bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between sedentary behaviour and indicators of stress: A systematic review
Authors: Teychenne Megan , Stephens Lena D , Costigan Sarah A , Olstad Dana Lee , Stubbs Brendon , Turner Anne I
Published: October 2019

Background: Emerging evidence shows sedentary behaviour may be associated with mental health outcomes. Yet, the strength of the evidence linking sedentary behaviour and stress is still unclear. This study aimed to synthesise evidence regarding associations between time spent in sedentary behaviour and stress in adults.
Methods: A systematic search was conducted (January 1990 – September 2019). Following PRISMA guidelines, an evaluation of methodological quality, and best-evidence synthesis of associations between time in sedentary behaviour (including sitting time, TV viewing, computer use) and stress were presented. Twenty-six studies reporting on data from n=72,795 people (age 18-98y, 62.7% women) were included.
Results: Across the studies (n=2 strong-, n=10 moderate- and n=14 weak-quality), there was insufficient evidence that overall time spent in sedentary behaviour and sitting time were associated with stress, particularly when using self-report measures of sedentary behaviour or stress. There was strong evidence of no association between TV viewing, or computer use and stress. Amongst studies using objective measures of sedentary behaviour and/or stress there was also strong evidence of no association.
Conclusion: Although previous research suggested sedentary behaviour may be linked to mental health outcomes such as depression and anxiety, the evidence for an association between various types of sedentary behaviour and stress is limited in quality, and associations are either inconsistent or null. High-quality longitudinal/interventional research is required to confirm findings and determine the direction of associations between different contexts (i.e. purpose) and domains (i.e. leisure, occupational, transport) of sedentary behaviour and stress.

Keywords: sedentary behaviour; sitting time; television viewing; stress; mental health; adults
1g versus 2g Daily Intravenous Ceftriaxone in the Treatment of Community Onset Pneumonia –a propensity score analysis of data from a Japanese multicenter registry
Authors: Hasegawa Shinya , Sada Ryuichi , Yaegashi Makito , Morimoto Konosuke , Mori Takahiro
Published: October 2019

Objectives: Community-onset pneumonia (COP) is a supplant concept of community acquired pneumonia, which includes the previous classification of healthcare-associated pneumonia. Although ceftriaxone (CRO) is one of the treatment choices for COP, it is unclear whether 1 or 2 g CRO daily has better efficacy. We compared the effectiveness of 1 g with 2 g of CRO for COP treatment. We hypothesized that 1 g CRO would show non-inferiority over 2 g CRO. Methods: This study was an analysis of prospectively registered data from four Japanese hospitals for patients with COP (the Adult Pneumonia Study Group-Japan: APSG-J). Subjects who were initially treated solely with 1 or 2 g of CRO were enrolled. The propensity score was estimated from the 33 pre-treatment variables, including age, sex, weight, pre-existing comorbidities, prescribed drugs prior to admission, risk factors for aspiration pneumonia, vital signs, laboratory data, and findings from chest xrays. The primary endpoint was the cure rate, for which a non-inferiority analysis was performed with a margin of 0.05. In addition, we performed three sensitivity analyses; using data limited to the group in which CRO solely was used until the completion of treatment, using data limited for inpatient cases, and including a generalised linear mixed-effect logistic regression analysis to assess the primary outcome after adjusting for random hospital effects. Results: Of the 3,817 adult subjects with pneumonia who were registered in the APSG-J study, 290 and 216 were initially treated solely with 1 or 2 g of CRO, respectively. Propensity score matching was used to extract 175 subjects in each group. The cure rate was 94.6% and 93.1% in the 1 and 2 g CRO groups, respectively (risk difference, 1.5%; 95% confidence interval, −3.1 to 6.0; p = 0.009 for non-inferiority). The results of the sensitivity analyses were consistent with the primary result. Conclusions: The propensity score-matched analysis of multicenter cohort data from Japan revealed that the cure rate for COP patients treated with 1 g CRO was non-inferior to that of patients treated with CRO.
The emotional labour of quality improvement work in end of life care: a qualitative study of Patient and Family Centred Care in England
Authors: Boulton Richard , Boaz Annette
Published: October 2019

BACKGROUND

There is a growing emphasis on understanding patient experience in order to inform efforts to support improvement. This paper reports findings from an implementation study of an evidence-based intervention called Patient and Family Centred Care (PFCC) designed to tap into patient experiences as a basis for improvement. In this study the PFCC intervention was spread to a new service area (end of life care) and delivered at scale in England. The findings presented here focus specifically on one key aspect of the intervention: staff shadowing of patients, and the experiences of staff carrying out shadowing for the purposes of service improvements.METHODS

The study methods were ethnographic observations of key events, semi-structured interviews with members of participating teams and the programme implementation support team and managers, and a review of the documents used in the set up and running of the programme.RESULTS

One of the key strengths of the PFCC approach is to encourage staff through shadowing to engage with patient experience of services. Many staff described the process of shadowing as a transformative experience that alerted them to immediate areas where their services could be improved. However, engaging with patient experience of end of life care services also had unintended consequences for some staff in the form of emotional labour. Furthermore, we observed difficulties encountered by staff that are not accounted for in the existing PFCC literature relating to how care service structures may unevenly distribute the amount of ‘emotional labour’ that staff members need to invest in implementing the programme.CONCLUSIONS

Connecting with patient experience is a crucial aspect of a number of quality improvement interventions that aim to help staff to engage with the lived experience of their services and reconnect their motivations for working in the health care system. However, there may be unintended consequences for health care service staff, particularly in sensitive areas of service delivery such as end of life care. The ‘emotional labour’ for staff of engaging in quality improvement work informed by patient experience should be considered in planning and supporting patient experience led quality improvement.
Functional analysis of GhCHS, GhANR and GhLAR in colored fiber formation of Gossypium hirsutum L.
Authors: Jianfang Gao , Li Shen , Jingli Yuan , Hongli Zheng , Quansheng Su , Weiguang Yang , Liqiang Zhang , Vitalis Nnaemeka Ekene , Sun Jie , Liping Ke , Sun Yuqiang
Published: October 2019

Background
The formation of natural colored fibers mainly results from the accumulation of different anthocyanidins and their derivatives in the fibers of Gossypium hirsutum L. Chalcone synthase (CHS) is the first committed enzyme of flavonoid biosynthesis, and anthocyanidins are transported into fiber cell after biosynthesis mainly by Anthocyanidin reductase (ANR) and Leucoanthocyanidin reductase (LAR) to present diverse colors with distinct stability. The biochemical and molecular mechanism of pigment formation in natural colored cotton fiber is not clear.
Results
The three key genes of GhCHS , GhANR and GhLAR were predominantly expressed in the developing fibers of colored cotton. In the GhCHSi , GhANRi and GhLARi transgenic cottons, the expression levels of GhCHS , GhANR and GhLAR significantly decreased in the developing cotton fiber, negatively correlated with the content of anthocyanidins and the color depth of cotton fiber. In colored cotton Zongxu1 (ZX1) and the GhCHSi , GhANRi and GhLARi transgenic lines of ZX1, HZ and ZH, the anthocyanidin contents of the leaves, cotton kernels, the mixture of fiber and seedcoat were all changed and positively correlated with the fiber color.
Conclusion
The three genes of GhCHS , GhANR and GhLAR were predominantly expressed early in developing colored cotton fibers and identified to be a key genes of cotton fiber color formation. The expression levels of the three genes affected the anthocyanidin contents and fiber color depth. So the three genes played a crucial part in cotton fiber color formation and has important significant to improve natural colored cotton quality and create new colored cotton germplasm resources by genetic engineering.
Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers?
Authors: Clavel Nathalie , Pomey Marie-Pascale , Ghadiri Djahanchah Philip (Sacha)
Published: October 2019

Background: Around the world, many healthcare organizations engage patients as a quality improvement strategy. In Canada, the University of Montreal has developed a model which consists in partnering with patient advisors, providers, and managers in quality improvement. This model was introduced through its Partners in Care Programs tested with several quality improvement teams in Quebec, Canada. Partnering with patients in quality improvement brings about new challenges for healthcare managers. This model is recent, and little is known about how managers contribute to implementing and sustaining it using key practices. Methods: In-depth multi-level case studies were conducted within two healthcare organizations which have implemented a Partners in Care Program in quality improvement. The longitudinal design of this research enabled us to monitor the implementation of patient partnership initiatives from 2015 to 2017. In total, 38 interviews were carried out with managers at different levels (top-level, mid-level, and front-line) involved in the implementation of Partners in Care Programs. Additionally, seven focus groups were conducted with patients and providers. Results: Our findings show that managers are engaged in four main types of practices: 1-designing the patient partnership approach so that it makes sense to the entire organization; 2-structuring patient partnership to support its implementation and sustainability; 3-managing patient advisor integration in quality improvement to avoid tokenistic involvement; 4-evaluating patient advisor integration to support continuous improvement. Designing and structuring patient partnership are based on typical management practices used to implement change initiatives in healthcare organizations, whereas managing and evaluating patient advisor integration require new daily practices from managers. Our results reveal that managers at all levels, from top to front-line, are concerned with the implementation of patient partnership in quality improvement. Conclusion: This research adds empirical support to the evidence regarding daily managerial practices used for implementing patient partnership initiatives in quality improvement and contributes to guiding healthcare organizations and managers when integrating such approaches.
Clinical and pathological features of idiopathic membranous nephropathy with focal segmental sclerosis
Authors: li jiatong , Chen Bing , Gao Caifeng , Huang Jing , Wang Yongmei , Zhang Shiyin , Xu Ying , Guo Wenkai , Wang Rong
Published: October 2019

Background Our goal was to investigate the clinical and pathological features and prognosis of idiopathic membranous nephropathy (IMN) with focal segmental lesions.
Methods In our hospital, 305 patients with nephrotic syndrome confirmed by renal biopsy as IMN were divided into a non-focal segmental lesion group (FSGS- group) and a focal segmental glomerulosclerosis (FSGS) group (FSGS+ group) and retrospectively analyzed. A total of 180 patients were followed for periods ranging from six months to two years. The general clinical and pathological data of both groups were compared, and the effects of different treatment schemes on the prognosis of both groups were observed.
Results The FSGS+ group had a longer disease course, higher blood pressure levels, and higher serum creatinine and β 2 -microglobulin levels than the FSGS- group (all P < 0.05). Pathologically, the FSGS+ group had increased glomerular sclerosis, glomerular mesangial hyperplasia, acute tubular lesion and chronic tubular lesion rates (all P< 0.05). The remission rate was lower in the FSGS+ group than in the FSGS- group (64.7% vs 82.2%) and was lower in patients treated with calmodulin inhibitors than in those treated with cyclophosphamide in the FSGS+ group (P < 0.01). Survival analysis showed that the FSGS+ group had a poor prognosis (χ 2 =4.377，P=0.036). Risk factor analysis suggested that age at renal biopsy (P=0.006), 24-hour urinary protein quantity (P=0.01), chronic tubulointerstitial lesions (P=0.055), and FSGS lesions (P= 0.062) were risk factors for worsening renal condition; 24-hour urinary protein quantity was an independent risk factor for worsening renal condition.
Conclusions Membranous nephropathy with FSGS is a risk factor, but not an independent risk factor, for IMN. Patients with membranous nephropathy with FSGS often present hypertension and tubule injury. The nonselective drug cyclophosphamide is preferred, and calcineurin inhibitors should be used with caution.
Key words Idiopathic membranous nephropathy; focal segmental sclerosis; cyclophosphamide; calmodulin inhibitor; prognosis;
Anti-PD-1 antibody decreases tumour-infiltrating regulatory T cells
Authors: Yoshida Kazushige , Okamoto Masanori , Sasaki Jun , Kuroda Chika , Ishida Haruka , Ueda Katsuya , Ideta Hirokazu , Kamanaka Takayuki , Sobajima Atsushi , Takizawa Takashi , Tanaka Manabu , Aoki Kaoru , Uemura Takeshi , Kato Hiroyuki , Haniu Hisao , Saito Naoto
Published: October 2019

Background: There are many types of therapies for cancer. In these days, immunotherapies, especially immune checkpoint inhibitors, are focused on. Though many types of immune checkpoint inhibitors are there, the difference of effect and its mechanism are unclear. Some reports suggest the response rate of anti-PD-1 antibody is superior to that of anti-PD-L1 antibody and could potentially produce different mechanisms of action. On the other hand, Treg also express PD-1; however, their relationship remains unclear. Methods: In this study, we used osteosarcoma cell lines in vitro and osteosarcoma mouse model in vivo. In vitro, we analyzed the effect of IFNγ for expression of PD-L1 on the surface of cell lines by flowcytometry. In vivo, murine osteosarcoma cell line LM8 was subcutaneously transplanted into the dorsum of mice. Mouse anti-PD-1 antibody was intraperitoneally administered. we analysed the effect for survival of anti-PD-1 antibody and proportion of T cells in the tumor by Flowcytometry. Results: We discovered that IFNγ increased PD-L1 expression on the surface of osteosarcoma cell lines. In assessing the relationship between anti-PD-1 antibody and Treg, we discovered the administration of anti-PD-1 antibody suppresses increases in tumour volume and prolongs overall survival time. In the tumor microenvironment, we found that the administration of anti-PD-1 antibody decreased Treg within the tumour and increased tumour-infiltrating lymphocytes. Conclusions: Here we clarify for the first time an additional mechanism of anti-tumour effect—as exerted by anti-PD-1 antibody decreasing Treg— we anticipate that our findings will lead to the development of new methods for cancer treatment. keywords: PD-1, Treg, osteosarcoma, anti-PD-1 antibody.
Sudden Intrauterine Unexplained Death: Time To Adopt Uniform Postmortem Investigative Guidelines?
Authors: Lavezzi Anna , Piscioli Francesco , Pusiol Teresa , Jorizzo Gianfranco , Ferrero Stefano
Published: October 2019

Background: In developed countries, one in 100–200 pregnancies ends in stillbirth, in the great part unexplained. The evenness and standardisation of the diagnostic criteria are prerequisites to understand the pathogenesis of these deaths. The core goal of this article is to propose new investigative post-mortem guidelines that should be adopted in all the Institutions especially when a fetal death, after a routine autopsy procedure, is diagnosed as “unexplained”. Methods: Updated investigative guidelines for the examination of unexplained stillbirths, prevalently focused on the histological examination of the brainstem, where the main centers that are involved in monitoring the vital functions are located, are here presented. A section of this protocol concerns the Immunohistochemical evaluation of specific functional markers such as the neuronal nuclear antigen, nicotinic acetylcholine receptors, serotonin, orexin, apoptosis and gliosis. The important role of risk factors, having regard in particular to maternal smoking and air pollution is also contemplated in these guidelines. Results: Specific morphological and/or functional alterations of vital brainstem structures have been found with high incidence in about 100 cases of unexplained fetal death sent to the “Lino Rossi Research Center” of the Milan University according to the Italian law. These alterations were rarely detected in a group of control cases. Conclusions: We hope this protocol can be adopted in all the Institutions notably for the examination of unexplained fetal deaths, in order to make uniform investigations. This will lead to identify a plausible explanation of the pathogenetic mechanism behind the unexplained fetal deaths and to design preventive strategies to decrease the incidence of these very distressing events for both parents and clinicians .
Prevalence and characteristics of COPD among residents in an urban informal settlement in Dar es Salaam, Tanzania
Authors: Magitta Ngweina Francis , Shimwela Meshack Denson , Madas Sapna Jitendra , Mwaiselage Julius David , Sanga Anna Alphonce , Apte Komalkirti Keshavkiran , Pharm Lucy Andrew Namkinga MSc , Salvi Sundeep Santoshi
Published: October 2019

Background: COPD is an important public health problem globally. To-date, indoor air pollution resulting from biomass fuel use is an important risk factor for COPD, particularly in Africa. The poor communities in informal settlements in major cities are likely to be exposed to higher pollution rates and could disproportionately develop COPD. Methods: We collected demographic data, respiratory symptoms and exposure history to air pollution using BOLD validated questionnaire and further performed spirometry using NDD EasyOneTM spirometer, with COPD diagnosed based on a post-bronchodilator FEV1/FVC <70%. The study was approved by the National Ethics committee. Results: A total of 1021 participants completed the questionnaire and had acceptable post-bronchodilator spirometry [(861 female, 66.70%)], with mean age of 52.16 ± 11.59 years. About 15.48% of respondents were smokers, of whom 6.46% were current smokers and 16.67% had significant nicotine dependency. Of all respondents, 11.71% reported living with a smoker and 5.31% reported a history of tuberculosis. The overall prevalence of COPD was estimated at 8.13% [(14.2% male, 5.14% female)], and found to be associated with age (p =0.005), gender (p=0.001), BMI (p=0.001) and smoking status (p=0.001). Over 98% of respondents reported significant exposure to biomass fuel. Over 78% of COPD patients had mild to moderate obstruction and the female had comparatively severe obstruction.Conclusion: In this population, COPD is relatively low compared to previous reports in Africa. Though multiple risk factors are responsible for COPD development, indoor pollution remains the most important factor. In this regard, access to affordable clean energy for domestic use is the most important strategy for COPD control.
Chronic Alcoholic Toxic Cerebral Encephalopathy manifested as Acute Marchiafava-Bignami Disease: a case report
Authors: Zhang Zhixiao , Liu Xiaofang , Jia Xiayan , Wang Li , Niu Jinliang , Cui Sha
Published: October 2019

Background: Marchiafava-Bignami Disease (MBD) is a alcohol-related disorder, its acute form is rather rare that is characterized by acute edema and demyelination of the corpus callosum, manifested as severe disorder of consciousness like coma, which can be accompanied by an increase in muscle tone. Case presentation: We report a 57-year-old man with a 40-year history of chronic and heavy alcohol abuse who progressively developed bilateral lower limb weakness and slurred speech for 3 days. On admission, neurological examination revealed abnormal mental status and cognitive deficits. His left nasolabial groove appeared shallow. The muscle power of the bilateral upper and lower limbs was only grade 4+ with lead-pipe rigidity of muscle. Deep tendon reflexes in the lower limbs were increased, and babinski reflexes were positive bilaterally ，and negative Hoffmann reflexes and the forced grasp reflex . He was diagnosed with erosive gastritis two years ago without any treatment. The immediate brain computed tomography(CT) showed hypodensity in the genu and splenium of the corpus callosum, which suggested an acute cerebrovascular disease, however, the laboratory tests were almost normal except for decreased serum level of folic acid (7.63mmol/L; normal range 11.8-56.2mmol/L), and MRI revealed bilateral hyperintensity on T2 , T2 FLAIR and DWI in the entire corpus callosum, with corresponding hypointensity on ADC images . Based on his medical history, physical examination, and imaging features, the definitive diagnosis of acute MBD was reasonable. But after nearly 5 months of treatment, the symptoms did not relieve significantly, which could be attributed to entire callosal lesion etc. Conclusions: MBD is mainly caused by chronic alcoholism. MRI findings, especially the DWI sequence, are critical for the early diagnosis of MBD in the acute stage, which prevent disease progression from irreversible callosal lesion.
Effect of Antiretroviral Therapy With Tenofovir, Lamivudine And Dolutegravir On Respiratory And Peripheral Muscles Strengh In People Living With Hiv/Aids
Authors: Cardoso Renata de Oliveira , Araújo Paulo Sérgio Ramos de , Maranhão Juliana Barros , Júnior Marco Aurélio de Valois Correia , Costa Eduarda Lubambo
Published: October 2019

Background Some antiretrovirals (ARVs) cause muscle toxicity and their use has been attributed to beginning of respiratory and peripheral muscle weakness in people living with HIV/AIDS (PLWHA) on treatment. Dolutegravir (DTG) has been adopted by Brazil as a first-line regimen with Tenofovir/Lamivudine (TDF/3TC) since 2017, with low toxicity profile. Due to the short use of this regimen, we have not found data in the literature regarding its effects in the respiratory and peripheral muscles in PLWHA. The aim of this study was to compare respiratory and peripheral muscle strength before and after start of this new combined ART (TDF/3TC/DTG).Methods Descriptive, longitudinal and prospective study, observational and analytical with 41 PLWHA evaluated before the initiation of antiretroviral therapy (ART) (T0) which of these, 28 were reevaluated after more than 50 days of treatment (T1).The assessments of maximum functional capacity (six-minute walk test distance), maximal inspiratory (MIP) and expiratory (MEP) pressures and handgrip strength (HGS) were performed using standardized methods. In addition, laboratory data (CD4, CD4/CD8 ratio and viral load-VL) were collected. Shapiro-Wilk test was applied for normality while Fisher's exact test and t-test or Wilcoxon test were used for comparisons of categorical and continuous variables, respectively. Pearson or Spearman correlations were used according to data normality and p-value < 0.05 were considered significant for all analyzes.Results The frequency of peripheral muscle weakness in patients evaluated at T0 was 97.6%, while 31.7% had inspiratory and / or expiratory muscle weakness. HGS was positively correlated with CD4 (p = 0.027) and negatively correlated with VL (p = 0.046). Both MIP (p = 0.0176) and HGS (p = 0.0018) showed improvement in T1.Conclusion ART combined with TDF / 3TC / DTG increased MIP and HGS after more than 50 days of treatment. Cohort studies are needed to better understand the action of these medications on PLWHA musculature under treatment.
Persistent pain of distal clavicle fractures with a large lateral angle acromion treated with a clavicle hook plate: Report on 9 cases
Authors: Wu Kailun , Xu Hao , Xu Yingjie , Yang Huilin , Guo Jiong Jiong
Published: October 2019

Background: The clavicular hook plate was a popular surgical treatment for distal clavicle fractures. The relationship among characteristics of the hook plate, acromioclavicular joint morphology and clinical outcome has remained poorly understood. We reviewed the clinical records of patients who had distal clavicle fractures with large lateral angle of acromion treated using a clavicle hook plate and evaluated the feasibility of this technique.Methods: Between 2010 and 2017, 9 patients (4 male and 5 female; mean age, 43 years) who had distal clavicle fractures with a large lateral angle of acromion were treated by clavicle hook plate at our institute. Follow-up ranged from 18 to 28 months (mean, 23 months). We examined clinical characteristics, MRI findings, treatments, and outcomes.Results: All patients complained of implant-related symptoms postoperatively. Clinical subacromial impingement was observed in all of them. Two patients had relief after removing the device. The symptoms in the remaining seven patients did not subside after removal of plate. Rotator cuff lesions were found in these cases, five of whom received rotator cuff repair and achieved remission of their symptoms.Conclusion: Distal clavicle–acromion coronal angle is an important factor for postoperative efficacy of the hook plate. The selection of a hook plate that makes the contact position between the hook and acromion more proximal may be helpful. Early limited mobility and removal of the implant may improve the prognosis and reduce the rate of impingement and rotator cuff lesions.Study Design: Restropective Review, Level of evidence, 4.
Screening And Quantification Of Anti-Quorum Sensing And Antibiofilm Activities Of Phyllosphere Bacteria Against Biofilm Forming Bacteria
Authors: THEODORA NADINE AMABEL , DOMINIKA VANIA , Waturangi Diana Elizabeth
Published: October 2019

Objective The objectives of this research were to screen anti-quorum sensing activity of phyllosphere bacteria and quantify their antibiofilm activity against biofilm forming bacteria ( Bacillus cereus, Staphylococcus aureus, Enterococcus faecalis, Salmonella typhimurium, Vibrio cholerae, Pseudomonas aeruginosa). Results We found 11 phyllosphere bacteria isolates with potential anti-quorum sensing activity. Most of the crude extracts from phyllosphere bacteria isolates had anti-quorum sensing activity against Chromobacterium violaceum at certain concentration (20 and 10 mg/mL), but not crude extract from isolate JB 7F. Crude extracts showed various antibiofilm activities against all tested pathogenic bacteria.
Comparison of Computed Tomographic Imaging-guided hook wire localization and electromagnetic navigation bronchoscope localization in the resection of pulmonary nodules
Authors: Tian Yu , Lu Ming , Yue Weiming , Si Libo , Li Lin , Li Shuhai , Tian Hui
Published: October 2019

Background: The resection of nodules by thoracoscopic surgery is difficult because the nodules may be hard to identify. Currently, preoperative localization of pulmonary nodules is widely used in the clinic, including Computed Tomographic Imaging (CT)-guided transthoracic approach, hook-wire and coil embolization, but these methods increase radiation exposure and cause complications. Methods: In this study, we retrospectively compared electromagnetic navigation bronchoscopy (ENB) guided and CT guided localization of small pulmonary nodules before resection. Results: Total 157 patients underwent the localization procedure successfully, and the nodules were localized by CT guidance in 105 patients and by ENB in 52 patients. The nodule size of magnetic navigation localization was smaller than that of CT-guided localization (P<0.001). Both CT-guided and ENB localization were well tolerated in all patients, without major complications or mortality (P=0.107). In CT-guided localization group, 6 patients failed to be located while none failed in ENB group (P=0.079). The procedure time was 15.15± 3.7 min for CT-guided localization and 21.29± 4.0 min for ENB localization (P<0.001). Conclusions: CT-guided localization is simple and feasible for uncertain pulmonary nodules before surgery. ENB localization could identify small lung nodules with high accuracy and low incidence of complications.
Single-cell RNA sequencing identifies the specific cell types of GWAS genes associated with liver disease
Authors: Yu Zhenyuan , Lu Ansi , Cheng Jiwen , Mo Zengnan
Published: October 2019

Background The liver is an important digestive organ in the human body, which has a variety of physiological functions. Once the liver occurs dysfunction, it may indicate the occurrence of liver disease. Genome-wide association studies (GWAS) have identified a lot of genetic variants which are associated with liver disease. However, it is not clear that the genes with variants in which have cell type specificity. Methods To investigate the association between liver cell types and liver disease, we used a new method that integrate the genes associated with liver diseases identified by GWAS and single-cell RNA sequencing (scRNA-seq) data for analysis. We applied the scRNA-seq data from the GEO database, which included 20 cell types from human liver and 9 cell types from mouse liver after reclassifying. The susceptibility genes of liver diseases were downloaded from GWAS catalog and matched to the results of liver scRNA-seq. Results We found that most susceptibility genes of chronic hepatitis B virus (HBV) infection were expressed in human B cells. And the susceptibility genes of biomarkers of liver dysfunction showed similar cell type specificity in human and mouse. Last, we discovered that primary liver disease phenotypes may be due to mutations in multiple cell types. Conclusions Collectively, this study localized the susceptibility genes of liver diseases to specific cell types and provided clues for the in-depth study of liver diseases at the transcriptome level.
Active management of third stage of labor practice and associated factors among skilled birth attendants in Gamo and Gofa zone, Southern, Ethiopia
Authors: alemu biresaw wassihun , Bante Agegnehu , Miskir Direslign , Gultie Teklemariam , Gebayehu Kassahun
Published: October 2019

Background Active management of third stage of labour is evidence based inexpensive and effective intervention for the prevention of postpartum hemorrhage which is the leading cause of maternal mortality in low and middle income countries. In spite of this technique being espoused in Ethiopia and internationally, its actual practice and factors influencing its practice were yet to be established.Objective The aim of this study was to assess status of active management of third stage of labor practice and associated factors among skilled birth Attendants in public health facilities of Gamo and Gofa zone, southern EthiopiaMethods Facility based cross-sectional study design was employed on 356 skilled birth attendants working in public health facilities of Gamo and Gofa zone. Semi- structured questionnaire with observational checklist was used to collect the data. Data was checked and entered into Epi info version 7 then exported to statically package for social science version 24 for analysis. Univariate, Bivariate and multivariable analysis with 95% CI was carried out.Result The finding of the study revealed that 48.1% of the skilled care providers were good practice towards active management of third stage of labour with 95% CI (43-53). Skilled birth attendants having clinical experience of 7 years and above were 2.52 times more likely performed good practice than others [AOR=7.00(95%CI, 1.82,7.75)] and those skilled birth attendants taken in service training were 2.55 times more likely performed good practice than others [AOR=2.55(95%CI, 1.99,6.56)]. In addition to this those skilled birth attendants who were working in favorable delivery rooms were 1.86 times more likely performed good practice than others [AOR= 1.86(95%CI, 1.32-2.24)]Conclusion The finding of this study showed that the practice of active management of third stage of labour was poor. Clinical year of experience, having conducive delivery room and taking in –service training on active of third management of labour were some of the factors associated with good practice. So crating satisfactory delivery room and providing training on active of third management of labour is very important to enhance their knowledge and skill of birth attendant.
Prevalence and determinants of modern contraceptive utilization among rural lactating mothers: Findings from the primary health care Project in two northwest Ethiopian Districts
Authors: Derso Terefe , Biks Gashaw Andargie , Yitayal Mezgebu , Ayele Tadesse Awoke , Alemu Kassahun , Debalkie Getu , Fekadu Hailab , Dellie Endalkachew , Azale Telake , Misganaw Bisrat , Kebede Adane , Fetene Destaw , G/medhin Tsegaye , Atnafu Asmamaw
Published: October 2019

Background Contraceptives utilization is a guarantee to avert unwanted pregnancy. However, in Ethiopia more than half of the rural women have shorter birth intervals. Also of all births in their pregnancies, 17% and 8% were mistimed (wanted at a later date) and unwanted births, respectively. Therefore, this paper investigates modern contraceptive utilization and predictors among rural lactating women.Methods community cross-sectional study was conducted from May 01 to June 29, 2019 in two (Dabat and Gondar zuria district) northwest Ethiopian Districts. A total of 603 lactating mothers were included in this study. Data was collected through face to face interview using a structured questionnaire. Bivariate and multivariate logistic regression analyses were done to identify the independent predictors of modern contraceptive utilization.Results The overall prevalence of modern contraceptive (MC) utilization rate was 45.8% [95% CI: 38.01, 53.59]. The contraceptive method mix was dominated by Depo-Provera (39.8%) and followed by implants (4.8%). The odds of modern utilization of contraceptive were 5.58 times higher among with children with fully immunization [AOR=5.58, 95% CI: 3.45, 9.01] compared to mothers with children with incomplete or not vaccinated. Mothers who received antenatal care [AOR= 1.743, 95% CI: 1.13, 4.43] and postnatal care[AOR=2.02, 95%CI: 1.24, 2.91) were 1.74 and 2.02 folds more likely utilize modern contraceptive than mothers who did not received antenatal care and postnatal care, respectively.Conclusion in the study area, low prevalence of modern contraceptive utilization is documented compared to the planed national figure. In the region child immunization services is one of a promising platform to reach lactating mothers with modern contraceptive utilization. Also our findings suggest antenatal care and postnatal care visit are the other key determinants for modern contraceptive utilization. According to our findings in a low-resource setting like Ethiopia, the health system approach to improved ANC, postnatal care and child immunization services should be intensified with more effective advice on modern contraceptive utilization to reduce unwanted pregnancy.
Drainage or nondrainage for single-level anterior cervical discectomy with fusion and plating
Authors: Li Pengfei , Chou Dean , Wang Yuqiang , Wang Limin , Zhang Ganggang , Zhang Shuhao , Zhao Yao , Ruan Tianchen , Xiong Yingjie , Shi Landa , Liu Yilin
Published: October 2019

Background Currently, conventional placement of natural pressure drainage after single-level anterior cervical discectomy with fusion and plating (ACDF) is used clinically to prevent complications such as symptomatic epidural hematoma and incision infection. Nevertheless, a literature review reported that there is no uniform standard for whether to place drainage after single-level ACDF surgery, and comparative studies on this subject are rare.Methods A prospective study of 100 patients who underwent single-level ACDF from January 2017 to June 2018 and met the selection criteria were randomly divided into the control group (45 patients with drainage after surgery) and the study group (48 patients without drainage after surgery). The same types of preoperative preparation, surgical technique and postoperative management were used in the two groups. The perioperative indicators, postoperative clinical efficacy and complications were compared between the two groups.Results The preoperative and postoperative Japanese Orthopaedic Association (JOA) scores, Visual Analogue Scale (VAS) scores and Neck Dysfunction Index (NDI) scores in the two groups were significantly different (P < 0.05). The length of hospital stay in the study group was significantly shorter than that in the control group (P < 0.05). There were no significant differences in postoperative fever, surgical site infection, symptomatic epidural hematoma, rate of incision healing, or complications between the two groups (P>0.05).Conclusions The safety and clinical outcome of patients with drainage after single-level ACDF were consistent with those of nondrainage patients. Additionally, nondrainage after single-level ACDF resulted in a decreased length of hospital stay and lessened the associated expenses.
KNOWLEDGE OF GLAUCOMA AND ASSOCIATED FACTORS AMONG ADULTS IN GISH ABAY TOWN, NORTHWEST ETHIOPIA, JUN 2018
Authors: Bizuneh Zewdu Yenegeta , Tsega Ayanaw , Addis Yezinash , Admassu Fisseha
Published: October 2019

Introduction Glaucoma is a global public health problem and it is the leading cause of irreversible blindness worldwide and the fifth cause of blindness in Ethiopia. Even though public knowledge of glaucoma is a key for early case identification and prevention of blindness, it is unknown in the study area, making provision of interventions difficult. Objective: To assess knowledge of glaucoma and associated factors among adults in Gish Abay town, Northwest Ethiopia, 2018 Methods: A Community based cross - sectional study design with systematic random sampling technique was used to select 630 adults. The study was conducted from April 25-May 05, 2018. Data was entered into Epi Info version 7 and was analysed by Statistical Package for Social Sciences version 23. Binary logistic regression model and adjusted odds ratio with 95% confidence level was used to identify the significant factors associated with knowledge of glaucoma. P–value ≤ 0.05 was considered statistically significant. Results: About 594 adults were participated with a response rate of 94%. Nearly 52% of the participants were females with median age of 28 years. The proportion of good knowledge was demonstrated in 68.9% [95% CI; 61, 75.9]. Educational status: secondary education [AOR; 4.01: 1.15, 13.94], college and above [AOR; 4.49: 1.31, 15.32], history of eye examination [AOR; 2.86: 1.05, 7.79] and younger age (18-22) [6.39: 1.82, 22.41] were positively associated with good knowledge of glaucoma. Conclusion and recommendation: The proportion of good knowledge of glaucoma was high. Better educational status, younger age, eye examination at least once in life and higher income level were associated with better knowledge of glaucoma. Recognizing the severity of glaucoma, enhancing knowledge is paramount at the community.
Malapposition of Graft-host Interface after Penetrating Keratoplasty (PK) and Deep Anterior lamellar Keratoplasty (DALK): an optical coherence tomography study
Authors: Zhao Yujin , Zhuang Hong , Hong Jiaxu , Tian Lijia , Xu Jianjiang
Published: October 2019

Backgroud: Previous studies of internal graft-host malappositions have not dealt with the precise ways in which each malapposition affected post-penetrating keratoplasty (post-PK) visual outcomes. In this study, we reviewed our post-PK and post-deep anterior lamellar keratoplasty (post-DALK) keratoconic patients and used anterior segment optical coherence tomography (AS-OCT) to evaluate the correlations between graft-host interface (GHI) characteristics and visual outcomes.
Methods: Novel GHI metrics included: mean graft-host touch (GHT), total prevalence of malapposition proportion (Pm), frequency of apposition (F), size of malapposition (Sm), junctional graft thickness (Tg), and the absolute value of difference between Tg and Th (|Tg-Th|). We connected the external and internal junction points of GHI (GHT) and drew a straight line through the central point, perpendicular to both sides of the cornea. Tg and Th were the thicknesses at cross-points 1 mm away from the meeting point on the external side of the graft and host, respectively. Correlations between GHI metrics and postsurgical visual outcomes [ logarithm of minimum angle of resolution best-corrected visual acuity (logMAR BCVA), spherical equivalent diopter (SE), diopter of spherical power (DS), diopter of cylindrical power (DC) and keratometric astigmatism (Astig value)] were evaluated for 45 patients (one eye each).
Results: 22 post-PK and 23 post-DALK keratoconic patients were enrolled. Compared with the regular-apposition results, GHT was decreased in step and gape patterns, and increased in hill and tag patterns. SE increased by 6.851, 5.428 and 5.164 times for every 1% increase in: F (step) [b=6.851; 95% Confidence interval (CI)=2.975-10.727; P=0.001]; F (graft step) [b=5.428; 95% CI=1.685-9.171; P=0.005]; and Pm [b=5.164; 95%CI=0.913-9.146; P=0.018], respectively. SE increased by 0.031 times for every 1-μm increment of |Tg-Th| [b=0.031; 95% CI=0.009-0.054; P=0.007]. LogMAR BCVA increased by 0.001 times for every 1-μm increment of both GHT [b=0.001; 95% CI=0-0.002; P=0.030]. and Tg [b=0.001; 95% CI=0.001-0.002; P=0.001]. Astig value increased by 0.017 times for 1-μm increment of Sm [b=0.017; 95% CI=0-0.033; P=0.047].
Conclusion: This investigation of GHI characteristics suggests explanations for varied ametropia in keratoconic eyes and has potential significance as a reference for promoting pre-surgical planning and technology for corneal transplantation.
Low-Dose CT Image Denoising using Image Decomposition and Sparse Representation
Authors: Trung Nguyen Thanh , Hoan Trinh Dinh , Trung Nguyen Linh , Luong Marie
Published: October 2019

X-ray computed tomography (CT) is now a widely used imaging modality for numerous medical purposes. The risk of high X-ray radiation may induce genetic, cancerous and other diseases, demanding the development of new image processing methods that are able to enhance the quality of low-dose CT images. However, lowering the radiation dose increases the noise in acquired images and hence affects important diagnostic information. This paper contributes an efficient denoising method for low-dose CT images. A noisy image is decomposed into three component images of low, medium and high frequency bands; noise is mainly presented in the medium and high component images. Then, by exploiting the fact that a small image patch of the noisy image can be approximated by a linear combination of several elements in a given dictionary of noise-free image patches generated from noise-free images taken at nearly the same position with the noisy image, noise in these medium and high component images are effectively eliminated.Specifically, we give new solutions for image decomposition to easily control the filter parameters, for dictionary construction to improve the effectiveness and reduce the running-time. Instead of using a large dataset of patches, only a structured small part of patches extracted from the raw data is used to form a dictionary, to be used in sparse coding. In addition, we illustrate the effectiveness of the proposed method in preserving image details which are subtle but clinically important. Experimental results conducted on both synthetic and real noise data demonstrate that the proposed method is competitive with the state-of-the-art methods.
Exploring climate change impacts during first half of the 21st century on flow regime of the transboundary Kabul River in the Hindukush region
Authors: Hashmi Muhammad Zia ur Rahman , Masood Amjad , Mushtaq Haris , Bukhari Syed Ahsan Ali , Ahmad Burhan , Tahir Adnan Ahmad
Published: October 2019

In transboundary river basins, climate change is being considered as a concern of higher degree than it is in other parts of the world. The Kabul River Basin, a sub-basin of the Indus River system shared by Pakistan and Afghanistan, is no exception. High level of sensitivity of its flow to temperature makes it imperative to analyse climate change impacts on the flow regime of this important river for efficient water resources management on both sides of the border. The snowmelt runoff model integrated with remote sensing snow cover product MODIS was selected to simulate daily discharges. Future projections were generated for two selected time slices, 2011–2030 (near future) and 2031–2050 (far future), based on output of an ensemble of four GCMs' RCP 4.5 and RCP 8.5 scenarios. Analysis shows a significant temperature increase under both scenarios in the near and far future at a high-altitude region of the basin which mostly receives snowfall that is also found increasing over time. Consequently, it causes a change in the flow regime and more frequent and heavier flooding events, thus calling for a joint strategy of the two riparian countries to mitigate the anticipated impacts in the basin for safety of people and overall prosperity.
Stem Cell Transplant for Advanced Stage Liver Disorders: Current Scenario and Future Prospects
Authors: Mahmood Anjum , Seetharaman Rajasekar , Kshatriya Prashant , Patel Divyang , Srivastava Anand S.
Published: October 2019

Background:

Chronic Liver Disorders (CLD), caused by the lifestyle patterns like alcoholism
or by non-alcoholic fatty liver disease or because of virus-mediated hepatitis, affect a large population
fraction across the world. CLD progresses into end-stage diseases with a high mortality rate. Liver
transplant is the only approved treatment available for such end-stage disease patients. However, the
number of liver transplants is limited due to the limited availability of suitable donors and the extremely
high cost of performing the procedure. Under such circumstances, Stem Cell (SC) mediated
liver regeneration has emerged as a potential therapeutic alternative approach.

Objective:

This review aims to critically analyze the current status and future prospects of stem cellbased
interventions for end-stage liver diseases. The clinical studies undertaken, the mechanism underlying
therapeutic effects and future directions have been examined.

Method:

The clinical trial databases were searched at https://clinicaltrials.gov.in and
http://www.isrctn.com to identify randomized, non-randomized and controlled studies undertaken with
keywords such as “liver disorder and Mesenchymal Stem Cells (MSCs)”, “liver cirrhosis and MSCs”
and “liver disorder and SCs”. Furthermore, https://www.ncbi.nlm.nih.gov/pubmed/ database was also
explored with similar keywords for finding the available reports and their critical analyses.

Results:

The search results yielded a significant number of studies that used bone marrow-derived stem
cells, MSCs and hepatocytes. The studies clearly indicated that SCs play a key role in the hepatoprotection
process by some mechanisms involving anti-inflammation, auto-immune-suppression, angiogenesis
and anti-apoptosis. Further, studies indicated that SCs derived paracrine factors promote angiogenesis,
reduce inflammation and inhibit hepatocyte apoptosis.

Conclusion:

The SC-based interventions provide a significant improvement in patients with CLD;
however, there is a need for randomized, controlled studies with the analysis of a long-term follow-up.