bluuebunny/crossref_metadata_2025 huggingface dataset:
An alarming rise of non-albicans Candida species and uncommon yeasts in the clinical samples; a combination of various molecular techniques for identification of etiologic agents
Authors: Taei Mohireh , Chadeganipour Mostafa , Mohammadi Rasoul
Published: October 2019

Objective: Yeasts are opportunistic microorganisms can cause human fungal infection among immunocompromised patients. This study aimed to identify Candida species and uncommon yeasts obtained from clinical specimens in Kashani university hospital and Shefa Lab as a referral medical mycology laboratory, in Isfahan, Iran, by combination of various molecular techniques. Results: A total of 202 yeast strains were isolated from 341 clinical samples between February 2017 to May 2019. All clinical isolates were identified using phenotypic and molecular tests. PCR-RFLP, duplex-PCR, multiplex-PCR, and PCR-sequencing were applied for molecular identification of yeasts. The most clinical samples were obtained from urine (66.8%), nail (9.4%), bronchoalveolar lavage (5.9%), sore (4.4%), and blood (3.9%). One hundred and twenty-one Candida species were identified as non- albicans against 76 Candida albicans. Trichosporon asahii, and Pichia terricola were uncommon non- Candida yeasts isolated from urine samples. For the first time, we isolated P. terricola as etiologic agent of urinary tract infection in a pregnant female. Since non- albicans Candida species and non- Candida yeasts have various virulence factors and antifungal susceptibility profile, precise molecular identification can help us to reach to the advantageous strategies for treatment of these fungal infections.
An integrated intervention for chronic care management in rural Nepal: a type 2 hybrid effectiveness-implementation study
Authors: Schwarz Dan , Dhungana Santosh , Kumar Anirudh , Acharya Bibhav , Agrawal Pawan , Aryal Anu , Baum Aaron , Choudhury Nandini , Citrin David , Dangal Binod , Dhimal Meghnath , Gauchan Bikash , Gupta Tula , Halliday Scott , Karmacharya Biraj , Kishore Sandeep , Koirala Bhagawan , Kshatriya Uday , Levine Erica , Maru Sheela , Rimal Pragya , Sapkota Sabitri , Schwarz Ryan , Shrestha Archana , Thapa Aradhana , Maru Duncan
Published: October 2019

Background In Nepal, the burden of non-communicable, chronic diseases is rapidly rising, and disproportionately affecting low- and middle-income countries. Integrated interventions are essential in strengthening primary care systems and addressing the burden of multiple comorbidities. A growing body of literature supports the involvement of frontline providers, namely mid-level practitioners and community health workers, in chronic care management. Important operational questions remain, however, around the digital, training, and supervisory structures to support the implementation of effective, affordable, and equitable chronic care management programs. Methods A twelve-month, population-level, type 2 hybrid effectiveness-implementation study will be conducted in rural Nepal to evaluate an integrated non-communicable disease care management intervention within Nepal’s new municipal governance structure. The intervention will leverage the government’s planned roll-out of the World Health Organization’s Package of Essential Non-communicable disease interventions (WHO-PEN) program in four municipalities in Nepal, with a study population of 80,000. The intervention will leverage both the WHO-PEN and its cardiovascular disease specific technical guidelines, HEARTS, and include three evidence-based components: 1) non-communicable disease care provision using mid-level practitioners and community health workers; 2) digital clinical decision support tools to ensure delivery of evidence-based care; and 3) training and digitally-supported supervision of mid-level practitioners to provide motivational interviewing for modifiable risk factor optimization, with a focus on medication adherence, and tobacco and alcohol use. The study will evaluate effectiveness using a pre-post design with stepped implementation. The primary outcomes will be disease-specific, “at-goal” metrics of chronic care management; secondary outcomes will include alcohol and tobacco consumption levels. Discussion This is the first population-level, hybrid effectiveness-implementation study of an integrated chronic care management intervention in Nepal. As low- and middle-income countries plan for the Sustainable Development Goals and universal health coverage, the results of this pragmatic study will offer insights into policy and programmatic design for non-communicable disease care management in the future.
Impact of Eastern Congo Ebola Outbreak on Child Health Services Delivery: Decline of Routine Child Immunization and Need for Vaccine Supplementation
Authors: Michel-Kabamba Nzaji , Christophe-Luhata Lungoyo , Ngatu Nlandu Roger , Othepa Charlotte , Bertin-Lora Mwimba , Arsene-Kabwaya Mukola , Bateyi Stephane H. , Hoff Nicole A. , Leon-Kabamba Ngombe , Muzembo Basilua Andre , Wada Koji , Ikeda Shunya , Mukamba Elisabeth , Guillaume-Ngoie Mwamba , Oscar-Luboya Numbi
Published: October 2019

Background An Ebola disaster, the deadliest in the history of Ebola in the Democratic Republic of Congo (DRC), is unfolding in North Kivu and Ituri provinces. An interdisciplinary research team investigated the impact of the Ebolavirus disease (EVD) outbreak on vital health services delivery under the coordination of DRC National Vaccination Program, Ministry of Health. We report on the impact of the ongoing Eastern Congo EVD outbreak on routine child immunization in the EVD-affected in North Kivu province, DRC.Methods This was a longitudinal study conducted in 40 public health facilities that organize routine child immunization in four of the 34 ‘Health Zones’ of the North Kivu province, namely Beni, Butembo, Katwa and Mabalako. Data were collected during two distinct 3-month periods: the “pre-Ebola period” (1 May through July 2018) and the “Ebola period” (1 August through October 2018), to compare the vaccination trends. Mean number of vaccine doses administered in pre-Ebola and Ebola periods were compared (unpaired t test).Results Compared to the “pre-Ebola period”, overall monthly mean vaccines uptake dropped during the “Ebola period”: BCG (157.1 ± 150.3 vs. 227.5 ± 138.4; p<0.0001), Oral polio (OPV: 505.1 ± 474.6 vs. 631.3 ± 353.9; p<0.001), Measles vaccine (147.6 ± 126.7 vs. 184.7 ± 102.5; p<0.001), pneumoccocal vaccine (PCV13: 445.8 ± 395.5 vs. 554.3 ± 299.8; p<0.001) and inactivated polio vaccine (IPV: 183.9 ± 141 vs. 153.9 ± 146.6; p<0.01). Furthermore, when considering the trend in child immunization in each of the four Health Zones during ‘Ebola period’, vaccine uptake shrank considerably in most health zones, whereas a complete disruption of vaccine delivery was observed in Mabalako health zone where the epicenter of this outbreak is located.Conclusion The ongoing Ebola outbreak has a negative impact on child health services, routine vaccination in particular. Supplementary immunization coupled with the strengthening of routine child vaccination services should be implemented to address gaps in immunity among children in affected provinces and reduce the risk of other infectious diseases outbreaks. Keywords: Democratic Republic of Congo; Ebola virus disease; Child immunization; Outbreak.
Characterization of genetic determinants of the resistance to phylloxera, Daktulosphaira vitifoliae, and the dagger nematode Xiphinema index from muscadine background
Authors: Rubio Bernadette , Lalanne-Tisné Guillaume , Voisin Roger , Tandonnet Jean-Pascal , Portier Ulysse , Ghelder Cyril Van , Lafargue Maria , Petit Jean-Pierre , Donnart Martine , Joubard Benjamin , Bert Pierre-Francois , Papura Daciana , Cunff Loïc Le , Ollat Nathalie , Esmenjaud Daniel
Published: October 2019

Muscadine ( Muscadinia rotundifolia ) is known as a resistance source to many pests and diseases in grapevine. The genetics of its resistance to two major grapevine pests, the phylloxera D. vitifoliae and the dagger nematode X. index , vector of the Grapevine fanleaf virus (GFLV) was investigated in a backcross progeny between the F1 resistant hybrid material VRH8771 ( Muscadinia-Vitis ) and V. vinifera cv. ‘Cabernet-Sauvignon’. Phylloxera resistance was assessed by monitoring root nodosity number in an “ in planta ” experiment and larval development in a root “ in vitro ” assay. Nematode resistance was studied using 10-12 month long tests for the selection of durable resistance and rating criteria based on nematode reproduction factor and gall index. A major QTL for phylloxera larval development, explaining more than 70% of the total variance and co-localizing with a QTL for nodosity number, was identified on LG 7. Additional QTLs were detected on LG 3 and LG 10, depending on the “ in planta ” or “in vitro” experiments, suggesting that various loci may influence or modulate nodosity formation and larval development. Using a Bulk Segregant Analysis approach and a proportion test, markers clustered in three regions on LG 9, LG 10 and LG 18 were shown to be associated to the nematode resistant. All these results open the way to the development of marker-assisted selection in grapevine rootstock breeding programs based on muscadine derived resistance to phylloxera and to X. index in order to delay GFLV transmission.
Role of the KNOTTED1-LIKE HOMEOBOX Protein (KD1) in regulating tomato flower pedicel abscission at early and late stages of the process
Authors: Sundaresan Srivignesh , Philosoph-Hadas Sonia , Ma Chao , Jiang Cai-Zhong , Riov Joseph , Kochanek Betina , Salim Shoshana , Reid Michael S. , Meir Shimon
Published: October 2019

Background The KNOTTED1-LIKE HOMEOBOX PROTEIN1 ( KD1 ) gene is highly expressed in flower and leaf abscission zones (AZs). RNA-antisense silencing of KD1 was shown to delay tomato pedicel and petiole abscission, induced by flower or leaf removal, respectively. KD1 was found to regulate flower pedicel abscission via alteration of auxin gradient through the flower AZ (FAZ), and disruption of the auxin response at the early stages of the abscission process. The present work was aimed to further understand how KD1 regulates signaling factors and regulatory genes involved in the delay of pedicel abscission using the silenced KD1 lines. For this purpose we performed a large scale transcriptome profiling of the FAZ at various time points after flower removal, using a customized AZ-specific microarray. Results The results highlighted a differential expression of regulatory genes in the FAZ of KD1 -silenced plants compared to the wild type (WT). These genes were controlled by KD1 before and after abscission induction. In the KD1 -silenced plants, KD1 expression already decreased at zero time before flower removal, resulting in altered expression of regulatory genes, including epigenetic modifiers, transcription factors (TFs), post-translation regulators, and antioxidative defense components. The increased expression of these regulatory genes, and genes related to exocytosis and gibberellin perception, observed in the WT FAZ, was inhibited in the KD1- silenced plants at 4 h after flower removal. This response led to an inhibited abscission phenotype and downregulation of genes involved in abscission execution and defense in the KD1 -silenced plants. Conclusions The data suggest that KD1 is a master regulator in tomato flower abscission. Some of the altered genes might directly affect auxin homeostasis and transport, resulting in slowing down auxin depletion in the FAZ. This probably delayed the subsequent cascade of the molecular events described above. The data obtained suggest that the inhibitory effect of KD1 silencing on flower pedicel abscission is not limited to manipulation of auxin levels and response as previously reported, but it probably also operates via alteration of other regulatory pathways that delay the acquisition of the competence of the FAZ cells to respond to ethylene signaling.
3-D digital modeling and bio-mechanics research of the anterior disk displacement without reduction temporomandibular joint system
Authors: Lai Linfeng , Xiong Guofeng , Huang Chenyao , Zhou Fan , Xia Fujian
Published: October 2019

Background： Anterior and/or medial displacement of the articular disc or intra-articular disorders( ID) is the most common form of TMJ dysfunction.In the present study,3D finite elements analysis (FEA) models including the maxilla, disc and mandible were established using 3D data registration technology. Materials and Methods： Six healthy volunteers and 20 TMD patients were selected.CT and MRI data were collected to build 3D FEA model of mandibular and TMJ disc. Result: Results showed that maximum stress of the normal lateral articular disc in the normal and pathological models appeared in the lateral part of the middle band. In the normal model, stress distribution was more uniform and the joint disc and the condyle were also subjected to higher load at the junction of the articular disc and the condyle. Conclusion: When the friction coefficient of the side with anterior displacement increased, stress on the disc, condyle and mandible of the opposite side increased. Simultaneously, stress values of the disc, condyle and mandible were cd32fvhigher than those of the normal lateral joint.
Continuous Incremental Heavy Halo Traction Combined with Posterior-only Approach for Severe Cervical Kyphosis with Neurofibromatosis-1.
Authors: Guo Chaofeng , Zhang Hongqi , Zhou Zhenhai , Liu Jinyang , Deng Ang
Published: October 2019

Background Surgical management of cervical kyphosis in patients with NF-1 is a challenging task. Presently, anterior-only (AO), posterior-only (PO) and combined anterior-posterior (AP) spinal fusion are common surgical strategies. However, the choice of surgical strategy and application of Halo traction remain controversial. Few studies have shown and recommended posterior-only approach for cervical kyphosis correction in patients with NF-1. The aim of this study is to evaluate the safety and the effectiveness of Continuous-Incremental-Heavy Halo Traction (CIH-HT) combined with posterior-only approach for treatment of cervical kyphosis with NF-1.
Methods 19 patients with severe cervical kyphosis due to NF-1 were reviewed retrospectively between January 2010 and April 2017. All the cases underwent CIH-HT combined with posterior instrumentation and fusion surgery. Correction result, neurologic status and complications were analyzed.
Results In this study, cervical kyphosis Cobb angle decreased from initial 63.0 ± 21.0 degrees to postoperative 10.8 ± 4.0 degrees(P＜0.01),with total correction rate of 92%, which consist of 44% from CIH-HT and 48% from surgical correction. JOA scores were improved from preoperative 13.6±1.6 to postoperative 16.0±1.0(P＜0.01). Neurological status was also improved. There was no correction loss and the neurological status was stable in mean 3.7 years follow-up. The incidence of complications was 36.8% (7/19). Six patients underwent local complications and one patient underwent a second surgery.
Conclusion CIH-HT combined PO approach is safe and effective method for cervical kyphosis correction in patients with NF-1. A satisfied correction result, and successful bone fusion can be achieved via this procedure, even improvement of neurological deficits can also be obtained. Our study suggested that CIH-HT combined PO approach is another consideration for cervical kyphosis correction in patients with NF-1.
Key words : Neurofibromatosis-1; Cervical kyphosis; Continuous-Incremental-Heavy Halo Traction; posterior-only approach;
Assessment of postoperative analgesic effect of rectus sheath block for patients who had emergency midline laparatomy, in University of Gondar Compressive Specialized Hospital, Northwest Ethiopia: an observational prospective cohort study.
Authors: Chekol Wubie Birlie , Tawuye Hailu Yimer , denu zewuditu abdissa , agegnehu Abatneh Feleke
Published: October 2019

Background : Postoperative pain is a major concern after midline abdominal surgeries. Rectus sheath block (RSB) has been indicated after midline laparatomy ; however, the analgesic effect of landmark technique on postoperative pain was not well investigated.
Objectives: we tested the hypothesis that RSB reduces pain scores, decreased total analgesic consumption and prolong first analgesic request time after emergency midline laparatomy .
Methods : Prospective cohort study was done from February 1 to May 10, 2018. Eighty eight patients were observed in this study, 44 in the RSB group and 44 in the non exposed group. Pain severity was assessed in first 24 hours postoperative period in terms of total analgesic consumption, first analgesic request time and visual analogue scale (VAS) score at 1 hour , 2 hours , 4 hours , 6 hours , 8 hours , 10 hours, 12 hours and 24 hours.
Results : The RSB group had significantly reduced VAS score at rest and on movement at (1, 2, 4, 6 and 8 hours), but not at (10, 12 and 24 hours) point assessed. Patients in RSB group had reduced tramadol requirement compared to non exposed group in 24 hours (255.68±80.13) VS (314.77±97.40), P=0.003). The 24 hours diclofenac consumption was significantly lowered in RSB group (75 ( 75-150) than non exposed group (150 ( 75-150), P=0.031.Mean time to first analgesic request was significantly longer in RSB group (372.95±131.41) than non exposed group (50.34±14.12), p≤0 . 001).
Conclusions : The RSB group resulted in less pain scores, reduced total analgesic utilization and stayed for longer time for first analgesic request. Therefore we recommend RSB as part of multimodal analgesia after emergency midline laparatomy.
Keywords: midline abdominal surgery, rectus sheath block, abdominal field block
Item Analysis: The impact of distractor efficiency on the discrimination power of multiple choice items
Authors: Rezigalla Assad Ali , Ibrahim Elwathiq Khalid , ElHussein Amar Babiker
Published: October 2019

Background Distractor efficiency of multiple choice item responses is a component of item analysis used by the examiners to to evaluate the credibility and functionality of the distractors.Objective To evaluate the impact of functionality (efficiency) of the distractors on difficulty and discrimination indices.Methods A cross-sectional study in which standard item analysis of an 80-item test consisted of A type MCQs was performed. Correlation and significance of variance among Difficulty index (DIF), discrimination index (DI), and distractor Efficiency (DE) were measured.Results There is a significant moderate positive correlation between difficulty index and distractor efficiency, which means there is a tendency for high difficulty index go with high distractor efficiency (and vice versa). A weak positive correlation between distractor efficiency and discrimination index.Conclusions Non-functional distractor can reduce discrimination power of multiple choice questions. More training and effort for construction of plausible options of MCQ items is essential for the validity and reliability of the tests.
Safety and long-term impacts on quality of life of segmental bowel resection for bowel endometriosis: a single-centred 5-year follow-up
Authors: Liu Duo , Liang Yanchun , Chen Ming , Pan Wenwei , Liu Lin , Yao Shuzhong
Published: October 2019

Purpose: To evaluate the long-term efficacy of segmental bowel resection for bowel endometriosis and the impact of post-operative complications on clinical outcomes.Methods: 62 symptomatic patients with bowel endometriosis undergoing segmental bowel resection from Jun. 2010 to Jan. 2014 were recruited. A visual analogue scale (VAS) and SF-36 questionnaire were administered before and at least 5 years after surgery. Post-operative complications and pregnancy were also recorded. Median follow-up after operation was 76 months (62-105 months).Results: 62 patients underwent laparoscopic segmental bowel resection, one of which converted to laparotomy. All patients complained of obvious pain symptoms, including dysmenorrhea, dyspareunia, bowel movement pain, chronic pelvic pain and tenesmus. Dysmenorrhea was the most frequent. The relief of all pain symptoms after surgery was statistically significant (P<0.001). The scores for 8 domains of SF-36 questionnaire were significant improved after operation (P<0.001), and the post-operative scores were improved to the level of Chinese female population. Post-operative complication included 18 cases of urinary retention, 4 rectovaginal fistulas, 2 cases of vaginal dehiscence, and 1 case each of thrombogenesis, diffuse peritonitis, peripheral nerve injury, bacteraemia, incomplete intestinal obstruction and mucus bloody stool. All of these patients recovered well. There was no significant difference in post-operative SF-36 questionnaire scores between the patients with and without complications.Conclusion: Segmental bowel resection can significantly relieve pain and improve long-term quality of life for patients with bowel endometriosis. Despite the relatively high complication rate, the complications had little impact on the improvement of quality of life.
In-hospital Mortality and Failure to Rescue Following Hepatobiliary Surgery in Germany - A Nationwide Analysis.
Authors: Krautz Christian , Gall Christine , Gefeller Olaf , Nimptsch Ulrike , Mansky Thomas , Brunner Maximilian , Weber Georg F. , Grützmann Robert , Kersting Stephan
Published: October 2019

Objective To determine the risk-adjusted in-hospital mortality for hepatobiliary resections at the national level in Germany and to examine the effect of hospital volume on in-hospital mortality, and failure to rescue. Summary Background Data There is a paucity of population-based outcome data on hepatobiliary surgery in European countries, including Germany. Methods We studied all inpatient cases of hepatobiliary surgery (n = 31,114) in Germany from 2009 to 2015, using national hospital discharge data. After ranking hospitals according to increasing hospital volumes, five volume categories were established based on all hepatobiliary resections. We evaluated the association between hospital volume and in-hospital mortality following minor and major hepatobiliary resections by using multivariable regression methods. Results Minor hepatobiliary resections were associated with an overall mortality rate of 3.9% and showed no significant volume-outcome associations. In contrast, overall mortality rate of major hepatobiliary resections was 10.3%. In this cohort, risk-adjusted in-hospital mortality following major resections varied widely across hospital volume categories, from 11.4% (95% CI 10.4–12.5) in very low volume hospitals to 7.4% (95% CI 6.6–8.2) in very high volume hospitals (risk-adjusted OR 0.59, 95% CI 0.41–0.54). Moreover, rates of failure to rescue decreased from 29.38% (95% CI 26.7-32.2) in very low volume hospitals to 21.38% (95% CI 19.2-23.8) in very high volume hospitals. Conclusions In Germany, patients who are undergoing major hepatobiliary resections have improved outcomes if they are admitted to higher volume hospitals. Given the high rates of nationwide in-hospital mortality, health political strategies to initiate a sufficient centralization process of major hepatobiliary surgery in Germany are needed.
Patient-reported quality indicators to evaluate physiotherapy care for hip and/or knee osteoarthritis- development and evaluation of the QUIPA tool.
Authors: Teo Pek Ling , Hinman Rana S , Egerton Thorlene , Dziedzic Krysia S , Kasza Jess , Bennell Kim L
Published: October 2019

Background: There is no physiotherapy-specific quality indicator tool available to evaluate physiotherapy care for people with hip and/or knee osteoarthritis (OA). This study aimed to develop a patient-reported quality indicator tool (QUIPA) for physiotherapy management of hip and knee OA and to assess its reliability and validity. Methods: To develop the QUIPA tool, quality indicators were initially developed based on clinical guideline recommendations most relevant to physiotherapy practice and those of an existing generic OA quality indicator tool. Draft items were then further refined using patient focus groups. Test-retest reliability, construct validity (hypothesis testing) and criterion validity were then evaluated. Sixty-five people with hip and/or knee OA attended a single physiotherapy consultation and completed the QUIPA tool one, twelve- and thirteen-weeks after. Physiotherapists (n=9) completed the tool post-consultation. Patient test-retest reliability was assessed between weeks twelve and thirteen. Construct validity was assessed with three predefined hypotheses and criterion validity was based on agreement between physiotherapists and participants at week one. Results: A draft list of 23 clinical guideline recommendations most relevant to physiotherapy was developed. Following feedback from three patient focus groups, the final QUIPA tool contained 18 items (three subscales) expressed in lay language. The test-retest reliability estimates (Cohen’s Kappa) for single items ranged from 0.30-0.83 with observed agreement of 64-94%. The intraclass correlation coefficient (ICC) and 95% confidence interval (CI) for the Assessment and Management Planning subscale was 0.70 (0.54, 0.81), Core Recommended Treatments subscale was 0.84 (0.75, 0.90), Adjunctive Treatments subscale was 0.70 (0.39, 0.87) and for the total QUIPA score was 0.80 (0.69, 0.88). All predefined hypotheses regarding construct validity were confirmed. However, agreement between physiotherapists and participants for single items showed large measurement error (Cohen’s Kappa estimates ranged from -0.04-0.59) with the ICC (95% CI) for the total score being 0.11 (-0.14, 0.34). Conclusions: The QUIPA tool showed acceptable test-retest reliability for subscales and total score but inadequate reliability for individual items. Construct validity was confirmed but criterion validity for individual items, subscales and the total score was inadequate. Further research is needed to refine the QUIPA tool to improve its clinimetric properties before implementation.
Distant Survival for Patients Undergoing Surgery Using Volatile versus IV Anesthesia for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: A Retrospective study
Authors: Meng Xiao-Yan , Zhang Xiu-Ping , Wang Hong-Qian , Yu Weifeng
Published: October 2019

Background Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) have lower postoperative survival rate, and anesthesia type may have an effect on tumor recurrence and metastasis.Methods A retrospective study was conducted in Eastern Hepatobiliary Surgery Hospital, Shanghai, China, from January 1, 2008 to December 24, 2012. A total of 1513 HCC patients with PVTT were delivered in the study period. Patients receiving the volatile inhalational anesthesia (INHA) and total IV (TIVA) anesthesia were screen out for comparison. The primary outcome was 5-year overall survival (OS), and secondary outcomes included recurrence-free survival (RFS), postoperative adverse events and liver function. Cox regression analysis was applied to balance confounding variables and estimate risk factors for mortality. Then subgroup analysis of anesthesia type on potential risk factors which were acquired in the final multivariable model were performed.Results After exclusions are applied, 263 patients remain in the INHA group and 208 in the TIVA group. Patients receiving INHA anesthesia have a lower 5-year survival rate than that of patients receiving TIVA anesthesia [12.6% (95% CI, 9.0 to 17.3) vs. 17.7% (95% CI, 11.3 to 20.8), P=0.024]. Results from multivariable regression analysis also identify that INHA anesthesia is significantly associated with the OS ang RFS compared with TIVA anesthesia, with HR (95%CI) of 1.303 (1.065, 1.595) and 1.265 (1.040, 1.539), respectively. Subgroup analysis suggested that in more severe cancer patients, the worse outcome related to INHA might be more significant.Conclusion This retrospective analysis identifies that patients receiving TIVA have better survival rate compare to receiving INHA in HCC patients with PVTT. Future prospective researches are urgent to verify this difference and figure out underlying causes of it.
Time to death and its predictors among adult with drug-resistance tuberculosis patients, in Eastern and East-Central Ethiopia, 2012-2018: A retrospective cohort study
Authors: Gebre Tsige , Hordofa Mulatu Ayana , Birhanu Molla Yigzaw , Siferih Melkamu , Leshargie Cheru Tesema
Published: October 2019

Background Drug-resistant tuberculosis (DRTB) is becoming a global public health problem in developing country including Ethiopia. It poses a greater challenge to the tuberculosis control program. Tuberculosis drugs namely; rifampicin and isoniazid, were the two most effective anti-tuberculosis drugs for which the agent become resistant. Understanding the survival time and the predictors of DRTB patients would be helpful to policy-makers and health practitioners in Ethiopia. However, there is a limited previous study on the aspect. Therefore, this study aimed to estimate the survival time and predictors of adult DRTB patients, in Eastern and East-Central Ethiopia.Methods A retrospective follow-up study was conducted in the Eastern and East-Central part of Ethiopia among adult drug resistance-tuberculosis patients from 1st September 2012 to 30th August 2017. The checklist was used to retrieve information among a total of 362 drug-resistant tuberculosis patients. Kaplan Meier curve method was used to estimate the median survival time with its interquartile range and risks. Multivariable Cox proportional regression modelling was used to investigating predictors of survival time. Hazard ratio with 95% CI was used to report the findings of regression modelling.Result A total of 362 participants were followed for 132,801 person day observation. During the follow-up period, there were 55 deaths with the overall incidence rate of 4 participants per 10,000-person day observation (95%CI: 3.18, 5.39). DRTB related death was higher among patients who had weight loss (AHRa: 9.0, 95%CI:2, 20.5), pulmonary with extra-pulmonary DRTB (AHR:10, 95% CI:3.3, 16), HIV co-infection (AHR:4, 95%CI:2.1,7.5) and comorbidity (AHR:4.40, 95% CI:1.7, 11), patients with BMI<18.5 (AHR:0.22, 95% CI:0.076, 0.63) were less likely to die of MDR-TB. BMI<18.5 patients with a history of relapse (AHR: 4.2, 95% CI: 1.9, 9) and after the failure of re-treatment (AHR: 6.3, 95%CI: 2.6, 13) were predictors of DRTB death.Conclusion To summarize, the survival time of patients with drug-resistant tuberculosis was low. DRTB related death was higher among patients with weight loss, people with extra-pulmonary, HIV co-infection, comorbidity, and history of relapse.
Exploring the use and experience of an infant feeding genogram to facilitate an assets-based approach to support infant feeding
Authors: Thomson Gill , Ingram Jenny , Clarke Joanne L , Johnson Debbie , Trickey Heather , Dombrowski Stephan U , Hoddinott Pat , Darwent Kirsty , Jolly Kate
Published: October 2019

Background A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s and infant feeding helpers’ experiences and use of an infant feeding genogram delivered to the intervention group of the Assets-based infant feeding help Before and After birth (ABA) randomised feasibility trial. Methods 103 primiparous mothers aged 16+ years were recruited to the trial in two sites (Site A and Site B) with low breastfeeding prevalence in the UK. Infant feeding helpers co-constructed a genogram at the first antenatal meeting for the intervention group, and then provided proactive, woman-centered support from ~32 weeks gestation to up to 5 months postnatal. Infant feeding helpers and women’s experiences of the infant feeding genogram were collected via interviews or focus groups. Completed genograms were shared with researchers. Content analysis of the genograms and qualitative data from the interviews and focus groups were analysed thematically. Results Data comprised 32 completed genograms, and qualitative insights from all 13 infant feeding helpers (two focus groups; 4 interviews) and interviews with a purposive sample of 21 of 50 intervention group women between 4-21 weeks after birth. Content analysis of the genograms highlighted variations, with more personal, individualised genograms completed at Site B compared to Site A. The perceived impact of the genogram was related to the IFHs’ application of the tool. The genogram was either used as intended to raise women’s awareness of available assets and motivate help-seeking behaviour, or as a data collection tool with limited perceived utility. Negative and positive unintended consequences of genogram use were highlighted.Discussion/Conclusion The genogram has the potential to offer a woman, family and community-centred approach that focusses on building assets for infant feeding. However, variations in genogram application indicate that revised training is required to clarify the purpose and ensure it is used as intended.
Genome-wide association study reveals genetic variation and candidate genes of lint yield components under salt field conditions in cotton (Gossypium hirsutum L.)
Authors: Zhu Guozhong , Gao Wenwei , Song Xiaohui , Sun Fenglei , Hou Sen , Liu Na , Huang Yajie , Zhang Dayong , Ni Zhiyong , Chen Quanjia , Guo Wangzhen
Published: October 2019

Background

Salinity is one of the most decisive environmental factors limiting the productivity of cotton. However, the key genetic components leading to the reduction of cotton yield in saline-alkali soils are still unclear.

Results

Here, we evaluated three main components of lint yield across 316 G. hirsutum accessions, including single boll weight (SBW), lint percentage (LP) and boll number per plant (BNPP), under four salt conditions for two years. Phenotypic analysis indicated that LP showed no change under different salt conditions, however BNPP decreased significantly while SBW increased slightly under high salt condition. Based on 57,413 high-quality single nucleotide polymorphisms (SNPs) and genome-wide association studies (GWAS) analysis, a total of 42, 91 and 25 stable quantitative trait loci (QTLs) were identified for SBW, LP and BNPP, respectively. Few overlapped QTLs and no significant phenotypic correlation among the three traits was observed. Gene Ontology (GO) analysis indicated that their regulatory mechanisms were also quite different. There were 8 overlapped QTLs for LP while fewer for SBW and BNPP identified by comparing different salt conditions. We detected that 10 genes from the 8 stable LP QTLs were predominantly expressed during fiber development. Further, haplotype analyses found that a MYB gene ( GhMYB103 ) with the two SNP variations in cis-regulatory and coding regions, was significantly correlated with lint percentage, implying the crucial role in lint yield. With transcriptome analysis, we identified that 40 candidate genes from BNPP QTLs were salt-inducible. However, these genes exhibited different regulation pattern. Genes related to carbohydrate metabolism and cell structure maintenance were rich in high salt condition, while genes related to ion transport were active in low salt condition.

Conclusions

This study provides a foundation for elucidating cotton salt tolerance mechanism and contributes gene resources for developing varieties with high yield and salt stress tolerance in upland cotton.
Integrated transcriptome and proteome analyses identifies novel genes and regulatory networks in intervertebral disc degeneration
Authors: Xu Chen , Luo Shengchang , Wei Leixin , Wu Huiqiao , Gu Wei , Zhou Wenchao , Sun Baifeng , Hu Bo , Zhou Hongyu , Liu Yang , Chen Huajiang , Ye Xiaojian , Yuan Wen
Published: October 2019

Background: Intervertebral disc degeneration is a major cause of symptoms like low back pain and neck pain. Many groups have tried to reveal the regulatory network using either transcriptome or proteome profiling technologies, however, the relationship between these differentially expressed proteins and mRNAs are not elucidated. Since post-transcriptional regulation and other mechanisms may affect the translation of mRNA to protein, a combined transcriptome and proteome study may give more precise data on unveiling important regulatory network and key genes of Intervertebral disc degeneration. Results: In the present study, we used the label-free quantification proteomic approach and identify 656 proteins expressed in either degenerated or normal nucleus pulposus, of which 503 proteins are differentially expressed. Taking advantage of the existing nucleus pulposus transcriptome data, we combine and reanalyze the data and find 105 differentially expressed mRNA between degenerated and normal nucleus pulposus. By comparing these data, only 9 genes show significant changes in both protein and mRNA data, while 6 genes (TNFAIP6, CHI3L1, KRT19, DPT, COL6A2 and COL11A2) show concordant changes in both protein and mRNA level. Further functional analyses show different functions of the altered mRNAs and proteins in degeneration, indicating great difference between protein network and mRNA network. Using the gene co-expression network method, we uncover novel regulatory network and potential genes that may play vital roles in intervertebral disc degeneration by combining protein and mRNA data. Conclusions: This is the first study to identify novel regulatory network of intervertebral disc degeneration using combined analysis of both transcriptome and proteome, which may give new insight into the molecular mechanism of intervertebral disc degeneration.
Transcriptome-wide map of m6A circRNAs identified in hypoxic pulmonary hypertension rat model
Authors: Su Hua , Wang Guowen , Wu Lingfang , Ma Xiuqing , Ying Kejing , Zhang Ruifeng
Published: October 2019

Background: Hypoxic pulmonary hypertension (HPH) is a lethal disease and lacks effective therapy. CircRNAs play significant roles in physiological process. Recently, circRNAs are found to be m 6 A-modified. The abundance of circRNAs was influenced by m 6 A. Furthermore, the significance of m 6 A circRNAs has not been elucidated in HPH yet. Here we aim to investigate the transcriptome-wide map of m 6 A circRNAs in HPH.
Results: Differentially expressed m 6 A abundance was detected in lungs of HPH rats. M 6 A abundance in circRNAs was significantly reduced in hypoxia in vitro . M6A circRNAs were mainly from protein-coding genes spanned single exons in control and HPH groups. Moreover, m 6 A influenced the circRNA–miRNA–mRNA co-expression network in hypoxia. M 6 A circXpo6 and m 6 A circTmtc3 were firstly identified to be downregulated in HPH.
Conclusion: Our study firstly identified the transcriptome-wide map of m 6 A circRNAs in HPH.
M 6 A can influence circRNA–miRNA–mRNA network. Furthermore, we firstly identified two HPH-associated m 6 A circRNAs: circXpo6 and circTmtc3. We suggested that m 6 A circRNAs may be used as a potential therapy targets or biomarkers.
Should Upper Limit of Available Water be Based on Field Capacity?
Authors: Logsdon Sally
Published: October 2019

Core Ideas

Plants can use water while soil drains.

Extra water can move up into the root zone.

Field measurements of water use are not restricted by boundary values.

Plant‐available water is usually determined from laboratory measurements as the difference between field capacity (undisturbed soil samples) and wilting point (disturbed samples), both of which are determined at arbitrary applied pressures. How much soil water is actually available to plants? The purpose of this report is to demonstrate that data are inconsistent with the concept of field capacity at a pressure head being the upper limit of available water. Existing field studies were re‐examined. Literature shows that a considerable portion of transpired water often comes from below the root zone. A site that had water table depths ranging from near the surface to 3 m deep showed that tensiometer pressure heads in the root zone rarely got as dry as −333 cm pressure head (approximate limit of field capacity). Another study showed that as surface soil dried, the roots were able to take up water from deeper soil, showing the flexibility of the root zone depth. Still other studies suggest that transpiration might start between 3 and 10 h after a rain ends, even while the soil is still draining. Together these studies strongly suggest that roots take up water under conditions wetter than −333 cm pressure head; therefore, laboratory‐determined field capacity should not be considered the upper cutoff of available water.
Nitrogen Content and Use Efficiency of Sweet Sorghum Grown in the Lower Midwest
Authors: Maw Michael J.W. , Houx James H. , Fritschi Felix B.
Published: October 2019

Optimizing N fertilizer inputs is imperative for improving sweet sorghum [Sorghum bicolor (L.) Moench] yields and biofuel feedstock system efficiency. A 2‐yr study was conducted to determine the physiological N‐use efficiency (NUE) response in sweet sorghum's ethanol yield of stem juice, bagasse, and total ethanol yield (TEY). Two sweet sorghum cultivars (‘Dale’ and ‘Top 76–6’) were fertilized at five N fertilizer rates (0, 56, 112, 168, and 224 kg ha−1). At harvest, the stem juice and bagasse yields were measured then analyzed for the corresponding N concentrations and N contents. Whole‐plant N recovery efficiency ranged from −1.5 to 57.6% across both years, with a significant N rate effect only in one study year. The NUE of juice ethanol yield only demonstrated an N response in the second year, whereas the NUE of lignocellulosic ethanol yield was greatest at the 56 kg ha−1 fertilizer rate each year. The NUE of total theoretical ethanol yield, determined as the sum of juice and bagasse conversion to ethanol, averaged 169 L EtOH kg−1 N across both years and was greatest at the 56 kg N ha−1 fertilizer rate in both years, and decreased at N rates exceeding 56 kg ha−1 in only one of the years. This study revealed that although sweet sorghum ethanol yields increased with N fertilizer application, NUE was greatest with low N fertilizer rates, consistent with previous research indicating that sweet sorghum is an appropriate biofuel feedstock for production in low‐input systems or on marginal lands.

Core Ideas

Nitrogen recovery and use efficiencies of sweet sorghum juice and bagasse were measured for two years in Missouri.

Nitrogen recovery efficiency was greatest in one study year when 224 kg N ha−1 was applied, with no differences in recovery in the second year.

The N use efficiency of estimated total ethanol yield was greatest at 56 kg N ha−1.
Influence of Slope Angle on Water Flow in a Three‐Layer Capillary Barrier Soil Cover under Heavy Rainfall
Authors: Chen Rui , Liu Jian , Ng Charles W. W. , Chen Zhong Kui
Published: October 2019

A three‐layer capillary barrier soil cover has been recently proposed for minimizing rainwater percolation in humid climates. Its performance has been preliminarily investigated by both physical and numerical modeling at a fixed slope angle of 10°. However, the slope angle of soil cover is varied in engineering practice and hence it is an essential design parameter. In this study, the influence of slope angle on water flow in the three‐layer soil cover was investigated via flume model tests subjected to heavy rainfall. A 3‐m long flume model of soil cover was instrumented to monitor matric potential and volumetric moisture content as well as components of water balance at slope angles of 3°, 10° and 18°. Furthermore, numerical simulations of transient seepage were conducted to back‐analyze the experiments. Both experimental and numerical results showed that the infiltration ratio increased as the slope angle increased because of the increase in the soil water potential gradient normal to the slope gradient. Meanwhile, the lateral water flow in the upper two layers was enhanced by the increase of slope angle due to water backfill effect at the top of clay layer. Correspondingly, the steeper the slope, the lower the matric potential, volumetric moisture content and soil water potential in the upper two layers were. Due to low hydraulic conductivity of the bottom clay layer, the percolation through the cover remained virtually nil at each slope angle. The above findings could have significant implications for the design of sloping three‐layer capillary barrier soil cover.
KONTUSIO LABIRIN PADA PASCA CEDERA KEPALA
Authors: Astuti Ari
Published: October 2019

Background : Blunt head trauma without any temporal bone fracture or longitudinal temporal bone fracture, with an associated fracture of the labyrinth may cause labyrinthine injury with hearing loss and vertigo because of a concusive injury to the membranous labyrinth.

Objective : To explain a case of labyrinthine concussion in patient with post traumatic brain injury experienced in Dr. Sardjito Hospital Yogyakarta.

Case Description : A patient who treated in the hospital with spinning sensation after crush injury. She also had fracture of the left collum femur. Head CT scan and laboratory examination was initiated within normal limit. Patient then diagnosed with labyrinthine concussion and treated with symptomatic therapy and physiotherapy.

Conclusion : Labyrinthine concussion can occur to the patient of blunt head trauma. Pharmacotherapy and physiotherapy should be initiated to reduce symptomps and uncomfortable sensation.

Keywords : labyrinthine concussion, traumatic brain injury, mixed type vertigo
Efficient H2O2 generation and electro-Fenton degradation of pollutants in microchannels of oxidized monolithic-porous-carbon cathode
Authors: Guo Yunfei , Wu Shuai , Yu Hongtao , Chen Shuo , Wang Chunna , Quan Xie , Lu Na
Published: October 2019

A monolithic-porous carbon (MPC) was fabricated by carbonizing a pine rod, and then the oxidized monolithic-porous carbon (O-MPC) was obtained via alkaline heat treatment of MPC. With well-ordered axial channels (diameters were 6–14 μm and 40–50 μm) and oxygen-containing functional groups, O-MPC as a flow-through cathode exhibited good capability in continuously generating H2O2 (422 μmol/L) via oxygen reduction. O-MPC and additional Fe2+ composed an electro-Fenton system and the performance of the system in degradation of organic pollutants was evaluated. For phenol, bisphenol A or sulfamethoxazole at initial concentration of 10 mg/L the removal efficiency reached 74%–82% in a hydraulic retention time of 100 seconds, nearly close to that of the homogeneous Fenton process (90%). This efficiency may be maintained for at least 10 hours, indicating a good stability of O-MPC. The results demonstrate the potential of O-MPC as a flow-through electrode to realize homogeneous-like degradation of organic pollutants in wastewater.