bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Reconstruction for Upper-Extremity Paralysis Following Acute Flaccid Myelitis
Authors: Doi Kazuteru , Sem Sei Haw , Hattori Yasunori , Sakamoto Sotetsu , Hayashi Kota , De la Red-Gallego Maria Angeles
Published: October 2019

Background:

Acute flaccid myelitis (AFM) is a debilitating illness that is defined by the sudden onset of flaccid paralysis in the extremities with spinal magnetic resonance imaging (MRI) demonstrating a longitudinal lesion confined to the gray matter. The purpose of this study was to report the types of upper-extremity palsy and outcomes of surgical reconstruction in patients with AFM.

Methods:

Eight patients with a median age at onset of 3.8 years (range, 2.3 to 9.9 years) were identified. There was loss of shoulder abduction and external rotation in all patients, loss of elbow flexion in 5 patients, complete or partial loss of hand function in 3 patients, and spinal accessory nerve palsy in 2 patients. All patients underwent surgical reconstruction, which was categorized into 3 main groups: nerve transfer, secondary muscle transfer, and free muscle transfer.

Results:

The median follow-up period was 39 months (range, 30 to 94 months). Four patients obtained ≥90° of shoulder abduction whereas the other 4 patients had shoulder abduction of ≤70°. The 5 patients who received free muscle transfer or nerve transfer to restore elbow function obtained ≥140° of elbow flexion. Two patients treated with free muscle transfer to restore finger function obtained satisfactory total active motion of the fingers (180°).

Conclusions:

The patterns of paralysis and the strategy and outcomes of surgical reconstruction for patients with AFM differed from those for traumatic and obstetric brachial plexus palsy. All patients had loss of shoulder abduction, and 2 had spinal accessory nerve palsy. Restoration of shoulder function was unpredictable and depended on the quality of the donor nerves and recovery of synergistic muscles. Restoration of elbow and hand function was more consistent and satisfactory.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete list of levels of evidence.
THE PROSPECTS FOR ISLAMIC SOCIAL BANKING IN INDONESIA
Authors: Hamidi M Luthfi , Worthington, Andrew , West Tracey , Ismal Rifki
Published: October 2019

Despite significant growth and development in recent years, Islamic banking (IB) continues to face widespread criticism given its apparently weak social outcomes. This study investigates the social performance of Islamic banking in Indonesia, including its justification as an IB objective and the means of improvement. We do this by surveying 506 current and potential Islamic banking customers across six Indonesian provinces, combined with in-depth interviews with 10 Islamic banking experts (regulators, practitioners, Syariah scholars, and academics). The findings strengthen previous results on the topic in that 42.89% of respondents consider that IB in Indonesia is defensive (doing the least that is required in terms of social outcomes), while 6.92% believe that it is reactive (doing less than that required). Of the remaining respondents, 34.78% consider the social performance as accommodative (doing all that is required) and 15.42% see it as proactive (doing more than is required). Most respondents (52.96%) suggest improvement by combining corporate social responsibility and the ZIS (Zakat, Infaq, shadaqah)-Waqf system. Only some (7.11%) suggest the establishment of Islamic social banking, whose main feature would be to design an alternative to collateral so that low- and middle-income customers could more readily access bank financing. We recommend that regulators and practitioners take action to address these weaknesses through incentives and long-term strategic planning.
IBN KHALDUN MODEL ON POVERTY: THE CASE OF ORGANIZATION OF ISLAMIC CONFERENCE (OIC) COUNTRIES
Authors: Fatoni Ahlis , Herman Sebastian , Abdullah Adam
Published: October 2019

If we consider the state of the world economy, especially in the OIC countries, somecountries have to struggle in dealing with the problems of poverty. Hypothetically,the wealth of natural resources is potentially in the welfare of the population, but thefacts on the ground say the situation is another in which it is far from being wellbeing.This study aims to analyze poverty in OIC countries by using a developmentmodel proposed by Ibn Khaldun. The model consists of six variables: human resourcevariable (proxy HDI), the variable role of government (proxy government spendingin education and health), variable of development (proxy foreign direct investment),state assets variable (proxy for GDP/capita), justice variable (gini index proxy) andsharia variable (a proxy perception index of corruption). This study uses panel dataregression analysis with nine object OIC member countries (Indonesia, Malaysia,Egypt, Azerbaijan, Kazakhstan, Tajikistan, Kyrgyzstan, Turkey and Benin) over theyears from 2010 to 2016. The results showed that the variables of development modelIbn Khaldun significant effect on poverty in OIC countries is development variable, thevariable role of government (proxy for government spending in health sector), justicevariable, wealth nation variable and control variables (unemployment). While the roleof government variable (proxy government spending in the education sector), HRvariables and sharia variables not significant. From these studies, it can be concludedthat not all the variables of development model Ibn Khaldun significant effect onpoverty in OIC countries.
Alkali/Cosolvent/Polymer Flooding of High-TAN Oil: Using Phase Experiments, Micromodels, and Corefloods for Injection-Agent Selection
Authors: Schumi Bettina , Clemens Torsten , Wegner Jonas , Ganzer Leonhard , Kaiser Anton , Hincapie Rafael E. , Leitenmüller Verena
Published: October 2019

Chemical enhanced oil recovery (EOR) leads to substantial incremental costs over waterflooding of oil reservoirs. Reservoirs containing oil with a high total acid number (TAN) could be produced by the injection of alkali. Alkali might lead to the generation of soaps and emulsify the oil. However, the generated emulsions are not always stable.

Phase experiments are used to determine the initial amount of emulsions generated and their stability if measured over time. On the basis of the phase experiments, the minimum concentration of alkali can be determined and the concentration of alkali above which no significant increase in the formation of initial emulsions is observed.

Micromodel experiments are performed to investigate the effects on the pore scale. For the injection of alkali into high-TAN oils, the mobilization of residual oil after waterflooding is seen. The oil mobilization results from the breaking up of oil ganglia or the movement of elongated ganglia through the porous medium. As the oil is depleting in surface-active components, residual oil saturation is left behind either as isolated ganglia or in the down gradient side of grains.

Simultaneous injection of alkali and polymers leads to a higher incremental oil production in the micromodels owing to larger pressure drops over the oil ganglia and more-effective mobilization accordingly.

Coreflood tests confirm the micromodel experiments, and additional data are derived from these tests. Alkali/cosolvent/polymer (ACP) injection leads to the highest incremental oil recovery of the chemical agents, which is difficult to differentiate in micromodel experiments. The polymer adsorption is substantially reduced if alkali is injected with polymers compared with polymer injection only. The reason is the effect of the pH on the polymers. As in the micromodels, the incremental oil recovery is also higher for alkali/polymer (AP) injection than with alkali injection only.

To evaluate the incremental operating costs of the chemical agents, equivalent utility factors (EqUFs) are calculated. The EqUF takes the costs of the various chemicals into account. The lowest EqUF and, hence, the lowest chemical incremental operating expenditures are incurred by the injection of Na2CO3; however, the highest incremental recovery factor is seen with ACP injection. It should be noted that the incremental oil recovery owing to macroscopic-sweep-efficiency improvement by the polymer needs to be accounted for to assess the efficiency of the chemical agents.
Diagnostic evaluation of IgM ELISA and IgM Immunofluorescence assay for the diagnosis of Acute Scrub Typhus in central Nepal
Authors: Gautam Rajendra , Parajuli Keshab , Tshokey Tshokey , Stenos John , Sherchand Jeevan Bahadur
Published: October 2019

Introduction Scrub typhus is an acute febrile illness caused by the obligate intracellular bacterium,Orientia tsutsugamushi. Given their affordability and ease of use, antibody based diagnostic assays can be important diagnostic tools for early detection of scrub typhus fever in resource poor countries like Nepal. Immunochromatography (ICT) and IgM ELISA are two of the routinely employed antibody based assays for diagnosis of Scrub typhus fever in Nepal, although the recommended gold standard diagnostic test is IgM Immunofluorescence assay (IFA). This study evaluated the InBios Scrub Typhus Detect™ Immunoglobulin M (IgM) ELISA and IgM Immunofluorescence assays in single serum sample at the time of admission. Methodology Study participants (1585 suspected cases), were enrolled based on acute febrile illness with suspected scrub typhus cases in central Nepal from April 2017 to March 2018. Blood sample was collected from the suspected patients of scrub typhus, presenting with acute febrile illness. IgM antibody to Orientia tsusugamushi was detected by using Scrub Typhus Detect™ Kit (In Bios International, USA) and an in-house IgM IFA (Australian Rickettsial Reference Laboratory, Geelong, Australia. The IFA assay was performed with the Gilliam, Karp, Kato strains and O. chuto antigens following the ARRL protocol. Result Statistical analysis of ELISA IgM results when compared to reference test, IgM IFA results demonstrated the following characteristics, sensitivity 84.0% (95%CI: 79.73%-87.68%), specificity 94.82% (95% CI: 93.43%-95.99%), positive likelihood ratio 16.21% (95% CI: 12.71%-20.67%), negative likelihood ratio 0.17% (95% CI: 0.13-0.21%), disease prevalence 22.08% (95% CI: 20.06%-24.21%), positive predictive value 82.12% (95% CI: 78.28-85.42%) and negative predictive value 95.44% (95% CI: 94.27%-96.38%) respectively. Conclusion The study indicated that the IgM ELISA has the sensitivity 84.0% (95% CI: 79.73%-87.68%) and specificity 94.82% (95% CI: 93.43%-95.99%). Although IgM IFA is considered the gold standard test for the diagnosis of scrub typhus cases, it is relatively expensive, requires trained personal and a microscope with fluorescence filters. Scrub typhus IgM ELISA with appropriate OD cut–off values may be the best alternative test and possible viable option for resource limited endemic countries like Nepal.
Occurrence and seasonal variation of human Plasmodium infection in Punjab Province, Pakistan
Authors: Qureshi Naveeda Akhtar , Fatima Huma - , Afzal Muhammad , Khattak Aamer Ali , Nawaz Muhammad Ali
Published: October 2019

Background: Malaria is the fifth leading cause of death worldwide. Pakistan is considered as a moderate malaria-endemic country but still, 177 million individuals are at risk of malaria. Roughly 60% of Pakistan’s population, live in malaria-endemic regions. The present study is based upon the survey of various health care centers in 10 major cities of Northern and Southern Punjab to find out the malarial infection patterns in 2015. The diagnosis, seasonal variations, age and gender-wise distribution of Plasmodium spp. circulating in the study area were also included in the objectives.
Methods: The malaria-suspected patients ‘16075’ were enrolled for malaria diagnosis using microscopy, out of which 925 were malaria positive which were processed for molecular analysis using nested PCR. The 18S rRNA genes of Plasmodium species were amplified, sequenced, blast and the phylogenetic tree was constructed based on sequences using online integrated tool MEGA7.
Results: The 364 cases recruited from Northern Punjab with the highest incidence in Rawalpindi (25.5%) and lowest in Chakwal (15.9%). From Southern Punjab 561 cases were enlisted Rajanpur (21.4%) maximum and lowest from Multan and Rahim Yar Khan (18%). The slide positivity rate, annual parasite incidence, and annual blood examination rates were 5.7 per 1000 population, 0.1%, and 0.2% respectively. The only P. vivax (66.7%), P. falciparum (23.7%) and mixed infection by these two species (9.6%) were diagnosed. The same trend (P. vivax>P. falciparum > mixed infection) in species identification %age was confirmed from molecular analysis. However, the occurrence of malaria was higher in Southern Punjab (5.5%) as compared to the Northern Punjab (4.0%). The overall malaria percentage occurrence of treatment-seeking patients in all recruited cities of Punjab was 4.9%. The age-group of 1-20 and males among genders were more affected by malaria. The comparison of different seasons showed that the malaria infection was at a peak in Summer and post-monsoon.
Conclusion: The incidence of malaria was high in the flood infected rural areas of Southern Punjab, Summer, and post-monsoon. The age group (1-20) and gender-wise males were more affected by malaria.
A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018
Authors: Ren Zuning , Mo Xichao , Chen Hongjie , Peng Jie
Published: October 2019

Background: Infective endocarditis (IE) is a lethal disease which has been changing significantly over the past decades; however, information about IE in China remains scarce. This study surveyed the changes in clinical characteristics of IE at a tertiary hospital in southern China over a period of nearly eighteen years. Methods: Medical records with IE patients consecutively hospitalized between June 2001 and June 2018 were selected from the electronic medical records system in Nanfang Hospital of Southern Medical University. Data were divided by admission time into two groups: early-period group, June 2001 to December 2009 and later-period group, January 2010 to July 2018. Results: A Total of 313 IE patients were included in our study. Compared with the early-period group, patients in the later-period group included fewer intravenous drug users (IVDU), older age at onset, reduced development of pulmonary embolism, less renal dysfunction, decreased proportion of Staphylococcus aureus infection and fewer vegetations observed in the right heart by echocardiography. The later-period group also showed a higher proportion of ischemic strokes and higher rate of whole-blood culture positive compared with the early-period group. The in-hospital mortality rate remained about the same between the two periods. Conclusions: Our study demonstrated a dramatic change in the profile and characteristics of IE over a period of eighteen years at a tertiary hospital in southern China, especially the decrease in intravenous drug users (IVDU), which might be responsible for many other changes.
Incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia: A retrospective record review
Authors: Temesgen Belisty , Kibret Getiye Dejenu , Alamirew Nakachew Mekonnen , Melkamu Mamaru Wubale , Hibstie Yitbarek Tenaw , Petrucka Pammla , Alebel Animut
Published: October 2019

Background: Tuberculosis is the leading cause of morbidity and mortality among people living with human immunodeficiency virus. Almost one-third of deaths among people living with human immunodeficiency virus are attributed to tuberculosis. Despite this evidence, in Ethiopia, there is a scarcity of information regarding the incidence and predictors of tuberculosis among people living with HIV. Thus, this study assessed the incidence and predictors of tuberculosis among HIV-positive adults on antiretroviral therapy.
Methods: This study was a retrospective record review including 544 HIV-positive adults on antiretroviral therapy at Debre Markos Referral Hospital between January 1, 2012 and December 31, 2017. The study participants were selected using a simple random sampling technique. The data extraction format was adapted from antiretroviral intake and follow-up forms. Cox-proportional hazards regression model was fitted and Cox-Snell residual test was used to assess the goodness of fit. Tuberculosis free survival time was estimated using the Kaplan-Meier survival curve. Both the bi-variable and multivariable Cox-proportional hazard regression models were used to identify predictors of tuberculosis.
Results: In the final analysis, a total of 492 HIV-positive adults were included, of whom, 83 (16.9%) developed tuberculosis at the time of follow-up. This study found that the incidence of tuberculosis was 6.5 (95% CI: 5.2, 8.0) per 100-person-years (PY) of observation. Advanced World Health Organization clinical disease stage (III and IV) (AHR: 2.1, 95% CI: 1.2, 3.2), being ambulatory and bedridden (AHR: 1.8, 95% CI: 1.1, 3.1), baseline opportunistic infections (AHR: 2.8, 95% CI: 1.7, 4.4), low hemoglobin level (AHR: 3.5, 95% CI: 2.1, 5.8), and not taking Isonized Preventive Therapy (AHR: 3.9, 95% CI: 1.9, 7.6) were found to be the predictors of tuberculosis.
Conclusion: The study found that there was a high rate of tuberculosis occurrence as compared to previous studies. Baseline opportunistic infections, being ambulatory and bedridden, advanced disease stage, low hemoglobin level, and not taking Isonized Preventive Therapy were found to be the predictors of tuberculosis. Therefore, early detection and treatment of opportunistic infections like tuberculosis should get a special attention.
Keywords: Debre Markos, HIV, Incidence, Predictors, tuberculosis
Rapid identification and characterization of genetic loci for defective kernel in bread wheat
Authors: Fu Chao , Du Jiuyuan , Tian Xiuling , He Zhonghu , Fu Luping , Wang Yue , Xu Dengan , Xu Xiaoting , Xia Xianchun , Zhang Yan , Cao Shuanghe
Published: October 2019

Background Wheat is a momentous crop and feeds billions of people in the world. The improvement of wheat yield is very important to ensure world food security. Normal development of grain is the essential guarantee for wheat yield formation. The genetic study of grain phenotype and identification of key genes for grain filling are of great significance upon dissecting the molecular mechanism of wheat grain morphogenesis and yield potential. Results Here we identified a pair of defective kernel (Dek) isogenic lines, BL31 and BL33, with plump and shrunken mature grains, respectively, and constructed a genetic population from the BL31/BL33 cross. Ten chromosomes had higher frequency of polymorphic single nucleotide polymorphism (SNP) markers between BL31 and BL33 using Wheat660K chip. Totally 783 simple sequence repeat (SSR) markers were chosen from the above chromosomes and 15 of these were integrated into two linkage groups using the genetic population. Genetic mapping identified three QTL, QDek.caas-3BS.1, QDek.caas-3BS.2 and QDek.caas-4AL, explaining 14.78 - 18.17%, 16.61 - 21.83% and 19.08 - 28.19% of phenotypic variances, respectively. Additionally, five polymorphic SNPs from Wheat660K were successfully converted into cleaved amplified polymorphic sequence (CAPS) markers and enriched the target regions of the above QTL. Biochemical analyses revealed that BL33 has significantly higher grain sucrose contents at filling stages and lower mature grain starch contents than BL31, indicating that the Dek QTL may be involved in carbohydrate metabolism. As such, the candidate genes for each QTL were determined according to International Wheat Genome Sequence Consortium (IWGSC) RefSeq v1.0. Conclusions Overall, we achieved a rapid QTL mapping and reasonable predication of causal genes for Dek, laying foundation to conduct fine mapping and dissect the regulatory mechanism underlying Dek trait in wheat.
Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register
Authors: Forss Anders , Myrelid Pär , Olén Ola , Everhov Åsa H , Nordenvall Caroline , Halfvarson Jonas , Ludvigsson Jonas F.
Published: October 2019

Validating surgical procedure codes for inflammatory bowel disease in the Swedish National Patient Register Background: About 50% of patients with Crohn’s disease (CD) and about 20% of those with ulcerative colitis (UC) undergo surgery at some point during the course of the disease. The diagnostic validity of the Swedish National Patient Register (NPR) has previously been shown to be high for inflammatory bowel disease (IBD), but there are little data on the validity of IBD-related surgical procedure codes. Methods: Using patient chart data as the gold standard, surgical procedure codes registered between 1966 and 2014 in the NPR were abstracted and validated in 262 patients with a medical diagnosis of IBD. Of these, 53 patients had reliable data about IBD-related surgery. The positive predictive value (PPV), sensitivity and specificity of the surgical procedure codes were calculated. Results: In total, 158 codes were registered in the NPR. 155 of these, representing 60 different surgical procedure codes, were also present in the patient charts and validated using a standardized form. Of the validated codes 153/155 were concordant against the patient charts, corresponding to a PPV of 96.8% (95%CI=93.9-99.1). Stratified in abdominal, perianal and other surgery, the corresponding PPVs were 94.1% (95%CI=88.7-98.6), 100% (95%CI=100-100) and 98.1% (95%CI=93.1-100), respectively. Of 164 surgical procedure codes in the validated patient charts, 155 were registered in the NPR, corresponding to a sensitivity of the surgical procedure codes of 94.5% (95%CI=89.6-99.3). The specificity of the NPR was 98.5% (95%CI=97.6-100). Conclusions: Data on IBD-related surgical procedure codes are reliable, with the Swedish National Patient Register showing a high sensitivity and specificity for such surgery. Keywords: Epidemiology, Inflammatory bowel disease, Validation, National Patient Register, Procedure code
Proteomic and transcriptomic analyses of early and late-chronic Toxoplasma gondii infection shows novel and stage specific transcripts
Authors: Garfoot Andrew , Wilson Gary , Coon Joshua , Knoll Laura
Published: October 2019

Background : The protozoan pathogen Toxoplasma gondii has the unique ability to develop a chronic infection in the brain of its host by transitioning from the fast growing tachyzoite morphology to latent bradyzoite morphology. A hallmark of the bradyzoite is the development of neuronal cysts that are resilient against host immune response and current therapeutics. The bradyzoite parasites within the cyst have a carbohydrate and protein-rich wall and a slow-replication cycle, allowing them to remain hidden from the host. The intracellular, encysted lifestyle of T. gondii has made them recalcitrant to molecular analysis in vivo .

Results : Here, we detail the results from transcriptional and proteomic analyses of bradyzoite-enriched fractions isolated from mouse brains infected with T. gondii over a time course of 21 to 150 days. The enrichment procedure afforded consistent identification of over 2,000 parasitic peptides from the mixed-organism sample, representing 366 T. gondii proteins at 28, 90, and 120 day timepoints. Deep sequencing of transcripts expressed during these three timepoints revealed that a subpopulation of genes that are transcriptionally expressed at a high level. Approximately one-third of these transcripts are more enriched during bradyzoite conditions compared to tachyzoites and approximately half are expressed at similar levels during each phase. The T. gondii transcript which increased the most over the course of chronic infection, sporoAMA1, shows stage specific isoform expression of the gene.

Conclusions : We have expanded the transcriptional profile of in vivo bradyzoites to 120 days post-infection and provided the first in vivo proteomic profile of T. gondii bradyzoites. The RNA sequencing depth of in vivo bradyzoite T. gondii was over 250-fold greater than previous reports and allowed us to identify low level transcripts and a novel bradyzoite-specific isoform of sporoAMA1.
Effectiveness of steroids vs placebo in preventing upper airway obstruction after extubation in critically-ill children: rationale and design of a multicentric, double-blind, randomized study.
Authors: Manrique Gema , Laiseca Laura Butragueño , González Rafael , Rey Corsino , Martínez Zuriñe , Gil Javier , Rodriguez Antonio , Martínez Cecilia , Manrique Silvia , López-Herce Jesús
Published: October 2019

Background Post-extubation upper airway obstruction (UAO) is a frequent complication causing stridor and respiratory distress, which occasionally may require reintubation, thereby increasing morbidity and mortality rates. Contradictory results have been obtained in studies assessing the effectiveness of steroids in preventing post-extubation UAO, and the available evidence is limited. We designed a multicentric randomized, placebo-controlled study to explore the effectiveness of dexamethasone in preventing post-extubation UAO in children. Methods A multicentric, prospective, double-blind, randomized, placebo-controlled, phase IV clinical trial has been designed. The sample will include pediatric patients between 1 month and 16 years of age who have been intubated for more than 48 hours. Patients with airway disorders or who have received steroids within the last seven days will be excluded. Patients will be randomized to receive either placebo or a therapy with dexamethasone 0.25 mg/kg every 6 hours to be started 6-to-12 hours prior to extubation, to a total of four doses. Randomization will be performed at a 1:1 ratio. Follow-up of patients will be carried out for 48 h after extubation. The main objective of this study is to assess the reduction of UAO symptoms following extubation, as measured using the Taussig scale. Secondary objectives include assessing the decrease in the incidence of reintubation, evaluating the use of additional therapies for upper airway obstruction, and monitoring dexamethasone potential side effects. Discussion The results of this study will contribute to the existing evidence on prophylaxis for post-extubation airway obstruction.
Effect of low dose naloxone on the immune system function of a patient undergoing video-assisted thoracoscopic resection of lung cancer with sufentanil controlled analgesia — a randomized controlled trial.
Authors: Yun Lin , Zhuang Miao , Yue Wu , Fangfang Ge , Qingping Wen
Published: October 2019

Background: Perioperative immune function plays an important role in the prognosis of patients. Several studies have indicated that low-dose opioid receptor blockers can improve immune function.
Methods: Sixty-nine patients undergoing video-assisted thoracoscopic resection of the lung cancer were randomly assigned to either the naloxone group (n=35) or the non-naloxone group (n=34) for postoperative analgesia during the first 48 hours after the operation. Both groups received sufentanil and palonosetron via postoperative analgesia pump, while 0.05μg·kg-1·h-1 naloxone was added in naloxone group. The primary outcomes were the level of opioid growth factor（OGF）and immune function assessed by natural killer cells and CD4+/CD8+ T-cell ratio. Second outcomes were assessed by the intensity of postoperative pain, postoperative rescue analgesia dose, postoperative nausea and vomiting (PONV).
Results: The level of OGF in the naloxone group increased significantly at 24 hours (p＜0.001) and 48 hours after the operation (P<0.01). The natural killer cells (P<0.05) and CD4+/CD8+ T-cell ratio (P<0.01) in the naloxone group increased significantly at 48 hours after the operation. The rest VAS scores were better with naloxone at 12 and 24 hours after operation（P<0.05）, and the coughing VAS scores were better with naloxone at 48 hours after the operation（P<0.05). The consumption of postoperative rescue analgesics in the naloxone group was lower (0.00（0.00-0.00）vs 25.00（0.00-62.50）），P<0.05). Postoperative nausea scores at 24 hours after operation decreased in naloxone group（0.00 (0.00-0.00) vs 1.00 (0.00-2.00), P < 0.01).
Conclusion: Infusion of 0.05μg·kg-1·h-1 naloxone for patients undergoing sufentanil-controlled analgesia for postoperative pain can significantly increase the level of OGF, natural killer cells, and CD4+/CD8+ T-cell ratio compared with non-naloxone group，and postoperative pain intensity, request for rescue analgesics, and opioid-related side effects can also be reduced.
Trial registration: ChiCTR1900021043 on January 26, 2019.
Keywords: Low-dose naloxone, Opioid growth factor, Immune function, Postoperative pain, nausea, vomiting
Efficacy of continuous epidural infusion with epidural electric stimulation compared to conventional continuous epidural infusion for acute herpes zoster management: A retrospective study
Authors: Lee Chung Hun , Choi Sang Sik , Lee Mi Kyoung , Lee Yeon Joo , Park Jong Sun
Published: October 2019

Background: A continuous epidural infusion is commonly used in clinical settings, and reduces the likelihood of transition to postherpetic neuralgia via pain control. The purpose of the present study was to compare the efficacy of conventional continuous epidural infusion to that of continuous epidural infusion where the catheter is specifically guided by electric stimulation to areas with neurological damage in the treatment of zoster-related pain and prevention of postherpetic neuralgia.

Methods: We analyzed the medical records of 114 patients in the present study. The patients were divided into two groups: contrast (conventional continuous epidural infusion), and stimulation (continuous epidural infusion with epidural electric stimulation). In the contrast group, the position of the epidural catheter was confirmed using contrast medium alone, whereas in the stimulation group, the site of herpes zoster infection was identified through electric stimulation using a guidewire in the catheter. Clinical efficacy was assessed using a numerical rating scale (pain score) up to 6 months after the procedures. We compared the percentage of patients who showed complete remission (pain score less than 2, and no further medication) in each group. We also investigated whether the patients required additional interventional treatment due to insufficient pain control during the 6-month follow-up period after each procedure.

Results: After adjusting for confounding variables, the pain score was significantly lower in the stimulation group than in the contrast group for 6 months after the procedure. The adjusted odds ratio of patients included in the complete remission category was 1.9 times higher in the stimulation group than in the contrast group (95% confidence interval: 0.81-4.44, P = 0.14). The adjusted odds ratio for other interventions within 6 months after the procedure was 3.62 times higher in the contrast group than in the stimulation group (95% confidence interval: 1.17-11.19, P = 0.03).

Conclusion: Epidural drug administration to specific spinal segments using electric stimulation catheters may be more helpful than conventional continuous epidural infusion for improving pain and preventing postherpetic neuralgia in acute phase of herpes zoster.
Natural variations of MeMYB2 in cassava varieties covering a wide range of the reactive oxygen scavenging enzymes under drought
Authors: Wang Bin , Guo Xin , Li Shuxia , Liang Jiaxin , Liao Wenbin , Peng Ming
Published: October 2019

Background Cassava (Manihot esculenta Crantz) is an important tropical crop with excellent stress tolerance and stress resistance genes. The antioxidant enzymes play an important role in regulating the cassava plants respond to stress. To date, little is known the relationship between natural variations of MYB genes that have been proven to regulate stress tolerance in model plants and the diversity of reactive oxygen scavenging enzymes under drought in cassava varieties. Therefore, we conducted this study to discover natural variations in MYB2 gene in association with the reactive oxygen scavenging enzymes.Results Here, the relationship between the natural variation of MYB2 gene and the reactive oxygen scavenging enzymes under drought in cassava were analyzed. Natural variation of antioxidant enzymes in leaf and roots of 97 cassava varieties under drought analyses indicated that the variation of the various antioxidant enzymes is very different among the cassava varieties. MeMYB2 expression profiling analysis indicated that MeMYB2 was up-regulated obviously when induced by drought stress. Re-sequencing analysis of the 97 cassava varieties indicated that the MeMYB2 gene region included 87 single nucleotide variants (SNPs) and two insertion/deletion variants (Insert/ Deletion, Indel), the SNP locus of the coding region of MeMYB2 gene can be divided into 29 haplotypes, including 7 major haplotypes. These 7 major haplotypes can be classified into two categories, one of which is more closely related to wild cassava genotype W14, which indicates that MeMYB2 is positively selected during cassava breeding. Correlation analysis between MeMYB2 and drought tolerance showed that 12 functional SNPs in the MeMYB2 coding region were significantly associated with CAT activity, proline content, SOD activity and other traits, and the prediction of interaction with key genes of drought tolerance was further confirmed that MeMYB2 and key genes involved in CAT, proline and SOD can interact through intermediate metabolic pathways.Conclusions Some natural variations exist in the MeMYB2, which might be involved in regulating the reactive oxygen scavenging enzymes (SOD and CAT) changes under stress. This study will facilitate the understanding of the roles of MYBs in regulating the reactive oxygen scavenging enzymes.
Inhibition of BUB3 shunts glucose to glycolytic pathway by inducing PFKFB3 accumulation
Authors: Li Jiajin , Zhang Ruixue , Huang Gang , Liu Jianjun
Published: October 2019

Purpose: Metabolic reprogramming as a hallmark of cancer has countless connections with other biological behavior of tumor such as rapid mitosis. Mitotic checkpoint protein BUB3 as a key protein involved in the regulation of mitosis is modulated by PKM2, an important glycolytic enzyme. However the role of BUB3 in glucose metabolism remains unknown. Methods: We analyzed the TCGA data to evaluate BUB3 expression in certain tumors. The uptake of glucose and CO2 incorporation was tested by isotopic tracer methods. The lactate, NADPH, NADP and metabolic enzyme activities were tested by assay kits accordingly. Results: We show here that BUB3 is over expressed in cervical cancer and hepatocellular carcinoma. Interference of BUB3 increase the uptake of glucose and shunts the metabolic flux from pentose phosphate pathway to glycolytic pathway. The glycolysis metabolites lactate is increased by BUB3 interference whereas NADPH/NADP ratio is reduced. With regard to metabolic enzymes, interference of BUB3 increase PFKFB3 on protein level and enzyme activity, but not mRNA level. Moreover, the increasing of protein level is diminished when proteasome degradation pathway is blocked by MG132. Conclusions: BUB3 is a potential tumor promoter and plays certain roles in cancer cellular metabolic reprogramming.
New transpulmonary thermodilution approach to assess hemodynamic changes in patients undergoing open abdominal cytoreductive surgery with hyperthermic intraperitoneal chemotherapy
Authors: Kim Myoung Hwa , Yoo Young Chul , Bai Sun Joon , Lee Kang-Young , Kim Nayeon , Lee Ki Young
Published: October 2019

Purpose The current treatment of peritoneal cancer combines cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). The present study aimed to use the VolumeView TM system to investigate the intraoperative physiological changes, including extravascular lung water, in patients undergoing cytoreductive surgery with HIPEC. Methods This prospective, observational study enrolled 21 patients undergoing elective cytoreductive surgery with HIPEC at our hospital between December 2014 and April 2016. In all patients, we applied the VolumeView TM system (Edwards Lifesciences, Irvine, CA). Internal jugular vein and femoral artery accesses were required to monitor hemodynamic parameters. Data were recorded and analyzed before skin incision; 30 min before HIPEC initiation; 30, 60, and 90 min after HIPEC initiation; 30 min after HIPEC completion; and 10 min before surgery completion. Results During HIPEC, patients showed a rise in body temperature, decrease in the systemic vascular resistance index, and increase in cardiac output. The global end-diastolic volume index was 715.4–809.7, and the extravascular lung water index was 6.9–7.3. Rapid insulin (mean, 6.8 units) was administered because of increased glucose levels, and lactate levels steadily increased during HIPEC. Only 1 patient had acute kidney injury postoperatively, and the mean length of hospital stay was 17 days. Conclusion Our study demonstrated the intraoperative physiological changes in patients undergoing open cytoreductive abdominal surgery with HIPEC. Advanced hemodynamic monitoring should be considered for better anesthetic management in these patients.
Inhibition of adenosine A1 receptors abolished the nutritional ketosis-evoked delay in the onset of isoflurane-induced anesthesia in Wistar Albino Glaxo Rijswijk rats
Authors: Kovács Zsolt , Brunner Brigitta , D'Agostino Dominic P. , Ari Csilla
Published: October 2019

Background It has been demonstrated that administration of exogenous ketone supplement ketone salt (KS) and ketone ester (KE) increased blood ketone level and delayed the onset of isoflurane-induced anesthesia (immobility) in different rodent models, such as Wistar Albino Glaxo Rijswijk (WAG/Rij) rats. The modulatory effect of adenosinergic system may have a role in the ketone supplementation-evoked effects on isoflurane-generated anesthesia. Thus, we investigated whether adenosine receptor antagonists can modulate the effect of exogenous ketone supplements on the onset of akinesia induced by isoflurane.Methods To investigate the effect of exogenous ketone supplements on anesthetic induction we used ketone supplement KE, KS, KEKS (1:1 mix of KE and KS), KSMCT and KEMCT (1:1 mix of KS and KE with medium chain triglyceride/MCT oil, respectively) in WAG/Rij rats. Animals were fed with standard diet, which was supplemented by oral gavage of different ketone supplements (2.5 g/kg/day) for 1 week. After 7 days, isoflurane (3%) was administered for 5 min and the time until onset of isoflurane-induced anesthesia (immobility) was measured. Changes in levels of blood β-hydroxybutyrate (βHB), blood glucose and body weight of animals were also recorded. To investigate the putative effects of adenosine receptors on ketone supplements-evoked influence on isoflurane-induced anesthesia we used a specific adenosine A1 receptor antagonist DPCPX (intraperitoneally/i.p. 0.2 mg/kg) and a selective adenosine A2A receptor antagonist SCH 58261 (i.p. 0.5 mg/kg) in combination with KEKS.Results Significant increases were demonstrated in both blood βHB levels and the number of seconds required before isoflurane-induced anesthesia (immobility) after the final treatment by all exogenous ketone supplements. Moreover, this effect of exogenous ketone supplements positively correlated with blood βHB levels. It was also demonstrated that DPCPX completely abolished the effect of KEKS on isoflurane-induced anesthesia (immobility), but not SCH 58261.Conclusions These findings strengthen our previous suggestion that exogenous ketone supplements-evoked increase in ketone levels (ketosis) might affect surgical anesthetic needs. Moreover, our results demonstrate that adenosinergic system (likely through A1Rs) may modulate the influence of exogenous ketone supplements-evoked ketosis on isoflurane-generated anesthesia.
IDENTIFICATION OF CRITICAL COMPONENTS OF RESILIENCE DURING AND AFTER ECONOMIC CRISES: THE CASE OF WOMEN FOOD OPERATORS IN KUALA LUMPUR
Authors: Nazatul Shima Abdul Rani  , K. Sarojani Krishnan  , Zurinah Suradi  , Nurita Juhdi
Published: October 2019

In the past, there has been a preponderance of studies on entrepreneurs or small and medium enterprises (SMEs) in Malaysia; however, very few studies concentrated on women entrepreneurs. Women entrepreneurs are known to be persistent and resilient in running their business. However, it may be interesting to focus on factors or components that contribute towards their resiliency. Hence, this study explores the critical components of entrepreneurial resiliency which play a significant role in the business survival of women entrepreneurs during and after undergoing economic crises. The term resilience comprises three components, namely hardiness, resourcefulness, and optimism. Hardiness refers to adaptive capacity, and not easily discouraged by failures. Resourcefulness, on the other hand, relates to cash flow, investment, relational networks, material assets, and the ability to adapt to changes, while optimism means the preparedness to make decisions, take action, and the ability to see the humorous side of things. The sample of the study consisted of 100 women entrepreneurs, mainly food operators in Klang Valley who were selected randomly. Most of the women entrepreneurs were aged above 30 years, and more than half have more than 10 years’ experience in running their business. A set of questionnaire with items on entrepreneurial resilience and its components—hardiness, resourcefulness, and optimism—was used to gain information among women entrepreneurs. The findings show that the most critical components for resilience during crises was resourcefulness, while optimism emerged as the most important component after undergoing crises.
Karbon Nanopartiküllerin Epoksi Yapıştırıcılarda Etkilerinin İncelenmesi
Authors: AYDIN Sinan
Published: October 2019

Günümüzde aynı veya farklı türlerdeki malzemelerin birleştirilmesi için kolay uygulanabilme ve ekonomik olmaları nedeniyle yapıştırıcılar oldukça fazla kullanılmaktadır. Gelişen teknoloji ve üretim yöntemleriyle beraber hemen hemen her alan için ihtiyaç duyulan yapıştırıcılar üretilmektedir. Yapıştırıcıların özelliklerinin iyileştirilmesi için çalışmalar yapılmaktadır. Çalışmada, epoksi yapıştırıcıların içerisine karbon nanopartikül eklenerek oluşturulan yapıştırma bağlantılarında nanopartikül oranının pürüzlü yüzeylerdeki yapışma dayanımına etkileri araştırılmıştır. Yapıştırıcılara, yapıştırıcı ağırlığının %0,5 ile %5’i aralığındaki oranlarda nanopartiküller eklenerek deneyler yapılmıştır. Nanopartiküllerin belirli bir orana kadar yapışma dayanımına olumlu etki gösterdiği sonrasında ise bu etkilerinin azaldığı görülmüştür. 
Fotokopi Merkezlerinde Uçucu Organik Bileşiklere Maruziyet
Authors: KARA Gülnihal
Published: October 2019

Fotokopi makineleri iç ortam hava kalite problemlerine yol açabilmektedir. Laboratuar ortamında test odasında yapılan çalışmalar fotokopi makinelerinin fotokopi işlemi süresince çok sayıda uçucu organik bileşiği (UOB) yaydığını göstermiştir. Bu çalışmada dört fotokopi merkezinden ve iki dış hava örneğinden alınan alan numuneleri aktif karbon tüplerinde toplanmış ve gaz kromatografisi-kütle spektrometresi kullanılarak NIOSH tarafından geliştirilen standart metoda göre analiz edilmiştir. Fotokopi merkezi 2’de 0,52-35,90 µg/m3 aralığında 18 farklı uçucu organik bileşik belirlenmiştir. Maksimum konsantrasyon 77,59 µg/m3 olarak (toluen, fotokopi merkezi 3) belirlenmiştir. Fotokopi merkezlerinde toplam uçucu organik bileşik maruziyeti 15,76-129,03 µg/m3.gün aralığında tespit edilmiştir. 
İnşaat Proje Organizasyonlarında Kişiler Arası Çatışma Çözüm Yaklaşımları ile Kişilik Özellikleri Arasındaki İlişki
Authors: ÇİVİCİ Tülay
Published: October 2019

Bu çalışmada, inşaat proje organizasyonlarında kişilerarası çatışma çözüm yaklaşımları ile kişilik özellikleri arasındaki ilişki incelenmiştir. Bunun için mimarlık/mühendislik ofisi ve şantiyede (yüklenici/tedarikçi) çalışan mimar ve inşaat mühendisine yönelik anket çalışması yapılmıştır. Anket çalışmasında çatışma çözüm yaklaşımı ölçeği ve beş faktör kişilik özellikleri ölçeği kullanılmış, veriler istatistiksel olarak incelenmiş, kişilik özellikleri ile çatışma çözüm yaklaşımları arasındaki ilişki ortaya konulmuştur. Bulgular, katılımcıların yüksek düzeyde problem çözme ve uzlaşma çatışma çözüm yaklaşımlarını benimsediklerini göstermektedir. Ayrıca bulgular, katılımcıların dışadönük, sorumluluk sahibi ve deneyime açık kişilik özellikleri gösteren bireyler oldukları yönündedir.
Yüksek pH Dayanımlı Yeni Tip Demir Şelat Formülünün Hazırlanması ve Yerfıstığı Üzerine Etkilerinin İncelenmesi
Authors: GÖNÜL İlyas , DELİKANLI Anıl , SERİN Selahattin
Published: October 2019

Bu çalışmada daha ucuz olan sitrik asit ve trietanolamin gibi ligandlarla oluşturulan demir şelatının yüksek pH’lardaki kararlılıkları incelenmiştir. Bitkiler için önemli bir besin elementi olan demir, kireçli ve yüksek pH değerine sahip topraklarda suda çözünmeyen demir hidroksit veya demir karbonat bileşiklerini oluşturarak bitkiler için yararsız hale gelmektedir. Demir iyonunun bitki bünyesine alınması ve bitkilerdeki demir iyonu eksikliğinin giderilmesi bu iyonun suda çözünür formda olmasıyla mümkündür. Bitki bünyesine demir iyonunun alınmaması veya yetersiz alınması bitkinin demir eksikliği klorozu olmasına neden olmaktadır.  Ülkemiz topraklarında rahatlıkla kullanılabilen demir şelat çözeltisi hazırlanmış ve bu demir şelat çözeltisinin NC-7 ve ÇOM yerfıstığı çeşitlerinin büyümesi üzerindeki etkileri incelenmiştir.
A global hydrology research agenda fit for the 2030s
Authors: Wilby Robert L.
Published: October 2019

Global assessments show profound impacts of human activities on freshwater systems that, without action, are expected to reach crisis point in the 2030s. By then, the capacity of natural systems to meet rising demands for water, food, and energy could be hampered by emerging signals of anthropogenic climate change. The hydrological community has always been solution-orientated, but our generation faces perhaps the greatest array of water challenges in human history. Ambitious programmes of research are needed to fill critical data, knowledge, and skills gaps. Priorities include filling data sparse places, predicting peak water, understanding the physical drivers of mega droughts, evaluating hyper-resolution models, managing compound hazards, and adjusting water infrastructure designs to climate change. Despite the opportunities presented by big data, we must not lose sight of the deep uncertainties affecting both our raw input data and hydrological models, nor neglect the human dimensions of water system change. Community-scale projects and international research partnerships are needed to connect new hydrological knowledge with most vulnerable communities as well as to achieve more integrated and grounded solutions. With these elements in place, we will be better equipped to meet the global hydrological challenges of the 2030s and beyond.