (CFA) The items of knowledge towards FP had normed chi-square of 4.5, RMSEA with 90% CI of 0.064(0.056,.0.071), SRMR of 0.039, CFI of 0.969 and TLI of 0961. All the developed items had a Cohen’s d ranges from 0.5 to 2. Moreover, the correlation test of the IBM ranges from 0.6 to 0.7 which shows a higher correlation between the measurement direct and indirect items. Conclusion : The pastoralist community version of the FP questionnaire is a valid and reliable tool and can be used to measure future family planning use. The indirect measurement of the IBM constructs was a good item to measure FP.
Family Planning Practices and Women’s Impression of an Adapted Reproductive Life Plan in a Disadvantaged Area in Eswatini
Authors: Engström Ellinor , Målqvist Mats , Hultstrand Jenny Niemeyer
Published: March 2020

Background Family planning in Eswatini is limited and unplanned pregnancies are common. The Reproductive Life Plan (RLP) is a clinical tool formerly evaluated in high-income settings aiming to increase pregnancy planning. Mentor Mothers (MM), i.e. Community Health Workers, were trained in using an adapted RLP and introduced it into family planning (FP) discussions with their clients. This study aimed to evaluate these women’s impression of the RLP and to investigate their FP practices.Method Women were recruited during home visits, purposively selected to cover all areas where the MMs are working. Data were collected in September and October 2018 using anonymous questionnaires filled out by women aged 15-44 years that were either mothers or pregnant mothers-to-be. The questionnaire consisted of 20 questions on background, fertility desires, pregnancy planning as well as quality and perceived need for FP support. Chi-square tests or Fisher’s exact test were used for group comparisons and the need for more FP support.Results A total of 203 women participated. Most women (74% n=148) expressed that FP discussions with their MM using the RLP had helped them ‘very much’. A majority had a perceived need for these discussions; 70% wanted to have more support from their MM and 92% wanted more information about FP. Significantly more women with lower educational level (secondary or lower) and younger women (age 15-24 years) wanted more support compared to women with higher educational level and older women (p<0.001 and p=0.028). The unmet need for contraception was 22%.Conclusion The introduction of the RLP was well received among women but most of them requested more support in FP. Using the RLP may help women in this context achieve their reproductive goals.
Intense and unpredictable perturbations during gait training improve dynamic balance abilities in chronic hemiparetic individuals: a randomized controlled pilot trial
Authors: Esmaeili Vahid , Juneau Andréanne , Dyer Joseph-Omer , Lamontagne Anouk , Kairy Dahlia , Bouyer Laurent , Duclos Cyril
Published: March 2020

Background: Previous studies have assessed the effects of perturbation training on balance after stroke. However, the perturbations were either applied while standing or were small in amplitude during gait, which is not representative of the most common fall conditions. The perturbations were also combined with other challenges such as progressive increases in treadmill speed. Objective: To determine the benefit of treadmill training with intense and unpredictable perturbations compared to treadmill walking-only training for dynamic balance and gait post-stroke. Methods: Twenty-one stroke individuals with reduced dynamic balance abilities, with or without a history of fall and ability to walk on a treadmill without external support or a walking aid for at least 1 minute were allocated to either an unpredictable gait perturbation (Perturb) group or a walking-only (NonPerturb) group through covariate adaptive randomization. Nine training sessions were conducted over three weeks. NonPerturb participants only walked on the treadmill but were offered perturbation training after the control intervention. Pre- and post-training evaluations included balance and gait abilities, maximal knee strength, balance confidence and community integration. Six-week phone follow-ups were conducted for balance confidence and community integration. Satisfaction with perturbation training was also assessed. Results: With no baseline differences between groups (p>0.075), perturbation training yielded large improvements in most variables in the Perturb (p<0.05, Effect Size: ES>.46) group (n=10) and the NonPerturb (p≤.089, ES>.45) group (n=7 post-crossing), except for maximal strength (p>.23) in the NonPerturb group. Walking-only training in the NonPerturb group (n=8, pre-crossing) mostly had no effect (p>.292, ES<.26), except on balance confidence (p=.063, ES=.46). The effects of the gait training were still present on balance confidence and community integration at follow-up. Satisfaction with the training program was high. Conclusion: Intense and unpredictable gait perturbations have the potential to be an efficient component of training to improve balance abilities and community integration in chronic stroke individuals. Retrospective registration: ClinicalTrials.gov. March 18th, 2020. Identifier: NCT04314830 (https://clinicaltrials.gov/ct2/show/NCT04314830?term=NCT04314830&draw=2&rank=1).
Comparative transcriptome analysis of two Cercospora sojina strains reveals differences in virulence under nitrogen starvation stress
Authors: Gu Xin , Yang Shuai , Yang Xiaohe , Yao Liangliang , Gao Xuedong , Zhang Maoming , Liu Wei , Zhao Haihong , Wang Qingsheng , Li Zengjie , Li Zhimin , Ding Junjie
Published: March 2020

Background: Cercospora sojina is a fungal pathogen that causes frogeye leaf spot in soybean-producing regions, leading to severe yield losses worldwide. It exhibits variations in virulence due to race differentiation between strains. However, the candidate virulence-related genes are unknown because the infection process is slow, making it difficult to collect transcriptome samples. Methods: In this study, virulence-related differentially expressed genes (DEGs) were obtained from the highly virulent Race15 strain and mildly virulent Race1 strain under nitrogen starvation stress, which mimics the physiology of the pathogen during infection. Weighted gene co-expression network analysis (WGCNA) was then used to find co-expressed gene modules and assess the relationship between gene networks and phenotypes. Results: Upon comparison of the transcriptomic differences in virulence between the strains, a total of 378 and 124 DEGs were upregulated, while 294 and 220 were downregulated in Race 1 and Race 15, respectively. Annotation of these DEGs revealed that many were associated with virulence differences, including scytalone dehydratase, 1,3,8-trihydroxynaphthalene reductase, and β-1,3-glucanase. In addition, two modules highly correlated with the highly virulent strain Race 15 and 36 virulence-related DEGs were found to contain mostly β-1,4-glucanase, β-1,4-xylanas, and cellobiose dehydrogenase. Conclusions: These important nitrogen starvation-responsive DEGs are frequently involved in the synthesis of melanin, polyphosphate storage in the vacuole, lignocellulose degradation, and cellulose degradation during fungal development and differentiation. Transcriptome analysis indicated unique gene expression patterns, providing further insight into pathogenesis.
Time to develop tuberculosis and predictors of incidence among anti-retroviral therapy children on two selected hospitals at benishangule Gumuz region, North West Ethiopia: A retrospective cohort study
Authors: Bizuneh Fassikaw kebede , Daba Tadese Tolossa , Mitiku Belayneh Mengist , Fikretsion Tamrat shewano
Published: March 2020

Background: Currently, tuberculosis (TB) incidence in peadtrics and children living with human immune-deficiency virus (HIV) is an emerging global concern. Although, the incidence of TB among adult HIV patients is exhaustively studied; the incidence of TB among children on ART is overlooked. Knowledge of the time when TB develops among children on ART could be helpful to develop time relevant intervention strategies.Methods: This was a hospital based retrospective cohort study conducted among 429 children on ART from 2009-2018. Time to develop TB was defined as time from enrollment for ART care until development of TB among children on ART. Proportional hazard assumption was checked for each variable and no variable was found with Schoenfeld test <0.05. Variables with P-value <0.25 at bivariate Cox regression analysis were entered into multivariable Cox model. Multivariable Cox regression model with 95%CI and AHR was used to identify significant predictor variables to develop TB at P< 0.05Result: 421 children were followed for a total of 662.5 Person Years of observation (PYO). The maximum and minimum follow up time on ART was 0.37 and 4.49 years, respectively. The median age of the children on ART at enrollment was 9 years (SD=3.36). The Overall incidence density of tuberculosis in HIV infected children was 9.6/ 100 PYOs 95%CI (8.06-10.3). Tuberculosis occurrence among HIV infected children was significantly associated within TB history of contact AHR=3.7, 95%CI (2.89-7.2), not started on cotrimoxazole(CPT) AHR=2.4: 95%CI (1.84-4.74), incomplete vaccination AHR=2.4, 95%CI (1.32-4.5), sever stunting AHR =2.99:95%CI (1.2-7.81), having hemoglobin (Hgb) ≤10 mg/dl AHR = 4.02, 95%CI (2.01-8.1)Conclusion: More than 80% of TB incidences occurred during two years of follow up after ART started. So intensified screening of CPT& therapeutic feeding is highly recommended for all children
Correlation between Fasting Blood Glucose Level at Admission and Mortality in COVID-19 Patients: A Retrospective Study
Authors: Zhu Bin , Jiang Chunguo , Feng Xiaokai , Zheng Yanfei , Yang Jie , Wang Feng , Liu Shi , Xu Fenghua , Zhang Liming , Zhao Zhigang , Tang Ziren
Published: March 2020

Background: Coronavirus disease-19 (COVID-19) has spread rapidly, with a growing number of cases confirmed around the world. This study explores the relationship of fasting blood glucose (FBG) at admission with mortality.Methods: In this retrospective, single-center study, we analyzed the clinical characteristics of confirmed cases of COVID-19 in Wu Han from 29 January 2020 to 23 February 2020. Cox proportional hazard regression analysis was performed to evaluate the relationship between FBG and mortality.Results: A total of 107 patients were enrolled in our study. The average age was 59.49 ± 13.33 and the FBG at admission was 7.35 ± 3.13 mmol/L. There were 16 people died of COVID-19 with an average age 68.1 ± 9.5 and the FBG was 8.94 ± 4.76 mmol/L. Regression analysis showed that there were significant association between FBG and death (HR = 1.13, 95%CI: 1.02-1.24). After adjusting for covariables, the significance still exists. In addition, our result showed that FBG > 7.0 mmol/L or diabetic mellitus can significantly increase mortality after adjusting for the age and gender.Conclusions: This study suggests that FBG at admission is an effective and reliable indicator for disease prognosis in COVID-19 patients.
Onset features and time to diagnosis in Friedreich's Ataxia
Authors: Indelicato Elisabetta , Nachbauer Wolfgang , Eigentler Andreas , Amprosi Matthias , Gothe Raffaella Matteucci , Giunti Paola , Mariotti Caterina , Arpa Javier , Durr Alexandra , Klopstock Thomas , Schöls Ludger , Giordano Ilaria , Bürk Katrin , Pandolfo Massimo , Didszdun Claire , Schulz Jörg , Boesch Sylvia
Published: March 2020

Background: In rare disorders diagnosis may be delayed due to limited awareness and unspecific presenting symptoms. Herein, we address the issue of diagnostic delay in Friedreich´s Ataxia (FRDA), a genetic disorder caused by homozygous GAA-repeat expansions.Methods: 611 genetically confirmed FRDA patients were recruited within a multicentric natural history study conducted by the EFACTS (European FRDA Consortium for Translational Studies, ClinicalTrials.gov-Identifier NCT02069509). Age and symptoms at onset as well as age at suspicion of FRDA were collected retrospectively at the baseline visit.Results: In 554 of cases (90.7%), disease presented with gait or coordination disturbances. In the others (n=57, 9.3%), non-neurological features such as scoliosis or cardiomyopathy predated ataxia. Before the discovery of the causal mutation in 1996, median time to diagnosis was 4(IQR=2-9) years and it improved significantly after the introduction of genetic testing (2(IQR=1-5) years, p <0.001). Still after 1996, time to diagnosis was longer in patients with a) non-neurological presentation (mean 6.7, 95%CI[5.5,7.9] vs 4.5, [4.2,5] years, p =0.001) as well as in b) patients with late-onset (3(IQR=1-7) vs 2(IQR=1-5) years compared to early onset <25 years of age, p =0.03). Age at onset significantly correlated with GAA-repeat length in case of neurological onset (r=-0,6; p <0,0001), but not in patients with non-neurological presentation (r=-0,1; p =0,4). Across 54 siblings’ pairs, differences in age at onset did not correlate with differences in GAA-repeat length (r=-0,14, p =0,3).Conclusions: In the genetic era, presentation with non-neurological features or in the adulthood still leads to a significant diagnostic delay in FRDA. Well-known correlations between GAA and disease milestones are not valid in case of atypical presentations or positive family history.
The differences of gut microbiota on schizophrenia with obesity and the potential effects of enterotype on metabolic pathways: cross-sectional study
Authors: Li Zhiyong , Shen Yang , Gao Jiayu , Huang Yichen , Yuan Ye , Zhang Meng , Ying Liang
Published: March 2020

Background: Recent studies have shown that gut microbiota has a certain influence on the occurrence of obesity. As a special classification of gut microbiota, different enterotypes have various preferences in metabolism. There is a significant risk of obesity in people with schizophrenia. This work proposed that the disorder of gut microbiota in patients with schizophrenia was based on microbial enterotypes, which promoted the increase of BMI.Methods: 97 schizophrenia patients and 69 matched health controls were recruited. The fresh feces of all subjects were collected to complete 16S rRNA sequence. Statistical analysis was performed using R-3.3.1 and metagenomic data statistical analysis software for identification of enterotypes. The relationships within samples were visualized by principal co-ordinates analysis and significant differences in microbial community composition were detected using analysis of similarities. Results: The BMI of schizophrenia was significantly higher than that of the controls. Patients with enterotype-P had a higher BMI than the others. There’re several differences in the gut microbes of enterotypes-P between patients and controls. Proteobacteria and Firmicutes had significantly higher abundance in patients’ group with enterotypes-P. The Bacteroidetes had higher abundance in health controls with enterotypes-P. There’re several differences in the metabolic pathways of the microbiota which the enterotype P belonged in different BMI intervals.Conclusions: The patients with schizophrenia had a significantly higher BMI than health controls. Patients with enterotype-P have a higher risk of BMI. The enterotype-P might affect a variety of metabolic pathways to disrupt the metabolism of glucose and lipid in human body.
The establishment of a rheumatoid arthritis primate model in Macaca fascicularis
Authors: Na Hyun Sik , Lee Seon-young , Min Hong Ki , Park Wan-je , Lee Jung-hwan , Cho Ka-hee , Hong Shin-hee , Kim Dae-hoon , Jhun Jooyeon , Choi Jeong-Won , Kim Sung-Min , Kwok Seung-Ki , Cho Mi-La , Park Sung-Hwan
Published: March 2020

Background Rheumatoid arthritis (RA) is a long-term autoimmune disorder that mostly affects the joints and leads to the destruction of cartilage. An RA model in non-human primates is especially useful because of their close phylogenetic relationship to humans in terms of cross-reactivity to compounds developed using modern drug technologies.Methods We used a collagen-induced arthritis (CIA) model in cynomolgus monkeys. CIA was induced by the immunization of chicken type II collagen. Swelling was measured as the longitudinal and transverse axes of 16 proximal interphalangeal joints.Results A new system for visual evaluation was created, with a perfect score of 16. Individual behavioral analysis was also conducted. Serum was collected once a week after the first immunization. Blood chemistry and inflammatory cytokine parameters were higher in the CIA group than in the wild type group.Conclusion In conclusion, we established CIA in cynomolgus monkeys, and the results can be used for drug evaluation models.
Clinical and CT imaging characteristics of COVID-19 cases in Wenzhou city: A retrospective analysis
Authors: Fu Li-ping , Gao Yuan-tong , Zhou Ke , Luo Min , Ma Peng-Cheng , Song Fa-Huan , Li Yong-chou
Published: March 2020

Background: In December 2019, Wuhan witnessed the outbreak of an “unexplained pneumonia” caused by a novel coronavirus strain infection and was dubbed the COVID-19 by the WHO. The disease quickly spread to China. This study aimed to investigate the disease’s evolving epidemiological history, as well as analyze the clinical and CT imaging characteristics, treatment regimens, and patients’ prognosis. Methods: This was a retrospective study whose cases were 64 patients with a confirmed diagnosis of COVID-19. The clinical data were obtained from patients who were admitted to the isolation ward from 21 January 2020 to 19 February 2020. Results: 60 out of 64 patients had a definitive history of exposure to people who had traveled from Wuhan City. The median time from onset of symptoms to first hospital admission was 3.9±1.9 days. The initial symptoms included fever (46/64), dry cough (38/64), fatigue or myalgia (23/64), sore throat (10/64), diarrhea (3/64) along with late-onset symptoms like chest pains (2/64) and headaches (2/64). The majority of the patients (43/64) had normal white blood cell counts while 29.7 % (19/64) had leukopenia. Only two patients (3.1 %) presented with leukocytosis. 58 of the 64patients had abnormal radiological findings on chest CTs. The first chest CTs (within 2 days) was more sensitive in detecting COVID-19 infection (85.9 %) compared to the initial RT-PCR (56.3 %; p<0.01). The CTs showed lesions in multiple lung lobes in three-quarters of the patients while 15.6 % had lesions localized to one lobe. Most of the lesions were typically dense with ground-glass opacity co-existing with consolidation or cord-like shadows. Most of these patients (50/64) have recovered and got discharged giving a mean length of hospital stay of 13.5±4.8 days. Our hospital unit has not reported any COVID-19 related death so far. Conclusions: Early intervention in COVID-19 disease improves patients’ prognosis. Our data demonstrate the superiority of early radiological tests ahead of RT-PCR. The initial and dynamic CT changes in COVID-19 patients along with other clinical data shared above can better guide clinical decision making.