bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Care Professionals’ Perspectives On Screening And Management Of Gestational Diabetes Mellitus In Public Hospitals Of South India – A Qualitative Study
Authors: Sahu Biswamitra , Babu Giridhara R , Gurav Kaveri Siddappa , Karthik Maithili , Deepa R , Lobo Eunice , John Daisy A , Oakley Laura , Oteng-Ntim E , Nadal Iliatha Papachristou , Kinra Sanjay
Published: September 2020

Background Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM is essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. Methods We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Results Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to natal home during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol.Conclusion There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.
Effect of Streptococcus anginosus on biological response of tongue squamous cell carcinoma cells
Authors: Xu Yuan , Jia Yuhuan , Chen Liang , Gao Jing , Yang Deqin
Published: September 2020

Background: Streptococcus anginosus(S.anginosus) was reported increased in oral squamous cell carcinoma(OSCC) tissue. The aim of this study was to investigate the response of oral cancer cells in the biological characteristics evoked by the S.anginosus and investigate its potential mechanisms.Methods: The growth curve and concentration standard curve of S.anginosus were determined , and a series of concentrations of S.anginosus supernatant were applied to OSCC cell lines SCC15,then selected an optimal time and concentration by CCK-8 assay. Then autophagic response, proliferative activity, cell cycle and apoptosis, invasion and migration abilities were evaluated in SCC15.Results: The results showed that when the ratio of S.anginosus supernatant to cell culture medium was 1:1 and the co-culture time was 16h, there was a most significant inhibited effect on SCC15; Furthermore, S.anginosus supernatant can up-regulate the autophagy activity of SCC15, then, the ability of proliferation, migration and invasion was observed inhibited obviously. Compared with the control groups, the cell cycle showed G1 arrest, S and G2 / M phases decreased, and the percentage of apoptotic cells relatively increased(P<0.05).Conclusion: S.anginosus can reduce the proliferation, migration and invasion of SCC15 cells and promote cell apoptosis; Moreover, autophagy may be one of the mechanisms in this process.
Country and Gender Differences in the Association between Violence and Cigarette Smoking Among Youth
Authors: Abu-Rmeileh Niveen ME , Alderete Ethel , Husseini Abdullatif , Livaudais-Toman Jennifer , Perez-Stable Eliseo J
Published: September 2020

Background: Exposure to violence in youth may be associated with substance use and other adverse health effects. This study examined cigarette smoking in two middle-income areas with different levels and types of exposure to violence. Methods: Association of exposure to verbal and physical violence with cigarette smoking in the West Bank oPt (2008) and in Jujuy Argentina (2006) was examined using cross-sectional surveys of 14 to 17-year old youth in 7th to 10th grade using probabilistic sampling. Results: Violence exposure rates were more than double for Palestinian girls (99.6% vs. 41.2%) and boys (98.7% vs. 41.1%) compared with Argentinians. The rate of current cigarette smoking was significantly higher among Argentinian girls compared with Palestinian girls (33.1% vs. 7.1%, p<0.001). Exposure to verbal violence from family and to physical violence increased the odds of current cigarette smoking, respectively, among Argentinian girls (aOR=1.3, 95% CI=1.0-1.7; aOR=2.5, 95%CI=1.7-3.8), Palestinian girls (aOR 2.2, 95%CI= 1.1-2.4; aOR=2.0, 95%CI=1.1-3.6) and Argentinian boys (aOR=1.5, 95%CI=1.1-2.0; aOR=2.2, 95%CI=1.6-3.0), but not among Palestinian boys.Conclusion: Findings highlight the importance of producing context and gender specific evidence from exposure to violence, to inform and increase the impact of targeted smoking prevention strategies.
The effects of changes in distance to nearest health facility on under-5 mortality and health care utilization in rural Malawi, 1980-1998
Authors: Quattrochi John Paul , Hill Kenneth , Salomon Joshua A , Castro Marcia C
Published: September 2020

Background: Despite important progress, the burden of under-5 mortality remains unacceptably high, with an estimated 5.3 million deaths in 2018. Lack of access to health care is a major risk factor for under-5 mortality, and distance to health care facilities has been shown to be associated with less access to care in multiple contexts, but few such studies have used a counterfactual approach to produce causal estimates. Methods: We combined retrospective reports on 18,714 births between 1980 and 1998 from the 2000 Malawi Demographic and Health Survey with a 1998 health facility census that includes the date of construction for each facility, including 335 maternity or maternity/dispensary facilities built in rural areas between 1980 and 1998. We estimated associations between distance to nearest health facility and (i) under-5 mortality, using Cox proportional hazards models, and (ii) maternal health care utilization (antenatal visits prior to delivery, place of delivery, receiving skilled assistance during delivery, and receiving a check-up following delivery), using linear probability models. We also estimated the causal effect of reducing the distance to nearest facility on those outcomes, using a two-way fixed effects approach. Findings: We found that greater distance was associated with higher mortality (hazard ratio 1.007 for one additional kilometer [95%CI 1.001 to 1.014]) and lower health care utilization (for one additional kilometer: 1.2 percentage point (pp) increase in homebirth [95%CI 0.8 to 1.5]; 0.8pp decrease in at least three antenatal visits [95% CI -1.4 to -0.2]; 1.2pp decrease in skilled assistance during delivery [95%CI -1.6 to -0.8]). However, we found no effects of a decrease in distance to the nearest health facility on the hazard of death before age five years, nor on antenatal visits prior to delivery, place of delivery, or receiving skilled assistance during delivery. We also found that reductions in distance decrease the probability that a woman receives a check-up following delivery (2.4pp decrease for a one kilometer decrease [95%CI 0.004 to 0.044]). Conclusion: Reducing under-5 mortality and increasing utilization of care in rural Malawi and similar settings may require more than the construction of new health infrastructure. Importantly, the effects estimated here likely depend on the quality of health care, the availability of transportation, the demand for health services, and the underlying causes of mortality, among other factors.
High-Quality Genome Sequence Assembly of R.A73 Enterococcus faecium Isolated from Freshwater fish mucus
Authors: Jeni Rim El , Ghedira Kais , Bour Monia El , Abdelhak Sonia , Kahla Alia Ben , Bouhaouala-Zahar Balkiss
Published: September 2020

Background: Whole-genome sequencing using high throughput technologies has revolutionized and speeded up the scientific investigation of bacterial genetics, biochemistry, and molecular biology. Lactic acid bacteria (LABs) have been extensively used in fermentation and more recently as probiotics in food products that promote health. Genome sequencing and functional genomics investigations of LABs varieties provide rapid and important information about their diversity and their evolution, revealing a significant molecular basis.This study investigated the whole genome sequences of the Enterococcus faecium strain (HG937697), isolated from the mucus of freshwater fish in Tunisian dams. Genomic DNA was extracted using the Quick-GDNA kit and sequenced using the Illumina HiSeq2500 system. Sequences quality assessment was performed using FastQC software. The complete genome annotation was carried out with the Rapid Annotation using Subsystem Technology (RAST) web server then NCBI PGAAP. Results: The Enterococcus faecium R.A73 assembled in 28 contigs consisting of 2,935,283 bps. The genome annotation revealed 2,884 genes in total including 2,834 coding sequences and 50 RNAs containing 3 rRNAs (one rRNA 16s, one rRNA 23s and one rRNA 5s) and 47 tRNAs. Twenty-two genes implicated in bacteriocin production are identified within the Enterococcus faecium R.A73 strain. Conclusion: Data obtained provide insights to further investigate the effective strategy for testing this Enterococcus faecium R.A73 strain in the industrial manufacturing process. Studying their metabolism with bioinformatics tools represents the future challenge and contribution to improving the utilization of the multi-purpose bacteria in food.
Evaluating the effectiveness of countermeasures to control the novel coronavirus disease 2019 in Jilin Province, China
Authors: Zhao Qinglong , Wang Yao , Yang Meng , Li Meina , Zhao Zeyu , Lu Xinrong , Shen Bo , Luan Bo , Zhao Yifei , Cao Bonan , Yao Laishun , Zhao Benhua , Su Yanhua , Chen Tianmu
Published: September 2020

Objective: Based on differences in populations and prevention and control measures, the spread of new coronary pneumonia in different countries and regions also differs. This study aimed to calculate the transmissibility of coronavirus disease 2019 (COVID-19), and to evaluate the effectiveness of countermeasures to control the disease in Jilin Province, China.
Methods: The data of reported COVID-19 cases were collected, including imported and local cases from Jilin Province as of March 14, 2019. A Susceptible–Exposed–Infectious–Asymptomatic–Recovered (SEIAR) model was developed to fit the data, and the effective reproduction number ( R eff ) was calculated at different stages in the province. Finally, the effectiveness of the countermeasures was assessed.
Results: A total of 97 COVID-19 infections were reported in Jilin Province, among which 45 were imported infections (including one asymptomatic infection) and 52 were local infections (including three asymptomatic infections). The model fit well with the reported data ( R 2 = 0.593, P < 0.001). The R eff of COVID-19 before and after February 1, 2020 was 1.64 and 0.05, respectively. Without the intervention taken on February 1, 2020, the predicted cases would reach a peak of 177,011 on October 22, 2020 (284 days from the first case). The projected number of cases until the end of the outbreak (on October 9, 2021) would be 17,129,367, with a total attack rate of 63.66%. Based on the comparison between the predicted incidence of the model and the actual incidence, the comprehensive intervention measures implemented in Jilin Province on February 1 reduced the incidence of cases by 99.99%. Therefore, according to the current measures and implementation efforts, Jilin Province can achieve good control of the virus’s spread.
Conclusions: COVID-19 has a moderate transmissibility in Jilin Province, China. The interventions implemented in the province had proved effective, increasing social distancing and a rapid response by the prevention and control system will help control the spread of the disease.
Kernel principal components based cascade forest towards disease identification with human microbiota
Authors: Zhou Jiayu , Wang Xuwen , Ye Yanqing , Jiang Jiang
Published: September 2020

Numerous pieces of clinical evidence have shown that many phenotypic traits of human disease are related to their gut microbiome. Through supervised classification, it is feasible to determine the human disease states by revealing the intestinal microbiota compositional information. However, the abundance matrix of microbiome data is so sparse, an interpretable deep model is crucial to further represent and mine the data for expansion, such as the deep forest. What's more, overfitting can still exist in the original deep forest model when dealing with such “large p, small n” biology data. Feature reduction is considered to improve the ensemble forest model especially towards the disease identification in the human microbiota. In this work, we propose the kernel principal components based cascade forest method, so-called KPCCF, to classify the disease states of patients by using taxonomic profiles of the microbiome at the family level. In detail, the kernel principal components analysis method is first used to reduce the original dimension of human microbiota datasets. Besides, the processed data is fed into the cascade forest to preliminarily discriminate the disease state of the samples. Thus, the proposed KPCCF algorithm can represent the small-scale and high-dimension human microbiota datasets with the sparse feature matrix. Systematic comparison experiments demonstrate that our method consistently outperforms the state-of-the-art methods with the comparative study on 4 datasets. Additionally, compared to other dimensionality reduction methods, the kernel principal components analysis method is more suitable for microbiota datasets.
Impact of Patron Saint Festivities on Cholera in Three Communes in Haiti
Authors: Moise Kenny , Achille Aude Mélody , Batumbo Doudou , Bourdeau Bertiny , Rebaudet Stanislas , Lerebours Gérald , Henrys Jean Hugues , Raccurt Christian
Published: September 2020

Background: Religious pilgrimages are among the anthropogenic factors known to be associated with the transmission of diarrheal diseases, such as cholera. This ecological study aimed to describe the evolution of cholera and assess the relationship between the implementation of the ‘coup de poing’ strategy during the patron saint festivities and the incidence of cholera in the three communes of Cabaret, Carrefour, and Croix-des-Bouquets in Haiti in 2017.Methods: An epidemiological curve was produced to illustrate the evolution of cholera at the communal level. Generalized linear models assuming a Poisson distribution were used to weight the annual cholera incidence of communal sections against variables such as the number of patronal festivities, population density and annual precipitation rates. The number of cases in the week of the festivity as well as one and two weeks later was weighted against patronal festivities and weekly precipitation rates.Results: In total, 3 633 suspected cholera cases were continuously reported in three communes in Haiti (Cabaret, Carrefour, Croix-des-bouquets) during the 52-epidemiological week period in 2017. After controlling for rainfall and population density, the implementation of the ‘coup de poing’ strategy during the patron saint festivities was associated with a significant reduction in cholera incidence of 57.23% [PR=0.4277 (97.5% CI: 0.2798-0.6193), p=0.0000244]. The implementation of the strategy was associated with a reduction in cholera incidence of 25.41% one week following patronal festivities.Conclusion: This study showed a continuous presence of cholera in three communes in Haiti in 2017 and an association between the implementation of the ‘coup de poing’ strategy during patronal festivities and a reduction in cholera incidence. The findings imply that the multi-partner ‘coup de poing’ strategy may have contributed to the reduced cholera incidence following patron saint festivities and in Ouest department in Haiti in 2017.
Stakeholders’ Perceptions of the Nutrition and Dietetics Needs and the Requisite Professional Competencies in Uganda: A Cross-Sectional Mixed Methods Study
Authors: Kikomeko Peterson Kato , Ochola Sophie , Kaaya Archileo N. , Ogada Irene , Birungi Tracy Lukiya , Nakitto Peace
Published: September 2020

Background: Effective implementation of nutrition and dietetics interventions necessitates professionals in these fields to possess the requisite competencies for health systems performance. This study explored the stakeholders’ perceptions of the community nutrition and dietetics needs, the nature of work done by graduates of the Bachelor’s degree in Human Nutrition/Human Nutrition and Dietetics (HN/HND), and the competencies required of Nutrition and Dietetics professionals in Uganda. Methods: A cross-sectional mixed methods design was used. Respondents included 132 graduates of the Bachelor’s degrees in HN/HND obtained from the Makerere and Kyambogo Universities during the period 2005-2016; 14 academic staff that train HN/HND in the two universities; and 10 HN/HND work/internship supervisors. Data from the graduates was collected through an email-based survey while that from other participants was through face to face interviews using a structured key informant interview guide. Results: Most HN/HND respondents (84.8%) obtained their Bachelor's degrees from Kyambogo University and 61.4% graduated in the years 2013-2016. Most (64.3%) academic staff that responded were females and the majority (57.1%) had doctorate training. All stakeholders viewed communities as facing a variety of nutrition and dietetics challenges some of which fall across different Sustainable Development Goals. The nutrition and dietetics interventions requested, provided, and considered a priority to provide to communities were both nutrition-specific and nutrition-sensitive. Work done by HN/HND graduates encompassed seven main domains; the dominant being organizational leadership and management; management of nutrition-related disease conditions; nutrition and health promotion; research and documentation; and advocacy, communication, and awareness. Conclusions: This study shows that nutrition and dietetics challenges in Uganda are multifaceted. HN/HND graduates are employed in different sectors; provide nutrition-specific and sensitive interventions in a multisectoral environment; are expected to possess a variety of knowledge and skills. However, graduates have knowledge and skills gaps even in some of the key areas they are expected to exhibit competency. We recommend using these findings to develop a HN/HND competency-based education model suitable for Uganda; develop a national HN/HND training and practice standards; and undertake further research to understand the quality and relevancy of HN/HND curricula to the job market requirements.
Views of advanced cancer patients, families, and oncologists on initiating and engaging in advance care planning: a qualitative study
Authors: Toguri James Thomas , Grant-Nunn Lindsay , Urquhart Robin
Published: September 2020

Background: Advance care planning (ACP) is a process by which patients reflect upon their goals, values and beliefs to allow them to make decisions about their future medical treatment that align with their goals and values, improving patient-centered care. Despite this, ACP is underutilized and is reported as one of the most difficult processes of oncology. We sought to: 1) explore patients’ and families’ understanding, experience and reflections on ACP, as well as what they need from their physicians during the process; 2) explore physicians’ views of ACP, including their experiences with initiating ACP and views on ACP training. Methods: This was a qualitative descriptive study in Nova Scotia, Canada with oncologists, advanced cancer out-patients and their family members. Semi-structured interviews with advanced cancer out-patients and their family members (n=4 patients, 4 family members) and oncologists (n=10) were conducted; each participant was recruited separately. Data were analyzed using constant comparative analysis, which entailed coding, categorizing, and identifying themes recurrent across the datasets. Results: Themes were identified from the patient / family and oncologist groups, four and five respectively. Themes from patients / families included: 1) positive attitudes towards ACP; 2) healthcare professionals (HCPs) lack an understanding of patients’ and families’ informational needs during the ACP process; 3) limited access to services and supports; and 4) poor communication between HCPs. Themes from oncologists included: 1) initiation of ACP discussions; 2) navigating patient-family dynamics; 3) limited formal training in ACP; 4) ACP requires a team approach; and 5) lack of coordinated systems hinders ACP. Conclusions: Stakeholders believe ACP for advanced cancer patients is important. Patients and families desire earlier and more in-depth discussion of ACP, additional services and supports, and improved communication between their HCPs. In the absence of formal training or guidance, oncologists have used clinical acumen to initiate ACP and a collaborative healthcare team approach.
Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study
Authors: Fan Shaoyi , Liang Ximin , Yun Tianchan , Pei Zhong , Hu Bin , Ismail Zahinoor , Yang Zhimin , Xu Fuping
Published: September 2020

Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a neurobehavioral syndrome characterized by later-life emergence of sustained neuropsychiatric symptoms, has yet to be elucidated.We aimed to evaluate the associations between mild behavioral impairment and frailty in non-dementia older adults.Methods: This is a cross-sectional study. A consecutive series of 137 non-dementia older adults in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist at a cut-off point of >8 (optimizing sensitivity and specificity), which was developed to assess emergent neuropsychiatric symptoms in accordance with the MBI criteria. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariate logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariate logistic regression analysis demonstrated that compared to MBI- status (without MBI), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49-37.21, p = 0.02).Conclusions: MBI is significantly associated with an increased risk of having frailty before the presence of overt dementia. This association merits further study to identify strategies for the early detection, prevention and therapeutic intervention of frailty.
A Multi-Method Exploratory Study of Health Professional Students’ Experiences with Compliance Behaviours
Authors: Violato Efrem , King Sharla , Bulut Okan
Published: September 2020

Background: Research in healthcare, including students as participants, has begun to document experiences with negative compliance, specifically conformity and obedience. There is a growing body of experimental and survey literature, however, currently lacking is a direct measure of the frequency at which health professional students have negative experiences with conformity and obedience integrated with psychological factors, the outcomes of negative compliance, and students’ perceptions. Methods: To develop empirical knowledge about the frequency of negative compliance and student perceptions during health professional education a multi-methods survey approach was used. The survey was administered to health professional students across ten disciplines at four institutions. Results: The results indicated students regularly experience obedience and conformity and are influenced by impression management and displacement of responsibility. Moral distress was identified as a consistent negative outcome. Student self-reported experiences aligned with the empirical findings. Conclusions: The findings of the present study demonstrate the pervasiveness of experiences with negative compliance during health professional’s education along with some attendant psychological factors. The findings have educational and practical implications, as well as pointing to the need for further integration of social and cognitive psychology in explaining compliance in healthcare. The results are likely generalizable to a population level however replication is encouraged to better understand the true frequency of negative compliance at a health professional population level.
Spatio-temporal mapping of breast and prostate cancers in South Iran from 2014-2017
Authors: Montazeri Mahdieh , Hoseini Benyamin , Firouraghi Neda , Kiani Fatemeh , Raouf-Mobini Hosein , Biabangard Adele , Dadashi Ali , Zolfaghari Vahideh , Ahmadian Leila , Eslami Saeid , Bergquist Robert , Bagheri Nasser , Kiani Behzad
Published: September 2020

Background: The most common gender-specific malignancies are cancer of the breast and the prostate. In developing countries, cancer screening of all at risk is impractical because of healthcare resource limitations. Thus, determining high-risk areas might be an important first screening step. This study explores potential high-risk clusters in the incidence pattern of breast and prostate cancers in southern Iran.Methods:This cross-sectional study was conducted in the province of Kerman, South Iran. Patient data were aggregated at the county and district levels and the incidence rate per 100,000 people both for cancer of the breast and the prostate were calculated. We used the natural-break classification with five classes to produce descriptive maps. A spatial clustering analysis (Anselin Local Moran’s I) was used to identify potential clusters and outliers in the pattern of these cancers from 2014 to 2017.Results:The age-standardised incidence rate of breast cancer showed an increase from 29.93 to 32.27 cases per 100,000 people and that of prostate cancer from 13.93 to 15.47 cases per 100,000 during 2014-2017. Cluster analysis at the county level identified high-high clusters of breast cancer in the North-West of the province for all years, but the analysis at the district level showed high-high clusters for only two of the years. Furthermore, cluster analysis at the county and district levels of prostate cancer also identified high-high clusters in the North-West of the province for two of the years.Conclusions:North-western Kerman had a significantly higher incidence rate of both breast and prostate cancer, which should help in designing tailored screening and surveillance systems. Furthermore, this study generates new hypotheses to test potential relationships between environmental risk factors and incidence of cancers in areas with higher cancer risk than the average.
Generating Real-world Evidence from Unstructured Clinical Notes to Examine Clinical Utility of Genetic Tests: Use Case in BRCAness
Authors: ZHAO Yiqing , Weroha Saravut J , Goode Ellen , Liu Hongfang , Wang Chen
Published: September 2020

Background : Next- generation sequencing provides comprehensive information about individuals’ genetic makeup and is commonplace in oncology clinical practice. However, the utility of genetic information in clinical decision-making process has not been examined extensively from a real-world, data-driven perspective. Through mining real-world data (RWD) from clinical notes, we could extract patients’ genetic information and further associate treatment decisions with genetic information. Methods : We proposed a real-world evidence (RWE) study framework that incorporates context-based natural language processing (NLP) methods and data quality examination before final association analysis. The framework was demonstrated in a Foundation-tested women cancer cohort (N=196). Upon retrieval of patients’ genetic information using NLP system, we assessed the completeness of genetic data captured in unstructured clinical notes according to a genetic data-model. We examined the distribution of different topics regarding BRCA1/2 throughout patients’ treatment process, and then analyzed the association between BRCA1/2 mutation status and the discussion/prescription of targeted therapy . Results: We identified seven topics in clinical context of genetic mentions including: Information, Evaluation, Insurance, Order, Negative, Positive, and Variants of unknown significance (VUS) . O ur rule-based system achieved a precision of 0.87, recall of 0.93 and F- measure of 0.91. Our machine learning system achieved a precision of 0.901, recall of 0.899 and F- measure of 0.9 for four-topic classification and a precision of 0.833, recall of 0.823 and F- measure of 0.82 for seven-topic classification. We found in result-containing sentences, capture of BRCA1/2 mutation information was 75%, but detailed variant information (e.g. variant types) is largely missing. Using cleaned RWD, significant associations were found between BRCA1/2 positive mutation and targeted therapies. Conclusions : In conclusion, we demonstrated a framework to generate RWE using RWD from different clinical sources. Rule-based NLP system achieved the best performance for resolving contextual variability when extracting RWD from unstructured clinical notes . Data quality issues such as incompleteness and discrepancies exist thus manual data cleaning is needed before further analysis can be performed. Finally, we were able to use cleaned RWD to evaluate real-world utility of genetic information to initiate a prescription of targeted therapy.
DNA Barcoding Reveals Cryptic Diversity in the Underestimated Genus Triplophysa (Cypriniformes: Cobitidae, Nemacheilinae) from the Northeastern Qinghai-Tibet Plateau
Authors: wang tai , Zhang Yanping , Yang Zhuoyu , Liu Zhe , Du Yanyan
Published: September 2020

Background: The northeastern part of the Qinghai-Tibet Plateau (QTP) is one of the areas where the number of species of plateau loach is the largest. As one of the three major groups of fishes distributed on the QTP, plateau loach have very important ecological value. However, their taxonomy and systematics are still controversial, and a large number of new species have been reported. The reason for this phenomenon is that the degree of morphological variation is low, the phylogenetic information provided by morphological and anatomical features used for species identification is relatively poor, and there are many cryptic species. Based on the high-density sampling points from the biodiversity hotspots surveyed, this study aims to evaluate the biodiversity of plateau loach in the northeastern of QTP and reveal the hidden diversity by comparing morphologic species with molecular operational taxonomic units (MOTUs). Results: After careful identification and comparison of the morphology and DNA barcoding of 1,630 specimens, 22 species were identified, 20 of which were considered valid local species and two of which were new species that had not been described. Based on the combination of morphological and molecular methods, a total of 24 native species have been found, two of which are cryptic species: Triplophysa robusta sp1 and Triplophysa minxianensis sp1. Fourteen of the 24 species form clusters of barcodes, which allow them to be reliably identified. The remaining cases involved 10 closely related species, some of which were rapidly differentiated, seemed to have experienced incomplete lineage sorting, or showed introgressions.Conclusions: The results highlight the need to combine traditional taxonomies with molecular methods to correctly identify species, especially in closely related species such as the plateau loach. This study provides a basis for protecting the biodiversity of plateau loach.
Evaluation of the Effect of Curcumin and Zinc Co-Supplementation on Glycemic Measurements, Lipid Profiles, Inflammatory and Antioxidant Biomarkers in Overweight or Obese Pre-Diabetic Patients: A study Protocol for a Randomized Double-Blind Placebo-Controlled Phase 2 Clinical Trial
Authors: Karandish Majid , Mozaffari-khosravi Hassan , Mohammadi Seyed Mohammad , cheraghian bahman , Azhdari Maryam
Published: September 2020

Background: The prevalence of prediabetes is increasing worldwide. Unfortunately, prediabetes is related to non-communicable diseases. A high risk of developing type 2 diabetes mellitus (T2DM) is reported in people with prediabetes. Curcumin, a polyphenol, might lead to its therapeutic role in obesity and some obesity-related metabolic diseases. Zinc is a trace element that plays a key role in the synthesis and action of insulin, carbohydrate metabolism, and decreasing inflammation. There has been no clinical trial of zinc and curcumin co-supplementation in patients with prediabetes. In previous studies, the single administration of zinc or curcumin hasn’t been conducted on many of the studied markers in pre-diabetic patients. Methods: The propose of this randomized double-blind placebo-controlled clinical trial is to investigate the effect of curcumin and zinc co-supplementation on glycemic measurements, lipid profiles, inflammatory and antioxidant biomarkers among 84 pre-diabetic patients with body mass index (BMI) between 25 and 35. Also, liver enzyme, serum zinc, urine zinc, blood pressure, anthropometric parameters, quality of life, adherence to co-supplementation, the side effects of co-supplementation, physical activity, and dietary intake will be assessed. Women or men (18-50 years old, for women: 18 years - before menopause) will be followed for three months (90 days). This study will be conducted at Yazd Diabetes Research Clinic, Shahid Sadoughi University of Medical Sciences. Discussion: A diet rich in antioxidants, polyphenols, and phytochemicals has been shown to have a beneficial role in prediabetes. According to the beneficial properties of curcumin or zinc and inadequate evidence, RCTs are needed to assess the effect of curcumin and zinc co-supplementation in native prediabetes patients. We hope the results of the present trial, negative or positive, fill this gap in the literature and facilitate the approach for a much larger, multi-center clinical trial. In conclusion, a synergic effect of co-supplementation along with a weight-loss diet may delay the progression to type 2 diabetes mellitus.Trial registration: The project is a registered clinical trial (Registration number: IRCT20190902044671N1, Iranian Registry of Clinical Trials (IRCT), registered October 11, 2019.
WITHDRAWN: Aging-related tumor associated fibroblasts changes could worsen the prognosis of GBM patients
Authors: Song Hongwang , Fu Xiaojun , Wu Chenxing , Li Shouwei
Published: September 2020

Background: Glioblastoma multiforme (GBM) is the most malignant tumor in human brain, with highly heterogeneity among different patients. Age could function as an incidence and prognosis risk factor for many tumors.Method: A series of bioinformatic experiments were conducted to evaluate the differences of incidence, differential expressed genes, enriched pathways with the data from Surveillance, Epidemiology, and End Results (SEER) program, the cancer genome atlas (TCGA) and Chinese glioma genome atlas (CGGA) project.Results: We discovered in our present study that distinct difference of incidence and prognosis of different aged GBM patients. By a series of bioinformatic method, we found that the tumor associated fibroblasts (TAFs) was the most crucial tumor microenvironment (TME) component that led to this phenomenon. Epithelial-mesenchymal transition (EMT) could be the mechanism by which TAFs regulate the progression of GBM. Conclusion: We have proposed a close correlation between age and GBM incidence and prognosis, and propose the underlying mechanism behind this correlation by mining different databases, which laid the foundation for future research.
Autosomal recessive polycystic kidney disease: case report of a newborn with rare PKHD1 mutation, rapid renal enlargement and early fatal outcome
Authors: Serra Gregorio , Corsello Giovanni , Antona Vincenzo , D'Alessandro Maria Michela , Cassata Nicola , Cimador Marcello , Giuffrè Mario , Schierz Ingrid Anne Mandy , Piro Ettore
Published: September 2020

Introduction: Autosomal recessive polycystic kidney disease (ARPKD; MIM#263200) is one of the most frequent pediatric renal cystic diseases, with an incidence of 1:20,000. It is caused by mutations of the PKHD1 gene, on chromosome 6p12. The clinical spectrum is highly variable, ranging from late-onset milder forms to severe perinatal manifestations. The management of newborns with severe pulmonary insufficiency is challenging, and causes of early death are sepsis or respiratory failure. In cases of massive renal enlargement, early bilateral nephrectomy and peritoneal dialysis may reduce infant mortality. However, there is no conclusive data on the role of surgery, and decision-making is driven by patient’s clinical condition and expertise of the center. Patient presentation: We hereby describe a preterm female newborn with perinatal, rapid and bilateral, abnormal growth of both kidneys, respiratory failure and initial signs of liver disease. She was subsequently confirmed to be affected by a rare and severe homozygous mutation of the PKHD1 gene, inherited from both her consanguineous parents. Our patient died 78 days after birth, due to a fungal sepsis which worsened her respiratory insufficiency. Conclusions: This patient report shows some of the clinical and ethical issues of neonatal ARPKD, and the need of multidisciplinary approach and good communication with the family. Target next generation sequencing (NGS) techniques may guide and support clinicians, as well as guarantee to these patients the most appropriate clinical management, avoiding unnecessary and/or disproportionate treatments.
Glycaemia and hand grip strength in aging people: Guangzhou Biobank Cohort Study
Authors: Liang Xue , Jiang Chao Qiang , Zhang Wei Sen , Zhu Feng , Jin Ya Li , Cheng Kar Keung , Lam Tai Hing , Xu Lin
Published: September 2020

BackgroundThere is a link between hyperglycemia and mechanical functions of muscle. However, existing evidence of the association between hyperglycemia and weaker muscle strength is limited and inconsistent. We examined whether glycemic status was associated with relative grip strength (RGS) in older Chinese.MethodsIn 2008-2012, 9180 participants (2516 men and 6664 women) from the Guangzhou Biobank Cohort Study had fasting and 2-hour post-load glucose measured. Glycemic status was categorized as normoglycaemia, prediabetes (i.e., impaired fasting glucose and/or impaired glucose tolerance) and diabetes. RGS was assessed using a Jamar Hydraulic Hand Dynamometer divided by body mass index. General linear model was used to assess the association of glycemic status with RGS.ResultsAfter adjusting for age, smoking status, alcohol use, physical activity, health status, body fat percentage and waist circumference, in men, hyperglycemia was associated with a lower RGS, with the RGS being 1.38 (95% confidence interval (CI)=1.34, 1.42) in normoglycaemia, 1.35 (95% CI=1.30, 1.39) in prediabetes, 1.33 (95% CI=1.29, 1.38) in newly diagnosed diabetes and 1.32 (95% CI=1.27, 1.37) in known diabetes (P for trend <0.001). The association of glycemic status with RGS was non-significant in women. Among the normoglycaemic group, no association was found between fasting glucose and RGS in men, whereas a significantly inverse association was found in women, with adjusted β for RGS per mmol/l increase in fasting glucose being -0.05 to -0.04 (P values from 0.002 to 0.03).ConclusionsHigher fasting glucose was associated with reduced grip strength in a dose-response manner, and the association was significant even in women with normoglycaemia. Our findings suggest that lowering glucose across the whole range might be important in preserving muscle strength, especially in aging women.
Infection Control and Management of COVID-19: Challenges for Paediatric Tertiary Care Hospitals
Authors: Remppis Jonathan , Ganzenmueller Tina , Vasconcelos Malte Kohns , Heinzel Oliver , Handgretinger Rupert , Renk Hanna
Published: September 2020

PURPOSE: To describe infection control measures and patient management at a tertiary children’s hospital in southern Germany during the COVID-19 pandemic.METHODS: Prospective, observational study of infection control measures, patient management, clinical and virologic data of paediatric patients treated at our hospital during the COVID-19 pandemic from February to May 2020. Infection control measures were documented beginning with preparation for the pandemic. All paediatric patients with suspected SARS-CoV-2 infection were prospectively included in the study.RESULTS: With local triage, restraint of patient admission and testing strategies implemented, healthcare capacity remained adequate and no healthcare-associated infections occurred. Workload in the paediatric emergency department significantly decreased following the lockdown of schools and kindergartens. 7 of 174 (4%) children with and 2 of 208 (1%) children without typical symptoms, respectively, were diagnosed with COVID-19 by PCR. Six out of nine inpatients treated for COVID-19 had underlying comorbidities, two were admitted to the intensive care unit. One patient died shortly after discharge.CONCLUSIONS: While COVID-19 generally causes mild disease in children, severe illness and fatal cases may occur, particularly among children with underlying diseases. Tertiary children’s hospitals may face challenges with treating potential high-risk patients during the pandemic. Thus, timely establishment of effective testing and triage strategies is crucial.
The Identification of Hub Genes and Pathways in type 2 Diabetes Mellitus by Bioinformatics Analysis
Authors: Li Jing , Jiang Xinkui , Chen Libo , Chen Hong
Published: September 2020

Background This study aimed to identify potential core genes and pathways involved in type 2 diabetes mellitus (T2DM) through exhaustive bioinformatics analysis. This study elucidated parts of the pathogenesis of T2DM and screened therapeutic targets of the treatment. Method: The original microarray data GSE25724 was downloaded from the Gene Expression Omnibus database. Data were processed by the limma package in R software and the differentially expressed genes(DEGs) were identified. Gene Ontology(GO) functional analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway analysis were carried out to identify potential biological functions and pathways of the DEGs. The STRING(Search Tool for the Retrieval of Interacting Genes ) and Cytoscape software were used to establish a protein-protein interaction(PPI) network for the DEGs.Hub genes were identified using the PPI network.Results In total, 75 DEGs were involved in T2DM, with 1 up-regulated gene, and 74 down-regulated genes. GO enrichment analysis showed that DEGs mainly enriched in the regulation of hormone levels, unfolded protein binding.KEGG pathway enrichment analysis showed that DEGs were significantly enriched in the fatty acid metabolism pathway, propionate metabolism pathway, and degradation pathway of valine, leucine, and isoleucine. Furthermore,Neuroendocrine protein 7B2(SCG5),Synaptosomal-associated protein 25 (SNAP25), Sterol Carrier Protein 2 (SCP2), Carboxypeptidase E (CPE),and Protein Convertase Subtilisin/Kexin Type 1 (PCSK1) were the core genes in the PPI network.Conclusion This study identified 5 hub genes as potential biomarkers of type 2 diabetes through bioinformatics analysis, which might increase our understanding of the potential molecular mechanisms of T2DM and provided targets for further research.
Evaluation frequency of Human Herpes Virus type 8 in Patients with Breast Cancer
Authors: Fozuni Elaheh , arabzadeh seyed Mohamad Ali , Mollaei Hamid Reza , Iranpour Maryam , Afshar Reza Malekpour
Published: September 2020

Background

Breast cancer is one of the most common malignancies and the most common cause of death women around worldwide. Recently, viral etiology theory has been proposed on physiopathology of the breast cancer.
Method:

In a retrospective study, to study of non-familial agents and a viral factors breast cancer, the Real time PCR were used to detect Kaposi Herpes virus or Human herpes virus type8(HHV8) in 138 patients with breast cancer.
Result

Out of the 138 embedded paraffin breast cancer tissues, 17(12.3%) were positive for HHV8. Among the viral positive breast cancer samples, 8 samples (10.95%) were positive in intermediate grade and 10 samples (11.9%) were positive in 40–60 years old age group. There was no significant relation between grades of tumors and there was a significant relation between age and breast cancer.
Conclusion

Out of 17 positive samples 15 samples (88.23%) and 2 samples (11.77%) had more than 5 and less than 3 infected lymph node. In this study, there was a significant relation between infected lymph node and positive samples with HHV-8. Therefore, it is likely that the lymphocytes infected with HHV-8 virus may be the source of cancer cells and may also cause infected cells to spread to other organs, as well as the treatment of these patients is difficult.