Outcomes and efficacy of magnetic resonance imaging-compatible sacral nerve stimulator for management of fecal incontinence: A multi-institutional study

BACKGROUND Fecal incontinence(FI)is an involuntary passage of fecal matter which can have a significant impact on a patient’s quality of life.Many modalities of treatment exist for FI.Sacral nerve stimulation is a well-established treatment for FI.Given the increased need of magnetic resonance imaging(MRI)for diagnostics,the In-terStim which was previously used in sacral nerve stimulation was limited by MRI incompatibility.Medtronic MRI-compatible InterStim was approved by the United States Food and Drug Administration in August 2020 and has been widely used.AIM To evaluate the efficacy,outcomes and complications of the MRI-compatible InterStim.METHODS Data of patients who underwent MRI-compatible Medtronic InterStim placement at UPMC Williamsport,University of Minnesota,Advocate Lutheran General Hospital,and University of Wisconsin-Madison was pooled and analyzed.Patient demographics,clinical features,surgical techniques,complications,and outcomes were analyzed.Strengthening the Reporting of Observational studies in Epidemiology(STROBE)cross-sectional reporting guidelines were used.RESULTS Seventy-three patients had the InterStim implanted.The mean age was 63.29±12.2 years.Fifty-seven(78.1%)patients were females and forty-two(57.5%)patients had diabetes.In addition to incontinence,overlapping symptoms included diarrhea(23.3%),fecal urgency(58.9%),and urinary incontinence(28.8%).Fifteen(20.5%)patients underwent Peripheral Nerve Evaluation before proceeding to definite implant placement.Thirty-two(43.8%)patients underwent rechargeable InterStim placement.Three(4.1%)patients needed removal of the implant.Migration of the external lead connection was observed in 7(9.6%)patients after the stage I procedure.The explanation for one patient was due to infection.Seven(9.6%)patients had other complications like nerve pain,hematoma,infection,lead fracture,and bleeding.The mean follow-up was 6.62±3.5 mo.Sixty-eight(93.2%)patients reported significant improvement of symptoms on follow-up evaluation.CONCLUSION This study shows promising results with significant symptom improvement,good efficacy and good patient outcomes with low complication rates while using MRI compatible InterStim for FI.Further long-term follow-up and future studies with a larger patient population is recommended.

GWAS identifies candidate genes controlling adventitious rooting in Populus trichocarpa

Adventitious rooting(AR)is critical to the propagation,breeding,and genetic engineering of trees.The capacity for plants to undergo this process is highly heritable and of a polygenic nature;however,the basis of its genetic variation is largely uncharacterized.To identify genetic regulators of AR,we performed a genome-wide association study(GWAS)using 1148 genotypes of Populus trichocarpa.GWASs are often limited by the abilities of researchers to collect precise phenotype data on a high-throughput scale;to help overcome this limitation,we developed a computer vision system to measure an array of traits related to adventitious root development in poplar,including temporal measures of lateral and basal root length and area.GWAS was performed using multiple methods and significance thresholds to handle non-normal phenotype statistics and to gain statistical power.These analyses yielded a total of 277 unique associations,suggesting that genes that control rooting include regulators of hormone signaling,cell division and structure,reactive oxygen species signaling,and other processes with known roles in root development.Numerous genes with uncharacterized functions and/or cryptic roles were also identified.These candidates provide targets for functional analysis,including physiological and epistatic analyses,to better characterize the complex polygenic regulation of AR.

Application of integrated traditional Chinese and Western medicine in the treatment of juvenile localized scleroderma with skin ulcer: a case report

Background:Juvenile Localized Scleroderma(JLS)is a rare pediatric rheumatic disease characterized by inflammation and skin sclerosis.The side effect of consensus-recommended medications and the risk of disability posed challenges to the JLS treatment.We intend to demonstrate the potential of traditional Chinese medicine in treating JLS with skin ulcers and reducing the dose of glucocorticoid.Method:Here we report a case of a 13-year-old male with JLS who took oral methotrexate tablets of 10 mg/week and methylprednisolone of 6 mg/day for over six months without significant effect and suffered from skin ulcers on the dorsal feet one month after drug cessation.Subsequently,the patient was treated with integrated traditional Chinese and Western medicine of low-dose glucocorticosteroid,adjusted Shenqi Huoxue formula and Jinshe Xiaoyan formula,etc.Results:After integrated treatment,the patient’s dorsal feet ulcers healed and the skin sclerosis and hyperpigmentation improved significantly.Conclusions:This case report suggests that integrated traditional Chinese and Western medicine can be used as an effective treatment for JLS.

木霉(Trichoderma spp.)对三种引起大棚蔬菜病害病原菌的影响

通过木霉属(Trichoderma) 3菌株与双鸭山蔬菜大棚中的黄瓜枯萎病菌(FusariumoxysporumSchlecht.f.cucumerinum)、黄瓜果腐病菌(PhytophthoracapsiciLeonian)、菜豆叶枯病菌(Cladosporiumsp .)的对峙培养试验,结果表明:绿色木霉1(TrichodermaviridePers.exGray 1)可作为双鸭山蔬菜大棚中的黄瓜枯萎病、黄瓜果腐病、菜豆叶枯病3种病害的生物防治拮抗菌加以利用,该拮抗菌对菜豆叶枯病菌抑制效果最好;绿色木霉2 (Tricho dermaviride 2 )对黄瓜果腐病菌抑制效果最好;而哈茨木霉(TrichodermaharzianumRifai)对以上3种病原菌都有抑制效果,对菜豆叶枯病菌抑制效果最好。从试验结果还可看出,绿色木霉2对黄瓜枯萎病菌和菜豆叶枯病菌的生长有促进作用。

Post-Harvest Handling Practices and Losses for Legumes and Starchy Staples in Uganda

High postharvest losses in developing countries negate the efforts geared towards improving food security. Poor produce quality including high prevalence of mycotoxin contamination is another significant problem. Appropriate postharvest handling and processing provide opportunities to reduce postharvest losses and improve food safety. This study was aimed at establishing the postharvest handling practices and estimating qualitative and quantitative postharvest losses for maize, millet, sorghum, beans, groundnuts, cassava, and sweet potatoes among farmers in 3 districts (Kamuli, Apac and Nakasongola) in Uganda, representing different agro-ecological zones. The study was done in late August 2014 after the first season harvests (June-August). Farmer interviews, focus group discussions and key informant interviews were used to collect data on postharvest loss estimates and postharvest handling practices. Samples of the different foods were collected and analyzed for physical quality characteristics, mould count and aflatoxin contamination using standard laboratory procedures. The results show predominance of rudimentary and inappropriate postharvest handling methods. Postharvest loss estimates were generally high, with values of 41%, 33%, 33%, 26%, 31%, 22%, 17% and 19% for maize, millet, sorghum, beans, groundnuts, cowpea, sweet potatoes and cassava respectively. The highest loss for all the crops was recorded at storage. Prevalence of aflatoxin contamination was 44%, 91%, 55%, 36%, 35% and 60% for maize, sorghum, groundnuts, millet, sweet potatoes and cassava respectively. Sorghum, maize and groundnuts were found to have the highest aflatoxin contamination levels. Chi-square test (p = 0.024, odds ratio = 5) showed that grain dried on bare ground had higher aflatoxin levels than that dried on a covered surface. The findings of this study reveal a serious need for postharvest interventions as a strategy to address food security.

Integration of Health Promotion into Nursing Practice: A Case Study in Pakistan

The purpose of this study was to understand the concept of health promotion and perceptions related to the integration of health promotion in nursing practice in Pakistan. The study utilized the qualitative single case study approach to explore and describe the concept of health promotion, its significance and ways to integrate health promotion strategies in nursing practice. The data were collected from three different sources;focus group discussion among final year Post-RN BScN students, key informant interviews of practicing nurses, faculty, and MScN students, as well as a document review of the Post-RN BScN curriculum. Data analysis included a content and thematic analysis, yielding four major themes—”Health Promotion as Diverse”, “Health Promotion as Necessary”, “Health Promotion as Nursing Role”, and “Health Promotion as a Strategic Imperative”. Further, the findings highlighted the competencies, support mechanisms, and barriers which select nurses faced while integrating the health promotion strategies in practice.

Trends of Temperature Extreme Indices over Arusha and Kilimanjaro Regions in Tanzania

The study aimed at analyzing the trends and variability of temperature extremes over the northeastern highlands in Tanzania, specifically over Arusha and Kilimanjaro regions. Quality controlled mean monthly, daily maximum and minimum temperature data for the period 1961 to 2020, obtained from Tanzania Meteorological Authority, were used in the study. Rclimdex and the National Climate Monitoring Products (NMCP) software, developed by the World Meteorological Organization (WMO), were used for computation of the indices at a monthly, seasonal and annual time scale. The computed indices were also subjected to trend analysis to determine their direction and magnitude of change. Extraction and assessment of the top five highest and lowest maximum and minimum temperatures were also done. Increasing trends of temperature anomalies for seasonal and annual timescales were observed for both Arusha and Kilimanjaro regions. Also, the increasing trends of warm and extreme warm days and nights and relatively increasing trends of cold and extreme cold days and nights were observed for both regions. The highest ever recorded temperatures since the establishment of the two stations were 36.3?C observed on 16th February 2011 and 38.6?C observed on 22nd February 2005 for Arusha and Kilimanjaro respectively. These results indicate that The last two decades have been characterized by enhanced warming, which is consistent with overall global temperature trend patterns as depicted in recent IPCC reports and the report of the State of Climate in Africa.

Continuing Results for Effervescent Aerosol Salt Water Spray Nozzles Intended for Marine Cloud Brightening

Marine Cloud Brightening (MCB) by effervescent spray atomization of mixed sea water brine with air is a candidate for solar radiation management to compensate for global warming. We discovered that the flow from mixing tee nozzle described earlier had occasional unstable slug flow. A new design that adding rotational swirl to the salt brine as it is mixed into the air stabilized the nozzle flow and no longer showed slug flow in spray pictures. Flow equations were developed for the relatively low speed of sound of a choked flow mixed brine and air nozzle. Experimental mixed flow measurements with 300b pressure and a 200 μm diameter nozzle and calculations using perfect gas, and isotropic processes equations compared well with the chocked flow equations. Analysis in EXCEL of particle sizers measurements from both a scanning mobility particle sizer (SMPS) and an aerodynamic particle sizer (APS) showed production of many nanometer sized particles estimated as usable for MCB. A small number of micron sized particles were also always present but with about 90% of the sprayed mass. This is a first report with good data over the complete size range. The micron sized particles measured were similar to the measurements of earlier reports which reported no nanometer sized particles. We hypothesize that many nano-particles are always produced by liquid-air effervescent sprays, but earlier, were not observed because SMPS instruments were not available. The presence of the large mass percentage of large particles in the spray may cause problems by evaporative cooling preventing the rise of the MCB particles. We suggest future systems design with an impactor filter to remove the large particles. Calculations combining increased brine concentration, lower pressure, and larger nozzle area showed that significant reductions in required power and number of nozzles could be realized. An EXCEL model is developed to calculate flow from experimental analysis equations and compare with mixed choked flow equations. Solving with the model predicted the power required and the number of nozzles required to produce 1015 particles/s. The model showed that increasing brine concentration strongly lowered total power. Lowering pressure decreased power and increased number of nozzles. Increasing nozzle area lowered the number of nozzles. This model predicted that, at 300b pressure and 200μm diameter nozzle as the experiment but using an increased brine concentration of 0.1 instead of 0.032 would require only 115 nozzles instead of 358 and power of 146 kw instead of 493 kw. Combining increased brine concentration, lower pressure, and larger nozzle area, the model predicted that with a 1 mm diameter nozzle at 30b pressure and salt concentration of 0.2, the nozzle count and power required would drop to only 24 nozzles and power of 28 kw. Whether extending the model to these conditions is valid is not known but suggests further development should be investigated. Filtering out and reusing the 90% or greater large particles mass sprayed combined with the lower power advantage of higher brine concentration is suggested for future systems.

Production of Lipase Using Cassava Peel and Sunflower Oil in Solid-State Fermentation： Preliminary Study

Full use of residues from industrial processes is a fundamental necessity of contemporary society, since it avoids impacts to the environment by using residues as inputs for other products of high economic and social importance. In this study, lipase production of the crude enzymatic extracts obtained by Aspergillus niger using cassava peel as substrate and sunflower oil as an inductor was investigated. The optimized cultivation temperature and concentration of inductor were determined using the response surface methodology. The two variables studied exercised influence in the production of lipase in the 95% level of confidence. The response surface obtained indicated that the conditions that maximize lipase activity production were 30.5 ~C and initial concentration of sunflower oil was 2.5% （w/w）. Through this analysis, it is evident that extremes in temperature and concentration of inductor tend to decrease lipase production, since low temperatures decrease metabolism and high temperatures may inactivate the lipase. Optimum lipase yield was 59.8 U/g of dry peel which was fermented for 60 h. Lipase production presents a peak of 61.3 U/g, at 72 h of fermentation. However, this value is statistically equal （p 〉 0.05） of the value of lipase activity obtained for 60 h and 84 h of fermentation.

Economic Evaluation of Grain Amaranth Production in Kamuli District, Uganda

In Uganda, grain amaranth is relatively new and has generally not been considered as an important crop compared to other grain crops and legumes. This study was therefore conducted to determine factors affecting adoption of grain amaranth growing, factors affecting production, and economic returns on investment of its production. The study was carried out in Kamuli district where a total of 174 grain amaranth farmers and 90 non-grain amaranth farmers were randomly selected and interviewed. Using descriptive statistics, regression analysis （logit model and a Cobb-Douglas type production function） and profitability ratios, it was found that grain amaranth is produced on a small scale and yields are low. Farmer adoption of the crop was favoured by age, gender （female）, education of the farmer, and source of income. The output was positively affected by the amount of labour and manure used in production, while a negative relationship existed between output and male farmers. The crop was most viable under small acreages （0.02-0.04 ha） with positive returns to investment of 0.016. Its production should therefore be encouraged because of its income generation potential and since it requires small land.

Voluntary Service:Contribute to the Realization of Chinese Dream——on Promoting the Development of Voluntary Service with Chinese Characteristics under New Historical Circumstance

China Volunteer Service Federation is a nationalfederated social organization composed ofvoluntary service organizations and volunteers.Since its founding in more than two years ago,by strengthening cooperation with diversifiedvoluntary service organizations at all levels,promoting the working methods innovationof voluntary service in all sectors and regions,

Beyond Individualism Perspective of Trauma: Evidence for Adopting Collective Narratives for Empowering Long-Term Rehabilitation for Children of the Ethnic Qiang People Who Have Been Affected by Disaster

Objective: Exploring how an ethnic culture-focused collective narrative strategy can be effectively used to promote resilience among the affected Qiang children for post-disaster psychological trauma at scale. Design: The study was conducted with a cohort of ethnic Qiang children through a pretest(n=1100) and post-three years test(n=957) to evaluate the effect of the intervention program from myth story-based collective narrative cultural practices. Results: Data from the study clearly indicate that children's resilience behaviour had been greatly improved by the myth story-based collective narrative activities with average scores on 11 items showing a significant increase from 2.08 at baseline to 4.12 at 3 years follow-up posttest(mean=2.04, 95% CI=0.97, 3.11, p <0.0001). No similar change occurred in the control groups(mean=0.74, 95% CI=-0.75, 2.23, n.s). Conclusion: The adoption of an ethnic culture-focused collectivism narrative approach for reduction of vulnerability was able to greatly promote the cultural variable to enhance coping for Qiang children affected by trauma at scale, which informed the urgency for developing an indigenous psych-cultural agenda for collectively responding to disaster trauma in ethnic minority contexts.

Mothers’ Knowledge, Beliefs, and Practices on Causes and Prevention of Anaemia in Children Aged 6 - 59 Months: A Case Study at Mkuranga District Hospital, Tanzania

Aims: Anaemia in children aged 6 - 59 months is an important public health problem associated with increasing hospital costs, lengths of hospital stay, and development of complications later in life. Due to the significant caregiver roles of mothers, the level of mothers’ knowledge, beliefs and practices are important in addressing anaemia in children. This study investigated knowledge, attitudes, beliefs, and practices of select mothers on anaemia and linked these with known factors for anaemia. Methodology: The case study was conducted at Mkuranga District Hospital, Paediatric Ward between December 2014 and April 2015. A cross-sectional design was used to recruit a convenience sample of 40 mothers whose children had a confirmed diagnosis of anaemia (through routine laboratory testing). Results: Within the sample, the majority of children were male (52.5%);aged 6 - 39 months (87.5%);and had a diagnosis of severe anaemia (75.0%) according to the World Health Organization’s definition. Over one third (35%) of mothers reported a prior history of anemia in their other children, and the majority (55%) had heard about anaemia prior to their child’s hospitalization. Maternal anaemia was reported by 67.5% of mothers. Mothers reported that maternal anemia (17.5%) and feeding practices (32.5%) are known contributing factors to anaemia in children. Mothers reported that anemia could be prevented (55.0%) and cured by herbal preparations (47.5%). In addition, some mothers indicated that anaemia was caused by witchcraft (22.5%) and eating lemons (2.5%). Conclusion: Severe anaemia was high among the studied population which aligned with their hospitalization status. Findings suggested potential gaps in control and management of anemia in children possibly related to low awareness or incorrect knowledge of the relationship between maternal and child anaemia. The findings also highlighted important cultural beliefs related to anaemia. There is an imperative for culturally and socially appropriate knowledge translation and exchange with mothers in order to impact on the prevention and control of anaemia in children in Tanzania.

The Nursing Documentation Dilemma in Uganda: Neglected but Necessary. A Case Study at Mulago National Referral Hospital

In Uganda, nursing documentation still remains a challenge, in most of the government hospitals and some private hospitals, it remains at a manual (non-technology driven) level and omissions have been observed. Nurses continue to capture standard elements in their documentation. A mixed methods intervention study was conducted to determine knowledge and attitudes of nurses towards documentation, including an evaluation of nurses’ response to a designed nursing documentation form. Forty participants were selected through convenience sampling from six wards of a Ugandan health institution. The study intervention involved teaching nurses the importance of documentation and using of the trial documentation tool. Pre- and post-testing and open-ended questionnaires were used in data collection. The results from the close-ended questions were presented in the previous publication;the responses from the open-ended questions would then be presented. The open-ended questions regarding comments about the nursing documentation process and suggestions about the process of implementing the nursing documentation system in the ward units were considered. All participants were provided the opportunity to provide personal comments, reflections, or stories of their experiences with documentation in patient care. A thematic analysis approach was used during data analysis. The results showed that the participants had positive attitude towards documentation of patient care, but they had constraints limiting them to document, they reflected issues concerning the perceived pressure from the administrations and support to document. The study findings have implication that there is need for organizational support and to have multisite studies and extension of the documentation tool.

A FIVE-YEAR PROSPECTIVE STUDY ON THE RELATIONSHIP BETWEEN GARLIC AND GASTRIC CANCER

A prospective study on the relationship between garlic and gastric cancer of 4552 subjects was made from Oct., 1980 through 1985. The volunteers, aged 50-59, were healthy males and came from different incidence areas of gastric cancer where they lived for long periods. The result of this study showed that the death rates of gastric cancer in < 2500 g and >500 g groups of annual garlic intake were 10.40/ 10000 and 0, respectively. The relative risk of gastric cancer was significantly much higher in the former than in the latter, and showed a dose-response relationship. Protective effect of garlic for the population equal annual garlic intake was roughly the same in different districts. It was further confirmed that garlic played important role in preventing gastric cancer and had no regional differences.

Heartfelt Work

FOR Wang Zhanshuo, a graduate in industrial engineering from Beijing＇s renowned Tsinghua University, after-graduation life went totally off the beaten track. Instead of going out to find plum placements in the lob market, the 21-year-old set off for Kenya with six classmates in July 2014 to work as volunteers. They took clothes, educational kits and other materials collected from donors in China to primary schools and a nature reserve in Kenya, offering to help out.

Application of transcutaneous diffuse reflectance spectroscopy in the measurement of blood glucose concentration

In this paper, the propagation characteristics of near-infrared (NIR) light in the palm tissue are analyzed, and the principle and feasibility of using transcutaneous diffuse reflectance spectroscopy for non-invasive blood glucose detection are presented. An optical probe suitable for measuring the diffuse reflectance spectrum of human palm and a non-invasive blood glucose detection system using NIR spectroscopy are designed. Based on this system, oral glucose tolerance tests are performed to measure the blood glucose concentrations of two young healthy volunteers. The partial least square calibration model is then constructed by all individual experimental data. The final result shows that correlation coefficients of the two experiments between the predicted blood glucose concentrations and the reference blood glucose concentrations are 0.9870 and 0.9854, respectively. The root mean square errors of prediction of full cross validation are 0.54 and 0.52 mmol/1, respectively.

Investigation of the microbiota associated with traditionally produced fruit vinegars with focus on acetic acid bacteria and lactic acid bacteria

The microbiological properties of traditionally produced fruit vinegars,i.e.,fig,mulberry,apple and plum vinegars,supplied from different cities in Turkey were investigated.The counts of acetic acid bacteria(AAB),lactic acid bacteria(LAB)and mold-yeast for fruit vinegars were found in the range of 2.54–7.05,1.91–6.81 and 1.32–7.10 log CFU/mL,respectively.The indigenous AAB and LAB isolates were recovered from the vinegars and characterized based on a combination of phenotypic and genotypic approaches including 16S rRNA gene sequencing.In AAB three different species,Acetobacter pasteurianus,A.ghanensis and A.fabarum,and in LAB five species,Lacticaseibacillus paracasei,Lactiplantibacillus plantarum,Levilactobacillus brevis,Leuconostoc sp.and Weisella confusa were identified in the vinegar samples.It was the first study reporting the identification of A.fabarum and Leuconostoc sp.,which were isolated from fig vinegar.The results of the study showed that A.pasteurianus and L.paracasei were predominant species found in vinegar samples.The study provides potential strains which may be used as starter cultures in food industry.

CHANGES OF PLASMA BETA-ENDORPHIN LEVELS BEFORE AND AFTER PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY IN PATIENTS WITH MITRAL STENOSIS

To clarify the contribution of left atrial pressure to the secretion of beta-endorphin, we have investigated the relation between plasma beta endorphin levels and hemodynamic changes in 35 patients with mitral stenosis undergoing percutaneous transvenous mitral commissurotomy (PTMC). Before PTMC, plasma beta-endorphin levels obtained from the antecubital vein (28.91 ± 5.59 pg / ml) and from the femoral vein (28.20 ± 5.44 pg / ml) in the patients with mitral stenosis were significantly higher than those obtained from the antecubital vein in the healthy volunteers (22.59 ± 3.86 pg / ml, n = 34, P< 0.001 for each). The levels of beta-endorphin in the femoral vein correlated well with the mean left atrial pressure (r=0.777, P< 0.001) and the mean right atrial pressure (r = 0.450, P<0.01) before the procedure. The antecubital venous levels of beta-endorphin in patients in New York Heart Association functional Classess Ⅱ (26.45 ± 5.39 pg / ml, n = 20) and Ⅲ (32.20 ± 4.02 pg / ml, n = 15) were significantly higher than those in control subjects (P< 0.005 and P< 0.001, respectively). The differences between Classes Ⅱ and Ⅲ were significant (P < 0.001). The plasma levels of beta-endorphin in the patients complicated with atrial fibrillation were also significantly higher than those in patients with normal sinus rhythm (33.31 ± 3.22 pg / ml, n= 13 vs 26.32± 5.07 pg / ml, n = 22, P< 0.001). In ten to fifteen minutes after commissurotomy, plasma levels of beta-endorphin in the femoral vein significantly increased from 28.20 ± 5.44 to 33.14 ± 5.72 pg / ml (P< 0.001). In seventy-two hours after the procedure, plasma beta-endorphin levels in the antecubital vein fell to 24.37 ± 2.59 pg / ml (P< 0.001 vs before PTMC and P<0.05 vs control subjects). Plasma beta-endorphin levels in the patients with atrial fibrillation (26.62 ± 2.36 pg / ml, P< 0.001 vs before PTMC and P< 0.002 vs control subjects) were still higher (P< 0.001) than those in patients with normal shins rhythm (23.05 ± 1.65 pg / ml, P< 0.001 vs before PTMC and P>50 vs control subjects. There was a significant correlation between the levels of beta-endorphin in the antecubital vein and heart rate (r = 0.502, P< 0.001), mean transmitral pressure gradient (r = 0.543, P< 0.001) or mitral valve area (r = -0.710, P< 0.001) before and 72 hours after the procedure.