bluuebunny/crossref_metadata_2025 huggingface dataset:
Frailty and Healthcare Utilisation Across Care Settings Among Community-Dwelling Older Adults in Singapore
Authors: Ge Lixia , Yap Chun Wei , Heng Bee Hoon , Tan Woan Shin
Published: May 2020

Background Frailty is frequently found to be associated with increased healthcare utilisation in western countries, but little is known in Asian population. This study was conducted to investigate the association between frailty and healthcare utilisation by care setting among community-dwelling older adults in Singapore.Methods We conducted a six-month look-back and six-month post-baseline analysis of healthcare utilisation. Data from a longitudinal population-based survey were linked with healthcare utilisation data obtained from an administrative database. Baseline frailty status was measured using the five-item FRAIL scale, which is categorised into three groups: robust (0), pre-frail (1–2), and frail (3–5). Healthcare utilisation included government primary care clinic visits, specialised outpatient clinic visits, emergency department visits, day surgery and hospitalisations. Multivariable logistic and negative binomial regression were applied to examine the associations between frailty with healthcare utilisation, controlling for other confounding variables. Results In our sample of 701 older adults, 64.8% were of robust health, 27.7% belonged to the pre-frail category, and 7.6% were frail. Compared to the non-frail group, frail individuals had a higher rate of specialised outpatient clinic visits (incidence rate ratio (IRR): 2.8, 95% confidence interval (CI): 1.2-6.5), emergency department visits (IRR: 3.1, 95%CI: 1.1-8.1), day surgeries done (IRR: 6.4, 95%CI: 1.3-30.9), and hospitalisations (IRR: 6.7, 95%CI: 2.1-21.1) in the six-months before the baseline and in subsequent six months (IRR: 3.3, 95%CI: 1.6-7.1; 6.4, 2.4-17.2; 5.8, 1.3-25.8; 13.1, 4.9-35.0; respectively). Frailty was also significantly associated with an increased in the number of specialised outpatient clinic visits, emergency department visits and hospitalisations in 6 months before and after baseline, with controlling for covariates. Conclusions Among community-dwelling adults, frailty was positively associated with the likelihood and the number of specialised outpatient clinic visits, emergency department visits, day surgeries and hospitalisations but no significant associations were observed with primary care utilization. The positive association was significant at 6-month before and after the baseline. As frailty is a potentially reversible health state with early screening and intervention, providing preventive activities that delay the onset or progression of frailty should have the potential effect on delaying secondary and tertiary care needs.
Exploring Perceptions of Dementia in Northern Ireland
Authors: Mitchell Gary , McTurk Victoria , Carter Gillian , Brown-Wilson Christine
Published: May 2020

Background: Improving public knowledge and understanding about dementia has been identified as a priority area by people living with the condition, researchers, educators and policymakers for a number of years. Societies that have a better understanding of the condition are more likely to enable people living with dementia to enjoy a better quality of life. The aim of this study was to explore current public perceptions of dementia from people living with the condition in Northern Ireland.Methods: Four focus group interviews were conducted with a total of 20 people living with a dementia across three Northern Irish Counties in June 2019. These interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Ethical approval was obtained for this study prior to data collection.Findings: Following thematic analysis, three themes emerged in relation to barriers and facilitators to living well with dementia. These were: ‘Emphasis on Disability NOT Capability’, which highlighted societal misconceptions about the activities and modes of life which people with dementia could or could not do; ‘Normalise Dementia – We Don’t Want a Fool’s Pardon’, which focused on how society could encourage people living with the condition to enjoy greater independence, and ‘Dementia isn’t a Death Sentence’, which considered how professionals, family members and friends treated the person after diagnosis.Conclusions: Public perception and knowledge about dementia are improving but people living with the condition still face significant challenges in their daily lives. Participants in this study acknowledged improvements in societal knowledge and perception about dementia, however they also acknowledged there is still an urgent need for continued improvement.
Early Inguinal Lymphadenectomy is Necessary in the Treatment of Penile Cancer T1G2.
Authors: li Jing , Li Zai-shang , Wang Bin , Yang Jian-an
Published: May 2020

Backgroud：At present, there is still no consensus on the early inguinal lymph node dissection (eILND) of T1G2 or T1aG2. In this study, we investigated the peculiarities of penile cancer T1G2 and T1aG2 to assess the necessity of eILND for this subgroup.Methods: A total of 144 patients had been treated for penile squamous cell carcinoma with primary tumor excision and early bilateral inguinal lymphadenectomy in my institution from January 2002 to March 2017, thus, 53 patients definitely diagnosed as T1G1 or T1G2 were included in this study. According to the recent guideline, T1aG1 and T1aG2 were even researched. The chi-square test and the Fisher exact test were used to compare categorical variables. Survival were retrospectively analyzed by the Kaplan-Meier method and assessed by log-rank tests. RESULTS: Among 53 patients, the proportion of positive lymph node of T1G2 was 68.8%, which was significantly higher than T1G1 (18.9%, P=0.001). Then we analyzed the patients of clinically node-negative patients (cN0), micro metastatic disease occurred in T1G2 was 50% but in T1G1 was 14.8%, which also reached statistical significance (p=0.043). According to the recent guideline, T1aG1 and T1aG2 had been further analyzed. As the risk for lymphatic spread, T1aG2 was 44.4% while only 4.5% of T1aG1 was found Inguinal lymph node metastasis, significant differences of which were also reached (P=0.017). In an addition, Survival Curve had been demonstrated but no statistical differences found between T1G1 and T1G2, as the same result also existed in the cohort of T1aG1 and T1aG2, all of which revealed a strong proof of therapeutic benefits of eILND.CONCLUSIONS: The option of a surveillance strategy is not applicable to patients of T1G2 or T1aG2, eILND should be highly recommended for this subgroup to achieve the most therapeutic benefits.
Did Granny know best? Evaluating the Antibacterial, Antifungal and Antiviral Efficacy of Acetic Acid for Home Care Procedures.
Authors: Zinn Marc-Kevin , Bockmuehl Dirk
Published: May 2020

Background: Acetic acid has been used for many decades to clean and disinfect surfaces in the household. Disinfection in the household is particularly important for the group of YOPI (young, old, pregnant, immunocompromised), as they represent a risk group. In addition to known pathogens, viruses are also becoming a major problem not only for this group, but due to the new Sars-CoV-2 virus all people are affected. The aim of this study is to show that acetic acid has a disinfecting effect against certain microorganisms and is able to destroy certain viruses. Furthermore, a disinfecting effect of laundry in a simulated washing cycle will be investigated. Results: At a concentration of 10% and an addition of 1.5% citric acid according to the specifications of DIN EN 1040 and DIN EN 1275, acetic acid showed a reduction of > 5-log steps in the following microorganisms: P. aeruginosa, E. coli, S. aureus, L. monocytogenes, K. pneumoniae, E. hirae and A. brasiliensis. For MRSA a logarithmic reduction of 3.19 was obtained. The results of the test according to DIN EN 13697 showed a complete reduction (> 5-log steps) for P. aeruginosa, E. coli, S. aureus, E. hirae, A. brasiliensis and C. albicans already from a acetic acid concentration of 5%. The results of the tests according to DIN EN 14476 and DIN EN 16777 showed a reduction of ≥ 4-log-steps against the Modified Vaccinia virus Ankara (MVA) for the tested acetic acid concentrations of 5%, 7.5% and 10%. This means a virucidal effect of 5% acetic acid. Furthermore, the results showed that acetic acid does not have a sufficient disinfecting effect on microorganisms in a dosage that is commonly used for cleaning. However, this can be achieved by increasing the concentration of acetic acid used, especially when combined with citric acid. Conclusions: Our results show a disinfecting effect of acetic acid in a concentration of 10% and an addition of 1.5% citric acid against a variety of microorganisms. A virucidal effect against enveloped viruses could also be proven. Furthermore, the results showed a disinfecting effect of acetic acid in domestic laundry procedures.
Three Redescriptions in Tintinnopsis (Protista ：Ciliophora: Tintinnina) from Coastal Waters of China, with Cytology and Phylogenetic Analyses Based on Ribosomal RNA Genes
Authors: Bai Yang , Wang Rui , Song Wen , Li Lifang , Santoferrara Luciana F. , Hu Xiaozhong
Published: May 2020

Background: The taxonomy of tintinnine ciliates is vastly unresolved because it has traditionally been based on the lorica (a secreted shell) and it has only recently incorporated cytological and molecular information. Tintinnopsis, the most speciose tintinnine genus, is also the most problematic: it is known to be non-monophyletic, but it cannot be revised until more of its species are studied with modern methods.Results: Here, T. hemispiralis Yin, 1956, T. kiaochowensis Yin, 1956, and T. uruguayensis Balech, 1948, from coastal waters of China, were studied. Lorica and cell features were morphometrically investigated in living and protargol-stained specimens, and sequences of three ribosomal RNA (rRNA) genes were phylogenetically analyzed. The three species show a complex ciliary pattern (with ventral, dorsal, and posterior kineties and right, left, and lateral ciliary fields), but differ in lorica morphology, details of the somatic ciliature and rRNA gene sequences. Tintinnopsis hemispiralis is further distinguished by a ciliary tuft (a ribbon of very long cilia originating from the middle portion of the ventral kinety and extending out of the lorica) and multiple macronuclear nodules. Both T. kiaochowensis and T. uruguayensis have two macronuclear nodules, but differ in the number of somatic kineties and the position of the posterior kinety. Two neotypes are fixed for T. hemispiralis and T. kiaochowensis to stabilize the species names objectively, mainly because of the previous unavailability of type materials. By phylogenetic analysis and comparison with closely-related species, we infer that the ciliary tuft and details such as the commencement of the rightmost kinety in the lateral ciliary field are synapomorphies that may help clarify the systematics of Tintinnopsis-like taxa.Conclusion: The redescriptions of three poorly known Tintinnopsis species, namely T. hemispiralis, T. kiaochowensis, and T. uruguayensis firstly revealed their ciliary pattern and rRNA sequences. This study expands knowledge and database of tintinnines and helps in identifying potential synapomorphies for future taxonomic rearrangements.
Circular DNA intermediates in the generation of large human segmental duplications.
Authors: Chicote Javier Ugarte , López-Sánchez Marcos , Marquès-Bonet Tomàs , Callizo José , Pérez-Jurado Luis Alberto , Garcia-España Antonio
Published: May 2020

Background: Duplications of large genomic segments provide genetic diversity in genome evolution. Despite their importance, how these duplications are generated remains uncertain, particularly for distant duplicated genomic segments. Results: Here we provide evidence of the participation of circular DNA intermediates in the single generation of some large human segmental duplications. A specific reversion of sequence order from A-B / C-D to B-A / D-C between duplicated segments and the presence of only microhomologies and short indels at the evolutionary breakpoints suggest a circularization of the donor ancestral locus and an accidental replicative interaction with the acceptor locus. Conclusions: This novel mechanism of random genomic mutation could explain several distant genomic duplications including some of the ones that took place during recent human evolution.
Covid-19 effects on the workload and mental health of Iranian healthcare workers
Authors: Shoja Esmail , Aghamohammadi Vahideh , Bazyar Hadi , Moghddam Hamed Rezakhani , Nasiri Khadijeh , Dashti Mohammad , Choupani Ali , Garaee Masoumeh , Asgari Amin
Published: May 2020

Background
Workload and mental health problems of health care workers (HCWs) in the COVID-19 pandemic is a concern. These problems increase medical error and mortality of patient and can reduce performance HCWs.
Methods
We studied 495 HCWs in Iran between March and April 2020. Three online questionnaires (NASA-TLX, GHQ-12, and demographic) were distributed to them via social networks. Data were entered into software SPSS v.25 and T-test, ANOVA, Regression methods were used for data analysis.
Results
Task load and mental disorder were significantly higher in HCWs who encountered COVID- 19 patients (p < 0.001). Among HCWs, nurses had the highest workload (71 ± 16.13, p < 0.001). Females had significantly higher GHQ scores compared to males (6.54 ± 1.84 vs. 5.90 ± 2.21, p = 0.003). Regarding the ward of work, health workers in the Corona part had more total task load scores compared to workers in health centers (71.56 ± 17.40 vs. 63.94 ± 17.36, p = 0.003). Total GHQ score had significant positive correlation with age (r = 0.12, p = 0.008), education level (r = 0.09, p = 0.03), and experience level (r = 0.15, p = 0.001). A positive significant correlation was observed between mental demand and age (r = 0.12, p = 0.007) and experience level (r = 0.10, p = 0.024). Task Load score, mental demand, temporal demand, and performance demand had a negative correlation with education level (p < 0.05).
Conclusions
This study suggests the following recommendations for reducing workload and mental disorders: Psychological intervention to mental support of medical staff, especially nurses and health experts, Attention to macro ergonomics factors and work shift planning according to psychophysiological characteristics workers can improve mental health.
Sex- and age-related variations in the three-dimensional orientations and curvatures of the articular surfaces of the human talus
Authors: Nozaki Shuhei , Watanabe Kota , Teramoto Atsushi , Kamiya Tomoaki , Katayose Masaki , Ogihara Naomichi
Published: May 2020

Background
The high prevalence of foot pathologies in women and the elderly is suggested to be linked to sex- and age-related differences in the calcaneal morphology. Given that, it is expected that there also exists sex- and age-related differences of the articular morphology in the keystone of the foot, the talus. The present study investigated the orientation and curvature of the three articular surfaces of the talus in relation to sex and age based on computer tomography (CT).
Methods
The CT images of 56 feet were used in this study. The orientations of the talocrural, subtalar, and talonavicular joints were quantified three-dimensionally by calculating normal and principal axes of the articular surfaces defined by planar approximation. The curvature radii of the articular surfaces were also quantified by cylindrical and spherical approximations.
Results
The talonavicular surface was significantly more twisted and less internally rotated in females than in males. With aging, the subtalar articular surface was significantly facing more posteriorly. Moreover, it was found that the curvature radii of the trochlea and navicular articular surfaces significantly increased with aging, indicating the flattening of the articular surfaces.
Conclusion
The sex- and age-related differences in talar articular morphology were observed. The substantial degeneration pattern of the talar morphology with aging could potentially lead to a higher prevalence of foot disorders in the elderly.
Potential efficacy of gut microbiome dysbiosis on alleviation the progress of osteoarthritis in mice
Authors: Guan zhiyuan , Jia Jialin , Zhang Chenggui , Sun Tiantong , Zhang Wang , Leng Huijie , Song Chunli
Published: May 2020

ObjectiveTo evaluate the relationship between the gut microbiota dysbiosis and progression of osteoarthritis (OA)DesignWe used a mice OA model (8 weeks) of destabilization of medial meniscus and the gut microbiome dysbiosis induced by antibiotic treatment(ABT) with ampicillin and neomycin for 8 weeks. The severity of OA was evaluated by micro-CT, X-ray and histology of osteoarthritis Research International (OARSI) score. Microbiome analysis by 16 s DNA qPCR was performed on the feces samples and the serum IL-6, TNF-α, osteocalcin, estrogen, calcium and magnesium ion were measured in enzyme-linked immunosorbent assay(ELISA).ResultCompare to the normal mice, the bone volume over total volume(BV/TV)(P < 0.01 for both subgroup analysis) and the osteoarthritis Research International (OARSI) score (P < 0.01 for both subgroup analysis) and in subchondral bone and was decreased significant in ABT treatment of female and male group. ABT decreased the osteophyte score in female mice with standard normal group(P < 0.05) and also declined osteophyte maturity score in both female(P < 0.01) and male(P < 0.05)mice. The level of IL-6(P < 0.01 for both subgroup analysis), TNF-α(P < 0.01 for both subgroup) and calcium(P < 0.01 for both subgroup analysis) were decreased significant in ABT group than control group while the magnesium(P < 0.01 for both subgroup analysis) and estrogen(P < 0.01 for both subgroup analysis) were increased significant in ABT female group than that in the control female group. Pearson’s correlation analyses demonstrated that subchondral bone BV/TV(r = -0.6145, P = 0.0001) and OARSI score in medial tibial plateau(r = -0.5407, P = 0.0007) are negatively correlated with the Firmicutes : Bacteroidetes ratio.ConclusionGut microbiome dysbiosis have a potential efficacy on alleviate the progress of OA.
Prevalence of Rheumatic Disorders and Related Disabilities in Bangladeshi Adults: A Cross-Sectional National Survey
Authors: Zahid-Al-Quadir Ahmad , Zaman Mohammad Mostafa , Ahmed Shamim , Bhuiyan Mahfuzur Rahman , Rahman Md Mujibur , Patwary Ismail , Das Bidhu Bhushan , Hossain Shaikh Amir , Paul Sujat , Shahin Abu , Rahman Mashiur , Haq Syed Atiqul
Published: May 2020

Objectives: To determine the prevalence of rheumatic disorders and related disabilities in the adult population of Bangladesh.Methods: A total of 2000 individuals aged 18 years or older were targeted where 1843 (92.1%) participated from 20 primary sampling units (urban and rural) of all former seven divisions of Bangladesh in 2015. Modified Community Oriented Program for Control of Rheumatic Disorders questionnaire was used to detect positive respondents. Standard criteria were used for diagnosing rheumatic disorders by residents of rheumatology and expert rheumatologists. A Bangla version of the Health Assessment Questionnaire was used to determine disability.Results: Among the respondents, 892 men and 951 women participated from rural (n=716) and urban (n=1127) areas. Their mean age was 40.5 (standard deviation 14.7) years. Almost a third did not have any formal schooling. Overall, 30.4% (95% confidence interval, 28.3-32.5) had rheumatic disorders. Nonspecific low back pain (12.7%, 11.2-14.2) and knee osteoarthritis (7.3%, 6.1-8.5) were the two top-ranking rheumatic disorders followed by lumbar spondylosis 6.0% (4.9-7.1) and soft tissue rheumatism 3.8% (2.9-4.7). Rheumatoid arthritis (1.6%, 1.0-2.1), spondyloarthritis (1.2%, 7-1.8) and frozen shoulder (1.4%, 0.9-1.9) are relatively uncommon. Among those who had rheumatic disorders, 24.8% (21.3-28.6) had some degree of disability. Of them, 24.4% (21.0-28.1) had history of work loss during last 12 months. Being overweight, having history of physical trauma and diabetes mellitus, age and female sex were positively but education was negatively associated with rheumatic disorders. Conclusions: The high burden of rheumatic disorders and related disabilities in Bangladesh warrants public health and clinical interventions.Highlights1. This is the first national level study using primary sampling units of Bangladesh Bureau of Statistics engaging rheumatology residents for data collection. The diagnoses have been validated or confirmed by rheumatologists in the field in partnership with divisional level medical college hospitals.2. Prevalence of rheumatological disorders (low back pain, knee osteoarthritis and lumbar spondylosis are commonly prevalent), associated pain, disability (as determined using B-HAQ) and work loss are so common that warrants public health and clinical intervention. Name of department(s) and institution(s) to which the work should be attributed:Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BangladeshThe source(s) of support in the form of grants or industrial support:This work was supported by World Health Organization, Bangladesh (Agreement Reference: SEBAN140895).
Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia
Authors: Somwaru Alexander S. , Metting Stephen , Flisnik Laura M. , Katabathina Venkat S.
Published: May 2020

Background
Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume larger than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective study examined the safety and long-term efficacy of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large cohort of patients.
Methods
72 patients with GPH and severe LUTS who underwent PAE were retrospectively evaluated. PAE was performed bilaterally with two embolic agents in sequence: 100 µm to 250 µm embolic particles followed by 2 mm and 3 mm coils. Clinical assessment was performed by collecting international prostate symptoms score (IPSS), quality of life (QoL), and post-void residual volume (PVR) before PAE and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before PAE and 12 months and 24 months after PAE.
Results
Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, PVR, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < .0.01) at 12 months and to 10.5 (P < .0.01) at 24 months. Mean QoL decreased from 6.0 to 4.0 (P < 0.01) at 12 months and to 2.0 (P < 0.01) at 24 months. Mean PVR decreased from 198.0 mL to 152.0 mL (P < 0.01) at 12 months and to 90 mL (P < 0.01) at 24 months. Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) at 12 months and to 209.0 mL (P < 0.01) at 24 months. There were no major complications.
Conclusions
PAE is a safe treatment option with long term efficacy in patients with severe LUTS due to GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.
Hepatitis B, Hepatitis C and HIV Prevalence and Related Sexual and Substance Use Risk Practices Among Key Populations Who Access HIV Prevention, Treatment and Related Services in South Africa: Findings from A Seven-City Cross-Sectional Survey (2017)
Authors: Scheibe Andrew , Young Katherine , Versfeld Anna , Spearman C Wendy , Sonderup Mark , Prabdial-Sing Nishi , Puren Adrian , Hausler Harry
Published: May 2020

Background: People who use drugs including people who inject drugs (PWUD/ID), sex workers (SWs) and men who have sex with men (MSM) are at increased risk for HIV and viral hepatitis infection. Limited data exists on the epidemiology of these infections among these key populations (KPs) in South Africa. We aimed to describe the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV and selected risk factors among these KPs to inform effective responses. Methods: We used convenience sampling to recruit a targeted 3 500 KPs accessing HIV-related health services across Cape Town (SWs, MSM, PWUD/ID), Durban (SWs, PWUD/ID), Pietermaritzburg (SWs), Mthatha (SWs), Port Elizabeth (SWs), Johannesburg (MSM) and Pretoria (MSM and PWUD/ID) into a cross-sectional survey. We used an interviewer administered questionnaire to assess socio-demographic characteristics, drug use and sexual risk practices. We tested for HBV surface antigen (HBsAg), HCV (antibody, viral load and genotype) and HIV antibody. We used descriptive statistics to explore data, which were stratified by KP. Results: Among the 3 439 people included in the study (1 528 SWs, 746 MSM, 1 165 PWUD/ID) the median age was 29 years, most participants were black African (60%), and 24% reported homelessness. 82% reported substance use in the last month, including alcohol (46%) and heroin (33%). 75% were sexually active in the previous month, with condom use at last sex at 74%. HIV prevalence was 37% (highest among SWs at 47%), HBsAg prevalence 4% (similar across KPs) and HCV prevalence was 16% (highest among PWUD/ID at 46%). Conclusions: HBV, HCV and HIV are major health threats for KPs in South Africa. While HIV is an important condition for all included KPs, HCV is of particular importance to PWUD/ID. For KPs, HBV vaccination and behaviour change interventions that support consistent condom and lubricant access and use are needed. Coverage of opioid substitution therapy and needle and syringe services, and access to HCV treatment for PWUD/ID need to be expanded.
Low Engagement in HIV Services and Progress through the Treatment Cascade among Key Populations Living with HIV in Mozambique: Alarming Gaps in Knowledge of Status
Authors: Boothe Makini , Sathane Isabel , Baltazar Cynthia Semá , Chicuecue Noela , Horth Roberta , Fazito Erika , Raymond Henry Fisher
Published: May 2020

Background.
Mozambique has a generalized HIV epidemic of 13.5% among the general population. Early modeling exercises estimate that key populations (KPs) and their partners account for about one third of all new infections due to their sexual and drug use behaviors. The Fast Track Targets monitor key indicators along the treatment cascade.
Methods.
We conducted a secondary data analysis of HIV-positive participants in the first Bio-behavioral Surveillance (BBS) surveys in Mozambique in order to assess HIV service uptake and progress though the HIV treatment cascade among men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID). Unweighted pooled estimates were calculated for each key population group.
Results.
Among HIV-positive MSM, 63.2% of participants had ever received an HIV test, 8.8% were aware of their status, 6.1% reported having been linked to care, while 3.5% initiated ART and were currently on treatment. Of the HIV-infected FSW participants, 76.5% reported a previous HIV test and 22.4% were previously aware of their status. Linkage to care was reported by 20.1%, while 12.7% reported having initiated ART and 11.8% reported being on treatment at the time of the survey. Among HIV-infected PWID participants, 79.9% had previously received an HIV test, 63.2% were aware of their HIV status, and 49.0% reported being linked to care for their HIV infection. ART initiation was reported by 42.7% of participants, while 29.4% were on ART at the time of the survey. All key population groups fell below the global targets of the HIV treatment cascade.
Conclusion.
Among the three high risk populations in Mozambique, losses occurred throughout critical areas of service uptake with the most alarming breakpoint occurring at knowledge of HIV status. Special attention should be given to increasing HIV testing and linkage to ART treatment. Future surveys will provide the opportunity to monitor improvements across the cascade and should include viral load testing to guarantee a more complete picture of the treatment cascade.
Effects of Combined High Temperature and Waterlogging Stress at Booting Stage on Root Anatomy of Rice (Oryza sativa L.)
Authors: Zhen Bo , Zhou Xinguo , Li Huizhen , Niu Qinglin , Qiu Husen , Tian Guangli , Lu Hongfei
Published: May 2020

Background In recent years, the alternating occurrence of high temperature and waterlogging disasters in South China from July to August has seriously reduced the yield of single cropping rice. Studying the changes in anatomical structure of the rice root system could provide theoretical basis for understanding the mechanisms of high temperature and waterlogging stress in rice plants.Results To examine the effects of high temperature and waterlogging stress on root anatomical structure of rice at booting stage, six treatments of rice plants were set up: high temperature stress (T1), high temperature × light waterlogging stress (water depth of 10 cm; T2), high temperature × heavy waterlogging stress (water depth of 15 cm; T3), light waterlogging stress (water depth of 10 cm; T4), heavy waterlogging stress (water depth of 15 cm;T5), and regular irrigation with shallow water (water depth of 0–5 cm) except at harvest maturity (CK). The interaction of high temperature and waterlogging stresses at the booting stage promoted earlier formation of the aeration tissue in rice roots and had a certain degree of continuity. High temperature inhibited the increase in rice root diameter, stele diameter, thickness of the outer root layer, and vessel diameter. Compared to the CK, root diameter and stele diameter under high temperature stress (T1) were decreased by 29.09% and 15.28%, respectively, at the booting stage, whereas high temperature × heavy waterlogging (T3) affected only the vessel diameter, reducing it by 14.11% compared with that in the CK. The increase in rice root diameter, stele diameter, thickness of the outer root cortex layer, and vessel diameter were inhibited under stress at the booting stage. Compared with high temperature stress, the interaction of high temperature and waterlogging stress alleviated the inhibiting effect of the changes in the root system on water and nutrient transport.Conclusion Therefore, under high temperature weather conditions after a rainstorm, water level of the surface of paddy fields should be maintained at about 10–15 cm for 5 days to alleviate the effect of high temperature on rice growth and reduce the loss of nitrogen and phosphorus.
Effectiveness of interventions to increase uptake and completion of treatment for diabetic retinopathy in low- and middle-income countries: a rapid review protocol.
Authors: Bascaran Covadonga , Mwangi Nyawira , D’Esposito Fabrizio , Cleland Charles , Gordon Iris , Ulloa Juan Alberto Lopez , Maswadi Ranad , Md Shaffi , Ramke Jacqueline , Evans Jennifer R , Burton Matthew
Published: May 2020

Background Vision loss due to diabetic retinopathy can largely be prevented or delayed through treatment. Patients with vision-threatening diabetic retinopathy are typically offered laser or intravitreal injections which often require more than one treatment cycle. However, treatment is not always initiated, or it is not completed, resulting in poor visual outcomes. Interventions aimed at improving the uptake or completion of treatment for diabetic retinopathy can potentially help prevent or delay visual loss in people with diabetes. Methods We will search MEDLINE, Embase, Global Health and Cochrane Register of Studies for studies reporting interventions to improve the uptake of treatment for diabetic retinopathy (DR) and/or diabetic macular oedema (DMO), compared with usual care, in adults with diabetes. The review will include studies published in the last 20 years in the English language. We will include any study design that measured any of the following outcomes in relation to treatment uptake and completion for DR and/or DMO: 1) Proportion of patients initiating treatment for DR and/or DMO among those to whom it is recommended, 2) Proportion of patients completing treatment for DR and/or DMO among those to whom it is recommended, 3)Proportion of patients completing treatment for DR and/or DMO among those initiating treatment, 4) Number and proportion of DR and/or DMO rounds from the recommended treatment protocol completed per patient. For included studies we will also report any measures of cost-effectiveness when available. Two reviewers will screen search results independently. Risk of bias assessment and data extraction will be done by one reviewer with verification of 10% of the papers by a second reviewer. The results will be synthesised narratively. Discussion This rapid review aims to identify and synthesise the peer-reviewed literature on the effectiveness of interventions to increase uptake and completion of treatment for DR and/or DMO in LMICs. The rapid review methodology was chosen in order to rapidly synthesise the available evidence to support program implementers and policy makers in designing evidence-based health programs, public health policy, and inform the allocation of resources. Rapid review registration OSF: osf.io/h5wgr
Development of risk factor-based scoring system for detection of hypervirulent Klebsiella pneumoniae bloodstream infections.
Authors: Togawa Atsushi , Yoshimura Michinobu , Tokushige Chiemi , Matsunaga Akira , Takata Tohru , Takamatsu Yasushi
Published: May 2020

Background
Hypervirulent Klebsiella pneumoniae (HVKp) infections have distinct clinical manifestations from classical K. pneumoniae infections. The hallmark of HVKp infections are liver abscess formation and metastatic infections. Due to the severe sequelae of these complications, method to identify patients at-risk of HVKp infections should be developed.
Results
A retrospective cohort study of 222 patients with K. pneumoniae bloodstream infections (BSIs) was performed. Patient demographics, clinical manifestations, and bacterial characteristics were investigated. Ten cases of liver abscesses were identified. Characteristics such as community-onset BSIs, hypermucoviscosity phenotype, and capsular serotype K1 were identified as risk factors for HVKp infections. A scoring system was developed based on the risk factors. The area under the receiver operating characteristic curve for the scoring system was 0.90. A score of ≥ 2 points provided sensitivity and specificity of 0.70 and 0.94, respectively.
Conclusions
Simple scoring system was developed for the diagnosis of HVKp infections. The system allows early identification of patients with K. pneumoniae BSIs in whom hypervirulent infections should be evaluated. Prospective evaluation is expected.
Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial
Authors: Ma Hui Xu , Wang Hairuo , Long Xiaotao , Xu Zexiang , Chen Xiaohua , Li Mingjin , He Tao , Wang Wei , Liu Lei , Liu Xi
Published: May 2020

Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group than in the NS group. Preoperative transfusion rate was significantly lower in the TXA group than in the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.
FDG uptake of the normal spinal cord in PET/MR imaging
Authors: Aiello Marco , Alfano Vincenzo , Salvatore Elena , Cavaliere Carlo , Picardi Marco , Pepa Roberta Della , Nicolai Emanuele , Soricelli Andrea , Vella Alessandra , Salvatore Marco , Mascalchi Mario
Published: May 2020

Background: The lack of visualization of the spinal cord hinders the evaluation of18F Fluoro-deoxy-glucose (FDG) uptake of the spinal cord in PET/CT. By exploiting the capability of MRI to precisely outline the spinal cord, we performed a retrospective study aimed to define normal pattern of spinal cord FDG uptake in PET/MRI.Methods: Forty-one patients with lymphoma without clinical or MRI signs of spinal cord or bone marrow involvement underwent simultaneous PET and MRI acquisition using Siemens Biograph mMR after injection of 3.5 MBq/kg body weight of 18FDG for staging purposes. Using a custom-made software, we placed ROIs of 3 and 9 mm in diameter in spinal cord, lumbar CSF and vertebral marrow that were identified on MRI at 5 levels (C2, C5, T6, T12 and L3). The SUVmax, SUVmean and the SUVmax and SUVmean normalized (NSUVmax and NSUVmean) to the liver were measured. For comparison, the same ROIs were placed in PET-CT images obtained immediately before the PET-MRI acquisition following the same tracer injection.Results: On PET/MRI using the 3 mm ROI the following average (all level excluding L3) spinal cord median (1st and 3rd quartile) values were measured: SUVmean1.68 (1.39 and 1.83), SUVmax1.92 (1.60 and 2.14), NSUVmean1.18 (0.93 and 1.36), NSUVmax1.27 (1.01 and 1.33). Using the 9 mm ROI the corresponding values were: SUVmean1.41 (1.25-1.55), SUVmax2.41 (2.08 and2.61), NSUVmean0.93 (0.79 and 1.04), NSUVmax1.28 (1.02 and 1.39). Using the 3 mm ROI the highest values of PET-MRI SUVmax, SUVmean, NSUVmax and NSUVmean were consistently observed at C5 and the lowest at T6. Using a 9 mm ROI the highest values were consistently observed at C5 and the lowest at T12 or T6. The spinal cord FDG-uptake values correlated with bone marrow uptake at the same level, especially in case of NSUVmax. Comparison with PET-CT data revealed that the average SUVmax and SUVmean of the spinal cord were similar in PET-MRI and PET-CT. However, the average NSUVmax and NSUVmean of the spinal cord were higher (range 21% - 47%) in PET-MRI than in PET-CT.Conclusions: Using a whole-body protocol we defined the maximum and mean FDG uptake of the normal spinal cord in PET/MRI. While the observed values show the expected longitudinal distribution, they appear to be higher than those measured in PET/CT. Normalizing the SUVmax and SUVmean of the spinal cord to the liver radiotracer uptake could help in multi-institutional comparisons and studies.
Quantitative Eeg as a Biomarker in Mild Cognitive Impairment With Lewy Bodies
Authors: Schumacher Julia , Taylor John-Paul , Hamilton Calum A. , Firbank Michael , Cromarty Ruth A. , Donaghy Paul C. , Roberts Gemma , Allan Louise , Lloyd Jim , Durcan Rory , Barnett Nicola , O’Brien John T. , Thomas Alan J.
Published: May 2020

Objectives:To investigate using quantitative EEG (1) differencesbetween patients with mild cognitive impairment with Lewy bodies (MCI-LB) and MCI with Alzheimer’s disease (MCI-AD) and (2) its utilityas a potential biomarker for early differential diagnosis.Methods:We analyzed eyes-closed, resting state, high-density EEG data from highly phenotyped participants (39 MCI-LB, 36 MCI-AD, and 31 healthy controls). EEG measures included spectral power in different frequency bands (delta, theta, pre-alpha, alpha, and beta), theta/alpha ratio, dominant frequency, and dominant frequency variability.Receiver operating characteristics (ROC) analyses were performed to assess diagnostic accuracy.Results:There was a shift in power from beta and alpha frequency bands towards slower frequencies in the pre-alpha and theta range in MCI-LB compared to healthy controls. Additionally, dominant frequency was slower in MCI-LB compared to controls. We found significantly increased pre-alpha power, decreased beta power, and slower dominant frequency in MCI-LB compared to MCI-AD. EEG abnormalities were more apparent in MCI-LB cases with more diagnostic features.There were no significant differences between MCI-AD and controls. In the ROC analysis, beta power and dominant frequency showed the highest area under the curve values of 0.71 and 0.70, respectively. While specificity was high for some measures (up to 0.97 for alpha power and 0.94 for theta/alpha ratio), sensitivity was generally much lower. Conclusions:Early EEG slowing is a specific feature of MCI-LB compared to MCI-AD.However, there is overlap between the two MCI groups which makes it difficult to distinguish between them based on EEG alone.
Host Reproductive Cycle Influences the Pouch Microbiota of Wild Southern Hairy-Nosed Wombats (Lasiorhinus Latifrons)
Authors: Weiss Sesilje , Taggart David , Smith Ian , Helgen Kristopher M , Eisenhofer Raphael
Published: May 2020

Background: Marsupials are born much earlier than placental mammals, with most crawling from the birth canal to the protective marsupium (pouch) to further their development. However, little is known about the microbiology of the pouch and how it changes throughout a marsupial’s reproductive cycle. Here, using stringent controls, we characterized the microbial composition of multiple body sites from 26 wild Southern Hairy-nosed Wombats (SHNWs), including pouch samples from animals at different reproductive stages. Results: Using qPCR of the 16S rRNA gene we found higher concentrations of microbial DNA in the pouch than in negative controls. We observed significant differences in microbial composition and diversity between the body sites tested, as well as between pouch samples from different reproductive stages. Three of the five most abundant taxa identified in reproductively active pouches had closest matches to microbes previously isolated from tammar wallaby pouches. Conclusions: Our results suggest that SHNW pouches contain communities of microorganisms that are altered by the host reproductive cycle. We recommend further investigation into the roles that pouch microorganisms may play in marsupial reproductive health and joey survival.
Diversity patterns of soil microbial communities in the Sophora flavescens rhizosphere in response to continuous monocropping
Authors: Lei Haiying , Hou Qinwen , Zhao Qingsong , Guo Jia , Wang Zhijun , Liu Ake
Published: May 2020

Background : Deterioration in soil continuously cropped with Sophora flavescens (a traditional Chinese herb sensitive to continuous monocropping systems) has not been elucidated, especially regarding taxa present in the microbial community and soil properties. Results : In this study, comparative 16S rRNA and internal transcribed spacer (ITS) MiSeq sequencing analyses were used to examine the taxonomic community structure and microbial diversity in nonrhizosphere soil (CK) and rhizosphere soils (SCC, TCC, and FCC) sampled from fields that had undergone two, three and five years of continuous cropping, respectively. Acidobacteria and Proteobacteria were the most enriched phyla in the bacterial communities, and Ascomycota and Mortierellomycota were the dominant phyla of fungal communities in soil continuously cropped for different periods of time. As the continuous cropping time increased, the diversity of the bacterial community decreased, but that of fungi increased, indicating that long-term monocropping exerted great impacts on microbial community distributions. Redundancy analysis also showed that among the properties of the rhizosphere soil, the available phosphorus, organic matter, total nitrogen and sucrase had the greatest impacts on the diversity of the rhizosphere microbial community. Moreover, a biomarker for S. flavescens soil was also identified using the most differentially abundant bacteria and fungi in soil samples.Conclusions : Overall, investigating the microbial community and physicochemical properties of rhizosphere soil will help clarify the relationship between continuous cropping with S. flavescens and soil degradation. Our study may aid in uncovering the theoretical basis underlying obstacles to continuous cropping and provide better guidance for crop production.
Evolutionary Chemical Binding Similarity Approach Integrated with 3D-QSAR Method for Effective Virtual Screening
Authors: Durai Prasannavenkatesh , Ko Young-Joon , Pan Cheol-Ho , Park Keunwan
Published: May 2020

Background: Despite continued efforts using chemical similarity methods in virtual screening, currently developed approaches suffer from time-consuming multistep procedures and low success rates. We recently developed a machine learning-based chemical binding similarity model considering common structural features from molecules binding to the same, or evolutionarily related targets. The chemical binding similarity measures the resemblance of chemical compounds in terms of binding site similarity to better describe functional similarities that arise from target binding. In this study, we have shown how the chemical binding similarity could be used in virtual screening together with the conventional structure-based methods. Results: The chemical binding similarity, receptor-based pharmacophore, chemical structure similarity, and molecular docking methods were evaluated to identify an effective virtual screening procedure for desired target proteins. When we tested the chemical binding similarity method with test sets of 51 kinases, it outperformed the traditional structural similarity-based methods as well as structure-based methods, such as molecular docking and receptor-based pharmacophore modeling, in terms of finding active compounds. We further validated the results by performing virtual screening (using the chemical binding similarity and receptor-based pharmacophore methods) against a completely blind dataset for mitogen-activated protein kinase kinase 1 (MEK1), ephrin type-B receptor 4 (EPHB4) and wee1-like protein kinase (WEE1). The in vitro kinase binding assay confirmed that 6 out of 13 (46.2%) for MEK1 and 2 out of 12 (16.7%) for EPHB4 were newly identified only by the chemical binding similarity model.Conclusions: We report that the virtual screening results could further be improved by combining the chemical binding similarity model with 3D-QSAR and molecular docking models. Not only the new inhibitors are identified in this study, but also many of the identified molecules have low structural similarity scores against already reported inhibitors and that show the revelation of novel scaffolds.