bluuebunny/crossref_metadata_2025 huggingface dataset:
Professional oral care in end-of-life patients with advanced cancers in a hospice ward: Improvement of oral conditions
Authors: Wu Ting-Ying , Liu Hsiu-Yueh , Wu Chien-Yi , Chen Hung-Cheng , Huang Shun-Te , Chen Ping-Ho
Published: May 2020

Background: In end-of-life patients with advanced cancers, oral examination, oral care, and oral re-examination are crucial. Although oral symptoms are among the major complaints of end-of-life patients, few studies have focused on oral care in these patients. In this study, the association between oral symptoms and oral dryness among end-of-life patients was examined, and improvement of oral conditions after oral care interventions by a professional dentist was quantified. Methods: This prospective intervention study included 27 terminally ill patients with advanced cancers in a hospice ward. Professional oral care was administered every morning, and the improvement of oral conditions was assessed by comparing oral conditions before and after the intervention. Oral assessment was performed using the Oral Health Assessment Tool (OHAT) and Oral Assessment Guide. Oral dryness was evaluated through Clinical Diagnosis Classification of oral dryness and an oral moisture device. Oral cleanliness was evaluated using a bacterial counter, and tongue smears were collected for Candida examination; furthermore, oral function was recorded. Results: The presence of oral mucositis was closely associated with severe oral dryness (odds ratio [OR] = 14.93; 95% confidence interval [CI]: 1.95–114.38). The level of oral debris retention was significantly related to the degree of oral dryness (OR = 15.97; 95% CI: 2.06–123.72). The group with higher scores (OHAT > 8), which represent poor oral conditions, showed severe oral dryness (OR = 17.97; 95% CI: 1.45–223.46). Total OHAT scores (median: 7 vs 2) and those of other subgroups (lip, tongue, gums and tissues, saliva, and oral cleanliness showed a significant decrease after the intervention. Furthermore, the occurrence of mucositis (47.1% vs 0%), candidiasis rate (68.8% vs 43.8%), oral dryness self-sensation (63.6% vs 9.1%), and severe oral debris (52.9% vs 11.8%) decreased significantly.Conclusions: Proper oral care can improve oral health and hygiene, reduce the rate of mucositis, reduce the sensation of oral dryness, increase oral moisture, and reduce the chances of oral infections among end-of-life patients. Daily oral care is necessary and can alleviate oral discomfort, increase food intake, and increase the chances of communication between end-of-life patients and their families.
De novo assembly and transcriptome characterization of an endemic species of Vietnam, Panax vietnamensis Ha et Grushv., including the development of EST-SSR markers for population genetics
Authors: Vu Duy Dinh , Shah Syed Noor Muhammad , Pham Mai Phuong , Bui Van Thang , Nguyen Minh Tam , Nguyen Thi Phuong Trang
Published: May 2020

Background: Understanding the genetic diversity in threatened species that occur in forest remnants is necessary to establish efficient strategies for the species conservation, restoration and management. Panax vietnamensis Ha et Grushv. is medicinally important, endemic and endangered species of Vietnam. However, genetic diversity and structure of population is unknown due to lack of efficient molecular markers.Results: In this study, we employed Illumina HiSeq TM 4000 sequencing to analyze the transcriptomes of P. vietnamensis (roots, leaves and stems). A total of 23,741,783 raw reads were obtained and assembled, from which, 89,271 unigenes with an average length of 598.3191 nt were generated. During functional annotation, 31,686 unigenes were annotated in Gene Ontology categories, Kyoto Encyclopedia of Genes and Genomes pathways, Swiss-Prot database, and Nucleotide Collection (NR/NT) database. In addition, 11,343 expressed sequence tag-simple sequence repeat (EST-SSRs) were detected. From 7,774 primer pairs, 101 were selected for polymorphism validation, in which, 20 primer pairs were successfully amplified to DNA fragments and significant amounts of polymorphism was observed within population. The nine polymorphic microsatellite loci were used to analyze genetic diversity and structure of the natural populations. The obtained results revealed that the shows high levels of genetic diversity in populations, the average observed and expected heterozygosity were H O = 0.422 and H E = 0.479. During the Bottleneck analysis using TPM and SMM models (p < 0.01) shows that targeted population is significantly heterozygote deficient. This suggests sign of bottleneck in all populations. Genetic differentiation among populations was moderate (F ST = 0.133) and indicating limited gene flow (Nm = 1.63). Analysis of molecular variance (AMOVA) showed 63.17% of variation within individuals and 12.45% among populations. These results showed a moderate genetic structure of P. vietnamensis. STRUCTURE analysis and the unweighted pair-group method with arithmetic means (UPGMA) tree revealed strong genetic structure and two genetic clusters related to geographical distances, as well. Conclusion: Our study will assist conservators in future conservation management, breeding, production and habitats restoration of the species.
An efficient method to reduce grain angle influence on NIR spectra for predicting extractives content from heartwood stem cores of Toona. sinensis
Authors: Li Yanjie , Dong Xin , Sun Yang , Liu Jun , Jiang Jingmin
Published: May 2020

Background: A fast, reliable and non-destructive method is needed to qualify the extractives content (EC) in heartwood of T. sinensis cores in the breeding program for studying the genetic effect on EC. However, the influence of grain angle on near infrared (NIR) spectra prediction model for EC is unclear. In this study, NIR spectra were collected from both cross section and radial section of wood core samples in order to predict the EC in heartwood. Results: The effect of grain angle on calibration EC model was studied. Several different spectra pre-processing methods were implemented for calibration. It was found that standard normal variation (SNV) followed by 1st derivative yielded the best calibration result for T. sinensis EC. Grain angle had a significant influence on the predicted model for EC when using the whole NIR spectra. However, after testing a certain point of the prior variables for EC that were selected by the significant multivariate correlation (sMC), the influence of grain angle was significantly eliminated. Conclusions: It is suggested that NIR spectroscopy is a promising method to predict EC in the solid wood without effecting grain angle.
Indoor air pollution concentrations and cardiometabolic health across four diverse settings in Peru: a cross-sectional study
Authors: Kephart Josiah L , Fandiño-Del-Rio Magdalena , Koehler Kirsten , Bernabe-Ortiz Antonio , Miranda J Jaime , Gilman Robert H , Checkley William
Published: May 2020

Background: Indoor air pollution is an important risk factor for health in low- and middle-income countries. Methods: We measured indoor fine particulate matter (PM 2.5 ) and carbon monoxide (CO) concentrations in 617 houses across four settings with varying urbanisation, altitude, and biomass cookstove use in Peru, between 2010 and 2016. We assessed the associations between indoor pollutant concentrations and blood pressure (BP), exhaled carbon monoxide (eCO), C-reactive protein (CRP), and haemoglobin A1c (HbA1c) using multivariable linear regression among all participants and stratifying by use of biomass cookstoves. Results: We found high concentrations of indoor PM 2.5 across all four settings (geometric mean ± geometric standard deviation of PM 2.5 daily average in µg/m 3 ): Lima 41.1 ± 1.3, Tumbes 35.8 ± 1.4, urban Puno 14.1 ± 1.7, and rural Puno 58.8 ± 3.1. High indoor CO concentrations were common in rural households (geometric mean ± geometric standard deviation of CO daily average in ppm): rural Puno 4.9 ± 4.3. Higher indoor PM 2.5 was associated with having a higher systolic BP (1.51 mmHg per interquartile range (IQR) increase, 95% CI 0.16 to 2.86), a higher diastolic BP (1.39 mmHg higher DBP per IQR increase, 95% CI 0.52 to 2.25), and a higher eCO (2.05 ppm higher per IQR increase, 95% CI 0.52 to 3.57). When stratifying by biomass cookstove use, our results were consistent with effect measure modification in the association between PM 2.5 and eCO: among biomass users eCO was 0.20 ppm higher per IQR increase in PM 2.5 (95% CI -2.05 to 2.46), and among non-biomass users eCO was 5.00 ppm higher per IQR increase in PM 2.5 (95% CI 1.58 to 8.41). We did not find associations between indoor air concentrations and CRP or HbA1c outcomes. Conclusions: Excessive indoor concentrations of PM 2.5 are widespread in homes across varying levels of urbanisation, altitude, and biomass cookstove use in Peru and are associated with worse BP and higher eCO.
Community health worker motivation to perform systematic household contact tuberculosis investigation in a high burden metropolitan district in South Africa
Authors: Kigozi Gladys , Heunis Christo , Engelbrecht Michelle
Published: May 2020

Background South Africa faces a chronic shortage of professional health workers. Accordingly, community health workers (CHWs) are being employed to mitigate the ongoing health workforce deficiencies. In addition to facilitating linkages between communities and primary health care (PHC) facilities, CHWs are entrusted with a range of crucial tuberculosis (TB), HIV/AIDS and maternal health services. As increased access to quality service delivery hinges upon their motivation, this study explored CHWs’ motivation to deliver systematic household contact TB investigation (SHCI). Methods In 2017, a cross-sectional survey was conducted among CHWs enrolled in the ward-based PHC outreach teams in the Mangaung Metropolitan District in the Free State Province. Exploratory factor analysis (EFA) was performed on a 30-item scale to determine the dimensions underlying CHW motivation. Items with factor loadings of 0.4 and above were retained. Descriptive and inferential analyses were used to determine CHW motivation levels. Multiple linear regression analysis was used investigate the determinants of CHW motivation. Statistical significance was determined at p ≤ 0.05. Results Out of 235 participants, the majority were female (89.2%). Participants’ median age was 39 (inter-quartile range: 33-45) years. CHW motivation was defined by 16 items across three dimensions — intrinsic job satisfaction, burnout and team commitment, together explaining 56.04% of the total variance. The derived 16-item scale showed satisfactory internal consistency (Cronbach’s α: 0.81), with a mean motivation score of 51.29 (sd: 5.14) out of 64. Formal CHWs — with at least phase 1 of standardised training scored statistically significantly higher than informal CHWs – with non-standardised training on the team commitment sub-scale (mean: 17.82; sd: 2.48) vs. 17.07; sd: 2.82; t(233) = 2.157; p = 0.013). CHW age (β = 0.117, p = 0.030), location (β = 1.759, p = 0.038), length of service (β = -0.505, p <0.001), attendance of TB SHCI training (B = 1.833, p = 0.33), and TB SHCI competence (β = 0.713, p <0.001), contributed statistically significantly to CHW motivation. Conclusion CHW motivation to perform TB SHCI was both intrinsic and extrinsic. The high overall mean score implies that the CHWs were well-motivated to perform TB SHCI. To ensure sustained improved access to quality TB SHCI service provision, the tool derived from this study could potentially be used by TB programme managers in the Free State and similar settings to monitor and inform CHW motivation interventions. Interventions should especially pay close attention to the CHWs’ formalisation, competence and training.
The Governance of Traditional Medicine and Herbal Remedies in the Selected Local Markets of Western Kenya.
Authors: Chebii Willy Kibet , Muthee John Kaunga , Kiemo Karatu
Published: May 2020

Background A lot of emphasis is often placed on modern governance systems and little or no attention is given to traditional governance practices which remain largely undocumented. The study aimed at finding out important traditional and modern governance practices that regulate traditional medicine sector in the Western Kenya. Materials and Methods The study was carried out in selected market centres of Western Kenya where the identified Traditional Medicine Practitioners (TMPs) sell their traditional medicine. All consenting TMPs and Professional Experts were interviewed with the aid of a semi-structured questionnaire. Purposive sampling design with elements of snow ball techniques was employed in tracing competent traditional medicine (TM) experts and relevant professional experts. The data collected was processed in Microsoft Excel and descriptive statistics performed. The Pearson’s Chi square statistics was carried out to determine the significance of the traditional and modern governance data sets using the STATA software. Results Modern governance practices were not significantly different in all the market centres surveyed (p=0.080). Equally, the traditional governance practices were also not significantly different in all the selected market centres (p=1.000). Conclusions Traditional governance practices play an important role in the governance of traditional medicine, and are shaped by the socio-cultural beliefs of the local communities. Modern governance practices, on the other hand, are widely perceived as top down regulation of the traditional medicine growing industry.
Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review
Authors: Niazkhani Zahra , Toni Esmaeel , Cheshmekaboodi Mojgan , Georgiou Andrew , Pirnejad Habibollah
Published: May 2020

Background Electronic personal health records (ePHRs) are defined as electronic applications through which individuals can access, manage and share health information in a private, secure, and confidential environment. Existing evidence shows their benefits in improving outcomes especially for chronic disease patients. However, their use has not been as widespread as expected partly due to barriers faced in their adoption and use. We aimed to identify the types of barriers to patient, provider, and caregiver adoption/use of ePHRs and to analyze their extent in chronic disease care. Methods A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) dtabase was performed to find original studies assessing barriers to ePHR adoption/use in chronic care till the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The MMAT was used to assess the quality of evidence. Results Sixty publications met our inclusion criteria. Issues found hindering ePHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting ePHRs due to workload, lack of reimbursement, and user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings and providers involved in chronic care). Conclusions ePHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating ePHR adoption/use in chronic disease care. Deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced ePHR adoption/use.
Association between physical activity and conversion from mild cognitive impairment to dementia
Authors: Kim Yeo Jin , Han Kyung-Do , Baek Min Seok , Cho Hanna , Lee Eun Joo , Lyoo Chul Hyoung
Published: May 2020

Background: Physical activity has been suggested to prevent the conversion of mild cognitive impairment (MCI) to dementia in patients. We investigated the association between the continuance and regularity of physical activity and the risk of developing dementia in patients with MCI.Methods: We analyzed 6-year followed up data for 247,149 individuals in the National Health Insurance Service (NHIS) cohort of Korea who were enrolled between January 1, 2009 and December 31, 2015. The patients were divided into four groups: those who did not engage in physical activity consistently (Never-PA group), those who initiated physical activity (Initiation-PA group), those who ceased physical activity (Withdrawal-PA group), and those who performed physical activity consistently (Maintenance-PA group). We also divided the patients into two groups: those who engaged in physical activity irregularly (Irregular-PA) and those who undertook physical activity regularly (Regular-PA).Results: When the risk for the Never-PA group was set as the benchmark (ref=1), the Maintenance-PA group had the lowest incidence of dementia of the Alzheimer type (DAT) compared to the other groups (HR= 0.82, 95% CI 0.79-0.86). The DAT risk of Initiation-PA group (HR = 0.89, 95% CI 0.85-0.93) was lower than the Never-PA group. In addition, compared to the Irregular-PA group, the Regular-PA group had a 15% reduced risk for developing DAT.Conclusions: Continued regular physical activity in patients with MCI is associated with a protective effect against developing DAT. Moreover, ceasing physical activity could halt this protective effect.
Three kinds of treatment with Homoharringtonine, Hydroxychloroquine or shRNA and their combination against coronavirus PEDV in intro
Authors: Li Cui-Cui , Wang Xiao-Jia
Published: May 2020

Background: Porcine epidemic diarrhea virus (PEDV) of the family Coronaviridae has caused substantial economic losses in the swine husbandry industry. There’s currently no specific drug available for treatment of coronaviruses or PEDV. Method: In the current study, we use coronavirus PEDV as a model to study antiviral agents. Briefly, a fusion inhibitor tHR2, recombinant lentivirus-delivered shRNAs targeted to conserved M and N sequences, homoharringtonine (HHT), and hydroxychloroquine (HCQ) were surveyed for their antiviral effects. Results: Treatment with HCQ at 50 mM and HHT at 150 nM reduced virus titer in TCID50 by 30 and 3.5 fold respectively, and the combination reduced virus titer in TCID50 by 200 fold. Conclusion: Our report demonstrates that the combination of HHT and HCQ exhibited higher antiviral activity than either HHT or HCQ exhibited. The information may contribute to the development of antiviral strategies effective in controlling PEDV infection.
Progress towards the 2020 Fast Track HIV/AIDS reduction targets in Ethiopia comparing with neighboring countries and across ages; using Global Burden of Diseases 2017 data
Authors: Mirkuzie Alemnesh H. , Ali Solomon , Abate Ebba , Worku Asnake , Misganaw Awoke
Published: May 2020

Background Sustainable Development Goal (SDG) 3.3, targets to eliminate HIV from being a public health threat by 2030. For better tracking of this target interim Fast Track milestones for 2020 and composite complementary measures have been indicated. This study measured the Fast Track progress in the epidemiology of HIV/AIDS in Ethiopia comparing with neighboring countries and across ages. Methods The National Data Management Center for health’s research team at the Ethiopian Public Health Institute has analyzed the Global Burden of Disease (GBD) 2017 data for the year 2010 to 2017 for Ethiopia and its neighbors. GBD 2017 data sources were census, demographic and a health survey, prevention of mother-to-child HIV transmission, antiretroviral treatment programs, sentinel surveillance, and UNAIDS reports. Age-standardized and age-specific HIV/AIDS incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), incidence:mortality ratio and incidence:prevalence ratio were calculated with corresponding 95% confidence intervals. Results Ethiopia and neighboring countries recorded slow progress in reducing new HIV infection in since 2010. Only Uganda would achieve the 75% target by 2020. Ethiopia, Tanzania, and Uganda already achieved the 75% mortality reduction target set for 2020. The incidence: prevalence ratio for Ethiopia, Rwanda, and Uganda were < 0.03, indicating the countries were on track to end HIV by 2030. Ethiopia had an incidence: mortality ratio <1 due to high mortality; while Kenya, Rwanda, Tanzania and Uganda had a ratio of >1 due to high incidence. The HIV incidence rate in Ethiopia was dropped by 76% among under 5 children in 2017 compared to 2010; the country would likely to attain the 2020 national target but far behind achieving the target among the 15-49 age groups. Conclusions Ethiopia and neighboring countries have made remarkable progress towards achieving the 75% HIV/AIDS mortality reduction target by 2020, although they progress poorly in reducing HIV incidence. By having an incidence:prevalence ratio benchmark less than 0.03, Ethiopia, Rwanda, and Uganda are well heading towards epidemic control. Nonetheless, the high HIV/AIDS mortality rate in Ethiopia for its incidence requires innovative strategies to reach out undiagnosed cases and to build institutional capacity for generating strong evidence to ensure sustainable epidemic control.
Secondary signs on preoperative CT as predictive factors for febrile urinary tract infection after ureteroscopic lithotripsy
Authors: Kim Jin Woo , Lee You Jin , Ha Yun-Sok , Lee Jun Nyung , Kim Hyun Tae , Chun So Young , Kim Bum Soo
Published: May 2020

Background: Febrile urinary tract infection (UTI) is one of the most common complications after ureteroscopic lithotripsy (URS). We evaluated the effect of secondary signs on preoperative computed tomography (CT) for febrile UTI after URS.Methods: In total, 182 patients who underwent URS for ureteral stones from January 2013 to December 2015 were retrospectively included in this study. These patients were divided into two groups according to the presence of postoperative febrile UTI after URS. We compared the clinical factors, stone factors, and secondary signs between the groups. Predictive factors for febrile UTI after URS were analyzed using a multivariate logistic regression model. Results: Febrile UTI occurred in 26 of the 182 patients. In univariate analysis, presence of comorbid chronic kidney disease (CKD) and stone size were significantly different between UTI and non-UTI groups. Among secondary signs, presence of hydroureter, perinephric fat stranding, periureteral fat stranding, and tissue rim sign were significantly different between the groups. In multivariate logistic regression analysis, comorbid CKD, stone size, perinephric fat stranding, and tissue rim sign were independent predictive factors for febrile UTI after URS. Conclusion: This study demonstrated that secondary signs including perinephric fat stranding and tissue rim sign on preoperative CT, CKD, and stone size are independent predictive factors for febrile UTI after URS.
Article Functional MYB transcription factor gene HtMYB2 is associated with anthocyanin biosynthesis in Helianthus tuberosus L.
Authors: Gao Jieming , Sun Xuemei , Zong Yuan , Yang Shipeng , Wang Lihui , Liu Baolong
Published: May 2020

Background: Tuber color is an important trait for Helianthus tuberosus L. (Jerusalem artichoke). Usually, purple tubers with high anthocyanin content are more nutritious than white tuber. But, the molecular mechanism underlying it is unknown.
Results: In the current study, high-throughput RNA-sequencing was used to compare the transcriptomes between plants with tubers with red or white epidermis. Anthocyanin biosynthesis structural genes had greater expression in the red-skinned tubers of cultivar QY1, indicating that the anthocyanin biosynthesis pathway was activated in ‘QY1’; quantitative PCR confirmed this difference in expression. HtMYB2 (Unigene44371_All) was the only MYB transcription factor, homologous to the MYB transcription factor regulating anthocyanin biosynthesis, expressed in the red tuber epidermis of ‘QY1’. The anthocyanin concentration in the root, stem, leaf, flower, and tuber epidermis of ‘QY1’ was higher than in ‘QY3’, especially tuber epidermis. Correspondingly, HtMYB2 had greater expression in these tissues of ‘QY1’ than in ‘QY3’. The expression of HtMYB2 was associated with anthocyanin accumulation in the different tissues. Overexpression of HtMYB2 activated the anthocyanin biosynthesis pathway, accumulating the pigment in leaves of transgenic tobacco, supporting the model that HtMYB2 regulated anthocyanin biosynthesis. Further experiments found that HtMYB2 had the same coding sequence and genomic sequence in ‘QY1’ and ‘QY3’, but that there were several single nucleotide polymorphisms and one insertion–deletion (indel) mutation of 21 nucleotides in the promoter region between the two alleles. The deletion of three nucleotides “AAA” made the promoter of ‘QY1’ predicted to contain one more possible promoter region. A specific primer, based on the indel, could differentiate between cultivars with red or white tuber epidermis. The genetic variation in HtMYB2 was associated with the tuber skin color in a natural population.
Conclusions: RNA-seq can successfully isolate the candidate gene ( HTMYB2 ) controlling anthocyanin biosynthesis in purple epidermis of Jerusalem artichoke tuber. HTMYB2 can regulate anthocyanin biosynthesis in plants and is closely related to the formation of purple phenotype in tubers. This study should be useful in understanding the genetic mechanism underlying different tuber skin colors and in breeding new H. tuberosus cultivars with different tuber skin colors.
Biovalorisation of crude glycerol and xylose into xylitol by oleaginous yeast Yarrowia lipolytica
Authors: Prabhu Ashish , Thomas Dominic J , Amaro Rodrigo Ledesma- , Leeke Gary A , Vaya Angel Medina , Verheecke-Vaessen Carol , Coulon Frederic , Agrawal Deepti , Kumar Vinod
Published: May 2020

Background: Xylitol is a commercially important chemical with multiple applications in the food and pharmaceutical industries. According to the US Department of Energy, xylitol is one of the top twelve platform chemicals that can be produced from biomass. The chemical method for xylitol synthesis is however expensive and energy intensive. In contrast, the biological route using microbial cell factories offers a potential cost-effective alternative process. The bioprocess occurs under ambient conditions and makes use of biocatalysts and biomass which can be sourced from renewable carbon originating from a variety of cheap waste feedstocks. Result: In this study, biotransformation of xylose to xylitol was investigated using Yarrowia lipolytica an oleaginous yeast which was firstly grown on a glycerol/glucose for screening of co-substrate, followed by media optimisation in shake flask, scale up in bioreactor and downstream processing of xylitol. A two-step medium optimization was employed using central composite design and artificial neural network coupled with genetic algorithm. The yeast amassed a concentration of 53.2 g/L xylitol using pure glycerol (PG) and xylose with a bioconversion yield of 0.97 g/g. Similar results were obtained when PG was substituted with crude glycerol (CG) from the biodiesel industry (titer: 50.5 g/L; yield: 0.92 g/g). Even when xylose from sugarcane bagasse hydrolysate was used as opposed to pure xylose, a xylitol yield of 0.54 g/g was achieved. Xylitol was successfully crystallized from PG/xylose and CG /xylose fermentation broths with a recovery of 39.5 and 35.3%, respectively. Conclusion: To the best of the author’s knowledge, this study demonstrates for the first time the potential of using Y. lipolytica as a microbial cell factory for xylitol synthesis from inexpensive feedstocks. The results obtained are competitive with other xylitol producing organisms.
Improved health-related quality of life in patients treated with topical sirolimus for facial angiofibroma associated with tuberous sclerosis complex.
Authors: Hatano Takashi , ohno Yuki , Imai YU , Moritake Jun , Endo Katsuhisa , Tamari Mayumi , Egawa Shin
Published: May 2020

Background: Tuberous sclerosis complex (TSC) is a rare autosomal dominant disorder forming hamartomas throughout the body. Facial angiofibromas (FAs) occur in 75% of TSC patients, which are often enlarged, impairing the appearance of the face, and reducing the patient's quality of life (QOL). The aim of this study was to characterize the impact of topical sirolimus treatment on the health-related QOL in patients with FA associated with TSC.Methods: We investigated a total of 33 patients who received sirolimus gel treatment for FA associated with TSC and assessed the changes in the health-related QOL using the Medical Outcomes Study 36-Item Short Form (SF-36) Health Survey. SF-36 surveys were performed before and after three months of treatment. The conditions of the patients after using the sirolimus gel were categorized into the following three categories: "improved," "unchanged," and "aggravated." Adverse events were investigated using the CTCAE v5.0-JCOG.Results: The median age of the patients was 25 (range 14-55) years. After 3 months of sirolimus gel treatment, three scale scores of the SF-36, vitality (VT), social function (SF), and mental health (MH), were significantly improved compared to before the treatment. The VT and SF in patients who had improved FA were significantly better than those in the other patients. There were no significant differences in any scale scores between patients with and without adverse events at three months after the initiation of sirolimus gel treatment.Conclusions: This is the first report regarding improved health-related quality of life in patients treated with sirolimus gel for FA associated with TSC by using the SF-36. The three scale scores associated with mental health were significantly improved compared to before the treatment. The health-related QOL in patients receiving sirolimus gel treatment is more strongly affected by the treatment efficacy than adverse events. Mini-abstractSirolimus gel treatment improves the health-related QOL in patients with FA associated with TSC.
Phenotyping Individuals With Newly-Diagnosed Type 2 Diabetes at Risk for All-Cause Mortality: A Single Centre Observational, Prospective Study
Authors: Biancalana Edoardo , Parolini Federico , Mengozzi Alessandro , Solini Anna
Published: May 2020

Background Type 2 diabetes (T2D) shows a high mortality rate, dependent on disease duration, comorbidities and glucose control over time. Data on patients with short disease duration are scanty.Methods We prospectively followed a cohort of newly-diagnosed T2D patients referring to a single diabetes centre, treated according to the international guidelines and checked every 6-12 months. All-cause mortality and major cardiovascular (CV) events were registered.Results 289 patients out of 3019 consecutive first attendances matched inclusion criteria and were included in the observation. Mean follow-up was 51.2 months. At 31 December 2018, 253 patients were alive and 36 deceased. At baseline, deceased individuals were older, with lower eGFR and lower uric acid, higher prevalence of atrial fibrillation. During the follow-up, 18 non-fatal CV events were adjudicated; patients with incident CV disease (CVD) differed at baseline for sex, previous history of CVD and retinopathy, higher use of secretagogues and lower use of metformin. At multivariate analysis, age and previous CVD were the only independent determinants of all-cause mortality and incident CVD, respectively. In deceased individuals, eGFR slope was markedly unstable and ΔeGFR at the end of the follow-up was higher (p<0.001), and predicted mortality. Conclusion Newly-diagnosed T2D patients followed according to the best clinical practice show a mortality rate similar to that reported in more complicated patients with longer disease duration; none of the clinical and biochemical variables commonly measured at baseline can predict mortality or incident CVD; early metformin use seems to be associated with no risk of prevalent or incident retinopathy.
Soil Physicochemical and Macrobiota Diversity Dynamics Under Enclosed Areas of Central Rift Valley of Ethiopia
Authors: Gebre Getachew Demie , Abera Getachew Birhanu , Shiferaw Solomon , Adaramola Samuel
Published: May 2020

Background Area enclosures have been implemented for many decades to restore degraded areas. The objective of this study was to evaluate its contribution to the enhancement of soil physicochemical and macrobiata diversity.Results Among the soil physicochemical parameters, the overall mean BD (0.002*), soil-MC (0.000*), % sand (0.011*), % clay (0.038*), pH (p = 0.022*), SOM (p = 0.005*), and Exch. Ca (p = 0.000*), and exch. K (p = 0.000*) exhibited a significant mean difference across the different land-use while % silt, EC, ava. K, ava. P, TN, CEC, and exch. Mg was insignificant at α-0.05. Although the whole study area was dominated by sandy, the result of ANOVA indicated that there was a significant mean difference in %sand (p = 0.011*) fraction across the land uses. The SOM also varied significantly and it is very high in the CA1, followed by CA2, PA, and OA, respectively. Though the result of Tukey's HSDa and homogeneity test showed that there is no statistically significant mean difference in the amount of available soil nutrients across the study sites, there was a slight variation in their magnitude, and PA was characterized by having high ava. P (9.70 ± 3.261a) and TN (0.28 ± 0.064a) while ava. K is very low (1062.29 ± 110.018a) compared to other land uses. In terms of the soil macrofauna, the CA1 had higher species diversity (1.90), abundance (32.69%), and richness (30.95%), and the species were evenly distributed. Followed by CA1, PA has a good species diversity (1.30), richness (26.19%), and abundance (24.16%), although the soil macrofauna was less evenly distributed compared to other land uses.Conclusion Generally, the enclosed area contributed to the improvement of soil physicochemical and biological components, and hence, expanding such measures in consultation with concerned bodies of the study area and proper follow-up mechanisms have a crucial role in rehabilitating degraded areas.
Innovative Value Addition in Tea Industry: Sri Lanka vs. Japan
Authors: Pilapitiya Herath Mudiyanselage Chamila Gayani , Silva Saliya De , Miyazaki Hideo
Published: May 2020

Sri Lanka is the third largest tea exporter in the world but nearly 60% of its exports are comprised of bulk tea. Bulk tea secures the lowest prices in world tea market. Sri Lanka earned an average value of US$4.83 per kilogram from 2014 to 2018 for its tea exports, compared to US$24.24 per kilogram in Japan, a highly innovative tea-producing country. The objective of this study is to examine the root causes of product innovation in Sri Lanka, as compared to Japan, by conducting a historical analysis of literature followed by field surveys in Sri Lanka and Ureshino, Japan. About 98% of the tea produced in Sri Lanka is black tea and has mainly focused on incremental innovations in blending, flavoring and packaging than radical innovations. Japan produces a large number of innovative beverage and non-beverage products from tea. Having a large number of small and medium processing factories (4698), Japan’s product innovation capabilities are mainly attributed to firm-level factors and support services. This study recommends that Sri Lanka should link together farmer organizations, processing factories, research institutes and universities to make its tea industry more innovative.
Effect of gut microbiota from Henoch-Schönlein Purpura patients on acid-sensitive ion channel 3 expression and intestinal motility in Germ-free rats
Authors: zhao jun-mei , yan bo , li wen ya , yuan li-ping
Published: May 2020

Background
It has been proven that intestinal microbiota alterations and acid-sensing ion channels are associated with the development of Henoch-Schönlein Purpura (HSP) and that the brain-gut axis, which involves the gut microbiota, plays important roles in many diseases. However, there have been no reports published on changes in ASIC3 expression caused by gut microbial composition and its impact on the development of HSP. This study was to investigate the impact of the intestinal microbiota in children with abdominal HSP on ASIC3 expression and interactions between the microbiota and ASIC3 expression on the development of HSP.
Methods
Feces collected from HSP children and healthy children at the First Affiliated Hospital of Anhui Medical University were made into fecal microbial solutions. Germ-free rats were randomly assigned to either the control or HSP groups. The HSP group of rats were administered the fecal microbiota solution of HSP children, while the control group rats were administered the fecal microbiota solution of healthy children. Abdominal withdrawal reflex (AWR) and intestinal propulsion rate of the rats were used to determine visceral sensitivity. Composition of the gut microbiota of HSP children was determined using 16S rRNA gene sequencing. ASIC3 expression in the dorsal root ganglion (DRG) was ascertained through real-time PCR as well as western blotting analysis.
Results
The results showed a reduction in the number of species and abundance in the intestinal microbiota of children with HSP. Visceral sensitivity and intestinal propulsion rate of HSP group rats increased significantly, compared with the control group. ASIC3 mRNA and protein levels in the DRG of the spinal cord of rats in the HSP group were found to be upregulated.
Conclusions
The microbiota dysbiosis of HSP patients could stimulate ASIC3 expression in the DRG of the spinal cord, which in turn affected intestinal motility. These results suggested that regulation of the brain-gut axis may show potential for the development of therapies that can prevent or treat HSP children, especially patients with severe gastrointestinal manifestations.
Risk Factors for Early Weight Loss in Breastfed, Early Term and Term Newborns
Authors: Eren Tijen , Kural Bahar , Gokcay Gulbin
Published: May 2020

Background: Infants lose some of their birth weight before hospital discharge. This loss, which is accepted as “physiological” up to a certain level (5-7%), is supplemented with food in early period for infants with over 7% of loss. While food supplementation does not have the benefits of mother’s milk, it may cause low breastfeeding success in the long run. In newborns, the identification of risk factors affecting weight loss in a few days following birth will increase exclusive breastfeeding success. The aim of this study is to evaluate the risk factors that cause weight loss in newborns before hospital discharge. Methods: Weight loss in infants born in a private trust hospital of Koc University American Hospital between 1 January 2011 and 31 December 2014 was evaluated. The hospital records of 3812 babies who completed the inclusion criteria were included in the study. The variables giving meaningful results in binary tables were evaluated with “Multivariate Logistic Regression”.Results: The increase in maternal age, Caesarean section birth, primiparity, female gender and being early term were statistically significant risk factors for early weight loss in newborns.
Poly-tobacco product use among a representative sample of Chinese current smokers: a population survey
Authors: Chau Siu Long , Wang Man Ping , Wu Yongda , Cheung Yee Tak , Kwong Cho-shing , Lai Vienna , Lam Tai Hing , Ho Sai Yin
Published: May 2020

BackgroundPoly-tobacco product use is increasingly popular, but little is known about the patterns, trends of concomitant use, and risk factors particularly in non-western countries.MethodA representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015-2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related risk factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population.Results 15.9% (95% CI 13.4-18.6%) were current poly-users, 12.3% (10.2-14.8%) used one tobacco product and 2.52% (1.59-3.97%) used two tobacco products in addition to cigarette. The co-use of cigarette with cigar was more common and the least co-use product was e-cigarette with cigarette. By age group, proportion of co-use of cigarette with waterpipe was highest in young poly-users, older age used more cigar and self-rolling cigarette in addition to cigarette. Prevalence of two products use with cigarette was low. Trends of concomitant use were varied. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12-3.61), younger age (AORs range from 1.34-4.65, P for trend < .001) and less ready to quit (2.08, 1.09-3.97). ConclusionsPrevalence of PTU increased slowly by year, co-use of one tobacco product with cigarette was more common. Being male, younger and less ready to quit were associated with current PTU. [236/250 words]
The efficacy and safety of intrathecal dexmedetomidine for parturients undergoing cesarean section: a double-blind randomized controlled trial
Authors: Li Xiao-xiao , Li Yu-mei , Lv Xue-li , Wang Xing-he , Liu Su
Published: May 2020

Background
The efficacy and safety of spinal anesthesia by intrathecal dexmedetomidine (DEX) for parturients undergoing cesarean section are still lack of evidence. This aim of our study was to evaluate the efficacy and safety of intrathecal DEX for parturients undergoing cesarean section to provide more data evidence for intrathecal applications.
Methods
300 parturients undergoing cesarean section under spinal anesthesia from two centers were randomly assigned into 3 groups : group B: 9.0 mg (1.2 ml) of bupivacaine 0.75% with saline (1 ml) ; group FB: 9.0 mg (1.2 ml) of bupivacaine 0.75% with 20 µg of fentanyl (1 ml) ; group DB : 9.0 mg (1.2 ml) of bupivacaine 0.75% with 5 µg of DEX (1 ml). Intraoperative block characteristics, parturients’ postoperative quality of recovery, maternal and neonatal outcomes and the plasma concentration of DEX were measured. All parturients were followed up for 30 days to determine whether nerve injury occurred.
Results
Compared with group B, the duration of sensory block in group FB and group DB were significantly prolonged (108.4 min [95% Confidence Interval (CI) = 104.6-112.3] in group B, and 122.0 min [95% CI = 116.8-127.3] in group FB, 148.2 min [95% CI = 145.3-151.1] in group DB). The overall score of quality recovery in group DB (71.6 [95% CI = 71.0-72.2]) was significantly higher than that in group FB (61.5 [95% CI = 60.8–62.2]) and group B (61.7 [95% CI = 61.0-62.4]). There were no statistically significant among the 3 groups for PH, PaO2, and PaCO2 in the umbilical artery and umbilical vein blood of newborn. The concentration of DEX in umbilical artery and umbilical vein was too low to be detected. The 30-days follow-up of parturients did not show any new onset of back, buttock or leg pain or paresthesia.
Conclusion
DEX is a potential local anesthetics adjuvant and the combination of 5 µg of DEX can exhibit a facilitatory effect when administered intrathecally as part of spinal anesthesia. However, large sample clinical studies to support the safety of intrathecal DEX use in the clinical setting are still needed.
Trial registration :
Chinese Clinical Trail Registry (Registration number # ChiCTR1900022019; Date of Registration on March 20th, 2019).
Uncovering fungal community composition in natural habitat of Ophiocordyceps sinensis using high-throughput sequencing and culture-dependent approaches
Authors: Zhang Chuanbo , Ren Chao-Hui , Wang Yan-Li , Wang Qi-Qi , Wang Yun-Sheng , Weng Qing-Bei
Published: May 2020

Background
The fungal communities inhabiting natural Ophiocordyceps sinensis play critical ecological roles in alpine meadow ecosystem, contribute to infect host insect, influence the occurrence of O. sinensis, and are repertoire of potential novel metabolites discovery. However, a comprehensive understanding of fungal communities of O. sinensis remain elusive. Therefore, the present study aimed to unravel fungal communities of natural O. sinensis using combination of high-throughput sequencing and culture-dependent approach.
Results
A total of 280,519 high-quality sequences, belonging to 5 fungal phyla, 15 classes, 41 orders, 79 families, 112 genera, and 352 putative operational taxonomic units (OTUs) were obtained from natural O. sinensis using high-throughput sequencing. Among of which, 43 genera were identified in external mycelial cortices (EMC), Ophiocordyceps, Sebacinia, Archaeorhizomyces were predominant genera with the abundance of 95.86%, 1.14%, 0.85%, respectively. Total 66 genera were identified from soil microhabitat, Inocybe, Archaeorhizomyces, Unclassified Thelephoraceae, Tomentella, Thelephora, Sebacina, Unclassified Ascomycota, Unclassified Fungi were predominant genera with an average abundance of 53.32%, 8.69%, 8.12%, 8.12%, 7.21%, 4.6%, 3.08% and 3.05%, respectively. The fungal communities in external mycelial cortices (EMC) were significantly distinct from the soil microhabitat (Soil). Meanwhile, seven culture media that benefit for the growth of O. sinensis were used to isolate culturable fungi at 16 °C, resulted in 77 fungal strains isolated for rDNA ITS sequence analysis, belonging to 33 genera, including Ophiocordyceps, Trichoderma, Cytospora, Truncatella, Dactylonectria, Isaria, Cephalosporium, Fusarium, Cosmospora, Paecilomyces, etc.. Among all culturable fungi, Mortierella and Trichoderma were predominant genera of total isolates.
Conclusions
The significantly distinction and overlap in fungal community structure between two approaches highlight that integration of approaches would generate more information than either of them. Our finding is the first investigation of fungal community structure of natural O. sinensis by two approachs, provide new insight into O. sinensis associated fungi, and support that microbiota of O. sinensis is an untapped source for novel bioactive metabolites discovery.