bluuebunny/crossref_metadata_2025 huggingface dataset:
TABASCO ES EL EDÉN DE LOS HUMEDALES
Authors: López Jiménez Leonardo Noriel
Published: August 2019

Tabasco está dominado por humedales, ya que es la mayor superficie inundada y el lugar más húmedo de México. Sus humedales ocupan el 28 % de la superficie estatal con más de 600,000 ha, y el tipo palustre es el más ampliamente distribuido. Estos humedales resguardan una gran diversidad biológica, integrada por más de 600 plantas y varios grupos de fauna, distribuidos en nueve tipos de vegetación. A pesar de la disminución de la vegetación en Tabasco, aún un 29 % de la superficie estatal está cubierto por vegetación, de la cual más del 90 % le corresponde a los humedales, razón por la cual es el edén para estos ecosistemas. Debido a los servicios ambientales que brindan, se han implementado estrategias que permiten su conservación efectiva a largo plazo a nivel nacional y estatal para asegurar que Tabasco siga siendo el edén de los humedales.
Effect of Total Amount of Metformin HCl on the Characteristics of Metformin-Ca Alginate Microspheres
Authors: Hariyadi Dewi Melani , Rosita Noorma , Rosadi Tiara Jeni
Published: August 2019

Introduction: Metformin hydrochloride (metformin HCl) is an antidiabetic drug that is specifically used for type 2 diabetes mellitus (DM) and belongs to the biguanide antidiabetic drugs. Objective: The aim of this research was to determine the effect of total amount of metformin HCl on the characteristics of metformin HCl-Ca alginate microspheres using aerosolization technique. Methods: The total amount of metformin were 0.5 g (F1); 1 g (F2); 1.5 g (F3) and 2 g (F4). Drug was encapsulated into alginate and was crosslinked using CaCl2. Results: The results showed that drug loadings were 5.09%; 9.61%; 13.11%; and 15.09% respectively, while the entrapment efficiencies were 48.35%; 41.99%; 38.67%; and 30.53%. The yields were 80.92%; 74.12%; 68.27%; and 59.11% respectively. Based on the statistical analysis, it was found that there were significant differences between formulas. Particles of formulas decreased as the amount of drug increased. The resulting sizes were 1.82 μm (F1); 1.96 μm (F2); 2.1 μm (F3); and  2.97 μm (F4). Conclusion: It can be concluded that amount of drug significantly affected the characteristics of metformin-alginate microspheres.
Optimasi Kondisi Sintesis Asam 4-Benzoiloksisinamat Menggunakan Iradiasi Gelombang Mikro
Authors: Sagitaras Ilham Bagus , Syahrani Achmad , Ekowati Juni
Published: August 2019

Pendahuluan: Salah satu usaha meningkatkan aktivitas asam p-kumarat adalah meningkatkan sifat lipofiliknya. Reaksi benzoilasi gugus fenol asam p-kumarat merupakan salah satu strategi meningkatkan sifat lipofilik. Iradiasi microwave merupakan salah satu alternative metode untuk meningkatkan efisiensi dalam reaksi organik. Selain memiliki kelebihan mempercepat reaksi kimia, penggunaan iradiasi gelombang mikro juga dapat menyebabkan kerusakan struktur kimia produk maupun terjadinya reaksi samping lainnya. Tujuan: Mendapatkan kondisi optimum reaksi sintesis asam 4-benzoiloksisinamat. Metode: asam 4-benzoiloksisinamat disintesis dengan cara mereaksikan asam p-kumarat, benzoil klorida dan piridin sebagai katalis. Reaksi benzoilasi dilakukan dengan iradiasi gelombang mikro pada daya 180, 270, dan 360 Watt. Karakterisasi asam 4-benzoiloksisinamat dilakukan menggunakan alat  spektrometer UV-Vis, FT-IR dan 1H–NMR. Hasil: Persentase hasil yang diperoleh pada daya 180, 270, dan 360 Watt berturut-turut adalah sebagai berikut 49,3%, 58,5%, and 47,7%. Terdapat perbedaan yang signifikan persentase hasil yang diperoleh pada daya 270 Watt dengan persentase hasil pada daya 180 Watt dan 360 Watt, tetapi tidak ada perbedaan bermakna persentase hasil pada daya 180 Watt dan 360 Watt. Persentase hasil terbesar diperoleh selama enam puluh detik pada daya 270 Watt, yaitu 61,4%. Jika reaksi dilakukan lebih dari enam puluh detik, terjadi kerusakan struktur senyawa target. Kesimpulan: Kondisi optimum sintesis asam 4-benzoiloksisinamat menggunakan iradiasi gelombang mikro adalah selama enam puluh detik pada daya 270 Watt.
Preliminary study of flavor compounds as oxidation markers in bottled white wines of Greek origin
Authors: Kanavouras Antonios , Karanika Eleni , Coutelieris Frank A , Kotseridis Yorgos , Kallithraka Stamatina
Published: August 2019

Aim: The aim of this project was to identify the characteristic flavor and off-flavor compounds that could be used as potential oxidation markers to establish the quality of the stored wines and to predict the wines’ shelf life employing a mathematical model.Materials and methods: Six mono-varietal Greek white wines (produced by three varieties) were bottled using two types of corks having different oxygen permeability properties. Volatile compounds, resistance to oxidative degradation and total and free-sulfur dioxide content were recorded in all samples. Results were processed using the root cause analysis versus packaging and storage conditions. Additionally, a predictive model has been constructed to estimate the shelf life of the bottled wine.Results: Physicochemical analysis indicated the absence of significant oxidative degradations during the first 7 months. Furthermore, 12-month stored samples showed a significant alteration in their flavor profile. Based on the concentration of the selected oxidation marker (isoamyl-alcohol), the possibility of the bottled product not reaching the end of its shelf life, has been used to quantify the product’s quality. A very successful fit was achieved between mathematical and experimentally obtained data concerning shelf life predictions.Significance and impact of the study: The modeling of the results indicated the importance of cork selection due to the Oxygen Transmission Rate (OTR) values that potentially impact the quality of the wines in time, according to the evolution of the isoamyl-alcohol concentration. For the wine industry, the selection of the appropriate cork according to the wine type is an important consideration.
Prognosticating Mesothelioma Using Predictive Analytics
Authors: Choudhury Avishek
Published: August 2019

Background: Malignant pleural mesothelioma (MPM) is an atypical, belligerent tumor that matures into cancer in the pleura, a stratum of tissue bordering the lungs. Pleural mesothelioma is a common type of mesothelioma that accounts for about 75 percent of all mesothelioma diagnosed yearly in the United States. Diagnosis of mesothelioma takes several months and is expensive. Given the difficulty of diagnosing MPM, early identification is crucial for patient survival. Our study implements artificial intelligence and recommends the best fit model for early diagnosis and prognosis of MPM. Method: We retrospectively retrieved patient’s medical reports generated by Dicle University, Turkey and implemented multi-layered perceptron (MLP), voted perceptron (VP), Clojure classifier (CC), kernel logistic regression (KLR), stochastic gradient decent SGD), adaptive boosting (AdaBoost), Hoeffding tree (VFDT), and primal estimated sub-gradient solver for support vector machine (s-Pegasos). We evaluated the models, compared and tested using paired T-test (corrected) at 0.05 significance based on their respective classification accuracy, f-measure, precision, recall, root mean squared error, receivers characteristic curve (ROC), and precision-recall curve (PRC). Results: In phase-1 SGD, AdaBoost.M1, KLR, MLP, VFDT generates optimal results with the highest possible performance measures. In phase-2, AdaBoost with a classification accuracy of 71.29% outperformed all other algorithms. C-reactive protein, platelet count, duration of symptoms, gender, and pleural protein were found to be the most relevant predictors that can prognosticate mesothelioma. Conclusion: This study confirms that data obtained from biopsy and imagining tests are strong predictors of mesothelioma but are associated with high cost, however, can identify mesothelioma with optimal accuracy. Predictive analytics without using biopsy results can diagnose mesothelioma with acceptable accuracy. Implementation of phase-2 followed by phase-1 can address diagnosis expenses and maximize disease prognosis. Additionally, results indicate improved MPM diagnosis using AI methods dependent upon the specific application.
On the Trends of Registered Birth and Death Rates in Nigeria: Evidence from Generalized Linear Models
Authors: Adenomon Monday Osagie , Anikweze Emmanuel Chukwuma
Published: August 2019

This study investigated the trends of registered Death and Birth in Nigeria using Generalized Linear Models. Annual data on Death and Birth was collected from National Population Commission for the period of 2004 to 2017. The Natural increase calculated revealed a positive trend in the natural increase in Nigeria from 2004 to 2017. Evidence from summary statistics revealed some level of over dispersion (variance > mean). This study explored Poisson Regression Models and Negative Binomial Regression Models using two links (identity and log). The results revealed a positive increase in registration of birth and death rates in Nigeria and among the competing the models, Negative Binomial regression model with identity link emerged as the best model for modeling birth and death rates registration in Nigeria. Data on numbers of deaths and causes of death are essential if countries are to determine priorities, formulate and monitor policies for public health care as well as other government policies that may be based on such data
ADCK2 Haploinsufficiency Reduces Mitochondrial Lipid Oxidation and Causes Myopathy Associated with CoQ Deficiency
Authors: Vázquez-Fonseca Luis , Schäfer Jochen , Navas-Enamorado Ignacio , Santos-Ocaña Carlos , Hernández-Camacho Juan D. , Guerra Ignacio , Cascajo María V. , Sánchez-Cuesta Ana , Horvath Zoltan , Siendones Emilio , Jou Cristina , Casado Mercedes , Gutierrez-Rios Purificación , Brea-Calvo Gloria , López-Lluch Guillermo , Fernández-Ayala Daniel J.M. , Cortés-Rodríguez Ana B. , Rodríguez-Aguilera Juan C. , Matté Cristiane , Ribes Antonia , Prieto-Soler Sandra Y. , Dominguez-del-Toro Eduardo , di Francesco Andrea , Aon Miguel A. , Bernier Michel , Salviati Leonardo , Artuch Rafael , de Cabo Rafael , Jackson Sandra , Navas Plácido
Published: August 2019

Fatty acids and glucose are the main bioenergetic substrates in mammals that are alternatively used during the transition between fasting and feeding. Impairment of mitochondrial fatty acid oxidation causes mitochondrial myopathy leading to decreased physical performance. Here, we report that haploinsufficiency of ADCK2, a member of the aarF domain-containing mitochondrial protein kinase family, in human is associated with liver dysfunction and severe mitochondrial myopathy with lipid droplets in skeletal muscle. In order to better understand the etiology of this rare disorder, we generated a heterozygous Adck2 knockout mouse model to perform in vivo and cellular studies using integrated analysis of physiological and omics data (transcriptomics-metabolomics). The data show that Aldh2+/- mice exhibits impaired fatty acid oxidation, liver dysfunction, and mitochondrial myopathy in skeletal muscle resulting in lower physical performance. Significant decrease in CoQ biosynthesis was observed and supplementation with CoQ partially rescued the phenotype both in the human subject and mouse model. These results indicate that ADCK2 is involved in organismal fatty acid metabolism and in CoQ biosynthesis in skeletal muscle. We propose that patients with isolated myopathies and myopathies involving lipid accumulation be tested for possible ADCK2 defect as they are likely to be responsive to CoQ supplementation.
Effects of Mining Activities on Gerbillus nanus in Saudi Arabia; A Biochemical and Histological Study
Authors: Almalki Ahmed , Ajarem Jamaan , Altoom Naif , Al-Otaibi Fahed , Maodaa Saleh , Allam Ahmed , Mahmoud Ayman
Published: August 2019

Mining can impact the environment, biodiversity and human health through direct and indirect practices. This study investigated the effects of gold mining on Gerbillus nanus, pointing to organ dysfunction and redox imbalance. Soil samples, Lycium shawii and G. nanus were collected from a site near a mining planet and a control site. Soil and L. shawii samples from the mining site showed a significant increase cadmium (Cd), cupper (Cu), mercury (Hg), arsenic (As), zinc (Zn), lead (Pb) and vanadium (V). Hepatic, renal and pulmonary Cd, Pb, Hg, Zn, Cu, Fe, As and V concentrations were increased significantly in G. nanus at the mining site. Markers of liver and kidney function were elevated in serum, and several histological manifestations were demonstrated in liver, kidney and lung of G. nanus at the mining site. Malondialdehyde and nitric oxide were increased, and glutathione and antioxidant enzyme were declined in the liver and kidney of G. nanus. In conclusion, mining practices triggered tissue damage and oxidative stress in G. nanus living close to the mining site. These findings can represent the scientific basis for evaluating the environmental and health impact of mining in the on the nearby communities.
Dysprosium Removal from Water Using Active Carbons Obtained from Spent Coffee Ground
Authors: Alcaraz Lorena , Escudero María Esther , Alguacil Francisco J. , Llorente Irene , Urbieta Ana , Fernández Paloma , López Félix Antonio
Published: August 2019

This paper describes the physico-chemical study of the adsorption of dysprosium (Dy3+) in aqueous solution onto two types of activated carbons synthesized from spent coffee ground. KOH activated carbon is a microporous material with a specific BET surface area of 2330 m2·g-1 and pores with a diameter of 3.2 nm. Carbon activated with water vapor and N2 is a solid mesoporous, with pores of 5.7 nm in diameter and a specific surface of 982 m2·g-1. A significant dependence of the adsorption capacity on the solution pH was found, while it does not depend significantly neither on the dysprosium concentration nor on the temperature. A maximum adsorption capacity of 31.26 mg·g-1 and 33.52 mg·g-1 for the chemically and physically activated carbons, respectively, were found. In both cases, the results obtained from adsorption isotherms and kinetic study were better fit to a Langmuir model and a pseudo-second-order kinetics. In addition, thermodynamic results indicate that dysprosium adsorption onto both activated carbons is an exothermic, spontaneous and favorable process.
Rebound Effect and Technical Learning of Energy-environmental Evaluation in Manufacturing Industry
Authors: Wang Jiang , Wang Kunyue , Wang Lijuan
Published: August 2019

We introduce a total energy and environmental evaluation method in the manufacturing industry. The method gives us a series of descriptive indexes to assess the overall environmental effect level on materials, energy, wastes and products in the life cycle process. Meanwhile, the method uses partial indexes, environmental effect factors, and correction offsets into the quantitative model to analyze the learning process and rebound effect on the energy and environment at each procedure. In this work, we choose S-shaped learning curves to describe how to decrease energy consumption and improve the technical learning by doing for recent 30 years. Also, we draw the different rebound effect curves of the total energy-environmental evaluation with technical learning method, which use the annual industrial production growth rate to show that it's significant to estimate its effect on technology changes. The ideas about the interaction of energy and production environment from material flows to energy consumption, direct us to build an example to estimate quantitatively the results with different condition factors, and realize the process improvement and develop new products.
Overview of Meta-Analyses: The Impact of Lifestyle on Stroke Risk
Authors: Altobelli Emma , Angeletti Paolo , Rapacchietta Leonardo , Mattucci Maria
Published: August 2019

Stroke is one of the most prevalent cardiovascular diseases worldwide, both in high-income countries and in medium and low-medium income countries. The WHO report on non-communicable diseases (NCDs) indicates that the highest behavioral risk in NCDs is attributable to incorrect nutrition. The objective of our work is to present an overview of meta-analyses that have investigated the impact of different foods and / or drinks in relationship with the risk of stroke events (ischemic/ hemorrhagic). The papers to be included in the overview were sought in the MEDLINE, EMBASE, Scopus, Clinicaltrials.gov, Web of Science, and Cochrane Library and were selected according to PRIMA flow chart. Quality assessment were made according to AMSTAR scale. This overview shows that all primary studies came from countries with high income level. This evidence shows that many countries are not represented. Therefore, different lifestyles, ethnic groups, potentially harmful or virtuous eating habits are not reported. It is important to underline how the choose of foods may help reduce the risk of cardiovascular diseases and stroke in particular.
Motor impairment in a rare form of spastic paraplegia (Spoan syndrome): a 10-year follow-up
Authors: Galvão Cláudia R. C. , Cavalcante Priscilla M. A. , Olinda Ricardo , Graciani Zodja , Zatz Mayana , Kok Fernando , Santos Silvana , Lancman Selma
Published: August 2019

Background: Spastic paraplegia, optic atrophy and neuropathy (Spoan syndrome) is an autosomal recessive disease with approximately 70 cases recorded in Brazil and Egypt. Methods: This is a prospective longitudinal study performed with 47 patients affected with Spoan syndrome of seven communities of Rio Grande do Norte (Brazil) to investigate changes in motor function based on comparative data obtained from a 10-year follow-up. Results: The mean age of the participants was 47.21±12.42 years old, and the mean age at loss of ambulation and hand function were 10.78±5.55 and 33.58±17.47 years old, respectively. Spearman’s correlation analysis between the score on the Modified Barthel Index and the investigated variables evidenced statistical significance for age (p<0.001) and right- and left-hand grip strength (p=0.042 and p=0.021, respectively). Statistical significance was not evidenced for the remainder of the variables, including age at onset of symptoms (p=0.634), age at loss of ambulation (p=0.664) and age at loss of hand function (p=0.118). Conclusions: Our analysis allows asserting that the participants exhibited slight dependence until age 35. The greatest losses occurred from ages 35 to 41, and starting at 50, practically all patients become completely dependent. These findings are relevant for determining the prognosis as well as suitable treatment, rehabilitation and assistive technology for these individuals.
Treatment outcomes and antiretroviral uptake in Multidrug-Resistant Tuberculosis and HIV coinfected Patients in Sub Saharan Africa. A Systematic Review and Meta-Analysis
Authors: Chem Elvis Dzelamonyuy , Hout Marie Claire Van , Hope Vivian
Published: August 2019

Background

Multidrug-resistant tuberculosis (MDR-TB) in HIV endemic settings is a major threat to public health. MDR-TB is a substantial and underreported problem in Sub-Saharan Africa (SSA), with recognised cases projected to increase with advancement in diagnostic technology. There is paucity of review evidence on treatment outcomes and antiretroviral (ART) uptake among MDR-TB patients with HIV in SSA. To address this gap a review of treatment outcomes in HIV patients co-infected with MDR-TB in the SSA region was undertaken.

Methods

Three databases (Medline, Web of Science, CINHAL), Union on Lung Heath conference proceedings and grey literature were searched for publications between January 2004 and May 2018. Records were assessed for eligibility and data extracted. Random effect meta-analysis was conducted using STATA and Cochrane’s review manager.

Results

A total of 271 publications were identified of which nine fulfilled the inclusion criteria. Data was collected from 3,368 MDR-TB and HIV co-infected patients from four SSA countries; South Africa (6), Lesotho (1), Botswana (1) and Ethiopia (1). The most common outcome was cure (34.9% cured in the pooled analysis), this was followed by death (18.1% in pooled analysis). ART uptake was high, at 83% in the pooled analysis. Cure ranged from 22.2% to 57.7% among patients on ART and from 28.6% to 54.7% among those not on ART medication. MDR-TB and HIV coinfected patients were less likely to be successfully treated than HIV negative MDR-TB patients (Risk Ratio = 0.87, 95% CI 0.97, 0.96).

Conclusion

Treatment outcomes for MDR-TB and HIV coinfected patients do not vary widely from those reported globally. However, treatment success was lower among HIV positive MDR-TB patients compared to HIV negative MDR-TB patients. Prompt antiretroviral initiation and interventions to improve treatment adherence are necessary.
Breaking barriers: using the Behavior Change Wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time
Authors: Ojo Samson O , Bailey Daniel P. , Brierley Marsha L. , Hewson David J. , Chater Angel M.
Published: August 2019

Background: The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers.
Methods: The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26-59 years, mean age 40.9 [SD=10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation – Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention.
Results: Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Reflective and automatic Motivation was highlighted as a core target for intervention. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace.
Conclusions: The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease prolonged sitting in the workplace.
Capsular Warning Syndrome: Clinical Analysis and Treatment
Authors: he lanying , Xu Ronghua , Wang Jian , Zhang Lili , Zhang Lijuan , Zhou Fangfang , Dong Weiwei
Published: August 2019

Background: Capsular warning syndrome (CWS) was a rare clinical syndrome, which was defined as recurrent transient lacunar syndromes. The mechanism and clinical management of CWS were not clear. The purpose of this study was to discuss the clinical characteristics, treatment and prognosis of the CWS.
Methods: This was a multicenter retrospective study that involved three medical centers, we collected clinical data from patients with CWS between January 2013 and December 2018. We analyzed the clinical characteristics of the CWS. Patients with CWS were divided into two groups: rt-PA and no rt-PA groups. We analyzed the therapeutic effects and prognosis between different groups.
Results: This study included 72 patients, 27 in rt-PA group, 45 in no rt-PA group, hypertension and dyslipidemia were the most common risk factors. The mean number of episodes before an irreversible neurological impairment or the symptoms completely disappeared was 5 times(3-11). 59 (81.94%) patients had acute infarction lesions on the diffusion weighted imaging (DWI). The most common infarct location was the internal capsule (76.38%,55), followed by the thalamus and pons. The difference in therapeutic effects between rt-PA, single and double antiplatelet groups was not significant(P>0.05). A good prognosis was observed in 61 (84.72%) patients at 3-month, 23 (23/27, 85.19%) patients in rt-PA group and 38 (38/45,84.44%) patients in no rt-PA group(P>0.05). After 3 months of follow-up, 2 patients had recurrent ischemic stroke.
Conclusions: The most effective treatment of CWS remains unclear. Despite the high incidence of infarction in CWS patients, more than 80% patients had favorable functional prognosis
ANTIMICROBIAL RESISTANCE PATTERN IN ESCHERICHIA COLI ISOLATED FROM CHILDREN ADMITTED AT SELECTED HEALTH CARE FACILITIES IN MOSHI MUNICIPALITY, TANZANIA
Authors: Daud Mzelifa , Nyombi Balthazar
Published: August 2019

Background

The emergence of antimicrobial resistance is a great challenge in preventing, controlling and treatment Gram-negative bacteria and has become a significant public health threat worldwide. The study aimed at determination of the prevalence and pattern of antimicrobial resistance in Escherichia coli isolated in children admitted at health facilities in Moshi municipality, Tanzania.

Methodology

A descriptive cross sectional study was carried out on archived rectal swabs collected from 282 children aged 3 to 168 months admitted at Kilimanjaro Christian Medical Centre (KCMC), Mawenzi Regional Referral Hospital and Pasua health centre in Moshi municipality. Rectal swabs were cultured on MacConkey agar media. The isolated Escherichia coli was identified and antimicrobial susceptibility test was done by using Kirby–Bauer disc diffusion method on Muller Hinton agar media.
Results

Escherichia coli were isolated in all 282 cultured archived rectal swabs and all isolates were susceptible to amikacin and meropenem. ESBL producers were 13.1% and 86.9% were non-ESBLs.

Conclusion

High resistance rate were observed on ampicillin, ceftriaxone, ceftazidime, cefuroxime, trimethoprim and ciprofloxacin among ESBL producing Escherichia coli. Among non ESBL producing Escherichia coli high resistance rate were observed on ampicillin and trimethoprim; however all isolates were sensitive to amikacin and meropenem.
Female sex workers perspectives and concerns regarding HIV self-testing: An exploratory study in Tanzania
Authors: Nnko Soori , Nyato Daniel , Kuringe Evodius , Casalini Caterina , Shao Amani , Komba Albert , Changalucha John , Wambura Mwita
Published: August 2019

Background
HIV testing is a gateway to HIV care and treatment for those testing positive, and can link those with negative reactive tests to HIV preventive services, including enrolment into pre exposure prophylaxis (PrEP). While benefits of HIV testing services (HTS) are known, uptake of HTS among female sex workers (FSWs) in Tanzania and across sub-Saharan Africa (SSA) remains suboptimal. Introduction of HIV self-testing (HIVST) may mitigate some of the barriers for the uptake of HTS, and contribute to greater linkage to care and prevention services. This study explored perspectives of FSWs towards HIVST, to inform a large-scale combination HIV prevention program addressing key populations (KPs) in Tanzania.

Methods
We conducted an exploratory study employing in-depth interviews (IDI) and participatory group discussions (PGD) with FSWs. PGD collected normative data e.g. perceptions and attitudes towards HTS, whereas IDI collected personal information e.g. sexual practices and HIV risk perceptions. Study participants were recruited through snowball sampling. Data were thematically analysed using NVivo software. Emerging themes were explored in the tradition of Grounded Theory. The analysis was informed by the social ecological model and focused on factors associated with feasibility of scale up of HIVST.

Results
A total of 20 PGD sessions were conducted involving 227 participants. We also conducted IDIs with 21 FSWs. Study participants were enthusiastic toward HIVST. Convenience (time and cost saved), and belief that HIVST will increase privacy and confidentiality were primary in participants’ support for the HIVST. Participants did express concerns about their ability to interpret and trust the results of the test. Participants also expressed concern that HIVST could cause personal harm, including severe distress and self-harm for the FSWs with reactive test – this was related to the lack of professional counselling support in the self-testing environment.

Conclusions
Increased confidentiality, reduced cost for care, and increased autonomy were among the leading motivations to use HIVST. Major concerns included fear of HIV positive results, and not trusting self-diagnoses. We underscore the importance of providing adequate support services in conjunction with HIVST, e.g. access to counselling and referral services, and user-accessible support to the interpretations of test results.
Incidence, clinical implications and impact on public health of infections with Shigella spp. and entero-invasive Escherichia coli (EIEC): results of a multicenter cross-sectional study in the Netherlands during 2016-2017
Authors: Beld Maaike van den , Warmelink Esther , Friedrich Alexander W. , Reubsaet Frans A.G. , Schipper Maarten , Boer Richard F. de , Notermans Daan W. , Petrignani Mariska W. F. , Zanten Evert van , Rossen John W.A. , Friesema Ingrid H.M. , Kooistra A.M.D. (Mirjam)
Published: August 2019

Background

Shigella spp. and entero-invasive E. coli (EIEC) use the same invasive mechanism to cause diarrheal diseases. Public health regulations apply only to Shigella spp. infections, but are hampered by the lack of simple methods to distinguish them from EIEC. In the last decades, molecular methods for detecting Shigella spp. and EIEC were implemented in medical microbiological laboratories (MMLs). However, shigellosis cases identified with molecular techniques alone are not notifiable in most countries. Our study investigates the impact of EIEC versus Shigella spp. infections and molecular diagnosed shigellosis versus culture confirmed shigellosis for re-examination of the rationale for the current public health regulations.

Methods

In this multicenter cross-sectional study, fecal samples of patients suspected for gastro-enteritis, referred to fifteen MMLs in the Netherlands, were screened by PCR for Shigella spp. or EIEC. Samples were also cultured to discriminate between the two pathogens. We compared, risk factors, symptoms, severity of disease, secondary infections and socio-economic consequences for (i) culture-confirmed Shigella spp. versus culture-confirmed EIEC cases (ii) culture positive versus PCR positive only shigellosis cases.

Results

In 2016-2017, 777 PCR positive fecal samples with patient data were included, 254 of these were culture-confirmed shigellosis cases and 32 were culture-confirmed EIEC cases. EIEC cases were more likely to report ingestion of contaminated food or water and were less likely to be men who have sex with men (MSM). Both pathogens were shown to cause serious disease although differences in specific symptoms were observed. Additionally, culture-negative but PCR positive cases were more likely report travel or ingestion of contaminated food or water and were less likely to be MSM than culture-positive cases. Culture-negative cases were more likely to suffer from multiple symptoms. No differences in degree of secondary infections were observed between both Shigella spp. and EIEC, and culture-negative and culture-positive cases.

Conclusions

No convincing evidence was found to support the current guidelines. Therefore, culture and molecular detection methods for Shigella spp. and EIEC should be considered equivalent for case definition and public health regulations regarding shigellosis. Differences were found regarding risks factors, indicating that different prevention strategies may be required.
Efficacy and Safety of Allogenic Canine Adipose Tissue-derived Mesenchymal Stem Cell Therapy for Insulin Dependent Diabetes Mellitus in Dogs: A pilot study
Authors: Rhew Sung-Yong , Song Woo-Jin , Li Qiang , An Ju-Hyun , Chae Hyung-Kyu , Jeung So-Young , Park Seol-Gi , Lee Jeong-Ha , Cho Hee-Seon , Sohn Sang-June , Youn Hwa-Young
Published: August 2019

Background

Since mesenchymal stem cells (MSCs) possess regenerative and immunomodulatory properties, and are capable of controlling the immune dysregulation that leads to β-cell destruction, stem cell transplantation could be used in the management of insulin-dependent diabetes mellitus (IDDM). In this pilot study, we assessed whether canine adipose tissue-derived MSC (cAT-MSC) therapy could be an option for treatment of canine diabetes mellitus.

Results

With the written informed consent of the owners, allogenic cAT-MSCs were infused intravenously in IDDM dogs. C-peptide was elevated by about 5–15% in 3 of 4 cases, and hyperlipidemia was resolved in 2 of 4 cases. Additionally, fructosamine and Hb/A1c levels were improved in 2 of 4 cases.

Conclusions

Considering that C-peptide secretion capacity and lipid metabolism are related to diabetic complications, these results suggest that cAT-MSC therapy in diabetic dogs might help to improve the insulin secretory capacity of dogs with IDDM and prevent diabetic complications.
Characterization of Pasteurella multocida isolated from dead rabbits with respiratory disease in Fujian, China
Authors: Wang Jinxiang , Sang Lei , Sun Shikun , Chen Yanfeng , Chen Dongjin , Xie Xiping
Published: August 2019

Background

Pasteurella multocida is one of the important pathogens infects rabbits, causing major economic losses in commercial rabbit farming. In this study, 205 P. multocida isolates recovered from lungs of dead rabbits with respiratory disease were defined capsular serogroups, lipopolysaccharide (LPS) genotypes and multi-locus sequence types, screened virulence factors, and tested antimicrobial susceptibility.

Results

The 205 isolates were assigned into 2 capsular types, A and D, and 2 LPS genotypes, L3 and L6. When combining capsular types with LPS genotypes, 4 serotypes were detected. A:L3 (51.22%, 105/205) was the most predominant serotype, followed by A:L6 (24.88%, 51/205), D:L6 (19.02%, 39/205), and D:L3 (4.88%, 10/205). The 205 isolates were grouped into 3 sequence types, ST10, ST11 and ST12. ST12 (56.10%, 115/205) was the most prevalent sequence type, followed by ST10 (24.88%, 51/205) and ST11 (19.02%, 39/205). In the 205 isolates, the virulence genes of ptfA, fur, hgbB, ompA, ompH and oma87 were positive, whereas the toxA and tbpA genes were negative. Notably, the 156 capsular serogroup A isolates carried pmHAS gene. All the 205 isolates were susceptible to most of the used antibiotics, except for streptomycin, gentamycin, kanamycin and ceftriaxone, and the resistance rates of which were 27.80%, 15.61%, 9.27% and 2.44%, respectively.

Conclusions

This study, for the first time, described the prevalence and characteristics of P. multocida causing respiratory disease in rabbits in Fujian Province, which might be useful for tracking the epidemic strains and development of efficient vaccines and methods to prevent and control the pathogen.
Early-stage clinical outcomes and rotational stability of TECNIS toric intraocular lens implantation in cataract cases with long axial length
Authors: He Suhong , Chen Xiang , Wu Xingdi , Ma Yajuan , Yu Xuewen , Xu Wen
Published: August 2019

Background: A major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with moderate to high myopia. In this study, we aimed to evaluate the clinical outcomes after implantation of TECNIS toric IOL in eyes with long axial length（AL）and identify factors influencing their early-stage stability with preoperative corneal astigmatism.
Methods: The study population consisted of 64 eyes from 52 cataract patients, and these patients had preoperative corneal astigmatism between 1.0 and 3.7 diopters (D) and underwent phacoemulsification and TECNIS toric IOL implantation. Ophthalmic biological measurements were carried out preoperatively, including AL, anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), anterior chamber volume (ACV) and sulcus-to-sulcus (STS). The 1- and 3-month clinical outcomes included visual acuity, manifest refraction, keratometry, postoperative toric IOL axis, the area of capsulorhexis, and the overlapped area between IOL optic and anterior capsulorhexis.
Results: The mean best corrected distance visual acuity (BCDVA) was improved from 0.93±0.35 logarithms of the minimal angle of resolution (logMAR) preoperatively to 0.07±0.10 logMAR postoperatively at 3 months after surgery. The mean residual astigmatism (RAS) was 0.91±0.74D at 3 months, which was significantly decreased compared with the preoperative corneal astigmatism of 1.71±0.55 D. The mean absolute rotation of TECNIS toric IOL at 1 and 3 months was 7.41±11.32 degree (°) and 7.48±11.19° (0°-79°), respectively. A positive correlation was found between IOL rotation and the area of capsulorhexis (Pearson’s r=0.297, P=0.017) at 3 months after surgery. No correlation was found between IOL rotation and AL (Pearson’s r=-0.020, P=0.876), ACD (Pearson’s r=-0.123, P=0.387), LT (Pearson’s r=0.083, P=0.523), VL (Pearson’s r=-0.082, P=0.546), ACV (Pearson’s r=-0.094, P=0.480), STS (Pearson’s r=0.019, P=0.884), or the overlapped area between capsulorhexis and optic (Pearson’s r=-0.191, P=0.131) .
Conclusions: The area of capsulorhexis was a risk factor for toric IOL rotation. Implantation of TECNIS toric IOL in cataract cases with long AL was effective and safe.
Recurrence in Stage I and II Triple-Negative Breast Cancer: Analysis of Clinicopathologic and Imaging Factors
Authors: Eom Hye Joung , Cha Joo Hee , Choi Woo Jung , Chae Eun Young , Shin Hee Jung , Kim Hak Hee
Published: August 2019

Background

To describe the outcomes of patients with early stage triple-negative breast cancer (TNBC) and to investigate whether certain imaging and clinicopathologic factors were associated with recurrence in patients with early stage TNBC.

Methods

We identified stage I and II TNBC patients treated between 2009 and 2011. Data included patient and tumor characteristics, time of recurrence, and findings on mammography, ultrasonography, and magnetic resonance imaging (MRI). Kaplan-Meier method was used to estimate recurrence free survival and Cox proportional hazards model was used to determine the association between imaging and clinicopathologic factors and recurrence.

Results

The study included 702 patients with mean age of 49.0 years (range, 24–82 years) and mean follow-up of 61 months (range, 6 - 93 months). Overall, 115 (115/702, 16.4%) had recurrence. Clinicopathologic factors associated with recurrence included increasing tumor size, positive nodal status, ki-67 index more than 14, presence of lymphovascular invasion (LVI), mastectomy, and neoadjuvant or adjuvant chemotherapy. Imaging factors associated with recurrence included moderate or marked background parenchymal enhancement on MRI. After controlling for all potential confounders, tumor size, nodal status, LVI, and adjuvant chemotherapy were independently associated with recurrence.

Conclusion

Sixteen percent of patients with early stage TNBC experienced recurrence, with 3 and 5 year recurrence rates being 12.4% and 15.3%, respectively. Tumor size, nodal status, LVI, and adjuvant chemotherapy were independently associated with recurrence, while none of the imaging factors showed association.
Prevalence and Factors Associated with Early Sexual Debut among Preparatory School Students in Gondar Town, North West Ethiopia 2018
Authors: Gudeta Betelihem , Habitu Yohannes Ayanaw , Atnafu Asmamaw
Published: August 2019

Objective: Early sexual debut increases youth exposure to risky sexual behaviors, STIs including HIV/AIDS, and unsafe abortion. There is study limitation on this specific issue on the study area. Therefore, this study aimed to determine the prevalence and associated factors of early sexual debut among preparatory school students in Gondar town, North West Ethiopia.
Results: From a total of 797 students, 750 respondents complete the questionnaire giving a response rate of 94.1%. About 20.5% with 95%CI (17.6, 23.3%) of the respondents had early sexual debut. Had lesson on sexuality education (AOR=2.14, 95%CI 1.15, 3.98), drinking alcohol (AOR= 14.5, 95%CI 7.81, 27.22), had good parental monitoring (AOR=3.6, 95%CI 1.8, 7.45), had discussion on sexual issues with parents (AOR=3.05, 95%CI 1.04, 8.88), and had good academic achievement (AOR=4.2, 95%CI 1.72, 10.26) were found to be significantly associated with early sexual debut. Sexual education programs at earlier life may help to delay sexual debut for school youths and is recommended to incorporate it in the curriculum.
Key words: Early sexual debut, factors, preparatory students, Gondar, Ethiopia
Role of inferior vena cava collapsibility index in the prediction of hypotension associated with general anesthesia: an observational study
Authors: Szabó Marcell , Bozó Anna , Darvas Katalin , Horváth Alexandra , Iványi Zsolt Dániel
Published: August 2019

Background: Intraoperative hypotension increases 30-day mortality and the risks of myocardial injury and acute renal failure. Patients with inadequate volume reserve before the induction of anesthesia are highly exposed. The identification of latent hypovolemia is therefore crucial. Ultrasonographic measurement of the inferior vena cava collapsibility index (IVCCI) is able to detect volume responsiveness in circulatory shock. No current evidence is available regarding whether preoperative measurement of the IVCCI could identify patients at high risk for hypotension associated with general anesthesia.
Methods: A total of 102 patients undergoing elective general surgery under general anesthesia with standardized propofol induction were recruited for this prospective observational study. The IVCCI was measured under spontaneous breathing. A collapsing (IVCCI≧50%) (CI+) and a noncollapsing (CI-) group were formed. Immediate postinduction changes in systolic and mean blood pressure were compared. The performance of the IVCCI as a diagnostic tool for predicting hypotension (systolic pressure <90 mmHg or a ≥30% drop from the baseline) was evaluated by ROC curve analysis.
Results: A total of 83 patients were available for analysis, with 20 in the CI+ and 63 in the CI- group, we excluded 19 previously eligible patients due to inadequate visualization of the IVC (7 cases), lack of adherence to the protocol (8 cases), missing data (2 cases) or change in anesthesiologic management (2 cases). The mean decrease in systolic pressure in the CI+ group was 53.8±15.3 compared to 35.8±18.1 mmHg in CI- patients (P=0.0001). The relative mean arterial pressure change medians were 34.1% (IQR 23.2%-43.0%) and 24.2% (IQR 17.2%-30.2%), respectively (P=0.0029). The ROC curve analysis for IVCCI showed an AUC of 64.8% (95%CI 52.1-77.5%). The selected 50% level of the IVCCI had a sensitivity of only 45.5% (95%CI 28.1-63.7%), but the specificity was high at 90.0% (78.2-96.7%). The positive predictive value was 75.0% (95%CI 50.9-91.3%), and the negative predictive value was 71.4% (95%CI 58.7-82.1%).
Conclusion: In spontaneously breathing preoperative noncardiac surgical patients, preoperatively detected IVCCI≧50% can predict postinduction hypotension with high specificity but low sensitivity. Despite moderate performance, IVCCI is an easy, noninvasive and attractive option to identify patients at risk and should be explored further.
Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia, a prospective, randomized study
Authors: yan wei , Xiong Yun , Yao Yu , Zhang Feng-jiang , Yu Li-an , Yan Min
Published: August 2019

Abstract
Background: Unsatisfactory analgesia would occur frequently during repeated cesarean section under epidural anesthesia. The aim of this study is to observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeated cesarean section under epidural anesthesia.
Methods: A total of 80 parturients undergoing repeated cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil- assisted epidural group (group R) and epidural group (group E), respectively (n=40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded.
Results: A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1±1.0 vs. 7.5±1.3, p<0.001), whereas the maximum VAS score was significantly lower in group R (1.8±1.2 vs. 4.0±0.9, p<0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p>0.05).
Conclusions: Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeated cesarean section under epidural anesthesia, without noticeable maternal or neonatal adverse effects.
Paramyotonia congenita with persistent distal and facial muscle weakness: A case report with literature review
Authors: Taminato Tomoya , Mori-Yoshimura Madoka , Miki Jun , Sasaki Ryogen , Satoh Noriko , Oya Yasushi , Nishino Ichizo , Takahashi Yuji
Published: August 2019

Introduction

Paramyotonia congenita (PC; OMIM 168300) is a non-dystrophic myotonia caused by mutations in the SCN4A gene. Transient muscle stiffness, usually induced by exposure to cold and aggravated by exercise, is the predominant clinical symptom, and interictal persistent weakness is uncommon.

Case presentation

We report a family with a history of PC accompanied by persistent distal hand dominant muscle weakness with masticatory muscle involvement. Persistent weakness was exacerbated with age, and MR analysis showed marked atrophy of temporal, masseter, and finger flexor muscles with fatty replacement. Cases within the family harbor the prevalent PC causative mutation, T1313M, in the SCN4A gene. Administration of acetazolamide chloride improved clinical symptoms and the results of cold and short exercise tests. Phenotypic variation within the family was remarkable, as the two younger affected patients did not present with persistent weakness or muscle atrophy.

Conclusions

PC associated with the T1313M mutation is a possible cause of persistent distal hand weakness.