bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring optimal examination to detect occult anastomotic leakage after rectal resection in patients with diverting stoma
Authors: Kitaguchi Daichi , Enomoto Tsuyoshi , Ohara Yusuke , Owada Yohei , Hisakura Katsuji , Akashi Yoshimasa , Takahashi Kazuhiro , Ogawa Koichi , Shimomura Osamu , Oda Tatsuya
Published: February 2020

Background When considering “early stoma closure”, both standardized inclusion/exclusion criteria and standardized methods to assess anastomosis are necessary to reduce the risk of occult anastomotic leakage (AL). However, in the immediate postoperative period, neither have the incidence and risk factors of occult AL in patients with diverting stoma (DS) been clarified nor have methods to assess anastomosis been standardized. The aim of this study was to elucidate the incidence and risk factors of occult AL in patients who had undergone rectal resection with DS and to evaluate the significance of computed tomography (CT) following water-soluble contrast enema (CE) to detect occult anastomotic leakage. Methods This was a single institutional prospective observational study of patients who had undergone rectal resection with the selective use of DS between May and October 2019. Fifteen patients had undergone CE and CT to assess for AL on postoperative day (POD) 7, and CT was performed just after CE. Univariate analysis was performed to assess the relationship between preoperative variables and the incidence of occult AL on POD 7 Results The incidence of occult AL on postoperative day 7 was 6 of 15 (40%). Hand-sewn anastomosis, compared with stapled anastomosis, was a significant risk factor. Five more cases with occult AL that could not be detected with CE could be detected on CT following CE; CE alone had a 33% false-negative radiological result rate. Conclusions Hand-sewn anastomosis appeared to be a risk factor for occult AL, and CE alone had a high false-negative radiological result rate. When considering the introduction of early stoma closure, stapled anastomosis and CT following CE could be an appropriate inclusion criterion and preoperative examination, respectively.
Care after pancreatic resection according to an algorithm for early detection and minimally invasive management of pancreatic fistula versus current practice (PORSCH-trial): design and rationale of a nationwide stepped-wedge cluster randomized trial
Authors: Smits Francina J , Henry AC , Eijck CH van , Besselink MG , Busch OR , Arntz M , Bollen TL , Delden OM van , Heuvel D van den , Leij C van der , Lienden KP van , Moelker A , Bonsing BA , Rinkes IHM Borel , Bosscha K , Dam RM van , Festen S , Koerkamp B Groot , Harst E van der , de Hingh I , Kazemier G , Liem M , Kolk BM van der , de Meijer VE , Patijn GA , Roos D , Schreinemakers JM , Wit F , Werkhoven CH van , Molenaar IQ , Santvoort HC van
Published: February 2020

Background Pancreatic resection is a major abdominal operation with 50% risk of postoperative complications. A common complication is pancreatic fistula, which may have severe clinical consequences such as postoperative bleeding, organ-failure and death. The objective of this study is to investigate whether implementation of an algorithm for early detection and minimally invasive management of pancreatic fistula may improve outcomes after pancreatic resection.

Methods This is a nationwide stepped-wedge, cluster randomized, superiority trial, designed in adherence to the CONSORT guidelines. During a period of 22 months, all Dutch centers performing pancreatic surgery will cross over in a randomized order from current practice to best practice according to the algorithm. This evidence- and consensus based algorithm will provide daily multilevel advice on the management of patients after pancreatic resection (i.e. indication for abdominal imaging, antibiotic treatment, percutaneous drainage and removal of abdominal drains). The algorithm is designed to aid early detection and minimally invasive step-up management of postoperative pancreatic fistula. Outcomes of current practice will be compared with outcomes after implementation of the algorithm. The primary outcome is a composite of major complications (i.e. postpancreatectomy bleeding, new-onset organ failure and death) and will be measured in a sample size of at least 1600 patients undergoing pancreatic resection. Secondary endpoints include the individual components of the primary endpoint and other clinical outcomes, healthcare resource utilization and costs analysis. Follow-up will be up to 90 days after pancreatic resection.

Discussion It is hypothesized that a structured nationwide implementation of a dedicated algorithm for early detection and minimally invasive step-up management of postoperative pancreatic fistula will reduce the risk of major complications and death after pancreatic resection, as compared to current practice.
Culture of 16HBE14o- Cells
Authors: McNabb Nicole A. , McCullough Shaun D.
Published: February 2020

This protocol describes the thawing, culturing, and cryopreservation of the human bronchial epithelial cell line 16HBE14o- (referred to as “16HBE”). The attached methods document is a formal version of the information included here. The attached worksheet is a fillable PDF that can be used to maintain cell passage records using this protocol.Please note: Deviation from the three-day passage cycle and cell plating density described here typically results in greater culture and experimental variability.Disclaimer: The contents of this article have been reviewed by the US Environmental Protection Agency and approved for publication and do not necessarily represent Agency policy. Mention of trade names or commercial products does not constitute endorsement or recommendations for use.
Measurement of Trans-Epithelial Electrical Resistance with EVOM2 and Chopstick Electrode
Authors: McCullough Shaun D.
Published: February 2020

Trans-epithelial Electrical Resistance (TEER) can be used as a measure of cell monolayer confluence, health, and integrity. An Epithelial Voltohmmeter (EVOM) is used to take TEER measurements. This method details how to take TEER readings using an EVOM with chopstick electrode.Please note that chopstick electrodes are only designed for use with 12 mm inserts.Disclaimer: The contents of this article have been reviewed by the US Environmental Protection Agency and approved for publication and do not necessarily represent Agency policy. Mention of trade names or commercial products does not constitute endorsement or recommendations for use.
Comparisons of Social and Demographic Determinants of Tobacco Use in the Democratic Republic of the Congo
Authors: Colwell Brian , Mosema Kizito , Bramble Matthew S. , Maddock Jay
Published: February 2020

Background Worldwide, tobacco use has caused over 100 million deaths in the twentieth century and is projected to cause death in up to one billion people in the twenty-first century. It is a leading cause of early death and disability in over 100 countries and accounts for over 11% of global deaths, disproportionately affecting low- and middle-income countries. The purpose of the study was to examine a variety of social determinants of tobacco use in the Democratic Republic of the Congo, including region, sex, ethnicity, education, literacy, wealth index and place of residence, to gain insights with regard to tobacco use among sub-national groups. Methods This project was a secondary data analysis of the 2013-2014 Demographics and Health Survey (DHS) for the Democratic Republic of the Congo. Logistic regressions predicting smoking, use of snuff and smoking cigars or natural tobacco as dichotomous variables were conducted. Independent variables included age, educational level, religion, rurality, literacy, wealth index, occupation and ethnicity. Results Tobacco use is highest among those with less education and low literacy. It was also highest among the working poor. Older age predicted smoking, as did living in small towns or the countryside, although the relationship between age and smoking was not linear. There was a strong linear effect for wealth. Being in a professional, technical or managerial position was highly protective against smoking while being engaged in services, skilled and unskilled manual labor, and the army had significantly greater odds of smoking. Conclusions Data indicate that tobacco use in the DRC, as is common in the developing world, is heavily concentrated in the working poor with lower educational status. Higher educational status is consistently predictive of avoiding tobacco use. Additionally, examining only national-level data to ascertain tobacco use levels and patterns may lead to mistaken conclusions that can lead to inefficient and ineffective allocation of resources aimed at controlling tobacco use.
Spirulina platensis enhances immune status, inflammatory and oxidative markers of HIV patients on antiretroviral therapy in Cameroon
Authors: Moor Vicky Jocelyne Ama , Anatole Pieme Constant , Nkeck Jan René , Nya Prosper Cabral Biapa , Mondinde Georges Ikomey , Kouanfack Charles , Assoumou Marie Claire Okomo , Ngogang Jeanne
Published: February 2020

Background Spirulina platensis is traditionally used as a food supplement with a potential strengthening of the immune system, inhibition of the replication of some viruses, and lipid-lowering effect. The aim of this study was to determine its effect on the inflammatory, immunological, and oxidative status of HIV patients on antiretroviral therapy (ART). Methods We performed a study on 62 HIV patients on ART (Tenofovir-Lamivudine-Efavirenz) divided into 2 groups. Group I, supplemented with 10 grams of Spirulina platensis daily, and group II only ART. Participants were paired on ART duration and followed-up for 6 months from December 2015 to June 2016 at the HIV care unit of the Yaounde Central Hospital and the Cité-Verte Hospital, Yaounde. Each group was sampled for CD4-count, viral load, serum levels of interleukins 6 and 8, TNFα and oxidative markers (malondialdehyde, FRAP, catalase, total peroxides, superoxide dismutase, glutathione peroxidase, reduced glutathione) at the beginning (T0) and the end of the trial (T1). Ethical clearance was obtained from the Cameroon National Ethics Committee for Human Health and Research (Ref 2016/01/699/CE/CNERSH/SP). Statistical analysis was performed using the software SPSS 21.0. The threshold of significance was set at 0.05. Results Mean ages of participants were 35 ± 8 and 37 ± 7 respectively for group I and II. We observed a significant decrease in viral load in patients receiving spirulina comparing at T0 and T1 (p = 0.001), not observed for participants in group II (p>0.05). CD4-counts were unchanged. There was a significant reduction of TNFα levels in group 1. The levels of pro-oxidative markers were significantly reduced in group 1 while increased in the other group. Antioxidant levels significantly increased in both groups. Conclusion Daily supplementation of Spirulina platensis could improve the immune status of HIV patients on ART, and decrease inflammatory and pro-oxidant levels.
Antimicrobial practices among small animal veterinarians in Greece: a survey
Authors: Valiakos George , Pavlidou Eleni , Zafeiridis Christos , Athanasakopoulou Zoi , Tsokana Constantina N , Vilas Victor J Del Rio
Published: February 2020

Background The inappropriate use of antibiotics is a major issue in clinical practice in Greece with serious implications for public health and animal health. The purpose of the present study was to provide a first insight into the use of antibiotics by small animal practitioners in Greece and assess their compliance with general rules for the rational use of antibiotics. This is the first survey of its kind in Greece. Methods A questionnaire was designed to collect basic information on the use of antibiotics by pet veterinarians. The questionnaire was sent to a total of 70 veterinarians mainly operating in the region of Attica, a region that comprises almost 50% of the Greek population and where veterinarians are engaged solely in small animal practice. The questionnaire consisted of 37 closed questions dealing with various aspects on the use of antibiotics. Results The majority of respondents’ report cases where the pet owner initiated antibiotic treatment without veterinary prescription. Almost every clinician reported owner-compliance challenges. Regarding microbiological analysis, 73% of respondents prefer to adopt the empirical treatment while waiting the laboratory results or use antibiogram only when the treatment is unsuccessful. Eighty-eight per cent declared to use antimicrobials postoperatively in clean surgical procedures. Different types of antimicrobials and treatment durations than the ones proposed by guidelines on rational use of antibiotics are preferred for various organ systems e.g. in urinary and gastrointestinal infections. Conclusions Our findings suggest the need for guidelines on antibiotic use in small animal practice in Greece, and the deployment of systematic surveillance on antimicrobials use and resistance to inform the initial choice of antibiotics upon local antimicrobial resistance profiles. Targeting the other end of the problem, pet owners, our findings indicate the need to educate them on the rational use of antibiotics and, critically, stop antibiotic availability without prescription.
Photodegradation kinetics of alkyd paints: the influence of varying amounts of inorganic pigments on the stability of the synthetic binder
Authors: Pagnin Laura , Wiesinger Rita , Schreiner Manfred
Published: February 2020

Nowadays, understanding the degradation processes of artworks exposed to outdoor conditions is essential in order to conserve these objects. In fact, the continuous climate changes risk to increasingly affecting their chemical-physical stability, especially for modern and contemporary ones. For this purpose, in this study, the kinetics of photo-oxidation processes occurring in synthetic binders and their stability in mixtures with different inorganic pigments were investigated. The aim was not only to characterize the different degradation reactions over time but to study the photodegradation kinetics according to the different pigments and pigment/binder ratio (P/BM) chosen. A total of 9 paint samples were prepared by mixing the inorganic pigments (artificial ultramarine blue, hydrated chromium oxide green, and cadmium yellow) with alkyd resin, in three different pigment/binder (P/BM) ratios: 1:2, 1:3, and 1:6. The paint samples were exposed to artificial sunlight for up to 1008 h, documented by optical 3D microscopy and analysed by Infrared Spectroscopy (ATR-FTIR) and colourimetry every 168 hours. The results obtained demonstrate that the degradation processes of alkyd resin are influenced by the different inorganic pigment used and its amount/concentration in the mixtures. Evaluation of these different deterioration mechanisms took into account the morphological/colour changes, the chemical reactions, and the physical properties of the materials. This study should contribute to the field of conservation-restoration, such as finding protection strategies for surfaces from degradation agents.
District-level differentiated HIV testing strategies are needed to achieve the 1st 90 in Zimbabwe
Authors: Makurumidze Richard , Decroo Tom , Lynen Lutgarde , Chinwadzimba Zororo Kudzaishe , Damme Wim Van , Hakim James , Rusakaniko Simbarashe
Published: February 2020

Objective Despite the improvement towards the 90-90-90 targets, more than 25% of people living with HIV in Zimbabwe still do not know their HIV status. We used data from a recently published survey to recommend district-level HIV testing strategies based on HIV prevalence and antiretroviral therapy coverage to implementers and policy makers. Results Of the 62 districts in Zimbabwe 38% were in the low HIV prevalence /low antiretroviral therapy coverage, 34% in low HIV prevalence /high antiretroviral therapy coverage, 15% in high HIV prevalence/high antiretroviral therapy coverage and 13% in high HIV prevalence/low antiretroviral therapy coverage categories. Districts with low HIV prevalence and low antiretroviral therapy coverage should employ targeted HIV testing approaches (index case testing, targeting sexual partners and HIV exposed infants; intensified provider initiated testing; key populations and hot spots). Those with high HIV prevalence and low antiretroviral therapy coverage should focus on expanding access to HIV testing to the community. Districts with already high antiretroviral therapy coverage should move to targeted HIV testing so that the few yet to be tested are reached. Further exploration to assess other contextual factors in the cascade of care beyond HIV testing is warranted to achieve the 90-90-90 strategies.
Association between socioeconomic status and fertility among adolescents aged 15 to 19: An analysis of the 2013/2014 Zambia Demographic Health Survey (ZDHS)
Authors: Munakampe Margarate Nzala , Fwemba Isaac , Zulu Joseph Mumba , Michelo Charles
Published: February 2020

BackgroundAdolescents face significant barriers to access and utilization of sexual and reproductive health services in many low-income settings which in turn may be associated with adverse consequences such as early pregnancy, sexually transmitted infections and unsafe abortion and mortality. There is evidence suggesting that limited access to sexual and reproductive health information and services among adolescents contribute to these outcomes. We aimed to find out the factors that affect the fertility of adolescents aged 15 to 19 years in Zambia and to identify possible drivers of adolescents’ fertility. Methods Secondary analysis of the ZDHS 2013/14 data was carried out to find out the factors that affect the fertility rate of adolescents aged 15 to 19 years using multivariate logistic regression (n=3,666). Results Overall, 23.1% of adolescents had given birth at least once in the five years leading to the survey (n= 3,666, 99.4% response), and 49.8% were rural-based while 50.2% were urban-based. The median number of schooling was 8 years (IQR= 6-10). About 52% of the adolescents were in the poorer, poor and medium wealth quintiles while the other 48% were in the rich and richer quintiles. Factors found to affect fertility include residence, wealth status, educational attainment, marriage and abortion. An urban-based adolescent with a lower socioeconomic status was 2.4 times more likely to give birth compared to rural-based poorer adolescents (95% CI 1.5, 3.7 p<0.001). Although odds of giving birth were much higher among rural married adolescents (aOR 8.0, 95%CI 8.0, 5.4, 11.9 p<0.001) compared to urban married adolescents (aOR 5.5, 95%CI 8.3, 16.0, p<0.001), and these relationship were both statistically significant. Higher educational attainment (aOR 0.7 95% CI 0.6, 0.8 p<0.001) and abortion (aOR 0.3 95% CI 0.1, 0.8 p=0.020) reduced these odds, particularly for rural-based adolescents. Conclusion Despite response aimed at reducing adolescent fertility, low wealth status, low educational attainment and early marriage remain significant drivers of adolescent fertility in Zambia. There is a need to address access to sexual and reproductive health needs of urban adolescents with a lower socioeconomic status.
Associations between infant and young child feeding practices and diarrhoea in Indian children: a regional analysis
Authors: Dhami Mansi Vijaybhai , Ogbo Felix Akpojene , Diallo Thierno , Agho Kingsley
Published: February 2020

Background: There are limited data on the association between infant and young child feeding (IYCF) practices and diarrhoea across regional India, to inform policy initiatives and advocacy. The present study examined the association between IYCF practices and diarrhoea in regional India. Method: The study used a weighted sample of 90,596 maternal responses from the 2015-16 National Family Health Survey in India. Prevalence estimates of diarrhoea by IYCF indicators were estimated for each administrative region, namely: North (n=11,200), South (n=16,469), East (n=23,317), West (n=11,512), Central (n=24,870) and North-East (n=3,228). Multivariate logistic regressions that adjust for clustering and sampling weights were used to investigate the association between IYCF and diarrhoea in regional India. The IYCF indicators include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, bottle feeding, continued breastfeeding at one year, continued breastfeeding at two years, children ever breastfed and the introduction of solid, semi-solid or soft foods. Results: The prevalence of diarrhoea was lower among infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed. Children whose mothers continued breastfeeding at one and two years, and infants who were introduced to complementary foods had a higher prevalence of diarrhoea. Early initiation of breastfeeding and EBF were protective against diarrhoea in the North, East and Central regions of India. However, predominant breastfeeding, bottle-feeding and introduction of complementary foods were risk factors for diarrhoea in Central India. Continued breastfeeding at two years was a risk factor for diarrhoea in Western India. Conclusion: Our study suggests that early initiation of breastfeeding and EBF were protective against diarrhoea in Northern, Eastern and Central India, while predominant breastfeeding, bottle feeding, continued breastfeeding at two years and introduction of solid, semi–solid or soft foods were risk factors for diarrhoea in various India regions. Improvements in IYCF practices are likely to reduce the burden of diarrhoea-related morbidity and mortality across India regions.
How does the self-reported health of undergraduate nursing students change during their degree programme? Survey results from a Scottish University
Authors: Evans Josie , Andreis Federico , Cameron Dawn M , Eades Claire E
Published: February 2020

Background The lifestyle behaviours, and the physical and mental health of nurses, are poorer than those of other allied health professionals, and of the general population. However, these were no less favourable among first year undergraduate nursing students at a Scottish Higher Education Institution (HEI) than among similar people of the same age. We compared health and health behaviours among the same cohort of undergraduate nursing students over the course of their degree. Methods An anonymous self-complete repeat cross-sectional survey was administered during a timetabled teaching session at three time-points to undergraduate nursing students at the start of Years 1, 2 and 3 of their programme. They had received written information about the study previously. Results Self-reported health did not change significantly over time, but there was a clear decline over the three years in the proportions of students rating their mental health as excellent/very good/good and a concomitant increase in those rating their mental health as fair/poor. Correspondingly, the mean WEMWBS wellbeing score declined over the three years, with the proportion of students with a score of <46 (indicating either high risk of major depression, or in high risk of psychological distress and increased risk of depression) increasing from one quarter to one half. This effect was captured and described using a Bayesian regression analysis. The most noticeable change in health behaviours was a decline in physical activity levels over the study period. The proportion of students managing 150 minutes of weekly physical activity decreased from three quarters to two thirds. This was reflected in higher self-reported sedentary time, although there were no observable trends over time in mean BMI, or proportions of students categorised as overweight or obese. Conclusions A clear picture emerges from this study of nursing students experiencing much poorer mental health over the course of their degree, and a decline in physical activity. The evidence suggests a need for the incorporation of regular, timetabled physical activity into nursing programmes, offering the opportunity for students to learn about health promotion and lifestyle change in practice, to improve their own physical health, and to address mental wellbeing.
Cortical potentiation induced by calcitonin gene-related peptide (CGRP) in the insular cortex of adult mice
Authors: Liu Yinlu , Chen Qi-Yu , Lee Jung Hyun , Li Xu-Hui , Yu Shengyuan , Zhuo Min
Published: February 2020

Recent studies demonstrate that calcitonin gene-related peptide (CGRP) plays critical roles in migraine. Immunohistochemistry and in situ hybridization studies have shown that CGRP and its receptors are expressed in cortical areas that are critical for pain perception including the anterior cingulate cortex (ACC) and insular cortex (IC). Recent studies reported that CGRP enhanced excitatory transmission in the ACC. However, little is known about the possible effect of CGRP on excitatory transmission in the IC. In the present study, we investigated the role of CGRP on synaptic transmission in the IC slices of adult male mice. Bath application of CGRP produced dose-dependent potentiation of evoked excitatory postsynaptic currents (eEPSCs). This potentiation was NMDA receptor (NMDAR) independent. After application of CGRP1 receptor antagonist CGRP8-37 or BIBN 4096, CGRP produced potentiation was significantly reduced. Paired-pulse facilitation was significantly decreased by CGRP, suggesting possible presynaptic mechanisms. Consistently, bath application of CGRP significantly increased the frequency of spontaneous and miniature excitatory postsynaptic currents (sEPSCs and mEPSCs). By contrast, amplitudes of sEPSCs and mEPSCs were not significantly affected. Finally, adenylyl cyclase subtype 1 (AC1) and protein kinase A (PKA) are critical for CGRP-produced potentiation, since both selective AC1 inhibitor NB001 and the PKA inhibitor KT5720 completely blocked the potentiation. Our results provide direct evidence that CGRP contributes to synaptic potentiation in the IC, and the AC1 inhibitor NB001 may be beneficial for the treatment of migraine in the future.
Low serum albumin, aspartate aminotransferase, and body mass are risk factors for frailty in elderly people with diabetes: possible mechanistic role of dehydroepiandrosterone sulfate – a cross-sectional study
Authors: Yanase Toshihiko , Yanagita Ikumi , Fujihara Yuya , Iwaya Chikayo , Kitajima Yuichi , Tajima Misuzu , Honda Masanao , Teruya Yuji , Asakawa Hideko , Ito Tomoko , Eda Terumi , Yamaguchi Noriko , Kayashima Yumi , Yoshimoto Mihoko , Harada Mayumi , Yoshimoto Shoji , Aida Eiji , Nawata Hajime , Muta Kazuo
Published: February 2020

Background: Relatively low dehydroepiandrosterone sulfate (DHEA-S) and high cortisol/DHEA ratio have been suggested to be associated with frailty, evaluated using a physical scale. However, the significance of these two hormones for frailty in elderly patients with type 2 diabetes mellitus (T2DM) has not been assessed using a wider range of measures of frailty, including physical, mental, and social indices. Methods: We performed a cross-sectional study to investigate the significance of these two hormones for frailty in elderly T2DM patients (n=148; ≥65 years), using a broad assessment, the clinical frailty scale, and to reevaluate the risk factors for frailty in elderly T2DM patients. We compared parameters between the non-frail and frail groups using the unpaired t and Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify relationships with the severity of frailty and risk factors were identified using binary regression analysis. Results: Simple regression analysis identified a number of significant risk factors for frailty, including DHEAS <70 µg/dL and cortisol/DHEA-S ratio ≥0.2. Multiple regression analysis showed that low albumin (<4.0 g/dl) (odds ratio [OR]=5.79, p <0.001), low aspartate aminotransferase (AST) activity (<25 IU/L) (OR=4.34, p =0.009), and low body mass (BM) (<53 kg) (OR=3.85, p =0.012) were independent risk factors for frailty. A significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S ratio occurred alongside increases in the severity of frailty. DHEA-S concentration positively correlated with both serum albumin and BM. Conclusions: Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in elderly T2DM patients, strongly implying relative malnutrition in these frail patients. DHEA-S may be important for the maintenance of liver function and BM. A decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in the mechanism of the effect of malnutrition in elderly T2DM patients.
Genome-Wide Identification and Functional Analysis of Chitinase Gene Family in Grape
Authors: Zheng Ting , Zhang Kekun , Zhu Xudong , Jiu Songtao , Dong Tianyu , Liu Zhongjie , Guan Le , Jia Haifeng , Fang Jinggui
Published: February 2020

Background: Chitinases, the important resistance-related proteins, are crucial hydrolytic enzymes, which attack fungal pathogens by catalyzing the fungal cell wall degradation. As a large gene family, the VvChis have not been systematically analyzed and effectively investigated in grape. Results: In this study, we identified 42 VvChis in grape by searching the conserved domains, and divided them into A, B, C, D and E groups according to pylogenetic relationships, gene structure and conserved domains analysis. Quantitative real-time PCR (qRT-PCR) and publicly microarray data analysis revealed distinct temporal and spatial expression patterns of VvChis in different tissues at various growth stages. The transcriptional level of most genes was high in the root of ‘Koyho’ and ‘Summer Black’. Combining cis-elements in the promoter, GO and KEGG analysis, and prediction of interaction proteins, we revealed the function of Chitinase. After the pathogen infecting the leaves and berries of grape, the expression levels of VvChis in A, B and E groups showed a significant upward trend, of which VvChi5, VvChi25, VvChi11 (leaf) and VvChi16 (fruit) were the most up-regulated. The interaction between Chi-17 and Metallothionein (MTL) was confirmed by yeast two-hybrid system and bimolecular fluorescence complementation (BiFC). In addition, VvChis in GH18 family were up-regulated under MeJA and ETH treatment, in particular to 500 mg·L -1 ETH、50 μmol·L -1 MeJA; The induction of VvChis by low temperature was more significant than that of high temperature; The expression of VvChis was positively correlated with the concentration of NaCl treatment. Conclusion: This study clarified the member composition and expression pattern of VvChi family in grape, initially explored the disease resistance function of VvChi, and analyzed the response of VvChis to hormones (MeJA and ETH) and environmental stress (temperature and NaCl) signals was analyzed, which laid a foundation for constructing the functional regulation network of VvChi in grapes.
The effect of tree (and cambium) age on genomic prediction for solid wood properties in Norway spruce
Authors: Zhou Linghua , Chen Zhiqiang , Olsson Lars , Grahn Thomas , Karlsson Bo , Wu Harry , Lundqvist Sven-olof , Gil Maria Rosario Garcia
Published: February 2020

Genomic selection (GS) or genomic prediction is considered as a promising approach to accelerate tree breeding and increase genetic gain by shortening breeding cycle. We investigated the predictive ability (PA) of GS based on 484 progeny trees from 62 half-sib families in Norway spruce ( Picea abies (L.) Karst.) for wood density, modulus of elasticity (MOE) and microfibril angle (MFA) measured with SilviScan, as well as for measurements on standing trees by Pilodyn and Hitman instruments. GS predictive abilities (PA) were comparable with those based on pedigree-based selection. The highest PAs were reached with at least 80-90% of the dataset used as training set. Use of different statistical methods had no significant impact on the estimated PAs. We also compared the abilities to predict density, MFA and MOE of 19 year old trees with use of models trained on data from coring at different ages and to different depths into the stem. The comparison indicated that close to the maximal PAs can be reached at age 10-12 by drilling only half way (ringwise) towards the pith, thereby reducing the impact on the tree.
Utilization of sexual and reproductive health services and associated factors among adolescents in youth-friendly service implemented and non-implemented high school of South Ari District, South Omo Zone, Southern Ethiopia, 2019.
Authors: Haile Bayu , Shegaze Mulugeta , Feleke Tesfaye , Glagn Mustefa
Published: February 2020

Background In Ethiopia a number of efforts have been made to support sexual and reproductive health services (SRHS) for adolescents. However, there is limited information regarding the level of SRH utilization and associated factors among adolescents. Therefore, this study aimed to assess the magnitude of utilization of sexual and reproductive health services and associated factors among secondary school adolescents in youth friendly services (YFS) implemented and non-implemented areas of South Ari Woreda, South Omo zone, Southern Ethiopia, 2019. Methods Institution based comparative cross-sectional study with multistage stage sampling procedure was employed. Data were collected by self- administered questionnaire. The collected data were entered in to Epi Data version 4.4.1 software and then exported to SPSS version 20 statistical packages for further analysis. Descriptive statistics were computed and summarized by tables, frequencies, graphs, mean, and proportion. Both Bivariate and multivariable analysis were carried by using binary logistic regression. Variables with a p-value ≤ 0.25 in Bivariate logistic regressions were taken as potential candidate for multivariable logistic regression analysis to control confounders. Association between reproductive health services utilization and associated factors were reported by odds ratio at 95% CI. Variables having p-value less than 0.05 in multivariable logistic regression model were considered as statistically significant. Results The magnitude of SRHS in YFS implemented and non-implemented schools were 33.8% [95% CI (28.2-40.4)] and 9.4% [95% CI (5.6, 13.6)] respectively. Grade ten level adolescents and those who discuss SRH issues with their family members were three times [AOR=3.28, 95% CI (1.7, 6.29)] and [AOR=3.3, 95% CI (1.47, 7.41)] more likely to have sexual and reproductive health care-seeking behavior as compared to grade nine level adolescents and those who didn’t discuss respectively. Furthermore, adolescents who travel less than 30 minutes were six times [AOR=5.72, 95%CI, 2.58, 12.64] more likely to uptake the SRHS as compared to those travel more an hour. Conclusion The magnitude of utilization of SRH services were low in YFS non implemented school when compared to YFS implemented school. There is a need of more efforts to scale up SRHS in YFS non implemented schools among stakeholders at different hierarchies. In addition, it is better to promote open discussion with adolescents at family level, and emphasizes should be given for women education.
Testing Contextualized Word Embeddings to Improve NER in Spanish Clinical Case Narratives
Authors: Akhtyamova Liliya , Martínez Paloma , Verspoor Karin , Cardiff John
Published: February 2020

Background: In the Big Data era there is an increasing need to fully exploit and analyse the huge quantity of information available about health. Natural Language Processing (NLP) technologies can contribute to extract relevant information from unstructured data contained in Electronic Health Records (EHR) such as clinical notes, patient’s discharge summaries and radiology reports among others. Extracted information could help in health-related decision making processes. Named entity recognition (NER) devoted to detect important concepts in texts (diseases, symptoms, drugs, etc.) is a crucial task in information extraction processes especially in languages other than English. In this work, we develop a deep learning-based NLP pipeline for biomedical entity extraction in Spanish clinical narrative. Methods: We explore the use of contextualized word embeddings to enhance named entity recognition in Spanish language clinical text, particularly of pharmacological substances, compounds, and proteins. Various combinations of word and sense embeddings were tested on the evaluation corpus of the PharmacoNER 2019 task, the Spanish Clinical Case Corpus (SPACCC). This data set consists of clinical case sections derived from open access Spanish-language medical publications. Results: NER system integrates in-domain pre-trained Flair and FastText word embeddings, byte-pairwise encoded and the bi-LSTM-based character word embeddings. The system yielded the best performance measure with F-score of 90.84%. Error analysis showed that the main source of errors for the best model is the newly detected false positive entities with the half of that amount of errors belonged to longer than the actual ones detected entities. Conclusions: Our study shows that our deep-learning-based system with domain-specific contextualized embeddings coupled with stacking of complementary embeddings yields superior performance over the system with integrated standard and general-domain word embeddings. With this system, we achieve performance competitive with the state-of-the-art.
Impacts on Energy and Environmental Efficiency by Media Report – Modifies Undesirable Dynamic DEA
Authors: Li Ying , Lin Tai-Yu , Chiu Yung-ho , Chen Huaming , Cen Hongyi
Published: February 2020

Background: Rapid economic growth in China has resulted in a commensurate increase in energy consumption, which in turn has caused an increase in environmental pollution problems. Past research has mainly focused on energy and environmental efficiency analyses with little consideration of the influence of media influence on environmental protection. Further, most studies have used static models and have ignored the dynamic changes over time. Methods : To go some way to filling this research gap, this study developed a modified undesirable Dynamic DEA model that included air quality index (AQI) and CO2 indicators to explore the relationship between energy, the environment and media efficiency in 31 Chinese cities from 2013 to 2016. Results: It was found that: 1. Chongqing, Guangzhou, Nanjing and Shanghai had efficiencies of 1, but Lanzhou, Shijiazhuang, Taiyuan, Xining and Yinchuan needed significant improvements; 2. while Chongqing, Guangzhou, Kunming, Nanning and Shanghai had relatively high media efficiency, the other cities had low efficiency and required improvements; 3. the CO 2 emissions efficiency in most cities was better than the air quality index efficiency; and 4. media reports in most cities were found to have a more positive impact on CO 2 emissions efficiency than AQI efficiency. Conclusions: As environmental awareness enhances the health of civilians and promotes economic growth, the news media needs to promote environmental protection, and should increase its environmental pollution coverage. The quality of media reports on environmental pollution and especially on air pollution need to be improved. Therefore, environmental pollution and awareness media coverage needs to be increased.
Short-Term Outcomes of Mirogabalin in Patients with Peripheral Neuropathic Pain: A Retrospective Study
Authors: Tetsunaga Tomoko , Tetsunaga Tomonori , Nishida Keiichiro , Misawa Haruo , Takigawa Tomoyuki , Yamane Kentaro , Tsuji Hironori , Takei Yoshitaka , Ozaki Toshifumi
Published: February 2020

Background: Mirogabalin, which is approved for the treatment of peripheral neuropathic pain in Japan, is a ligand for the α2δ subunit of voltage-gated calcium channels. Both pregabalin and mirogabalin act as nonselective ligands at the α2δ-1 and α2δ-2 subunits. Mirogabalin has a unique binding profile and long duration of action. Pregabalin has been reported to produce intolerable adverse effects in some patients. This study investigated outcomes associated with mirogabalin in patients with peripheral neuropathic pain who withdrew from treatment with pregabalin. Methods: We retrospectively assessed peripheral neuropathic pain in 187 patients (58 men, 129 women) who were treated with mirogabalin. All patients had been treated with pregabalin and withdrew from therapy due to lack of efficacy or adverse events. The mean age of patients was 72.3 years (range, 30–94 years), and mean duration of disease was 37 months (range, 3–252 months). Results: After treatment with mirogabalin for 1 week, numeric rating scale (NRS) scores decreased significantly compared with baseline, and continued to decrease over time . After 8 weeks, NRS scores improved by ³30% from baseline in 113 patients (69.3%). Twenty-four patients (12.8%) stopped mirogabalin treatment due to adverse events. Somnolence (26.7%), dizziness (12.3%), edema (5.9%), and weight gain (0.5%) were noted as adverse events of mirogabalin. Conclusions: The results of this investigation indicate that mirogabalin is safe and effective for reducing peripheral neuropathic pain.
Long-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell diseaseLong-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease
Authors: Mo Guo-ye , Zhou Teng-peng , Li Yong-xian , Guo Hui-zhi , Guo Dan-qing , Luo Pei-jie , Li Dong-xiao , Yuan Kai , Mo Ling , Zhang ShunCong , Tang Yong-chao
Published: February 2020

Purpose This study aimed to evaluate the efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease. Methods Twenty-five patients with stage III Kümmell disease who received bone cement-augmented pedicle screw fixation at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between June 2009 and December 2015 were enrolled. All patients were females with a history of osteoporosis. The vertebral Cobb angle (V-Cobb angle), the fixed segment Cobb Angle (S-Cobb angle), pelvic parameters, visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI) were assessed preoperatively, postoperatively and at the final follow-up. Complications, loosening rate, operation time, and intraoperative bleeding were recorded. Results The average lumbar vertebral density T-value was -3.68 ± 0.71 SD, and the average age was 71.84 ± 5.39. The V-Cobb angle, S-Cobb angle, and Sagittal Vertical Axis（SVA） were significantly smaller postoperatively compared to the preoperative values. The VAS and ODI at 1 month after surgery were 3.60 ± 1.00 and 36.04 ± 6.12%, respectively, which were both significantly lower than before surgery (VAS: 8.56±1.04, ODI: 77.80 ± 6.57%). Conclusion Bone cement-augmented pedicle screw fixation is a safe and effective treatment for stage III Kümmell disease. It can effectively correct kyphosis, restore and maintain sagittal balance, and maintain spinal stability.
Factors associated with overall survival in patients with non-squamous NSCLC in New Zealand: A comparative analysis by EGFR gene mutation status
Authors: Aye Phyu Sin , McKeage Mark James , Tin Sandar Tin , Khwaounjoo Prashannata , Elwood J Mark
Published: February 2020

Introduction: Non-small cell lung cancer (NSCLC) is increasingly regarded as a heterogeneous group of diseases defined by specific gene mutations. Previous studies reported inconsistent results regarding the influence of epidermal growth factor receptor (EGFR) mutations on overall survival. This study assesses the effect of EGFR mutation on overall survival, and how the effects of other survival predictors are modified by EGFR mutation status, in non-squamous NSCLC patients.Methods: The study was based on a population-based cohort of 1534 non-squamous NSCLC patients who were registered in northern New Zealand between 1 February 2010 and 31 July 2017. Kaplan-Meier analyses and log-rank tests were performed to assess the overall survival among different patient groups. Cox regression survival analyses were used to explore the associations between clinico-pathological factors and overall survival in terms of EGFR mutation status. The factors included were age at diagnosis, sex, ethnicity, smoking status, performance status, metastasis status and site of tumour. Results: In this cohort, 20.2% had an EGFR mutation. The median overall survival was 0.79 years and 2.81 years in EGFR mutation-negative and mutation-positive groups respectively (log-rank p<0.0001). Metastasis status showed large and significant effects on overall survival in both EGFR mutation-negative and mutation-positive groups (hazard ratio, HR=3.6 and 3.3, respectively). In subgroup analyses by mutation status and metastasis status, overall survival decreased with an increase in age and decrease in performance status, and was lower in current smokers in all subgroups. In specific groups, females had lower survival only if mutation-positive; Māori had lower survival compared to NZ Europeans only if the disease was metastatic; and tumour site had significant effects on overall survival only in patients without metastasis. Conclusion: EGFR mutation status and metastasis are the main predictors for overall survival in non-squamous NSCLC patients in northern New Zealand. The effects of age, smoking status and performance status are similar in all subgroups, but the effects of sex, ethnicity and site of tumour vary depending on EGFR mutation and metastasis status.
How Residents MET their training: Resident’s perception of Medical Emergency Team and its contribution to their Training
Authors: Ng Kangqi , Jones Daryl , Tee Augustine
Published: February 2020

Background Medical Emergency Teams (MET) have been implemented in many hospitals to improve patient safety. Few studies examined how residents perceive the MET as part of training. Objective We aimed to evaluate residents’ perceptions of how MET rotation affected training in the core competencies specified by Accreditation Council for Graduate Medical Education (ACGME). Methods We conducted an online survey of 106 residents. They are either junior residents who are in training in internal medicine, non-trainee registrars or senior residents who are training in respiratory or advanced internal medicine. Results We achieved a response rate of 62.3%. More than 90% of residents agreed or strongly agreed that MET contributed positively to their training, made resuscitation of patients safer and more efficient, and disagreed or strongly disagreed that MET made resuscitation of patients more time-consuming or cumbersome. More than 80% agreed or strongly agreed that the MET improved their clinical judgement in medical emergencies, helped achieve their learning goals and exposed them to a wide variety of cases. At least two-thirds thought that the MET posting improved their procedural skills and communication in end of life care discussions. In contrast, 26.6% of respondents agreed or strongly agreed that the MET decreased autonomy of the primary team. One-third felt they needed formal training for the MET posting. Conclusion Our findings suggest that residents perceive participation in MET was beneficial in training and improved patient care. We also found that formal training and consultant oversight may be needed for junior team leaders of MET.