bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era
Authors: Shiraishi Takuya , Nishizawa Yuji , Ikeda Koji , Tsukada Yuichiro , Sasaki Takeshi , Ito Masaaki 
Published: May 2020

Abstract
Background: Laparoscopic approach is now a widespread technique used worldwide, but there are few recent studies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of parastomal hernia in laparoscopic and open surgery in which a loop stoma was created and was intended to be temporary, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia and other stoma-related complications were also analyzed. Methods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive patients who underwent a temporary diverting loop ileostomy or colostomy after surgery related to malignant diseases at our hospital from January to December 2016. Results: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination and 38 (24.8%) detected by CT alone. On multivariate analysis, a stoma not passing through the middle of the rectus abdominis muscle was the only independent risk factor for parastomal hernia formation (p=0.005) during the median follow-up of 245.0 days. When we analyzed the factors that were associated with a stoma not passing through the middle of the rectus abdominis muscle, the only independent factor associated with this misplacement of the stoma was a laparoscopic approach (p=0.012). An analysis of stoma-related complications showed that peristomal skin disorders were significantly associated with parastomal hernia (p=0.049). Conclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis muscle is a risk factor for parastomal hernia formation, and that a laparoscopic approach is associated with this risk factor. Moreover, a parastomal hernia is significantly associated with peristomal skin disorders.
Characterising urban green space density and footpath-accessibility in models of BMI
Authors: Carthy Philip , Lyons Sean , Nolan Anne 
Published: May 2020

AbstractBackground: While exposure to urban green spaces has been associated with various physical health benefits, the evidence linking these spaces to lower BMI, particularly among older people, is mixed. We ask whether footpath availability, generally unobserved in the existing literature, may mediate exposure to urban green space and help explain this volatility in results. The aim of this study is to add to the literature on the association between urban green space and BMI by considering alternative measures of urban green space that incorporate measures of footpath availability. Methods: We conduct a cross-sectional study combining data from The Irish Longitudinal Study on Ageing and detailed land use information. We proxy respondents’ exposure to urban green spaces at their residential addresses using street-side and area buffers that take account of the presence of footpaths. Generalised linear models are used to test the association between exposure to several measures of urban green space and BMI. Results: Relative to the third quintile, exposure to the lowest quintile of urban green space, as measured within a 1600m footpath-accessible network buffer, is associated with slightly higher BMI (marginal effect: 0.80; 95% CI: 0.16-1.44). The results, however, are not robust to small changes in how green space is measured and no statistically significant association between urban green spaces and BMI is found under other variants of our regression model. Conclusion: The relationship between urban green spaces and BMI among older adults is highly sensitive to the characterisation of local green space. Our results suggest that there are some unobserved factors other than footpath availability that mediate the relationship between urban green spaces and weight status.
Role of Sex Hormones and Their Receptors on Gastric Nrf2 and Neuronal Nitric Oxide Synthase Function in an Experimental Hyperglycemia Model
Authors: Sprouse Jeremy , Sampath Chethan , GANGULA PANDU 
Published: May 2020

Abstract
Background: Gastroparesis, a condition of abnormal gastric emptying, is most commonly observed in diabetic women. To date, the role of ovarian hormones and/or gastric hormone receptors on regulating nitrergic-mediated gastric motility remains inconclusive. Aim: The purpose of this study is to investigate whether sex hormones/their receptors can attenuate altered Nuclear factor (erythroid-derived 2)-like 2 (Nrf2), neuronal Nitric Oxide Synthase (nNOS) expression and nitrergic relaxation in gastric neuromuscular tissues exposed to in-vitro hyperglycemia (HG). Methods: Gastric neuromuscular sections from adult female C57BL/6J mice were incubated in normoglycemic (NG, 5mM) or hyperglycemic (30 mM or 50 mM) conditions in the presence or absence of selective estrogen receptor (ER) agonists (ERα /PPT or ERβ: DPN); or non-selective sex hormone receptor antagonists (ER/ICI 182,780, or progesterone receptor (PR)/ RU486) for 48 hours. mRNA, protein expression and nitrergic relaxation of circular gastric neuromuscular strips were assessed. Results: Our findings in HG, compared to NG, demonstrate a significant reduction in ER, Nrf2, and nNOS expression in gastric specimens. In addition, in-vitro treatment with sex hormones and/or their agonists significantly (*p<0.05) restored Nrf2/nNOSα expression and total nitrite production. Conversely, ER, but not PR, antagonist significantly reduced Nrf2/nNOSα expression and nitrergic relaxation. Conclusions: Our data suggest that ER’s can regulate nitrergic function by improving Nrf2/nNOS expression in experimental hyperglycemia.
Macronutrients, immunoglobulin A and total antioxidant capacity of human milk during prolonged lactation
Authors: ongprasert krongporn , Ruangsuriya Jetsada , Malasao Rungnapa , Sapbamrer Ratana , Suppansan Pikul , Ayood Pisittawoot , Kittisakmontri Kulnipa , Siviroj Penprapa 
Published: May 2020

Abstract
Background: A longer duration of breastfeeding of up to two years is encouraged by many health authorities, but there is limited information regarding the composition of the milk after one year postpartum. The aim of the study was to determine the longitudinal changes in human milk macronutrients, immunoglobulin A (IgA) and total antioxidant capacity (TAC) during prolonged lactation.Methods: One hundred eighty-four breastfeeding mothers with full-term healthy children who had been lactating from 1 to 24 months were recruited from January 2019 to April 2019. Human milk was biochemically analyzed for protein and carbohydrate content by colorimetric assays. The fat content was determined by capillary centrifugation, and the energy content was calculated from the results of centrifugation. IgA levels and TAC were determined by ELISA and a Trolox equivalent antioxidant capacity (TEAC) assay, respectively. Pearson Correlation Coefficient and Spearman’s Rank Correlation Coefficient were used to determine the association of milk composition with month of lactation.Results: The concentrations of fat, energy and IgA were positively correlated with the duration of lactation (r = 0.229, p < 0.01; r = 0.229, p < 0.01 and r = 0.304, p < 0.01, respectively). No significant correlations of protein, carbohydrate concentrations and TAC with the duration of lactation was observed (r = 0.106, p = 0.15; r = -0.032, p = 0.67; r = -0.056, p = 0.45, respectively).Conclusions: We demonstrated that fat, energy and IgA contents increased during prolonged lactation lasting up to two years postpartum, while protein and carbohydrate concentration and TAC were not related to lactation duration. Based on the results, lactating mothers should be encouraged to continue breastfeeding for at least two years postpartum.
Low program access despite high burden of sexual, structural, and reproductive health vulnerabilities among young women who sell sex in Mombasa, Kenya
Authors: Roberts Elizabeth , Ma Huiting , Bhattacharjee Parinita , Musyoki Helgar K , Gichangi Peter , Avery Lisa , Musimbi Janet , Tsang Jenkin , Kaosa Shem , Kioko Japheth , Becker Marissa L , Mishra Sharmistha 
Published: May 2020

Abstract
Background: Across Sub-Saharan Africa, young women who sell sex (YSW) face institutional barriers in accessing sexual health and HIV prevention programs designed for female sex workers. In 2018, Kenya developed a national framework to guide service provision for YSW aged 14 – 24 years. To help inform the implementation of the framework, we estimated the burden of vulnerabilities related to the Sustainable Development Goals (SDGs related to health and gender equality) and program contact among YSW. Methods: We used data from Transitions, a 2015 bio-behavioural cross-sectional survey of 408 YSW aged 14 – 24 years in Mombasa, Kenya. We estimated the prevalence of sexual (inconsistent condom use), structural (financial, violence), and reproductive health vulnerabilities; and characterized engagement with local HIV programs tailored to sex workers. We then compared the prevalence of vulnerabilities by age group (14 – 18 years, N=117; 19 – 24 years, N=291) and by program contact (ever contacted by local program for sex workers). Results: 47.3% reported inconsistent condom use with any partner in the previous week (no difference by age-group, p=1.00) . Structural vulnerabilities were common and did not vary by age: 83.6% did not have a regular source of income; 29.9% and 29.2% had experienced physical and sexual violence, respectively. 26.5% reported at least one pregnancy before age 18, and 18.5% used a non-reliable form of contraception with little variability by age. 25.7% were aware of at least one program, and only 13.7% of YSW had ever been contacted by a program (8.5% of those aged 14 – 18 years; and 15.8% of those aged 19 – 24 years, p=0.06). Sexual, structural, and reproductive health vulnerabilities did not vary by program contact. Conclusions: SDG-related vulnerabilities begin early in the lives of YSW who are not currently reached by programs designed for female sex workers.
Scaling up Malaria Elimination Management and Leadership: A pilot in three provinces in Zimbabwe, 2016 -2018
Authors: Chung Amanda Marr , Case Peter , Gosling Jonathan , Gosling Roland , Madinga Munashe , Chikodzore Rudo , Hove Macdonald , Viljoen Greyling , Chitapi Precious , Gumbi Matsiliso , Mnguni Peliwe , Murungu Joseph , Dube Busisani , Dhliwayo Patience , Mberikunashe Joseph 
Published: May 2020

Abstract
Background Focus for improved malaria programme performance is often placed on the technical challenges, while operational issues are neglected. Many of the operational challenges that inhibit malaria programme effectiveness can be addressed by improving communication and coordination, increasing accountability, maintaining motivation, providing adequate training and supervision, and removing bureaucratic silos. Methods A programme of work was piloted in Zimbabwe with one malaria eliminating province, Matabeleland South in 2016-2017, and scaled up to include two other provinces, Matabeleland North and Midlands, in 2017-2018. The intervention included participatory, organization development and quality improvement methods. Results Workshop participants in Matabeleland South reported an improvement in data management. In Matabeleland North, motivation among nurses improved as they gained confidence in case management from training, and overall staff morale improved. There was also an improvement in data quality and data sharing. In Midlands, the poorly performing district was motivated to improve, and both participating districts became more goal-oriented. They also became more focused on monitoring their data regularly. Participants from all provinces reported having gained skills in listening, communicating, facilitating discussions, and making presentations. Participation in the intervention changed the mindset of malaria programme staff, increasing ownership and accountability, and empowering them to identify and solve problems, make decisions, and act within their sphere of influence, elevating challenges when appropriate. Conclusions This pilot demonstrates that a participatory, organization development and quality improvement approach has broad ranging effects, including improving local delivery of interventions, tailoring strategies to target specific populations, finding efficiencies in the system that could not be found using the traditional top-down approach, and improving motivation and communication between different cadres of health workers. Scale-up of this simple model can be achieved and benefits sustained over time if the process is imbedded into the programme with the training of health staff who can serve as management improvement coaches. Methods to improve operational performance that are scalable at the district level are urgently needed: this approach is a possible tactic that can significantly contribute to the achievement of global malaria eradication goals.
Isolation of axenic cyanobacterium and the promoting effect of associated bacterium on axenic cyanobacterium
Authors: Gao Suqin , Kong Yun , Yu Jing , Miao Lihong , Ji Lipeng , Song Lirong , Zeng Chi 
Published: May 2020

Abstract
Background: Harmful algal blooms have attracted wide attention all over the world as they cause water quality deterioration and ecosystem health issues. Microcystis aeruginosa associated with a large number of bacteria is one of the most common and widespread bloom-forming cyanobacteria that secret toxins. These associated bacteria are considered to benefit from organic substrates released by the cyanobacterium. In order to avoid the influence of associated bacteria on the target cyanobacteria for physiological and molecular studies, it is urgent to obtain an axenic M. aeruginosa culture and further investigate the speciﬁc interaction between the cyanobacterium-associated bacterium and the cyanobacterium.Results: A traditional and reliable method based on solid-liquid alternate cultivation is carried out to purify the xenic cyanobacterium M. aeruginosa FACHB-905. On the basis of 16S rDNA gene sequences, two associated bacteria named strain B905-1 and strain B905-2, are identified as Pannonibacter sp. and Chryseobacterium sp. with a 99% and 97% similarity value, respectively. The axenic M. aeruginosa FACHB-905A is not able to form colonies on BG11 agar medium without the addition of strain B905-1, while it grows well in BG11 liquid medium. Although the presence of B905-1 is not indispensable for the growth of M. aeruginosa FACHB-905A, B905-1 has a positive effect on promoting the growth of M. aeruginosa FACHB-905A. Conclusions: The associated bacteria are eliminated by solid-liquid alternate cultivation method and the axenic M. aeruginosa FACHB-905A is successfully purified. The associated bacterium B905-1 has the potential to promote the growth of M. aeruginosa FACHB-905A. Moreover, the purification technique for cyanobacteria described in this study is potentially applicable to a wider range of unicellular cyanobacteria.
Implementing a Combined Infection Prevention and Control with Antimicrobial Stewardship Joint Program to Prevent Caesarean Section Surgical Site Infections and Antimicrobial Resistance: a Tanzanian Tertiary Hospital Experience
Authors: Gentilotti Elisa , De Nardo Pasquale , Nguhuni Boniface , Piscini Alessandro , Damian Caroline , Vairo Francesco , Chaula Zainab , Mencarini Paola , Torokaa Peter , Zumla Alimuddin , Nicastri Emanuele , Ippolito Giuseppe 
Published: May 2020

Abstract
Background. Surgical site infections are a leading cause of morbidity and mortality after caesarean section, especially in Low and Middle Income Countries. We hypothesized that a combined infection prevention and control with antimicrobial stewardship joint program would decrease the rate of post- caesarean section surgical site infections at the Obstetrics & Gynaecology Department of a Tanzanian tertiary hospital. Methods. The intervention included: 1. formal and on-job trainings on infection prevention and control; 2. evidence-based education on antimicrobial resistance and good antimicrobial prescribing practice. A second survey was performed to determine the impact of the intervention. The primary outcome of the study was post-caesarean section surgical site infections prevalence and secondary outcome the determinant factors of surgical site infections before/after the intervention and overall. The microbiological characteristics and patterns of antimicrobial resistance were ascertained.Results. Total 464 and 573 women were surveyed before and after the intervention, respectively. After the intervention, the antibiotic prophylaxis was administered to a significantly higher number of patients (98% vs 2%, p<0.001), caesarean sections were performed by more qualified operators (40% vs 28%, p=0.001), with higher rates of Pfannenstiel skin incisions (29% vs 18%, p<0.001) and of absorbable continuous intradermic sutures (30% vs 19%, p<0.001). The total number of post-caesarean section surgical site infections was 225 (48%) in the pre-intervention and 95 (17%) in the post intervention group (p<0.001). A low prevalence of gram-positive isolates and of methicillin-resistant Staphylococus aureus was detected in the post-intervention survey. Conclusions. Further researches are needed to better understand the potential of a hospital-based multidisciplinary approach to surgical site infections and antimicrobial resistance prevention in resource-constrained settings.
Gene network in pulmonary tuberculosis based on bioinformatic analysis
Authors: Li Lili , Lv Jian , He Yuan , Wang Zhihua 
Published: May 2020

Abstract
Background: Pulmonary tuberculosis (PTB) is one of the serious infectious diseases worldwide; however, the gene network involved in the host response remain largely unclear. Methods: This study integrated two cohorts profile datasets GSE34608 and GSE83456 to elucidate the potential gene network and signaling pathways in PTB. Differentially expressed genes (DEGs) were obtained for Gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis using Metascape database. Protein-Protein Interaction (PPI) network of DEGs was constructed by the online database the Search Tool for the Retrieval of Interacting Genes (STRING). Modules were identified by the plug-in APP Molecular Complex Detection (MCODE) in Cytoscape. GO and KEGG pathway of Module 1 were further analyzed by STRING. Hub genes were selected for further expression validation in dataset GSE19439. The gene expression level was also investigated in the dataset GSE31348 to display the change pattern during the PTB treatment. Results: Totally, 180 shared DEGs were identified from two datasets. Gene function and KEGG pathway enrichment revealed that DEGs mainly enriched in defense response to other organism, response to bacterium, myeloid leukocyte activation, cytokine production, etc. Seven modules were clustered based on PPI network. Module 1 contained 35 genes related to cytokine associated functions, among which 14 genes, including chemokine receptors, interferon-induced proteins and Toll-like receptors, were identified as hub genes. Expression levels of the hub genes were validated with a third dataset GSE19439. The signature of this core gene network showed significant response to Mycobacterium tuberculosis (Mtb) infection, and correlated with the gene network pattern during anti-PTB therapy. Conclusions: Our study unveils the coordination of causal genes during PTB infection, and provides a promising gene panel for PTB diagnosis. As major regulators of the host immune response to Mtb infection, the 14 hub genes are also potential molecular targets for developing PTB drugs.
Engineering Pichia pastoris with surface-display minicellulosomes for carboxymethyl cellulose hydrolysis and ethanol production
Authors: Dong Ce , Qiao Jie , Wang Xinping , Sun Wenli , Chen Lixia , Li Shuntang , Wu Ke , Ma Lixin , liu yi 
Published: May 2020

Abstract
Backgrounds: Engineering yeast as a consolidated bioprocessing (CBP) microorganism by surface assembly of cellulosomes has been aggressively utilized for cellulosic ethanol production. However, most of the previous studies focused on Saccharomyces cerevisiae, achieving efficient conversion of phosphoric acid-swollen cellulose (PASC) or microcrystalline cellulose (Avicel) but not carboxymethyl cellulose (CMC) to ethanol, with an average titer below 2 g/L. Results: Harnessing an ultra-high-affinity IM7/CL7 protein pair, here we describe a method to engineer Pichia pastoris with minicellulosomes by in vitro assembly of three recombinant cellulases including an endoglucanase (EG), an exoglucanase (CBH) and a β-glucosidase (BGL), as well as a carbohydrate binding module (CBM) on the cell surface. For the first time, the engineered yeasts enable efficient and direct conversion of CMC to bioethanol, observing an impressive ethanol titer of 5.1 g/L. Conclusions: The research promotes the application of P. pastoris as a CBP cell factory in cellulosic ethanol production and provides a promising platform for screening the cellulases from different species to construct surface-assembly celluosome.
Accommodating conscientious objection in the midwifery workforce: a ratio-data analysis of midwives, birth and late abortions in 18 European countries in 2016
Authors: Fleming Valerie , Maxwell Clare , Ramsayer Beate 
Published: May 2020

Abstract
Background In recent years the role of a midwife has expanded to include the provision of abortion related care. The laws on abortion in many European countries allow for those who hold a conscientious objection to participating to refrain from such participation. However, some writers have expressed concerns that this may have a detrimental effect on the workforce and limit women’s access to the service. Method The aim of this study was to provide a picture of the potential exposure midwives in Europe have to late abortions, an important factor in the integration of accommodation of conscientious objection to abortion by midwives into workload planning. We collected data from Ministries of Health or government statistical departments in 32 European countries on numbers of: births, abortions, late abortions and midwives in 2016. We conducted a ratio-data analysis in those countries that met the inclusion criteria. Results 18 of the 32 countries provided full data thus our calculations are based on a total of 4,036,633 live births, 49,834 late abortions and a total of 132,071 midwives. The calculated ratios of live births to midwife, abortions to midwife and late abortions to midwife illustrate the wide variations between countries in relation to ratios of midwives to live births (15.22 - 53.99) and late abortions, (0.17-1.47) Conclusions This study provides the first comprehensive insight to ratios relating to birth and abortion, especially late abortion services, with regard to the midwifery workforce. It is essential to improve the reporting of abortion data and access to it within Europe to support evidence-informed decisions on optimising the contribution of the midwifery workforce especially within highly contentious fields such as abortion services. The study’s findings suggest that there should be neither be any difficulty for those who are responsible for workload allocation nor compromises to a women’s right to abortion services.