Showing papers in "SpringerPlus in 2015"

Alteration of Zeta potential and membrane permeability in bacteria: a study with cationic agents.

Abstract: In the present study, we have tried to establish the correlation between changes in Zeta potential with that of cell surface permeability using bacteria (Escherichia coli and Staphylococcus aureus). An effort has been made to establish Zeta potential as a possible marker for the assessment of membrane damage, with a scope for predicting alteration of cell viability. Cationic agents like, cetyl trimethyl ammonium bromide and polymyxin B were used for inducing alteration of Zeta potential, and the changes occurring in the membrane permeability were studied. In addition, assessment of poly-dispersity index (PDI), cell viability along with confocal microscopic analysis were performed. Based on our results, it can be suggested that alteration of Zeta potential may be correlated to the enhancement of membrane permeability and PDI, and it was observed that beyond a critical point, it leads to cell death (both Gram-positive and Gram-negative bacteria). The present findings can not only be used for studying membrane active molecules but also for understanding the surface potential versus permeability relationship.

Feasibility, safety, clinical, and laboratory effects of convalescent plasma therapy for patients with Middle East respiratory syndrome coronavirus infection: a study protocol.

Abstract: As of September 30, 2015, a total of 1589 laboratory-confirmed cases of infection with the Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization (WHO). At present there is no effective specific therapy against MERS-CoV. The use of convalescent plasma (CP) has been suggested as a potential therapy based on existing evidence from other viral infections. We aim to study the feasibility of CP therapy as well as its safety and clinical and laboratory effects in critically ill patients with MERS-CoV infection. We will also examine the pharmacokinetics of the MERS-CoV antibody response and viral load over the course of MERS-CoV infection. This study will inform a future randomized controlled trial that will examine the efficacy of CP therapy for MERS-CoV infection. In the CP collection phase, potential donors will be tested by the enzyme linked immunosorbent assay (ELISA) and the indirect fluorescent antibody (IFA) techniques for the presence of anti-MERS-CoV antibodies. Subjects with anti-MERS-CoV IFA titer of ≥1:160 and no clinical or laboratory evidence of MERS-CoV infection will be screened for eligibility for plasma donation according to standard donation criteria. In the CP therapy phase, 20 consecutive critically ill patients admitted to intensive care unit with laboratory-confirmed MERS-CoV infection will be enrolled and each will receive 2 units of CP. Post enrollment, patients will be followed for clinical and laboratory outcomes that include anti-MERS-CoV antibodies and viral load. This protocol was developed collaboratively by King Abdullah International Medical Research Center (KAIMRC), Gulf Cooperation Council (GCC) Infection Control Center Group and the World Health Organization—International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC-WHO) MERS-CoV Working Group. It was approved in June 2014 by the Ministry of the National Guard Health Affairs Institutional Review Board (IRB). A data safety monitoring board (DSMB) was formulated. The study is registered at http://www.clinicaltrials.gov (NCT02190799).

Fault detection and classification in electrical power transmission system using artificial neural network

Abstract: This paper focuses on the detection and classification of the faults on electrical power transmission line using artificial neural networks. The three phase currents and voltages of one end are taken as inputs in the proposed scheme. The feed forward neural network along with back propagation algorithm has been employed for detection and classification of the fault for analysis of each of the three phases involved in the process. A detailed analysis with varying number of hidden layers has been performed to validate the choice of the neural network. The simulation results concluded that the present method based on the neural network is efficient in detecting and classifying the faults on transmission lines with satisfactory performances. The different faults are simulated with different parameters to check the versatility of the method. The proposed method can be extended to the Distribution network of the Power System. The various simulations and analysis of signals is done in the MATLAB® environment.

Mechanical versus enzymatic isolation of stromal vascular fraction cells from adipose tissue.

Abstract: Clinical use of adipose-derived stem cells (ASCs) for a variety of indications is rapidly expanding in medicine. Most commonly, ASCs are isolated at the point of care from lipoaspirate tissue as the stromal vascular fraction (SVF). The cells are immediately administered to the patient as an injection or used to enrich fat grafts. Isolation of ASCs from adipose tissue is a relatively simple process performed routinely in cell biology laboratories, but isolation at the point of care for immediate clinical administration requires special methodology to prevent contamination, ensure integrity of clinical research and comply with regulatory requirements. A lack of practical laboratory experience, regulatory uncertainty and a relative paucity of objective published data can make selection of the optimum separation method for specific indications a difficult task for the clinician and can discourage clinical adoption. In this paper, we discuss the processes which can be used to separate SVF cells from fat tissue. We compare the various mechanical and enzymatic methods. We discuss the practical considerations involved in selecting an appropriate method from a clinical perspective. Studies consistently show that breakdown of the extracellular matrix achieved with proteolytic enzymes affords significantly greater efficiency to the separation process. SVF isolated through mechanical methods is equally safe, less costly and less time consuming but the product contains a higher frequency of blood mononuclear cells and fewer progenitor cells. Mechanical methods can provide a low cost, rapid and simple alternative to enzymatic isolation methods, and are attractive when smaller quantities of ASCs are sufficient.

Perception of climate change and its impact by smallholders in pastoral/agropastoral systems of Borana, South Ethiopia

Abstract: This study investigates the perception of historic changes in climate and associated impact on local agriculture among smallholders in pastoral/agropastoral systems of Borana in southern Ethiopia. We drew on empirical data obtained from farm household surveys conducted in 5 districts, 20 pastoral/agropastoral associations and 480 farm households. Using this data, this study analyses smallholders’ perception of climate change and its associated impact on local agriculture, and the effect of various household and farm attributes on perception. Results suggest that most participants perceived climatic change and its negative impact on agricultural and considered climate change as a salient risk to their future livelihoods and economic development. Different levels of perception were expressed in terms of climate change and the impact on traditional rain-fed agriculture. Age, education level, livestock holding, access to climate information and extension services significantly affected perception levels. Household size, production system, farm and non-farm incomes did not significantly affect perception levels of smallholders. Smallholders attributed climate change to a range of biophysical, deistic and anthropogenic causes. Increased access to agricultural support services, which improves the availability and the quality of relevant climate information will further enhance awareness of climate change within of the rural community and result in better management of climate-induced risks in these vulnerable agricultural systems.

Phosphate fertilizer is a main source of arsenic in areas affected with chronic kidney disease of unknown etiology in Sri Lanka

Abstract: Chronic Kidney Disease of unknown etiology (CKDu) has escalated into an epidemic in North Central Province (NCP) and adjacent farming areas in the dry zone of Sri Lanka. Studies have shown that this special type of CKD is a toxic nephropathy and arsenic may play a causative role along with a number of other heavy metals. We investigated the hypothesis that chemical fertilizers and pesticide could be a source of arsenic. 226 samples of Fertilizers and 273 samples of pesticides were collected and analyzed using atomic absorption spectrometry and inductively coupled plasma mass spectrometry for arsenic and other heavy metals in two university laboratories. Almost all the agrochemicals available to the farmers in the study area are contaminated with arsenic. The highest amount was in triple super phosphate (TSP) with a mean value of 31 mg/kg. Also TSP is a rich source of other nephrotoxic metals including Cr, Co, Ni, Pb and V. Annually more than 0.1 million tons of TSP is imported to Sri Lanka containing approximately 2100 kg of arsenic. The next highest concentration was seen in the rock phosphate obtained from an open pit mine in NCP (8.56 mg/kg). Organic fertilizer contained very low amounts of arsenic. Arsenic contamination in pesticides varied from 0.18 mg/kg to 2.53 mg/kg although arsenic containing pesticides are banned in Sri Lanka. Glyphosate the most widely used pesticide in Sri Lanka contains average of 1.9 mg/kg arsenic. Findings suggest that agrochemicals especially phosphate fertilizers are a major source of inorganic arsenic in CKDu endemic areas. Organic fertilizer available in Sri Lanka is comparatively very low in arsenic and hence the farmers in CKDu endemic areas in Sri Lanka should be encouraged to minimize the use of imported chemical fertilizer and use organic fertilizers instead.

Facial expression recognition and histograms of oriented gradients: a comprehensive study.

Abstract: Automatic facial expression recognition (FER) is a topic of growing interest mainly due to the rapid spread of assistive technology applications, as human–robot interaction, where a robust emotional awareness is a key point to best accomplish the assistive task. This paper proposes a comprehensive study on the application of histogram of oriented gradients (HOG) descriptor in the FER problem, highlighting as this powerful technique could be effectively exploited for this purpose. In particular, this paper highlights that a proper set of the HOG parameters can make this descriptor one of the most suitable to characterize facial expression peculiarities. A large experimental session, that can be divided into three different phases, was carried out exploiting a consolidated algorithmic pipeline. The first experimental phase was aimed at proving the suitability of the HOG descriptor to characterize facial expression traits and, to do this, a successful comparison with most commonly used FER frameworks was carried out. In the second experimental phase, different publicly available facial datasets were used to test the system on images acquired in different conditions (e.g. image resolution, lighting conditions, etc.). As a final phase, a test on continuous data streams was carried out on-line in order to validate the system in real-world operating conditions that simulated a real-time human–machine interaction.

The mechanisms of action of vaccines containing aluminum adjuvants: an in vitro vs in vivo paradigm

Abstract: Adjuvants such as the aluminum compounds (alum) have been dominantly used in many vaccines due to their immunopotentiation and safety records since 1920s. However, how these mineral agents influence the immune response to vaccination remains elusive. Many hypotheses exist as to the mode of action of these adjuvants, such as depot formation, antigen (Ag) targeting, and the induction of inflammation. These hypotheses are based on many in vitro and few in vivo studies. Understanding how cells interact with adjuvants in vivo will be crucial to fully understanding the mechanisms of action of these adjuvants. Interestingly, how alum influences the target cell at both the cellular and molecular level, and the consequent innate and adaptive responses, will be critical in the rational design of effective vaccines against many diseases. Thus, in this review, mechanisms of action of alum have been discussed based on available in vitro vs in vivo evidences to date.

Editorial: preclinical data reproducibility for R&D - the challenge for neuroscience.

Abstract: The inability to reproduce published findings has been identified as a major issue in science. Reports of only a low percentage of landmark studies being reproduced at pharmaceutical companies like Bayer (Prinz et al. 2011) gained much interest in the scientific community and raised high levels of concerns. A more recent analysis from Amgen (Begley and Ellis 2012) suggested that those non-reproducible studies may have an even stronger impact on the field than those that can be reproduced, possibly because the more remarkable and exciting findings are reported in higher impact journals. Evidently, this is not just a problem of pharmaceutical industry. About half of respondents from faculty and trainees at the academic MD Anderson Cancer Center, Houston, Texas, had experienced at least one episode of inability to reproduce published data in a survey by Mobley et al. (2013) and comparable figures may be expected in neuroscience.

Lysine nutrition in swine and the related monogastric animals: muscle protein biosynthesis and beyond

Abstract: Improving feed efficiency of pigs with dietary application of amino acids (AAs) is becoming increasingly important because this practice can not only secure the plasma AA supply for muscle growth but also protect the environment from nitrogen discharge with feces and urine. Lysine, the first limiting AA in typical swine diets, is a substrate for generating body proteins, peptides, and non-peptide molecules, while excess lysine is catabolized as an energy source. From a regulatory standpoint, lysine is at the top level in controlling AA metabolism, and lysine can also affect the metabolism of other nutrients. The effect of lysine on hormone production and activities is reflected by the change of plasma concentrations of insulin and insulin-like growth factor 1. Lysine residues in peptides are important sites for protein post-translational modification involved in epigenetic regulation of gene expression. An inborn error of a cationic AA transporter in humans can lead to a lysinuric protein intolerance condition. Dietary deficiency of lysine will impair animal immunity and elevate animal susceptibility to infectious diseases. Because lysine deficiency has negative impact on animal health and growth performance and it appears that dietary lysine is non-toxic even at a high dose of supplementation, nutritional emphasis should be put on lysine supplementation to avoid its deficiency rather than toxicity. Improvement of muscle growth of monogastric animals such as pigs via dietary lysine supply may be due to a greater increase in protein synthesis rather than a decrease in protein degradation. Nevertheless, the underlying metabolic and molecular mechanisms regarding lysine effect on muscle protein accretion merits further clarification. Future research undertaken to fully elucidate the metabolic and regulatory mechanisms of lysine nutrition could provide a sound scientific foundation necessary for developing novel nutritional strategies to enhance the muscle growth and development of meat animals.

The Perceptions of Pre-Service and In-Service Teachers Regarding a Project-Based STEM Approach to Teaching Science

Abstract: Whilst much attention has focused on project-based approaches to teaching Science, Technology, Engineering and Mathematics (STEM) subjects, little has been reported on the views of South-East Asian science teachers on project-based STEM approaches. Such knowledge could provide relevant information for education training institutions on how to influence innovative teaching of STEM subjects in schools. This article reports on a study that investigated the perceptions of 25 pre-service and 21 in-service Malaysian science teachers in adopting an interdisciplinary project-based STEM approach to teaching science. The teachers undertook an eight hour workshop which exposed them to different science-based STEM projects suitable for presenting science content in the Malaysian high school science syllabus. Data on teachers’ perceptions were captured through surveys, interviews, open-ended questions and classroom discussion before and at the end of the workshop. Study findings showed that STEM professional development workshops can provide insights into the support required for teachers to adopt innovative, effective, project-based STEM approaches to teaching science in their schools.

Isolation and functional characterization of novel biosurfactant produced by Enterococcus faecium

Abstract: The objective of the present study was to isolate the biosurfactant (BS) producing lactic acid bacteria (LAB) from traditional fermented food (buttermilk) and its functional and structural characterization. BS isolated from strain MRTL9 reduced surface tension from 72.0 to 40.2 mN m-1. The critical micelle concentration (CMC) of BS was 2.25 mg ml-1 with emulsification efficiency (E24) after 24 h of 64% against kerosene oil. The cell bound BS was partially purified by silica gel column chromatography and found as glycolipid. The gas chromatography and mass spectroscopy data revealed the fatty acid as hexadecanoic acid. Xylose was determined as hydrophilic moiety. The BS was found to be stable to pH changes over a range of 4.0-12.0, being most effective at pH 7 and showed no apparent loss of surface tension and emulsification efficiency after heat treatment at 120°C for 15 min. The outcomes of cellular toxicity showed lower toxicity of BS in comparison to SDS and rhamnolipids. Current study confirmed the preventive anti-adhesion activity of BS. These amphiphilic molecules, interferes with the microbial adhesion and found to be least cytotoxic with cellular compatibility with mouse fibroblasts cells.

Potential utilization of bagasse as feed material for earthworm Eisenia fetida and production of vermicompost

Abstract: In the present work bagasse (B) i.e waste of the sugar industry, was fed to Eisenia fetida with cattle dung (CD) support as feed material at various ratios (waste: CD) of 0:100 (B0), 25:75 (B25), 50:50 (B50), 75:25 (B75) and 100:0 (B100) on dry weight basis. Co-composting with cattle dung helped to improve their acceptability for E. fetida and also improved physico-chemical characteristics. Best appropriate ratio for survival, maximum growth and population buildup of E. fetida was determined by observing population buildup, growth rate, biomass, mortality and cocoon formation. Minimum mortality and highest population size of worms was observed in 50:50 (B50) ratio. Increasing concentrations of wastes significantly affected the growth and reproduction of worms. Nutrients like nitrogen, phosphorus and sodium increased from pre-vermicompost to post-vermicompost, while organic carbon, and C:N ratio decreased in all the end products of post-vermicomposting. Heavy metals decreased significantly from initial except zinc, iron and manganese which increased significantly. Scanning electron microscopy (SEM) was used to recognize the changes in texture in the pre and post-vermicomposted samples. The post-vermicomposted ratios in the presence of earthworms validate more surface changes that prove to be good manure. The results observed from the present study indicated that the earthworm E. fetida was able to change bagasse waste into nutrient-rich manure and thus play a major role in industrial waste management.

A comprehensive review on privacy preserving data mining

Abstract: Preservation of privacy in data mining has emerged as an absolute prerequisite for exchanging confidential information in terms of data analysis, validation, and publishing. Ever-escalating internet phishing posed severe threat on widespread propagation of sensitive information over the web. Conversely, the dubious feelings and contentions mediated unwillingness of various information providers towards the reliability protection of data from disclosure often results utter rejection in data sharing or incorrect information sharing. This article provides a panoramic overview on new perspective and systematic interpretation of a list published literatures via their meticulous organization in subcategories. The fundamental notions of the existing privacy preserving data mining methods, their merits, and shortcomings are presented. The current privacy preserving data mining techniques are classified based on distortion, association rule, hide association rule, taxonomy, clustering, associative classification, outsourced data mining, distributed, and k-anonymity, where their notable advantages and disadvantages are emphasized. This careful scrutiny reveals the past development, present research challenges, future trends, the gaps and weaknesses. Further significant enhancements for more robust privacy protection and preservation are affirmed to be mandatory.

Review of the tactical evaluation tools for youth players, assessing the tactics in team sports: football

Abstract: For sports assessment to be comprehensive, it must address all variables of sports development, such as psychological, social-emotional, physical and physiological, technical and tactical. Tactical assessment has been a neglected variable until the 1980s or 1990s. In the last two decades (1995–2015), the evolution of tactical assessment has grown considerably, given its importance in game performance. The aim of this paper is to compile and analyze different tactical measuring tools in team sports, particularly in soccer, through a bibliographical review. Six tools have been selected on five different criteria: (1) Instruments which assess tactics, (2) The studies have an evolution approach related to the tactical principles, (3) With a valid and reliable method, (4) The existence of publications mentioning the tool in the method, v. Applicable in different sports contexts. All six tools are structured around seven headings: introduction, objective(s), tactical principles, materials, procedures, instructions/rules of the game and published studies. In conclusion, the teaching–learning processes more tactical oriented have useful tactical assessment instrument in the literature. The selection of one or another depends some context information, like age and level of expertise of the players.

Socioeconomic status and incidence of breast cancer by hormone receptor subtype

Abstract: Recent developments in genetics and molecular biology have classified breast cancer into subtypes based on tumor markers of estrogen (ER), progesterone (PR) and human epidermal growth Factor-2 receptors (Her-2), with the basal-like (ER−, PR−, Her2−) subtype commonly referred to as “triple negative” breast cancer (TNBC) being the most aggressive. Prior studies have provided evidence that higher socio-economic status (SES) is associated with increased breast cancer risk, likely due to hormone related risk factors such as parity and hormonal contraceptive use. However, it is unclear if the relationship between SES and overall breast cancer incidence exists within each subtype, and if this association varies by race/ethnicity. Analysis was based on data obtained from the SEER database linked to 2008–2012 American Community Survey data, and restricted to women diagnosed with breast cancer in 2010. The NCI SES census tract SES index based on measures of income, poverty, unemployment, occupational class, education and house value, was examined and categorized into quintiles. Age-adjusted incidence rate ratios were calculated comparing the lowest to the highest SES groups by subtype, separately for each race/ethnic group. We identified 47,586 women with breast cancer diagnosed in 2010. The majority was diagnosed with Her2−/HR+ tumors (73 %), while 12 % had triple negative tumors (TNBC). There was a significant trend of higher incidence with increasing SES for Her2−/HR+ (IRR Highest vs. Lowest SES: 1.32, 95 % CI 1.27–1.39; p value trend: 0.01) and Her2+/HR+ tumors (IRR Highest vs. Lowest SES: 1.46, 95 % CI 1.27–1.68; p value trend: 0.01) among White cases. There was no association between SES and incidence of HR− subtypes (Her2+/HR− or TNBC). Similar associations were observed among Black, Hispanic and Asian or Pacific Islander cases. The positive association between SES and breast cancer incidence is primarily driven by hormone receptor positive tumors. To the extent that neighborhood SES is a proxy for individual SES, future studies are still needed to identify etiologic risk factors for other breast cancer subtypes.

Improved Bat algorithm for the detection of myocardial infarction

Abstract: The medical practitioners study the electrical activity of the human heart in order to detect heart diseases from the electrocardiogram (ECG) of the heart patients. A myocardial infarction (MI) or heart attack is a heart disease, that occurs when there is a block (blood clot) in the pathway of one or more coronary blood vessels (arteries) that supply blood to the heart muscle. The abnormalities in the heart can be identified by the changes in the ECG signal. The first step in the detection of MI is Preprocessing of ECGs which removes noise by using filters. Feature extraction is the next key process in detecting the changes in the ECG signals. This paper presents a method for extracting key features from each cardiac beat using Improved Bat algorithm. Using this algorithm best features are extracted, then these best (reduced) features are applied to the input of the neural network classifier. It has been observed that the performance of the classifier is improved with the help of the optimized features.

Pathological brain detection in MRI scanning by wavelet packet Tsallis entropy and fuzzy support vector machine

Abstract: An computer-aided diagnosis system of pathological brain detection (PBD) is important for help physicians interpret and analyze medical images. We proposed a novel automatic PBD to distinguish pathological brains from healthy brains in magnetic resonance imaging scanning in this paper. The proposed method simplified the PBD problem to a binary classification task. We extracted the wavelet packet Tsallis entropy (WPTE) from each brain image. The WPTE is the Tsallis entropy of the coefficients of the discrete wavelet packet transform. The, the features were submitted to the fuzzy support vector machine (FSVM). We tested the proposed diagnosis method on 3 benchmark datasets with different sizes. A ten runs of K-fold stratified cross validation was carried out. The results demonstrated that the proposed WPTE + FSVM method excelled 17 state-of-the-art methods w.r.t. classification accuracy. The WPTE is superior to discrete wavelet transform. The Tsallis entropy performs better than Shannon entropy. The FSVM excels standard SVM. In closing, the proposed method “WPTE + FSVM” is effective in PBD.

Intraluminal pressure profiles during flexible ureterorenoscopy.

Abstract: Background Irrigation and instrumentation during ureterorenoscopic procedures may cause increased pressure in the renal pelvis (PP) with potential harmful adverse effects. In order to assess the pressure increases during ureterorenoscopy, we measured the intraluminal renal pelvic pressure during retrograde intrarenal stone surgery (RIRS).

Diabetes knowledge and glycemic control among patients with type 2 diabetes in Bangladesh

Abstract: Aims: To explore the association between knowledge on diabetes and glycemic control among patients with type 2 diabetes in Bangladesh. Methods: A cross-sectional study was conducted among 515 patients with type 2 diabetes attending a tertiary hospital in Dhaka, Bangladesh. Trained interviewers were used to collect data on socioeconomic status, time since the onset of diabetes, co-morbidities, anthropometric measurements, blood tests, knowledge and perceptions about the causes, management, and complications of diabetes through face to face interviewers based on a structured questionnaire. Diabetes knowledge was reported using a composite score. Chi square tests and correlation analysis were performed to measure the association between knowledge on diabetes and glycemic control. Results: Overall, 45.6% participants had good, 37.7% moderate and 16.7% poor knowledge on diabetes. The mean composite score was 0.75 ± 0.28 and the proportion of participants with a score of ≤50% was 16.7%. Only 24.3% participants identified physical inactivity as a risk factor for diabetes. Knowledge on diabetes was significantly asso ciated with education, gender, monthly income, duration of diabetes, body mass index, family history of diabetes, and marital status but not with glycated hemoglobin (HbA1c). Correlation matrix showed weak negative association between diabetes knowledge score and glycemic control (p < 0.001). Conclusion: Patients with type 2 diabetes in Bangladesh have limited knowledge on the causes, management and risk factors for diabetes, despite receiving professional health education and care in a tertiary diabetic hospital. Strategies to improve the quality of diabetes education and identifying other potential factors for glycemic control are important for ensuring optimum management of diabetes in Bangladesh.

Be rich or don't be sick: estimating Vietnamese patients' risk of falling into destitution

Abstract: This paper represents the first research attempt to estimate the probabilities of Vietnamese patients falling into destitution due to financial burdens occurring during a curative hospital stay. The study models risk against such factors as level of insurance coverage, residency status of patient, and cost of treatment, among others. The results show that very high probabilities of destitution, approximately 70 %, apply to a large group of patients, who are non-residents, poor and ineligible for significant insurance coverage. There is also a probability of 58 % that seriously ill low-income patients who face higher health care costs would quit their treatment. These facts put the Vietnamese government’s ambitious plan of increasing both universal coverage (UC) to 100 % of expenditure and the rate of UC beneficiaries to 100 %, to a serious test. The current study also raises issues of asymmetric information and alternative financing options for the poor, who are most exposed to risk of destitution following market-based health care reforms.

Non-O1, non-O139 Vibrio cholerae bacteraemia: case report and literature review

Abstract: Non-O1, non-O139 Vibrio cholerae (NOVC) are increasingly frequently observed ubiquitous microorganisms occasionally responsible for intestinal and extra-intestinal infections. Most cases involve self-limiting gastroenteritis or ear and wound infections in immunocompetent patients. Bacteraemia, which have been described in patients with predisposing factors, are rare and poorly known, both on the clinical and therapeutic aspects. We describe a case of NOVC bacteraemia and a systematic literature review in PubMed conducted up to November 2014 using a combination of the following search terms: “Vibrio cholerae non-O1” and “bacter(a)emia”. The case was a 70 year-old healthy male subject returning from Senegal and suffering from NOVC bacteraemia associated with liver abscesses. Disease evolution was favourable after 2 months’ therapy (ceftriaxone then ciprofloxacin). Three hundred and fifty cases of NOVC bacteraemia have been identified in the literature. The majority of patients were male (77 %), with a median age of 56 years and presenting with predisposing conditions (96 %), such as cirrhosis (55 %) or malignant disease (20 %). Diarrhoea was inconstant (42 %). Mortality was 33 %. The source of infection, identified in only 25 % of cases, was seafood consumption (54 %) or contaminated water (30 %). Practitioners should be aware of these infections, in order to warn patients with predisposing conditions, on the risk of ingesting raw or undercooked seafood or bathing in potentially infected waters.

Bacteriological profile and antimicrobial susceptibility patterns of blood culture isolates among febrile patients in Mekelle Hospital, Northern Ethiopia.

Abstract: Bacterial bloodstream infections are a major public health problem, which leads to high morbidity and mortality of patients. On time diagnosis and appropriate medication will be the best way to save the lives of affected ones. The aim of the present study was to determine the bacterial profile of bloodstream infections and their antibiotic susceptibility pattern in Mekelle Hospital. Cross sectional study method was carried out in 514 (269 females and 245 males) febrile patients in Mekelle hospital from March to October 2014. Standard bacteriological methods were used for blood collection, bacterial isolation and antimicrobial susceptibility pattern. Out of the total 514 febrile patients, 144 (28%) culture positive were isolated. Staphylococcus aureus 54 (37.5%), Coagulase-negative staphylococci 44 (30.6%), Escherichia coli 16 (3.1%), Citrobacter spp. 9 (1.7%) and Salmonella typhi 8 (1.6%) were the most dominant isolates, collectively accounting for >90% of the isolates. Antimicrobial resistance pattern for gram positive and gram negative bacteria was 0–83.3% and 0–100%, respectively. High resistance was seen to Trimethoprim-sulphamethoxazole 101 (70.1%), Oxacillin 65 (62.5%), Ceftriaxone 79 (58.9%) and Doxycycline 71 (49.3%). Fifty-nine percent of the isolated bacteria in this study were multi drug resistant. Most bacterial isolates were sensitive to Gentamicin, Ciprofloxacin and Amoxicillin clavulanic acid. All gram positive isolates in this current study were sensitive to vancomycin. Prevalence of bacterial isolates in blood was high. It also reveals isolated bacteria species developed multi drug resistance to most of the antibiotics tested, which highlights for periodic surveillance of etiologic agent, antibiotic susceptibility to prevent further emergence and spread of resistant bacterial pathogens.

YouTube videos as a source of medical information during the Ebola hemorrhagic fever epidemic

Abstract: The content and quality of medical information available on video sharing websites such as YouTube is not known. We analyzed the source and quality of medical information about Ebola hemorrhagic fever (EHF) disseminated on YouTube and the video characteristics that influence viewer behavior. An inquiry for the search term ‘Ebola’ was made on YouTube. The first 100 results were arranged in decreasing order of “relevance” using the default YouTube algorithm. Videos 1–50 and 51–100 were allocated to a high relevance (HR), and a low relevance (LR) video group, respectively. Multivariable logistic regression models were used to assess the predictors of a video being included in the HR vs. LR groups. Fourteen videos were excluded because they were parodies, songs or stand-up comedies (n = 11), not in English (n = 2) or a remaining part of a previous video (n = 1). Two scales, the video information and quality and index and the medical information and content index (MICI) assessed the overall quality, and the medical content of the videos, respectively. There were no videos from hospitals or academic medical centers. Videos in the HR group had a higher median number of views (186,705 vs. 43,796, p < 0.001), more ‘likes’ (1119 vs. 224, p < 0.001), channel subscriptions (208 vs. 32, p < 0.001), and ‘shares’ (519 vs. 98, p < 0.001). Multivariable logistic regression showed that only the ‘clinical symptoms’ component of the MICI scale was associated with a higher likelihood of a video being included in the HR vs. LR group.(OR 1.86, 95 % CI 1.06–3.28, p = 0.03). YouTube videos presenting clinical symptoms of infectious diseases during epidemics are more likely to be included in the HR group and influence viewers behavior.

Heterogeneity of the definition of elderly age in current orthopaedic research

Abstract: Medical research often defines a person as elderly when they are 65 years of age or above, however defining elderly age by chronology alone has its limitations. Moreover, potential variability in definitions of elderly age can make interpretation of the collective body of evidence within a particular field of research confusing. Our research goals were to (1) evaluate published orthopaedic research and determine whether there is variability in proposed definitions of an elderly person, and (2) to determine whether variability exists within the important research sub-group of hip fractures. A defined search protocol was used within PubMed, EMBASE and the Cochrane Library that identified orthopaedic research articles published in 2012 that stated within their objective, intent to examine an intervention in an elderly population. 80 studies that included 271,470 patients were identified and subject to analysis. Four (5 %) studies failed to define their elderly population. The remaining 76 (95 %) studies all defined elderly age by chronology alone. Definitions of an elderly person ranged from 50 to 80 years and above. The most commonly used age to define an elderly person was 65, however this accounted for only 38 (47.5 %) of studies. Orthopedic research appears to favor defining elderly age by chronology alone, and there is considerable heterogeneity amongst these definitions. This may confuse interpretation of the evidence base in areas of orthopaedic research that focus on elderly patients. The findings of this study underline the importance of future research in orthopaedics adopting validated frailty index measures so that population descriptions in older patients are more uniform and clinically relevant.

Overrepresentation of unaccompanied refugee minors in inpatient psychiatric care

Abstract: Unaccompanied refugee minors (URMs) have high levels of psychiatric symptoms, and concerns for their access to mental health services have been raised. From the mid-2000s, an increasing number of asylum-seeking URMs, mainly adolescent boys from Afghanistan, have been referred to the Child & Adolescent Psychiatry emergency unit in Malmo, Sweden. The aim of the study was to compare inpatient psychiatric care between URMs and non-URMs.

OnabotulinumtoxinA 155 U in medication overuse headache: a two years prospective study

Abstract: The efficacy and safety of OnabotulinumtoxinA 155-195 U (BOTOX®) in adults with chronic migraine (CM) were demonstrated in both the Phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) studies. However, data about its long-term efficacy and safety in clinical settings are scanty. Therefore, the objective of this study is to evaluate OnabotulinumtoxinA 155 U treatment in patients affected with CM and co-morbid medication overuse headache (MOH) over 2-year analysis. We prospectively evaluated 155 CM and MOH affected patients started on OnabotulinumtoxinA 155U (PREEMPT injection paradigm) between October 2010 and November 2011 and followed-up for 2 years. All patients failed to positively respond to previous multiple preventive therapies that were withdrawn before starting OnabotulinumtoxinA. Headache days, migraine days, acute pain medication intake days and Headache Impact Test (HIT)-6 score were used as efficacy measures, whereas safety was evaluated with side effects occurrence during the treatment phase. Baseline data were collected from patients headache diary referred to the previous month, and patients were evaluated every 3 months at the time of each injection. OnabotulinumtoxinA 155U significantly reduced the number of headache and migraine days (p < 0.001), acute pain medication intake days (p < 0.001) and HIT-6 score (p < 0.001) when compared with the baseline data. The reduction was significant after the first injection (p < 0.001), and gradually increased during the 2 years of treatment. Treatment related adverse events were transient and mild-moderate (e.g. headache, injection-site pain, eyelid ptosis, musculoskeletal weakness). This prospective 2-years analysis of efficacy and safety of long-term treatment with OnabotulinumtoxinA 155 U in patients affected with CM and MOH confirms the efficacy data from previous Randomized Clinical Trials for CM prophylaxis. Moreover, here we demonstrate that OnabotulinumtoxinA can be safely used for the long-term treatment of MOH comorbidity in CM.

Dietary practice and associated factors among type 2 diabetic patients: a cross sectional hospital based study, Addis Ababa, Ethiopia

Abstract: Dietary management which is considered to be one of the cornerstones of diabetes care is based on the principle of healthy eating in the context of social, cultural and psychological influences on food choice. In Ethiopia, there is lack of data on the dietary practice of diabetic patients which underestimates its role in the management of diabetes. Hence, this study assesses the level of dietary practices and their associated factors among Type 2 diabetic patients in Addis Ababa, Ethiopia. Institution-based cross-sectional quantitative study design was employed. A total of 403 study subjects were included in the study. A pretested questionnaire was used to collect data. The collected data were entered into Epi Info version 3.5.3 and exported to SPSS version 20.0 software packages for further statistical analysis. The data were analyzed using bivariate and multivariate logistic regression. The degree of association between dependent and independent variables was assessed using the odds ratio with a 95% confidence interval and variables with p-value ≤0.05 were considered significant. About 46.4% of the patients were overweight and obese. More than half of the respondents (58.8%) had FBG level ≥ 126 mg/dl. The level of dietary practice among 207 (51.4%) type 2 diabetic patients was poor. Not getting nutrition education in hospitals [AOR = 4.47, 95% CI: (1.92,10.40)], despondency [AOR = 2.15, 95% CI: (1.14,4.02)], facing difficulty to choose foods [AOR = 9.66, 95% CI: (5.12,18.24)], non- availability of fruits and vegetables [AOR = 2.78, 95% CI: (1.03,7.54)], thinking about the high cost of foods [AOR = 2.36,95% CI: (1.18, 4.70)] were the factors significantly associated with the poor dietary practice. Findings of this study indicated that the majority of the patients had poor dietary practice. Therefore, the integration of diabetic based nutrition education with motivation and home gardening is highly recommended.

Knowledge of prostate cancer among males attending a urology clinic, a South African study.

Abstract: In South Africa, the rate of histologically diagnosed prostate cancer is 40.1 per 100 000 in whites and 14 per 100 000 in blacks. However, blacks have limited access to diagnostic facilities and present late with an advanced disease. Knowledge about prostate cancer in the South African male population is necessary in order to increase the acceptance of early prostate cancer screening. This study assessed the knowledge of prostate cancer among men attending the urology outpatient clinic at a tertiary hospital in South Africa. A cross-sectional study was conducted from February to March 2010. A structured questionnaire was administered to participants using consecutive sampling of eligible patients and consisted of sections on sociodemographic details and knowledge about prostate cancer. A total of 346 males, 35 years of age and older, participated in the study. The majority of the respondents (n = 258; 75.0%) were black, married (n = 220; 64.0%), from the Free State Province (n = 320; 92.8%), and had access to television (n = 248; 71.7%). Only 38 (11.0%) knew the three main symptoms and signs associated with prostate cancer. Level of school education, race and language were statistically significantly associated with level of knowledge whereas age and marital status were not. More than half (54.4%) of the respondents had not heard of prostate cancer. The majority of men who had heard of prostate cancer had a moderate level of knowledge. The factors significantly associated with level of knowledge need to be considered in educational campaigns, prostate cancer screening and treatment.

Circulating cell-free DNA and its integrity as a prognostic marker for breast cancer.

Abstract: The aim of our study was to look for alternative predictive biomarkers for breast cancer management in limited resource setup. A comprehensive analysis of circulating cell-free DNA (CCFD) in serum at baseline was performed to assess its prognostic potential. Quantitative polymerase chain reaction (qPCR) of ALU sequences using ALU115 and ALU247 primers was carried out in patients (N: baseline 148, postoperative 47) and 51 healthy controls. Mean serum DNA integrity, levels of ALU 247 and levels of ALU 115 were significantly higher in patients than in healthy females. No significant differences were observed in the levels ALU 247 and ALU 115 between stage IV and earlier stages of the disease. The DNA integrity was significantly higher in stage IV than earlier stages. A significant decrease in DNA integrity was observed after surgery (pre: 0.55 ± 0.23 vs post: 0.43 ± 0.30; P = 0.002) while no such change could be observed for ALU 247 and ALU 115. Baseline DNA integrity was significantly higher in relapsed patients than in patients who were free of disease (P = 0.005). Higher baseline DNA integrity was also indicated, though statistically not significant, in patients who died (P = 0.14). In contrast, ALU 247 and ALU 115 levels were decreased in died patients as compared to survivors (24.8 ± 34.80 vs 73.5 ± 170.83, P = 0.02 for ALU 247 and 41.0 ± 47.99 vs 159.5 ± 299.54, P = 0.005 for ALU 115). Baseline levels of ALU 115 and ALU 247 were lower in relapsed patients, though statistically not significant. In univariate analysis, the only clinic-pathological parameter associated with disease prognosis was tumor size. The hazards of 5-year overall mortality was 3.60 (95 % CI: 1.03 12.53, P = 0.03) among patients with lower baseline serum levels of CCFD (ALU 247 < 21 and ALU 115 < 41). Similarly the 4 year hazards for recurrence was 2.30 (95 % CI: 0.96 5.52, P = 0.05) among patients with higher DNA integrity. Baseline serum levels of CCFD and its integrity were found to be potential prognostic biomarkers in patients of primary breast cancer at our centre.