bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation and Analysis of Standardized Training for Residents of General Practitioners of Gansu Province in China
Authors: Cai Hui , Wang Hongjing , He Jin , Zhang Dongzhi , Wu Yue , Wang Peidong
Published: April 2020

Background: China’s standardized training for residents of General Practitioners (GPs) is aimed at providing the postgraduate training for family doctors who will serve the primary health care institutions. The aim of this paper is to investigate the standardized training situation, satisfaction with standardized training, work situation, intention, satisfaction and attitude of GPs who have finished standardized training. Methods: This study was undertaken in 6 training hospitals in Gansu province using a questionnaire with 45 questions. Results: Approximately 275 residents of GPs were enrolled. Finally, 263 residents completed the questionnaire (95.64% response rate), including 133 females (50.57%) and 130 males (49.43%) with an average age of 28 years (standard deviation, 1.93 years; range, 25-36 years). Additionally, 56.65% were single and 43.35% were married. Of all subjects, 92.40% residents had obtained certification of standardized training for residents of GPs and only 39.54% residents were satisfied with monthly income during training. There were 171 oriented rural medical graduates, of whom, only 42.69% expressed the willing to continue working in the primary health care institutions after the serve time (6 years) expired. Around 86.31% of residents of GPs who had finished standardized training got jobs with more than half serving in the primary health care institutions. For medical institutions and sanitary bureau were clear about general medicine policies, only 29.96% subjects registered as GPs. Among the residents in general practice department, 68.42% were engaged in the diagnosis and treatment of common disease and frequently-occurring diseases as well as referral of patients. The percentage of residents who were satisfied with the job and income were 30.40% and 14.98%, respectively. Conclusion: Standardized training for residents of GPs in China is gradually improving. In order to cultivate more GPs and increase their willing to serve in the primary health care institutions, it is necessary to formulate and execute better policy of GPs, publize general medicine and improve the training quality.
Serum levels of cytokines in infants treated with Conbercept for retinopathy of prematurity
Authors: Cheng Yong , Zhu Xuemei , Linghu Dandan , Jia Zhongxu , Xu Yongsheng , Liang Jianhong
Published: April 2020

The authors have withdrawn this preprint due to author disagreement.
Trends in Measles Cases in Bayelsa State, Nigeria: A Five-year Review of Case-based Surveillance Data (2014- 2018).
Authors: AWORABHI NENI , Numbere Tamunowari , Balogun Mohammed Shakir , Usman Aisha , Utulu Rowland , Ebere Nkechi , Omubo Wakiente , Stow Jones , Abba Shehu , Olorukooba Abdulhakim
Published: April 2020

Background Measles is a vaccine preventable, highly transmissible viral infection that affects mostly children under five years. It has been ear marked for elimination and Nigeria adopted the measles elimination strategies of the World Health Organization (WHO) African region to reduce cases and deaths. This study was done to determine trends in measles cases in Bayelsa state, to describe cases in terms of person and place, identify gaps in the case-based surveillance data collection system and identify risk factors for measles infection. Methods We carried out a secondary data analysis of measles case-based surveillance data for the period of January 2014 to December 2018 obtained in Microsoft Excel from the State Ministry of Health. Cases were defined according to WHO standard case definitions. We calculated frequencies, proportions, estimated odds ratios (OR), 95% confidence intervals (CI) and multivariate analysis. Results A total of 449 cases of measles were reported. There were 245(54.6%) males and the most affected age group was 1-4 years with 288(64.1%) cases. Of all cases, 289(9.35%) were confirmed and 70 (48.27%) had received at least one dose of measles vaccine. There was an all-year transmission with increased cases in the 4 th quarter of the year. Yenegoa local government area had the highest number of cases. Timeliness of specimen reaching the laboratory and the proportion of specimens received at the laboratory with results sent to the national level timely was below WHO recommended 80% respectively. Predictors of measles infection were, age less than 5 years (AOR: 0.57, 95% CI: 0.36-0.91) and residing in an urban area (AOR: 1.55, 95% CI:1.02-2.34). Conclusions Measles infection occurred all-year round, with children less than 5 years being more affected. Measles case-based surveillance system showed high levels of case investigation with poor data quality and poor but improving indicators. Being less than 5 years was protective of measles while living in urban areas increased risk for infection. We recommended to the state government to prioritize immunization activities in the urban centers, start campaigns by the 4th quarter and continue to support measles surveillance activities and the federal government to strengthen regional laboratory capacities.
Meta-analysis of the diagnostic performance of circulating microRNAs for pancreatic cancer
Authors: Peng Cheng , Li Zhiqiang , Huang Lihua , Gao Wenzhe , Wang Jiale , Liu Yunfei , Li Xia , Yu Xiao
Published: April 2020

Background: Pancreatic cancer (PC) is characterized by high malignancy and a poor prognosis. The detection of circulating microRNAs (miRNAs) is a liquid biopsy diagnostic approaches. Numerous studies have suggested that some differentially expressed miRNAs may be promising diagnostic markers for PC, but the results have varied among studies. The present study was performed to summarize the diagnostic accuracy of circulating miRNAs, carbohydrate antigen 19-9 (CA19-9), and the combination of miRNAs and CA19-9.Methods: A literature search of online databases including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and WanFang was conducted. Relative data were extracted from eligible included studies, and a meta-analysis was performed.Results: A total of 46 studies involving 4,326 PC patients and 4,277 non-PC controls were included. The pooled sensitivity (SEN), specificity (SPE) and AUC of the circulating miRNAs for differentiating PC patients from non-PC controls were 0.79 (0.77-0.81), 0.77 (0.75-0.79), and 0.85 (0.81-0.87), respectively. For CA19-9, the SEN, SPE and AUC were 0.78 (0.75-0.80), 0.90 (0.85-0.94) and 0.85 (0.82-0.88), respectively. The combination of miRNAs and CA19-9 greatly improved the SEN, SPE and AUC to 0.84 (0.80-0.87), 0.91 (0.89-0.93) and 0.94 (0.92-0.96), respectively. Moreover, circulating miRNAs also yielded an acceptable diagnostic accuracy for early-stage PC with a SEN of 0.79 (0.76-0.82), a SPE of 0.74 (0.68-0.79) and an AUC of 0.81 (0.77-0.84).Conclusions: Circulating miRNAs exhibited satisfactory diagnostic performance for PC and even early-stage PC. The combination of circulating miRNAs and the traditional marker CA19-9 can further improve the diagnostic accuracy, providing a novel strategy for PC diagnosis.
Reverse reaming distraction for acetabular reconstruction of chronic pelvic discontinuity
Authors: Sun Jing-yang , Ni Ming , Ma Hai-yang , Du Yin-qiao , Shen Jun-min , Chen Ji-ying , Zhou Yong-gang , Zhang Guo-qiang
Published: April 2020

Background: The acetabular distraction technique demonstrates encouraging radiographic and clinical outcomes in treating chronic pelvic discontinuity. The aim of this study is to describe a modified distraction technique and to show our results. Methods: This study identified 12 cases of chronic pelvic discontinuity undergoing primary or revision total hip arthroplasty (THA) with the technique of reverse reaming distraction between July 2015 and November 2018. All 12 patients had a minimum follow-up of 12 months. Radiographs were reviewed to inspect for component loosening. Clinical assessment included the Harris hip score (HHS) and an ambulatory scoring system. Results: At the time of final follow-up, no patient was revised. One patient had up to 1 cm migration of the cup in a horizontal or vertical direction and more than 20° change in the abduction angle but was asymptomatic. In the remaining 11 patients, no migration of the component was detected. Both the HHS and ambulatory score showed improvement in all patients. There were no perioperative complications. No postoperative dislocation occurred. Conclusions: Reverse reaming distraction is a feasible technique in treatment of chronic pelvic discontinuity, with encouraging results at early-term. However, ongoing follow-up is required to determine the long-term prognosis in patients receiving this technique.
Analysis of virulence factors and antibiotic resistance genes in Group B Streptococcus from clinical samples
Authors: Mudzana Raymond , Mavenyengwa Rooyen T , Gudza-Mugabe Muchaneta
Published: April 2020

Background: Streptococcus agalacticae (Group B Streptococcus, GBS) is one of the most important causative agents of serious infections among neonates. This study was carried out to identify antibiotic resistance and virulence genes associated with GBS isolated from pregnant women. Methods: A total of 43 GBS isolates were obtained from 420 vaginal samples collected from HIV positive and negative women who were 13-35 weeks pregnant attending Antenatal Care at Chitungwiza and Harare Central Hospitals in Zimbabwe. Identification tests of GBS isolates was done using standard bacteriological methods and molecular identification testing. Antibiotic susceptibility testing was done using the modified Kirby-Bauer method. The boiling method was used to extract DNA and Polymerase Chain Reaction (PCR) was used to screen for 13 genes. Data was fed into SPSS 24.0 and the Spearman rank correlation test used to determine correlation among genes. Results: Nine distinct virulence gene profiles were identified. The profiles hly-scpB-bca-rib 37.2% (16/43) and hly-scpB-bca 18.6% (8/43) were common. The virulence genes identified were namely hly 97.8% (42/43), scpB 90.1% (39/43), bca 86.0% (37/43), rib 69.8% (30/43) and bac 11.6% (5/43). High resistance to tetracycline 97.7% (42/43) was reported followed by penicillin G, 69.8% (30/43), ampicillin 58.1% (25/43), clindamycin 55.8% (24/43) and erythromycin 30.2% (13/43). Antibiotic resistance genes among the resistant and intermediate-resistant isolates showed high frequencies for tetM 97.6% (41/42) and low frequencies for ermB 34.5% (10/29), ermTR 10.3% (3/29), mefA 3.4% (1/29), tetO 2.4% (1/42) and linB 0% (0/35). The atr housekeeping gene yielded 100% (43/43) positive results, whilst the mobile genetic element IS1548 yielded 9.3% (4/43). Conclusion: The study showed a high prevalence of hly, scpB, bca and rib virulence genes in S. agalactiae strains isolated from pregnant women. Tetracycline resistance was found to be predominantly caused by the tetM gene, whilst macrolide resistance was predominantly due to the presence of erm methylase, with the ermB gene being more prevalent. The recovery of resistant isolates to antimicrobial agents such as penicillins indicates the importance of GBS surveillance and susceptibility tests. It was also observed that in vitro phenotypic resistance is not always accurately predicted by resistance genotypes.
A novel gene expression system for Ralstonia eutropha based on the T7 promoter
Authors: Hu Muzi , Xiong Bin , Li Zhongkang , Liu Li , Li Siwei , Zhang Chunzhi , Bi Changhao , Zhang Xueli
Published: April 2020

Background: Ralstonia eutropha (syn. Cupriavidus necator) is a model microorganism for studying metabolism of polyhydroxyalkanoates (PHAs) and a potential chassis for protein expression due to various advantages. Although current plasmid systems of R. eutropha provide a basic platform for gene expression, the performance of the expression-inducing systems is still limited. In addition, the sizes of the cloned genes are limited due to the large sizes of the plasmid backbones.Results: In this study, an R. eutropha T7 expression system was established by integrating a T7 RNA polymerase gene driven by the PBAD promoter into the genome of R. eutropha, as well as adding a T7 promoter into a pBBR1-derived plasmid for gene expression. In addition, the essential DNA sequence necessary for pBBR1 plasmid replication was identified, and the redundant parts were deleted reducing the expression plasmid size to 3392 bp, which improved the electroporation efficiency about 4 times. As a result, the highest expression level of RFP was enhanced, and the L-arabinose concentration for expression induction was decreased 20 times. Conclusions: The R. eutropha T7 expression system provides an efficient platform for protein production and synthetic biology applications.
Efficacy of Unilateral Ilioinguinal Transversus Abdominis Plane Block for Alleviation of Catheter-related Bladder Discomfort in Male Patients after Emergence from General Anesthesia: a Prospective, Randomized Controlled Trial
Authors: Zhao Xiyue , Wang Liangrong , Hu Yi , Chen Lei
Published: April 2020

Background: Urinary catheterization frequently leads to catheter-related bladder discomfort (CRBD) in male patients after general anesthesia. This prospective cohort trial aimed to prove the efficacy of unilateral ilioinguinal transversus abdominis plane block (TAPB) in attenuating CRBD in male patients. Methods: Male patients with a severe CRBD were randomized to receive unilateral ilioinguinal TAPB with 0.375% ropivacaine 10 mL (group T) or intravenous sufentanil 0.15 μg/kg (group C). The primary outcomes were the incidence rates of moderate-to-severe CRBD at 0.5, 1, 2, and 6 hours after treatment, and the other outcomes were postoperative adverse events related to treatments. Results: The incidence rates of moderate-to-severe CRBD were significantly lower in group T than in group C at 0.5 hours (11.5% vs 87.4%, P<0.001), 1 hour (7.6% vs 92.3%, P=0.001), 2 hours (7.6% vs 92.3%, P=0.001), and 6 hours (11.5% vs 100%, P<0.001) after treatment. The postoperative incidences of sedation and respiratory depression were decreased significantly in group T compared to group C (P<0.05). Conclusions: Unilateral ilioinguinal TAPB with ropivacaine can decrease the incidence of moderate-to-severe CRBD and reduce side effects in male patients after general anesthesia compared to intravenous sufentanil administration. Trial registration: This trial was registered with Clinicaltrials.gov as ChiCTR1900022869 on April 29, 2019, http://www.chictr.org.cn/showproj.aspx?proj=38516.
Stepwise in vitro induction of human somitic mesoderm and its derivatives
Authors: Alev Cantas , Yamanaka Yoshihiro , Uemura Maya
Published: April 2020

Our understanding of human somitogenesis is limited and largely based on insights gained from model organisms. Pluripotent stem cell-based
in vitro
approaches aiming to recapitulate distinct aspects of this core developmental process have recently been reported, including our recent paper on the
in vitro
recapitulation of the human segmentation clock
1
. Here we describe in detail our stepwise induction protocol of presomitic mesoderm (PSM), somitic mesoderm (SM), and its two major derivatives, sclerotome (SCL) and dermomyotome (DM) from human induced pluripotent stem cells (iPSCs). We further briefly address the subsequent molecular and functional analysis of these
in vitro
induced human mesodermal lineages and cell-types.
p21 inhibitor UC2288 ameliorates MPTP induced Parkinson’s disease progression through inhibition of oxidative stress and neuroinflammation
Authors: Im Jun Hyung , Yeo In Jun , Jeon Seong Hee , Lee Dong Hun , Ham Hyeon Joo , Yun Jaesuk , Han Sang-Bae , Hong Jin Tae
Published: April 2020

BackgroundParkinson's disease (PD) is a neurodegenerative disease characterized by the early prominent death of dopaminergic neurons and a decrease of dopamine levels. Dopamine depletion leads to several motor dysfunctions, including resting tremor, muscular rigidity, bradykinesia and postural instability. Our previous study determined that knockout of parkin, a gene of PD degrade p21, suppresses neurogenesis which is critical for a neurodegenerative disease. MethodsThus, we investigated the effect of UC2288, an inhibitor of p21, for its therapeutic effect on PD. We found that UC2288 attenuated 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced behavioral impairment in Rota-rod and Pole test as well as dopamine depletion.ResultsMoreover, UC2288 recovered the number of TH positive cells, but decreased the number of GFAP and Iba-1 positive cells accompanied the decrease of BAX and cleaved caspase3 as well as iNOS and COX-2 expression. In cultured neurons, UC2288 recovered MPP+-induced neuronal cell death in a concentration dependent manner. We also found that UC2288 decreased the p21 reactive cell number, oxidative neuronal damages, cytokines product in vivo and cultured neurons. In a mechanism study, we found that UC2288 significantly decreased the activation of ERK and p38 kinase pathway in the mitogen-activated protein kinase (MAPK) pathway. In addition, 1-10 μM concentration of ERK kinase inhibitor U0126 recovered MPP+-induced neuronal cell death. However, ERK kinase inhibitor U0126 further decreased cell viability with the increase of H2O2.ConclusionThese results indicated that the administration of UC2288 exerted neuroprotective effects on the death of dopaminergic neurons through the suppression of oxidative stress and neuroinflammation via ERK pathway inhibition.
Completely Resected Stage Iii Melanoma Controversy: 15 Years Of National Tertiary Centre Experience
Authors: Perić Barbara , Milicevic Sara , Perhavec Andraz , Hocevar Marko , Zgajnar Janez
Published: April 2020

BACKGROUNDTwo prospective randomized studies analysing cutaneous melanoma (CM) patients with sentinel lymph node (SLN) metastases and rapid development of adjuvant therapy have changed our approach to stage III CM treatment. The aim of this study was to compare results of retrospective survival analysis of stage III CM patients’ treatment from Slovenian national CM register to current clinical guidelines.METHODSSince 2000, all Slovenian CM patients with primary tumour ≥ TIb are treated at the Institute of Oncology Ljubljana and data are prospectively collected into a national CM registry. A retrospective analysis of 2426 sentinel lymph node (SLN) biopsies and 789 lymphadenectomies performed until 2015 was conducted using Kaplan-Meier survival curves and log-rank tests.RESULTSPositive SLN was found in 519/2426 (21.4%) of patients and completion dissection (CLND) was performed in 455 patients. The 5-year overall survival (OS) of CLND group was 58% versus 47% of metachronous metastases group (MLNM) (p = 0.003). The 5-year OS of patients with lymph node (LN) metastases and unknown primary site (UPM) was 45% versus 21% of patients with synchronous LN metastasis. Patients with SLN tumour burden < 0.3 mm had 5-year OS similar to SLN negative patients (86% vs. 85%; p = 0.926). The 5-year OS of patients with burden > 1.0 mm was similar to the MLNM group (49% vs 47%; p = 0.280). CONCLUSIONStage III melanoma patients is a heterogeneous group with significant OS differences. CLND after positive SLNB might still remain a method of treatment for some of those patients if low postoperative complication rates can be reassured.
Treadmill integrated robot-assisted ankle dorsiflexion training for stroke rehabilitation: A randomized controlled trial
Authors: Conroy Susan , Roy Anindo , Magder Laurence , Eversley Derek , Flores Kate , Kerns Zachary , Kittner Steven , Macko Richard
Published: April 2020

Background: Stroke-related ankle dysfunction due to hemiparesis has a profound negative impact on gait biomechanics and walking. Task-oriented treadmill training improves gait velocity but does not lead to restitution of ankle function. Advances in robotic technology have led to the development of an adaptive ankle robot that can be integrated into treadmill walking and provide precisely timed graded assistance consistent with motor learning approaches. The aim of this study was to compare the effectiveness of a 6-week treadmill-integrated adaptive ankle robot (TMR) training to 6-weeks of treadmill training (TM) alone on improved paretic ankle motor control and gait performance. Methods: This was a single-blind (evaluator-blinded) randomized controlled trial. 45 participants received either TMR or TM training 3 times per week for 6 weeks. Primary outcomes were improved peak paretic ankle dorsiflexion (DF) angle at swing, improved DF angle at foot strike (weight acceptance), and increased gait velocity during self-selected over-ground walking. The primary analysis was based on intention-to-treat using a longitudinal regression model. An additional sub-set analysis of subjects with biomechanically defined foot drop was performed. Results: There were no significant post-training ankle dorsiflexion or gait velocity differences between groups. Six-week post-training mean peak paretic DF swing angle was (4.84 ± 6.83; 4.2 ± 6.83 p=0.63) and DF angle at foot strike was (-0.70 ± 6.55; -0.46 ± 5.70 p=0.84) respectively for TMR and TM. Gait velocity gains were similar and TMR had a mean increase of 0.54 m/s ± 0.24 and TM increased 0.56 m/s ±0.32. p=0.48 post-training.Conclusion: Integrating adaptive ankle robotics into task-specific locomotor training was not significantly better than treadmill training alone. Both interventions improved gait velocity. Promising results in ankle motor control were seen in a subset of subjects with biomechanically defined foot drop that warrants further investigation. Clinical Trial Registration: Clinical trials.gov id: NCT02483676. Registered June 29, 2015, https://clinicaltrials.gov/ct2/show/NCT02483676
Analysis of local habitat selection and large-scale attraction/avoidance based on animal tracking data: is there a single best method?
Authors: Mercker Moritz , Schwemmer Philipp , Peschko Verena , Enners Leonie , Garthe Stefan
Published: April 2020

Background: New wildlife telemetry and tracking technologies have become available in the last decade, leading to a large increase in the volume and resolution of animal tracking data. These technical developments have been accompanied by various statistical tools aimed at analysing the data obtained by these methods. Methods: We used simulated habitat and tracking data to compare some of the different statistical methods frequently used to infer local resource selection and large-scale attraction/avoidance from tracking data. Notably, we compared the performances of spatial logistic regression models (SLRMs), point process models (PPMs), and integrated step selection models ((i)SSMs) and their interplays with habitat, tracking-device, and animal movement properties. Results: We demonstrated that SLRMs were inappropriate for large-scale attraction studies and prone to bias when inferring habitat selection. In contrast, PPMs and (i)SSMs showed comparable (unbiased) performances for both habitat selection and large-scale effect studies. However, (i)SSMs had several advantages over PPMs with respect to robustness, user-friendly implementation, and computation time. Conclusions: We recommend the use of (i)SSMs to infer habitat selection or large-scale attraction/avoidance from animal tracking data. This method has several practical advantages over PPMs and additionally extends SSMs, thus increasing its predictive capacity and allowing the derivation of mechanistic movement models.
Detection of Brucella abortus and Brucellla melitensis in cattle and sheep from southern Cameroon
Authors: Mitterran Kamga Ndefo Rolin , Barberine Silatsa Assongo , Oumarou Farikou , Simo Gustave
Published: April 2020

Background: Brucellosis is an infectious disease caused by bacterial of the genus Brucella. Although several investigations detected Brucella antibodies in many animal species, low attention has been paid for specific identification of different Brucella species in animals of Sub-Saharan African counties. It is in this light that this study was designed to identify Brucella abortus and Brucellla melitensis in cattle and sheep of several villages of southern Cameroon in order to improve our epidemiological knowledge on brucellosis in central AfricaMethods: Blood samples were collected in 597 cattle and 315 sheep of 15 villages of two regions of Cameroon. DNA was extracted from blood samples and primers amplifying bcsp31 gene enabled the identification of Brucella spp infections in domestic animals. Amongst animals found with Brucella spp infections, specific primes were used to identify B. abortus and B. melitensis respectively. Results: From 912 animals analyzed in this study, 159 (17%) were found with Brucella infections. This gives an infection rate of 20.93% (125/597) in cattle and 10.79% (34/315) in sheep respectively. Of the 159 animals harboring Brucella infections, 118 (12.93%) were infected by B. abortus and 29 (3.17%) by B. melitensis. The Brucella infection rate (20.56%) was high in animals of the Noun division compared to those (12.35%) of Yoko. Between animal species, significant differences were observed in infection rates of both abortus and B. melitensis. The difference in the B. abortus infection rates remains significant between Yoko and Noun, and especially between villages of the Noun division. Conclusion: This study revealed for the first time B. melitensis and B. abortus infections in cattle and sheep of the Noun and Yoko in the southern Cameroon. The identification of B. melitensis and B. abortus in animals suggests further investigations on human brucellosis. Results of this study highlight the need of developing and implementing control measures against brucellosis in Cameroon, especially in villages presenting high risk for Brucella infections.
Data Cleaning Process for HIV Indicator Data Extracted from DHIS2 National Reporting System: Case Example of Kenya
Authors: Gesicho Milka , Babic Ankica , Were Martin
Published: April 2020

Background
The District Health Information Software 2 (DHIS2) is widely used by countries for national-level aggregate reporting of health data. To best leverage DHIS2 data for decision-making, countries need to ensure that data within their systems are of the highest quality. Comprehensive, systematic and transparent data cleaning approaches form a core component of preparing DHIS2 data for use. Unfortunately, there is paucity of exhaustive and systematic descriptions of data cleaning processes employed on DHIS2-based data. In this paper, we describe results of systematic data cleaning approach applied on a national-level DHIS2 instance, using Kenya as the case example.
Methods
Broeck et al’s framework, involving repeated cycles of a three-phase process (data screening, data diagnosis and data treatment), was employed on six HIV indicator reports collected monthly from all care facilities in Kenya from 2011 to 2018. This resulted to repeated facility reporting instances. Quality dimensions evaluated included reporting rate, reporting timeliness, and indicator completeness of submitted reports each done per facility per year. The various error types were categorized, and Friedman analyses of variance conducted to examine differences in distribution of facilities by error types. Data cleaning was done during the treatment phases.
Results
A generic five-step data cleaning sequence was developed and applied in cleaning HIV indicator data reports extracted from DHIS2. Initially, 93,179 facility reporting instances were extracted from year 2011 to 2018. 50.23% of these instances submitted no reports and were removed. Of the remaining reporting instances, there was over reporting in 0.03%. Quality issues related to timeliness included scenarios where reports were empty or had data but were never on time. Percentage of reporting instances in these scenarios varied by reporting type. Of submitted reports empty reports also varied by report type and ranged from 1.32–18.04%. Report quality varied significantly by facility distribution (p = 0.00) and report type.
Conclusions
The case instance of Kenya reveals significant data quality issues for HIV reported data that were not detected by the inbuilt error detection procedures within DHIS2. More robust and systematic data cleaning processes should be integrated to current DHIS2 implementations to ensure highest quality data.
Acute hospital staff’s attitudes towards dementia and perceived dementia knowledge: a cross-sectional survey in Ireland
Authors: Keogh Brian , To Wing Ting , Daly Louise , Hynes Geralyn , Kennelly Siobhan , Lawlor Brian , Timmons Suzanne , O’Reilly Susan , Bracken-Scally Mairead , Ciblis Aurelia , Cole Natalie , Drury Amanda , Pittalis Chiara , Kennelly Brendan , McCarron Mary , Brady Anne-Marie
Published: April 2020

Background: Little is known about staff’s attitudes in Irish acute hospital settings towards people living with dementia and their perceived dementia knowledge. The objective of this study was to understand the general level of dementia knowledge and attitudes towards dementia in different types of hospital staff, as well as to explore the potential influence of previous dementia training and experience (having a family member with dementia) and the potential moderating effects of personal characteristics. Methods: A cross-sectional survey was carried out among a diverse range of hospital staff (n = 1795) in three urban acute general hospitals in Ireland, including doctors, nurses, healthcare attendants, allied professionals, and general support staff. Participants’ perceived dementia knowledge and attitudes were assessed as well as their previous dementia training and experience. To measure participant’s attitude towards dementia, the validated Approaches to Dementia Questionnaire (ADQ) was used. Results : Hospital staff demonstrated positive attitudes towards people living with dementia, and believed they had a fair to moderate understanding of dementia. Both ‘having previous dementia training’ and ‘having a relative living with dementia’ predicted attitude towards dementia and perceived dementia knowledge. Interestingly, certain personal staff characteristics did impact dementia training in predicting attitude towards dementia and perceived dementia knowledge. Conclusion : This study provides a baseline of data regarding the attitudes towards dementia and perceived dementia knowledge for hospital staff in Irish acute hospitals. The results can inform educational initiatives that target different hospital staff, in order to increase awareness and knowledge to improve quality of dementia care in Irish hospitals.
Dkk1 is a negative regulator for the pathogenesis of ossification of the posterior longitudinal ligament
Authors: Dong Jun , Xu Xiqiang , Zhang Qingyu , Wang Naiguo , Yuan Zenong , Tan Bingyi
Published: April 2020

PurposeOssification of the posterior longitudinal ligament (OPLL) is an osteogenic disorder characterized by ectopic bone formation in the posterior longitudinal ligament of the spine. dinkkopf 1 (Dkk1) is a secreted inhibitor of the Wnt pathway, which negatively regulates bone formation during skeletal development. However, whether Dkk1 impacts the pathogenesis of OPLL has not been reported. This study is to investigate the implication of Dkk1 in the pathogenesis of OPLL.MethodsThe serum level of Dkk1 in OPLL patients was determined using ELISA. The expression of Dkk1 and activation of the Wnt/β-catenin signaling were examined in OPLL ligament-derived fibroblasts. The modulation of Dkk1 on OPLL cell proliferation, apoptosis, as well as BMP2-induced osteogenic differentiation was also investigated.ResultsThe serum level of Dkk1 is decreased in OPLL patients as compared to non-OPLL patients. The expression of Dkk1 is also reduced in OPLL fibroblasts. Downregulation of Dkk1 in OPLL cells is associated with stabilized β-catenin and increased TCF-dependent transcriptional activity, indicating an activation of the Wnt/β-catenin signaling pathway. Functionally, Dkk1 exerts a growth-inhibitory effect by repressing proliferation but promoting apoptosis of OPLL fibroblasts. Dkk1 also suppresses BMP2-induced entire osteogenic differentiation of OPLL cells and this suppression is mediated via its inhibition of the Wnt pathway.ConclusionDkk1 acts as an important negative regulator in the pathogenesis of OPLL. Targeting the Wnt pathway using Dkk1 or small molecule inhibitors may represent a potential therapeutic strategy for the treatment of OPLL.
Qualitative and quantitative assay of glucose 6 phosphate dehydrogenase in patients attending tertiary care center
Authors: Sharma Uday , Mishra Satyendra , Gautam Narayan , Gupta Badri Kumar
Published: April 2020

Objectives
The study was carried out to with the aim to find out the frequency of G6PD deficiency among the patients attending the hospital and to rationalize methemoglobin reduction test (Qualitative method) in reference to the spectrophotometric assay (Quantitative method). Timely screening of the patients for Glucose 6 phosphate dehydrogenase deficiency with appropriate screening method can play an important role in preventing hemolytic crisis that arises from therapeutic use of oxidative drugs like primaquine.
Result
The frequency of Glucose 6 phosphate dehydrogenase deficient cases was 3% by both of the employed tests. The mean ± SD of Glucose 6 phosphate dehydrogenase activity in the patients under study was 15.34 ± 4.7 IU/l in males, 16.01 ± 3.74 IU/l in females. G6PD activity was positively associated with reticulocyte count (r = 0.289, p-value = 0.004) and negatively with mean corpuscular hemoglobin concentration (r = -0.220, p-value = 0.028). The correlation of Red blood corpuscular count and Glucose 6 phosphate dehydrogenase was statistically significant (p-value = 0.048).
Nurses' perceptions and practices regarding oral care in hospitalized patients: a qualitative study on missed nursing care
Authors: Charalambous Melanie Elia , Efstathiou Georgios , Christodoulou Persefoni Lambrou , Irakleous Iraklis , Papastavrou Evridiki
Published: April 2020

BACKGROUND: Oral health is considered essential for individuals’ well-being. Poor oral health has a negative impact on overall human health while contributing and predisposing to other diseases. It has been internationally documented that nurses delay or omit oral care of hospitalized patients and as a result of this, the risk of adverse events is increased. METHODS: Four focus groups were organized (n=30) to elicit the issue under study. Nurse managers and nurses working in medical and surgical departments in 3 acute care hospitals participated in June 2019. The discussions were coordinated by an independent moderator, using a semi-structured interview guide. Recordings of the conversations were transcribed and thematic analysis was performed according to Krueger and Casey guidelines. RESULTS The findings confirm that oral care of hospitalized patients is often omitted and is not acknowledged as an important patient need. The barriers and facilitators that affected oral health care positively or negatively were divided into three themes and included patient’ characteristics, nurses’ knowledge and skills and recourses as well as the working environment . CONCLUSIONS: Oral care is not considered as priority and there are many factors that contribute negatively or positively to its implementation. Nurse managers and nurses can play a crucial role for the adoption of universal oral care practices in hospitalized patients.
An experimental model of neurodegenerative disease based on porcine hemagglutinating encephalomyelitis virus-related lysosomal abnormalities
Authors: Lan Yungang , Li Zi , Wang Zhenzhen , Wang Xinran , Wang Gaili , Zhao Kui , Gao Feng , He Wenqi
Published: April 2020

Advances in experimental models for neurodegenerative diseases have enhanced the understanding of its molecular pathogenesis and begun to revealed promising therapeutic avenues. Lysosomes are involved in pathogenesis of a variety of neurodegenerative diseases and play a large role in neurodegenerative disorders caused by virus infection. However, whether virus-infected cells or animals can be used as experimental models of neurodegeneration in humans based on virus-related lysosomal dysfunction remain unclear. Porcine hemagglutinating encephalomyelitis virus (PHEV) displays neurotropism in mice and neural cells are its targets for viral progression. PHEV infection may be a risk factor for neurodegenerative diseases. Our findings demonstrated for the first time that PHEV infection can lead to lysosome disorders and showed that the specific mechanism of lysosome dysfunction is related to PGRN expression deficiency and indicated similar pathogenesis compared to human neurodegenerative diseases such as neuronal ceroid lipofuscinosis (NCL) and frontotemporal lobar degeneration (FTLD) upon PHEV infection. Trehalose can also increase progranulin (PGRN) expression and rescue abnormalities in lysosomal structure in PHEV-infected cells. In conclusion, these results suggest that PHEV may serve as a disease model for studying the pathogenic mechanisms and prevention of other degenerative diseases.
Dietary intakes and their association with weight status in male and female school children in South India: A cross-sectional study
Authors: Swaminathan Sumathi , Selvam Sumithra , Thomas Tinku , Jayachitra Krishnaswamy G , Kurpad Anura V
Published: April 2020

BackgroundWith India going through a nutrition transition evaluating food consumption of children is important. The present analysis was done to cross-sectionally examine the diets of school-aged children by sex and weight status. MethodsUrban school-going children 8-15 years of age, representing all strata of socio-economic status were recruited through stratified quota sampling. Dietary intake was assessed by three interviewer-administered 24-hour dietary recalls. The proportion with inadequate intakes for macro- and micro-nutrients and percentage energy intake of macronutrients below and above the Acceptable Macronutrient Distribution Range (AMDR) were compared between sexes. Association of dietary intake with weight status were examined by multinomial logistic regression in boys and girls separately with the reference category being the highest tertile of each food group intake. ResultsTotally, 634 children were recruited (13.7% boys, 15.6% girls underweight;18.8% boys, 18.5% girls overweight). In general, boys had significantly higher mean intakes of all nutrients (p<0.05) except for vitamin B 12 (0.96 µg in boys versus 0.87 µg in girls, p=0.055) and vitamin A (225.4 µgRAE in boys and 222.2 µgRAE in girls, p=0.073). The prevalence of inadequate intake was the highest for vitamin A (96.8% in boys vs 94.8% in girls, p=0.152). The proportions of inadequacy were significantly higher in girls for all nutrients (p<0.05), except for folate and vitamin A. High carbohydrate intake (OR:3.11; 95% CI:1.55, 6.24, p=0.002) and low fat intake (OR:2.15; 95% CI:1.06, 4.35, p=0.041) were significantly associated with underweight in girls but not for boys. After adjusting for age and total energy intake, lower intake of vegetables and higher intake of fruits were significantly associated with underweight boys while, lower intake of root vegetables, nuts, milk products and added sugar were associated with underweight girls. A higher proportion of overweight boys was observed in the lowest tertile of pulse intake and lower proportion in the lowest tertile of nut intake. Overweight girls were more likely to be in the lowest tertile of meat intake. ConclusionsChildren’s diets need to be improved to meet nutrient requirements. Promotion of healthy diets in children which reduce prevalence of underweight and arrest increase in overweight is required.
Socio-demographic and environmental factors of diarrhoea among under-five children in India
Authors: Paul Pintu
Published: April 2020

Background Globally, diarrhoea is a second leading cause of deaths among under-five children and is a major public health problem. Despite several health care initiatives, a large proportion of under-five children are still experienced diarrhoeal diseases causes high mortality in India. This study aims to examine the socio-demographic and environmental factors of diarrhoea among children under-five in India.Methods A cross-sectional study was designed using the recent round of the National Family Health Survey (NFHS), conducted in 2015-16. A total of living children below 5 years of age were utilized for the analysis of this study. Bi-variate and multivariate logistic regression were carried out to investigate the factors of childhood diarrhoea.Results In India, about 9% under-five children experience diarrhoeal disease in the past 2 weeks. Children from rural areas (AOR: 1.05; 95% CI: 1.01, 1.09), Scheduled Tribe (AOR: 0.83; 95% CI: 0.79, 0.89) and others caste (AOR: 0.92; 95% CI: 0.88, 0.97), Muslim (AOR: 1.18; 95% CI: 1.13, 1.24), and from central (AOR: 1.61; 95% CI: 1.52, 1.70) and west region (AOR: 1.08; 95% CI: 1.01, 1.15) were significantly associated with higher likelihood of diarrhoea in past 2 weeks. Furthermore, this study also revealed that child’s stool disposal (AOR: 1.06; 95% CI: 0.98, 1.09), floor materials (AOR: 1.08; 95% CI: 1.03, 1.12) and roof materials (AOR: 1.08; 95% CI: 1.04, 1.13) of the household were found to be significant factors of childhood diarrhoea occurrence.Conclusions Diarrhoeal disease remains a serious public health problem in India. The findings of this study suggest strengthening of existing health care programs. Policy intervention should also address socio-economic vulnerabilities of mothers and children to combat the incidence of diarrhoea. In addition, provisioning of sanitation and housing facilities may help positively to control diarrhoeal disease that could eventually reduce the incidence of child mortality.
Comparison of oral health care between dental and non-dental students in Southwestern China--exploring the future priority for oral health education
Authors: Li Mingming , Wu Zhiwu , Zhang Rui , Lei Lei , Cheng Ran , Hu Tao
Published: April 2020

Background
Dental caries and periodontal disease are still serious oral problems in China after decades of Oral health education(OHE). It’s necessary to figure out the problems. The aim of this study was to figure out the oral health care knowledge and habits of undergraduates in Sichuan University and the existing problems, by comparing the differences between dental and non-dental students. It was hoped to provide some suggestions for future OHE.
Methods
A quasi-experimental study design with a pre-test and post-test group was applied. 217 dental-students and 135 non-dental students were enrolled. They were given a course for OHE. A knowledge test and a survey about oral health care were conducted before and after course.
Results
According to the pre-course survey, dental students surpassed non-dentals in terms of tooth-brushing frequency, method, time and flossing. Unfortunately, flossing was overlooked by all the students. After the course, both dental and non-dental students improved a lot in the oral health care knowledge and habits. More non-dental students than dental students were willing to use toothpicks and Chinese herbal toothpaste before and after course.
Conclusions
OHE plays a positive role for university students. Future OHE should focus on the flossing, toothbrushing methods, toothpick, Chinese herbal toothpaste and modification to adapt new media.
Molecular screening for nigericin treatment in pancreatic cancer by high-throughput RNA sequencing
Authors: Xu Zhihua , Zhi Qiaoming , Gao Guanzhuang , Liu Fei , Han Ye , Dai Chen , Wang Sentai , Wei Guobang , Kuang Yuting , Wan Daiwei , Xu Ye
Published: April 2020

Background Nigericin, an antibiotic derived from Streptomyces hygroscopicus, has been proved to exhibit promising anti-cancer effects on a variety of cancers. Our previous study investigated the potential anti-cancer properties in pancreatic cancer (PC), and demonstrated that nigericin could inhibited the cell viabilities in concentration- and time-dependent manners via differentially expressed circular RNAs (circRNAs). However, the knowledge of nigericin associated with long non-coding RNA (lncRNA) and mRNA in pancreatic cancer (PC) has not been studied. This study is to elucidate the underlying mechanism from the perspective of lncRNA and mRNA.Methods The continuously varying molecules (lncRNAs and mRNAs) were comprehensively screened by high-throughput RNA sequencing.Results Our data showed that 76 lncRNAs and 172 mRNAs were common differentially expressed in the nigericin anti-cancer process. Subsequently, the bioinformatics analyses, including GO and KEGG analysis, coding and non-coding co-expression network, cis- and trans-regulation predictions and PPI network, were applied to annotate the potential regulatory mechanisms among these coding and non-coding RNAs during the nigericin anti-cancer process.Conclusion These findings provided new insight into the molecular mechanism of nigericin toward cancer cells, and suggested a possible clinical application in PC.
PD-L1 Tumor Cell Expression in Upper Tract Urothelial Carcinomas is Associated with Higher Pathological Stage
Authors: Ward Michael , Albertson Daniel , Furtado Larissa V. , Deftereos Georgios
Published: April 2020

Background

Upper tract urothelial carcinomas (UTUCs) are a rare and unique subset of urothelial carcinoma (UC). Immune checkpoint inhibitors are showing promise in the treatment of UC of the bladder and UTUC alike. While several large studies have looked at PD-L1 expression in UC in general, most have not investigated UTUC as a separate group. Moreover, comparison between studies of PD-L1 expression is challenging as the different immune checkpoint inhibitors require different PD-L1 scoring systems and cutoffs (i.e. tumor proportion score, combined positive score, and immune cell score).
Methods

This is a retrospective study of 37 cases of resected UTUC. Representative tissue from each case was compiled into tissue microarrays and immunohistochemical stains for PD-L1 (Dako antibody clones 223C and 28 − 8) were performed. PD-L1 staining was evaluated using several established scoring systems: tumor proportion score (TPS), combined positive score (CPS) and immune cell (IC) score. Associations between PD-L1 expression and clinicopathologic features were investigated.
Results

Overall expression of PD-L1 in UTUC was 29.7% when using a TPS cutoff of ≥ 1%. 55.6% of cases with higher pathological stage (pT3 or pT4) were positive for PD-L1, compared to only 5.3% of cases with lower pathological stage (pTis, pT1, or pT2; p = 0.0011). When using a CPS cutoff of ≥ 10, there was no significant association between tumor stage and PD-L1 expression. There was no association between PD-L1 positivity and tumor grade, tumor location, gender, or age. There was 100% concordance between 22C3 and 28 − 8 in terms of positivity rate.
Conclusions

Our study shows that 29.7% of UTUCs are positive for PD-L1 TPS expression, comparable to the 20–30% reported in UC literature. Our study also shows that PD-L1 expression in UTUC is more often associated with high pathological stage, which may reflect an immune response evasion mechanism that UC cells acquire later in disease progression. Finally, PD-L1 22C3 and 28 − 8 clones show similar overall patterns of staining in this setting.