bluuebunny/crossref_metadata_2025 huggingface dataset:
LCAT Deficiency in Amerindian Populations: A Systematic Review With the Clinical and Genetic Description of Mexican Kindred
Authors: Mehta Roopa , Elías-López Daniel , Martagón Alexandro J , Pérez-Méndez Oscar A , Ordóñez-Sánchez María L , Segura Yayoi , Tusié María Teresa , Aguilar-Salinas Carlos A
Published: October 2020

Background: LCAT deficiency is a rare disease, characterized by two distinct phenotypes, familial LCAT deficiency (FLD) and Fish Eye disease (FED). There is little knowledge of LCAT deficiency syndromes in Amerindian populations. We present the results of the first systematic review evaluating the ethnic distribution of LCAT deficiency, with particular emphasis on Latin America and discuss the case histories of three Mexican-Mestizo probands. Methods: A systematic review was conducted following the PRISMA Statement in Pubmed and SciELO. Articles which described subjects with LCAT deficiency syndromes and an assessment of the ethnic group to which the subject pertained, were considered for analysis. Results: In our region, 47 cases of LCAT deficiency have been published from six countries (Argentina (1 unclassified), Brazil (38 FLD), Chile (1 FLD), Columbia (1 FLD), Ecuador (1 FLD) and Mexico (4 FLD, 1 FED and 1 unclassified). In Mexico, one of the FLD probands’ showed a novel mutation; this patient came from an isolated village in the south of Mexico, with little genetic admixture in this region.The systematic review revealed 215 cases of LCAT deficiency (154 FLD, 41 FED and 20 unclassified) in at least 33 ethnic/racial groups (predominantly Caucasian). In addition, at least 138 different mutations in the LCAT gene have been identified. There was no association between genetic alteration and ethnicity. The mean age of diagnosis was 42 ± 16.5 years, with FED identified significantly later than FLD (55 ± 13.8 vs. 41 ± 14.7 years respectively). The prevalence of premature coronary heart disease was significantly greater in FED vs. FLD (p=0.00). Conclusion: The systematic review shows that LCAT deficiency syndromes are clinically and genetically heterogeneous. We were unable to confirm any association between ethnicity and LCAT mutation. However, we were able to show a significantly greater risk of premature coronary artery disease in FED compared to FLD. In FLD, the emphasis should be in preventing progression of renal disease, while in FED, cardiovascular risk management should be the priority. The LCAT mutations discussed in this article are the only ones reported in the Mexican- Amerindian population.
Reversed L-shaped Association Between Baseline Brachial-ankle Pulse Wave Velocity and Short-Term Risk of First Stroke in Patients With Hypertension: A Population-based Cohort Study
Authors: Hu Lihua , Bi Chonglei , Liu Lishun , Song Yun , Zhang Yue , Wang Binyan , Fang Chongqian , Ma Hai , Huang Xiao , Zhang Yan , Bao Huihui , Li Ping , Xu Xiping , Wang Xiaobin , Cheng Xiaoshu , Huo Yong , Li Jianping
Published: October 2020

Background: Brachial–ankle pulse wave velocity (baPWV) is available as a noninvasive measure of arterial stiffness. However, little information is available on the association between baPWV and the short-term risk of stroke in patients with hypertension. Therefore, our current study aimed to assess the association between baseline baPWV and short-term risk of first stroke. We were particularly interested in identifying those individuals at high risk of developing stroke among patients with hypertension.Methods: From January 1, 2017, to December 31, 2017, a total of 9787 individuals without preexisting stroke from the China Hypertension Registry Study were included in this analysis. Follow-up continued until December 31, 2018. The primary outcome was first stroke. The crude and adjusted risks of first stroke were estimated by hazard ratios (HRs) and 95% CIs using Cox proportional hazards models, without or with adjusting for pertinent covariates, respectively.Results: During a median follow-up of 20.8 months, there were 138 total first strokes including 123 first ischemic strokes and 15 first hemorrhagic strokes. Smooth curve showed that the relationship between baPWV and risk of first stroke and first ischemic stroke was curvilinear and reversed L-shaped. High baPWV levels (≥ 21.31 m/s) was associated with increased risk of first stroke (HR = 1.52; 95% CI: 1.05-2.21) and first ischemic stroke (HR = 1.53; 95% CI: 1.03-2.26) compared to low baPWV levels (< 21.31 m/s). E-value analysis suggested robustness to unmeasured confounding. Our findings may propose the applicability of baPWV measurement for prediction of stroke development, especially in subjects with a low cardiovascular (CVD) risk.Conclusions: High baPWV levels (≥ 21.31 m/s) were associated with increased the short-term risk of first stroke among Chinese hypertensive adults, compared to low baPWV levels, supporting a reversed L-shaped association. Our findings warrant additional investigation.
Microbiota Dynamics in Semi-Solid Fermentation of Light-Flavor Liquor with Corn as Main Material by Illumina Miseq Sequencing
Authors: Liu Xiao , Ma Rufei , Hu Jinrong , Zhou Xia , Wang Mengya , Zhang Jingsheng , Liu Ping
Published: October 2020

Background: Light-flavor liquor, with ethyl acetate as the main aroma component, is regarded as one of the four basic types in china. The traditional solid-state fermentation has a long period and a complicated process, but the content of esters and acids in liquid fermentation is not as good as that in solid-state fermentation. In this study, according to the methods of solid fermentation and liquid fermentation, the semi-solid fermentation of light-flavor liquor was simulated with optimized fermentation conditions, using corn and sorghum as brewing materials (corn: sorghum=7: 3). Furthermore, the bacterial and fungal community were investigated by high-throughput sequencing. Results: The physical and chemical results showed that the content of reducing sugar, alcohol and ethyl acetate first increased and then decreased, while the contents of reducing sugar, alcohol and ethyl acetate reached the peak at 1 d, 11 d and 20 d, respectively. The Illumina MiSeq Sequencing results showed that Lactobacillaceae and Leuconostocaceae were the dominant bacteria on the family level. Moreover, Pediococcus and Weissella were the main bacteria on the genera level. Meanwhile, 4 fungal phyla were identified with Ascomycota (83.6-99.99%) as the dominant phyla. There were 5 species of fungi with the relative abundance over 1.00%, with Saccharomyces cerevisiae and Saccharomycopsis fibuligera were the main species. From the 3rd day, the relative abundance of Saccharomycopsis fibuligera decreased rapidly to 2.4%, while Saccharomyces cerevisiae (up to 99.2%) became the absolute dominant fungus species. The results of Redundancy analysis (RDA) showed that starch and reducing sugar had a significant influence on Pediococcus. Saccharomycopsis fibuligera was most affected by starch. In addition, Saccharomyces cerevisiae was most affected by alcohol. Conclusions: Saccharomycopsis fibuligera and Pediococcus were positively correlated to starch and reducing sugar, highlighting their important roles in the starch saccharification. Saccharomyces cerevisiae contributed to the glycolysis and esterification，because they were positively correlated to alcohol and total acid. Nevertheless, Saccharomyces cerevisiae, as the dominant fungus, had maintained a high abundance during the whole fermentation. This study could provide new insights to design new processes for semi-solid fermentation and improve the quality and controllability of liquor production.
Evaluation of Non-invasive Imaging Parameters in Coronary Microvascular Disease: A Systematic Review
Authors: Groepenhoff Floor , Klaassen R.G.M. , Valstar G.B. , Bots S.H. , Onland-Moret N.C. , Ruijter H.M. Den , Leiner T. , Eikendal A.L.M.
Published: October 2020

Background: Coronary microvascular dysfunction (CMD) is an important underlying cause of angina pectoris. Currently, no diagnostic tool is available to directly visualize the coronary microvasculature. Invasive microvascular reactivity testing is the diagnostic standard for CMD, but several non-invasive imaging techniques are being evaluated. However, evidence on reported non-invasive parameters and cut-off values is limited. Thus, we aimed to provide an overview of reported non-invasive parameters and corresponding cut-off values for CMD.Methods: Pubmed and EMBASE databases were systematically searched for studies enrolling patients with angina pectoris without obstructed coronary arteries, investigating at least one non-invasive imaging technique to quantify CMD. Methodological quality assessment of included studies was performed using QUADAS-2.Results: Thirty-six studies were included. Nine cardiac magnetic resonance (CMR) studies reported MPRI (n = 9) and nine positron emission tomography (PET) and transthoracic echocardiography (TTE) studies reported CFR. Mean MPRI ranged from 1.47 ± 0.36 to 1.83 ± 0.50 in patients and from 1.50 ± 0.47 to 2.23 ± 0.37 in healthy controls. Reported mean CFR in PET and TTE ranged from 1.39 ± 0.31 to 2.85 ± 1.35 and 1.69 ± 0.40 to 2.40 ± 0.40 for patients, and 2.68 ± 0.83 to 4.32 ± 1.78 and 2.65 ± 0.65 to 3.31 ± 1.10 for controls, respectively.Conclusions: This systematic review summarized current evidence on reported parameters and cut-off values to diagnose CMD for various non-invasive imaging modalities. Nonetheless, standardization of methodology and reporting of outcome measures is required to provide clinically applicable reference values.
Prevalence of Abnormal and Borderline Electrocardiogram Changes in 13, 079 Chinese Amateur Marathon Runners
Authors: Wen Xu , Huang Yumin , Shen Tonghui , Gong Yinglan , Dong Ruiqing , Xia Ling , xie tiansheng
Published: October 2020

The purpose of this study was to assess the prevalence of normal, borderline and abnormal ECG changes in marathon runners. The 12-lead ECG data of 13,079 amateur marathon runners between the ages of 18 and 35 years were included for analysis. The prevalence of ECG abnormalities among different gender groups was compared with chi-square tests. In terms of training-related changes, sinus bradycardia, sinus arrhythmia and left ventricular high voltage were found in approximately 15%, 5% and 3.28% of the participants, respectively. The incidence of right axis deviation in the marathon runners was 1.78%, which was slightly higher than the incidence of left axis deviation (0.88%). No more than 0.1% of the amateur marathon runners exhibited ST segment depression, T wave inversion (TWI), premature ventricular contraction, pathologic Q waves and prolonged QT interval. In conclusion, training-related ECG changes, including sinus bradycardia, sinus arrhythmia and left ventricular high voltage, were common in the amateur marathon runners. Most of abnormal ECG changes, including ST segment depression, TWI, premature ventricular contraction, pathologic Q waves and prolonged QT interval, were infrequently found in the amateur marathon runners.
The importance of cardiorespiratory fitness in obesity-related disease: a cross sectional-analysis
Authors: Sabag Angelo , Keating Shelley E. , Way Kimberley L. , Sultana Rachelle N. , Lanting Sean M. , Twigg Stephen M. , Johnson Nathan A.
Published: October 2020

Background: Exercise-induced improvements in cardiorespiratory fitness (CRF) often coincide with improvements in insulin sensitivity and intrahepatic lipid content (IHL). The aim of this study was to examine the association between CRF, IHL, and insulin resistance in inactive adults with obesity and with or without type 2 diabetes, via cross-sectional design.Methods: CRF was determined via a graded exercise test. IHL was assessed via proton magnetic resonance spectroscopy (1H-MRS) and insulin resistance was assessed via homeostatic model of insulin resistance (HOMA-IR). Participants were stratified into CRF quartiles and analysis of variance was employed to determine significant differences in IHL%, HOMA-IR and cardiometabolic outcomes between CRF quartiles. Results: Seventy-two adults (46% male) with a mean age of 49 ± 10 years, IHL of 8.37 ± 6.90%, and CRF of 21.52 ± 3.77 mL/kg/min participated in this study. CRF was inversely associated with IHL (r= -0.28, p=0.019) and HOMA-IR (r= -0.40, p<0.001). Participants with the lowest CRF had significantly higher IHL% and HOMA-IR than those with the highest CRF (+5.31%, p = 0.021; +2.50, p = 0.001, respectively). Participants with the lowest CRF also had significantly greater cardiovascular and inflammatory abnormalities than those with the highest CRF.Conclusion: CRF was inversely associated with IHL and HOMA-IR and participants with the highest levels of CRF had significantly lower cardiometabolic risk than those with the lowest levels of fitness. Improving CRF should remain a key therapeutic target for the management of obesity-related disease.
Superimposed high-frequency jet ventilation minimises diaphragm, bronchus, and mediastinum motion during one-lung flooding
Authors: Lesser Thomas Günther , Wolfram Frank , Braun Conny , Gottschall Reiner
Published: October 2020

Background: One-lung flooding (OLF) represents an ideal acoustic pathway for focused ultrasound ablation of lung tumours. Despite stabilization of the adjacent hemidiaphragm by OLF, standard pressure-controlled ventilation (PCV) of the contralateral lung causes an unacceptable movement of the flooded lung. We examined whether superimposed high-frequency jet ventilation (SHFJV) reduces lung motion compared to PCV during OLF.Methods: The study included 15 pigs: 10 underwent OLF; 5 controls underwent two-lung ventilation without OLF. Using ultrasound, diaphragm displacement on the flooded lung side was measured during PCV and SHFJV in the left lateral (LLP), supine (SP), and right lateral positions (RLP). Bronchus and mediastinum displacements were measured in the right lateral position. Results: Diaphragm displacement on the flooded lung side was significantly reduced during SHFJV, compared with PCV, in all animal positions (LLP: 7 mm [4.75–8.0] vs. 17 mm [14.75–19.0], P = 0.0039; SP: 4 mm [3.75–4.25] vs. 17 mm [16.0–18.5], P = 0.0039; RLP: 8 mm [5.75–9.0] vs. 20 mm [14.0–23.25], P = 0.0078). Displacement of both the bronchus and mediastinum were significantly reduced during SHFJV, compared with PCV, in RLP (bronchus: 2.0 mm [1.75–2.25] vs. 3.0 mm [2.75–3.0], P = 0.027; mediastinum: 4.5 mm [4.0–5.0] vs. 10 mm [7.0–10.0], P = 0.0078; Figs. 5, 6). Conclusion: Thus, SHFJV minimises diaphragm, bronchus, and mediastinum motion during OLF, which is a prerequisite for effective lung tumour ablation.
A Robot Goes to Rehab: A Novel Gamified System for Stroke Rehabilitation using a Socially Assistive Robot: Methodology & Feasibility Testing
Authors: Polak Ronit Feingold , Levy-Tzedek Shelly
Published: October 2020

Background: Socially assistive robots (SARs) have been proposed as a tool to help individuals who have had a stroke to perform their exercise during their rehabilitation process. Methods: Here, we describe a robot-based gamified exercise platform, which we developed for long-term post-stroke rehabilitation. The platform uses the humanoid robot Pepper, and also has a computer-based configuration (with no robot). It includes seven gamified sets of exercises, which are based on functional tasks from the everyday life of the patients, such as reaching to a cup, or turning a key in a lock. The platform gives the patients instructions, as well as feedback on their performance, and can track their performance over time. We performed a long-term patient-usability study, where 14 stroke patients exercised with this platform (in either the robot or the computer configuration) over a 5-week period, 3 times per week, for a total of 210 sessions. Results: The stroke patients reported that this rehabilitation platform addressed their arm rehabilitation needs, and they expressed their desire to continue training with the platform even after the study ended. Conclusions: These results are especially encouraging during the COVID-19 pandemic, when the requirement to reduce physical contact and keep a social distance accentuates the need for alternative rehabilitative tools, such as SARs, to enable patients to have an uninterrupted (even if modified) rehabilitation regime. Trial Registration: This trial is registered in the NIH ClinicalTrials.gov database. Registration number NCT03651063, registration date 21.08.2018. https://clinicaltrials.gov/ct2/show/NCT03651063
Risk Factors for Metastasis to No.253 Lymph Node for Colorectal Cancer Patients
Authors: Du Zhouyuan , Wang Dianshi , Li Yuan , Hu Peng , Wu Chuanqing , Tao Kaixiong
Published: October 2020

Background: No.253 lymph nodes metastasis is related to poor prognosis of colorectal cancer, while the role of No.253 lymph nodes dissection in colorectal cancer is still controversial.Methods: A total of 157 patients who were received laparoscopic radical resection of colorectal cancer with preservation of the left colon artery + D3 lymph node dissection (low ligation + high dissection) in our hospital were enrolled. No.253 lymph nodes of each patients were dissected and sent for examination. Clinicaopathological factors correlated with No.253 lymph nodes metastasis, including gender, age, tumor location, tumor size, length of tumor from the anus, whether lymphovascular invasion, whether perineural invasion, tumor markers CEA, CA125 and CA199, tumor T stage, whether it is distant metastasis, the total number of lymph nodes harvested, tumor type, and histologic grade were respectively analyzed.Results: A total of 2286 lymph nodes were sent for examination, of which 557 No.253 lymph nodes were sent for examination. Among them, 5 patients had a total of 27 No.253 lymph node metastases. Preoperative CA125 level (X2=4.736, p=0.030), whether perineural invasion (X2=8.086, p<0.01), whether lymphovascular invasion (X2= 7.053, p<0.01), tumor type (X2=21.019, p<0.01), histologic grade (X2=15.315, p<0.01) were significantly correlated with positive No.253 lymph nodes metastasis. A multivariate logistic regression analysis showed that none of risk factor from above are independent risk factors for No.253 lymph node metastasis(P>0.05).Conclusion: Preoperative CA125 level, whether perineural invasion, whether lymphovascular invasion, tumor type, histologic grade were risk factors of the No.253 lymph nodes metastasis. Multivariate analysis showed that five risk factors from above were not the independent risk factor for No.253 lymph nodes metastasis. Colorectal cancer patients with the risk factors above were suggested to receive radical resection + D3 lymph node dissection.
Accident-related Hepatic Trauma in a Medical Clinical Center in Eastern China: A Cross-sectional Study
Authors: Xu Zipeng , Hu Weidong , Shen Xu , Gu Yanyan , Dai Zhengxing , Chen Jie , Zhu Zhenghai , Zhou Ying , Zhao Wanwen , CHEN CHAOBO
Published: October 2020

Background: The treatment of hepatic injury can be complicated. Medical clinical hospitals are often the first line hospitals for the diagnosis and treatment of hepatic trauma in China. This paper aimed to summarize the experience in the diagnosis and treatment of hepatic trauma in one medical clinical center in China. Methods: This retrospective study included patients with hepatic trauma admitted between January 2002 and December 2019 at the Xishan People’s Hospital of Wuxi. The outcomes were cure rate and death within 14 days post-discharge. Results: Among the 318 patients with hepatic trauma, 146 patients underwent surgical treatment, and 172 received conservative treatment; three patients were transferred to other hospitals for further treatment; 283 patients were cured, and 35 died. Severe hepatic trauma occurred in 74 patients, with a mortality rate of 31.1%, or 7.2% of all patients. American Association for the Surgery of Trauma (AAST) grading >III (OR=3.51, 95%CI: 1.32-9.37, P=0.012) and multiple organ injury (OR=7.51, 95%CI: 2.51-22.46, P<0.001) were independently associated with death. Among patients with AAST grading >III, surgery was an independent protective factor for death (OR=0.08, 95%CI: 0.01-0.45, P=0.004). Among patients with ASST >III and who underwent surgery, age (OR=5.29, 95%CI: 1.37-20.33, P=0.015) and PHP (OR=5.54, 95%CI: 1.43-21.487, P=0.013) were independently associated with death.Conclusions: AAST grading >III and multiple organ injury were independently associated with death. Among patients with AAST grading >III, surgery was an independent protective factor for death. Among patients with ASST >III and who underwent surgery, age and PHP were independently associated with death.
Hemodynamic Environment Characteristics in the Ascending Aorta After Dilation Formed for the Bicuspid Aortic Valve Patients
Authors: Zheng Tie , Zhu Shuai , Lu Shijie , Ou Jiafu , Zhu Jun-Ming
Published: October 2020

Background: The bicuspid aortic valve is one of the common congenital heart anomalies in adults. Although many studies have proved the coincidence between bicuspid aortic valve and the occurrence of ascending aortic dilation, seldom study has focused on the hemodynamic environments after the dilation already formed. Four numerical models of bicuspid aortic valve were constructed in this study, based on medical images, with different ascending aortic dilation levels. The diameters of ascending aortic are 3.5cm, 4.0cm, 4.5cm and 5.0cm, respectively; while, the size and the geometry of other parts are fixed. Then hemodynamics in these models was simulated numerically and the flow patterns and loading distributions were investigated. Aim of this study is to investigate the hemodynamic environment characteristics in the ascending aorta after dilation formed for the bicuspid aortic valve (BAV) patients. Results: Hemodynamics environments in the dilated ascending aorta were simulated, with different level of dilation. As the diameter increases, the blood flow becomes more disturbing. The wall shear stress at the ascending aortic decreases while oscillatory shear index increases with the increase of diameter. The pressure at ascending aortic increases as the diameter increases. Moreover, all these hemodynamic parameters described above are asymmetrically distributed with the increase of ascending aortic diameter and more parts of aorta would be affected with the increasing ascending aorta diametersConclusions: The study revealed that the ascending aortic dilation levels can significantly influence the magnificent and distribution of the dynamics. There are altered flow patterns, pressure difference, WSS and OSI distribution features in bicuspid aortic valve patients with valvular dilation. As the extent of aortic dilatation increases, more parts of aorta like aortic arch should be paid more attention to when an individual is referred for surgery
Radiofrequency Ablation Versus Hepatic Resection for Recurrent Hepatocellular Carcinoma: An Updated Meta-analysis
Authors: Yang Daopeng , Zhuang Bowen , Wang Yan , Xie Xiaoyan , Xie Xiaohua
Published: October 2020

Background:The clinical benefits of treatment with radiofrequency ablation (RFA) and repeat hepatic resection (RHR) for recurrent hepatocellular carcinoma (RHCC) remain controversial. This meta-analysis aims to evaluate the outcomes and major complications of RFA versus RHR in patients with early-stage RHCC.Methods:PubMed, Embase, Web of Science and the Cochrane Library were systematically searched for comparative studies on the evaluation of RHR versus RFA for RHCC. The primary outcome was overall survival (OS), and the secondary outcomes were progression-free survival (PFS) and major complications. Meta-analysis was performed using a random-effects model or fixed-effects model, and heterogeneity was tested by the Cochran Q statistic. Results:Ten studies with 1612 patients (RHR = 654, RFA = 958) were included in the meta-analysis. The meta-analysis showed that RHR had superior OS (HR 0.77, 95% CI =0.65-0.92, P=0.004) and PFS (HR 0.81, 95% CI =0.67-0.98, P=0.027) compared to RFA, whereas major complications may be less frequent in the RFA group (OR 0.15, 95% CI = 0.06-0.39, P<0.001). In the subgroup analysis of patients with single RHCC ≤ 3 cm, OS (HR 1.03, 95% CI =0.69-1.52, P=0.897) and PFS (HR 0.99, 95% CI=0.71-1.37, P=0.929) showed no significant differences in the comparison of RHR and RFA. In single RHCC>3 cm and ≤5 cm, RFA showed an increased mortality in terms of OS (HR 0.57, 95% CI=0.37-0.89, P=0.014).Conclusion:RHR offers a longer OS and PFS than RFA for patients with RHCC, but no statistically significant difference was observed for single RHCC ≤ 3 cm. The advantages of fewer major complications may render RFA an alternative treatment option for selected patients.
The Efficacy of the Direct-Acting Antiviral Combination in Hemodialysis Patients With Chronic Hepatitis C Virus Genotype 1 Infection
Authors: Öztürk Tuba Erürker , GÜREL SELİM , ORUÇ AYŞEGÜL , ERSOY ALPASLAN
Published: October 2020

Background Interferon and/or ribavirin treatment previously used in the treatment of HCV cannot be used effectively in hemodialysis patients due to dose adjustment and drug-related side effects. The direct-acting antiviral combination (DAA) is reported to be effective in hemodialysis patients. We evaluated the effectiveness of DAA in hemodialysis patients with chronic hepatitis C .Method Twenty hemodialysis patients with chronic hepatitis C kept under surveillance at the policlinic of the Department of Gastroenterology, … , … between 2016 and 2018 were evaluated retrospectively. Results Of the 20 patients, 12 were male, and 8 were female. The average age of the patients was 50,7 ± 8,6. Six patients had no treatment experience. A total of 14 patients (70%) had previously been treated with interferon and/or ribavirin, but SVR could not be achieved. Genotype Ib was detected in 14 patients (70%), genotype Ia was found in 4 patients (20%), and genotype I was detected in 2 patients (10%). Two of the patients were cirrhotic (10%) and the Child-Pugh Score (CPS) was A. Treatment was discontinued in 2 patients due to thrombus formation in AV fistula in the first month of DAA treatment. SVR12 was evaluated in 14 out of 18 patients and found to be 100%. One of the ten patients whose SVR24 was evaluated had a relapse. This is similar to SVR24 in the average population.Conclusions OBV/PTV/r + DSV is an easily appropriate and effective regimen for the treatment of hemodialysis patients with chronic hepatitis C.
Normalization of the Psychometric Encephalopathy Score in Cameroonian Population
Authors: Djomatcho Larissa Pessidjo , Kowo Mathurin , Ndam Antonin Ndjitoyap , Njonnou Sylvain Raoul Simeni , Kenfack Gabin Ulrich , Andoulo Firmin Ankouane , Bagnaka Servais Fiacre Eloumou , Bekolo Winnie Tatiana , Malongue Agnès , Babagna Isabelle Dang , Sida Magloire Biwolé , Luma Henry , Njoya Oudou
Published: October 2020

Background: Minimal hepatic encephalopathy (MHE) is the presence of neuropsychological abnormalities detectable by psychometric tests. Psychometric Hepatic Encephalopathy Score (PHES) is a gold standard test for the early diagnosis of MHE in cirrhotic patients. Aim: To standardize the PHES in a healthy Cameroonian population and to evaluate the prevalence of MHE among cirrhotic patients. Methods: This was a prospective, multicentric study from December 1st, 2018 to July 31st, 2019 in two groups: healthy volunteers and cirrhotic patients without clinical signs of hepatic encephalopathy. The results of the Number Connection Test-A (NCT-A), Number Connection Test-B (NCT-B), Serial Dotting Test (SDT), Line Tracing Test (LTT) were expressed in seconds and those of the Digit Symbol Test (DST) in points. Results: A total of 102 healthy volunteers (54 men, 48 women) and 50 cirrhotic patients (29 men, 31 women) were included. The mean age was 38.1 ± 12.55 years in healthy volunteers and 49.3±15.6 years in cirrhotic patients. The mean years of education level was 11.63 ± 4.20 years in healthy volunteers and 9.62±3,9 years in cirrhotic patients. The PHES of the healthy volunteer group was -0.08 ± 1.28 and the cut-off between normal and pathological values was set at −3 points. PHES of the cirrhotic patients was -7.66 ± 5.62 points and significantly lower than that of volunteers (p <0.001). Prevalence of MHE was 74% among cirrhotic patients. Age and education level were associated with MHE.Conclusion: PHES cut-off value in Cameroonians is -3, with MHE prevalence of 74% among cirrhotic patients.
Maternal Alcohol Use, Adverse Neonatal Outcomes and Pregnancy Complications in British Columbia, Canada: A Population-based Study
Authors: Popova Svetlana , Dozet Danijela , O'Hanlon Graham , Temple Valerie , Rehm Jurgen
Published: October 2020

BackgroundThe current study aimed to estimate the prevalence of alcohol use identified as a risk factor during pregnancies by the antenatal care providers, resulting in live births in British Columbia (BC) and to examine associations between alcohol use, adverse neonatal outcomes, and pregnancy complications.MethodsThis population-based cross-sectional study utilized linked obstetrical and neonatal records within the BC Perinatal Data Registry (BCDPR), for deliveries that were discharged between January 1, 2015 and March 31, 2018. The main outcome measures were alcohol use identified as a risk factor during pregnancy, associated maternal characteristics, pregnancy complications, and adverse neonatal outcomes. Estimates for the period and fiscal year prevalence were calculated. Chi-square tests were used to compare adverse neonatal outcomes and pregnancy complications by alcohol use during pregnancy. Logistic regression was used to examine the association between alcohol use during pregnancy and adverse neonatal outcomes and pregnancy complications, after adjusting for identified risk factors.ResultsA total of 144,779 linked records within the BCDPR were examined. The period prevalence of alcohol use during pregnancy identified as a risk factor was estimated to be 1.1% and yearly prevalence was 1.1%, 1.1%, 1.3% and 0.9% from the 2014/2015 fiscal year to 2017/2018, respectively. Indicated alcohol use was associated with younger maternal age, fewer antenatal visits, being nulliparous, a history of mental illness, substance use and smoking. Alcohol-exposed neonates had greater odds of being diagnosed with low birth weight (aOR = 1.25; 95% CI: 1.01, 1.53), other respiration distress of newborn (aOR = 2.57; 95% CI: 1.52, 4.07), neonatal difficulty in breastfeeding (aOR = 1.97; 95% CI: 1.27, 2.92) and unspecified feeding problems (aOR = 2.06; 95% CI: 1.31, 3.09)ConclusionsThe prevalence of alcohol use during pregnancy identified as a risk factor, estimated in this study, was comparable to the previous estimates within BCDPR. Prenatal alcohol exposure was associated with notable differences in maternal and neonatal characteristics and adverse neonatal outcomes. More consistent and thorough screening and prevention efforts targeting alcohol use in pregnancy are urgently needed in Canada.
Psychosocial Stratification of Antenatal Indicators to Guide Population-Based Programs in Perinatal Depression
Authors: Eastwood John , Wang Andy , Khanlari Sarah , Montgomery Alicia , Yang Jean Yee Hwa
Published: October 2020

Background: There is increasing awareness that perinatal psychosocial adversity experienced by mothers, children, and their families, may influence health and well-being across the life course. To maximise the impact of population-based interventions for optimising perinatal wellbeing, health services can utilise empirical methods to identify subgroups at highest risk of poor outcomes relative to the overall population. Methods: This study sought to identify sub-groups using latent class analysis within a population of mothers in Sydney, Australia, based on their differing experience of self-reported indicators of psychosocial adversity. Subgroups differences in antenatal and postnatal depressive symptoms were then assessed, as measured by Edinburgh Postnatal Depression Scale scores recorded at antenatal booking and early postnatal assessments, respectively.Results: Latent class analysis identified four distinct subgroups within the cohort, who were distinguished empirically on the basis of their native language, current smoking status, previous involvement with Family-and-Community Services (FaCS), history of child abuse, presence of a supportive partner, and a history of intimate partner psychological violence. One group consisted of socially supported ‘local’ women who speak English as their primary language (Group L), another of socially supported ‘migrant’ women who speak a language other than English as their primary language (Group M), another of socially stressed ‘local’ women who speak English as their primary language (Group Ls), and socially stressed ‘migrant’ women who speak a language other than English as their primary language (Group Ms). Compared to local and not socially stressed residents (L group), the odds of antenatal depression were nearly three times higher for the socially stressed groups (Ls OR: 2.87 95%CI 2.10-3.94) and nearly nine times more in the Ms group (Ms OR: 8.78, 95%CI 5.13-15.03). Antenatal symptoms of depression were also higher in the not socially stressed migrant group (M OR: 1.70 95%CI 1.47-1.97) compared to non-migrants. In the postnatal period, Group M was 1.5 times more likely, while Ms group was over five times more likely, to experience suboptimal mental health compared to Group L (OR 1.50, 95%CI 1.22-1.84; and OR 5.28, 95%CI 2.63-10.63, for M and Ms respectively). Conclusions: This study demonstrates that it is possible to stratify pregnant women into subpopulations using their demographic and psychosocial characteristics, to identify those at greatest risk of suboptimal mental health in the antenatal and postnatal periods. The application of empirical subgrouping analysis permits an informed approach to targeted resource allocation for optimising perinatal maternal wellbeing.
The Application of Late Amniocentesis: A Retrospective Study in a Tertiary Fetal Medicine Center in China
Authors: Li Yingting , Yan Huanchen , Chen Jingsi , Chen Fei , Jian Wei , Wang Jiayan , Ye Xiaoqing , Li Yufan , Li Nan , Chiu Philip C.N. , Chen Min
Published: October 2020

Background: To assess the indications and complications of late amniocentesis, and the advantage of advanced genetic test results in a tertiary university fetal medical medicine unit.Methods: In this retrospective study, women that underwent amniocentesis at 24+0 to 39+4 weeks, between January 2014 and December 2019, were recruited. Indications, complications, genetic test results, and pregnancy outcomes were reported for each pregnancy. Information was retrieved from patient medical records, checked by research staff, and analyzed. Results: Of the 1277 women (1311 fetuses) included, late detected sonographic abnormalities (86.2%) were the most common indication. The overall preterm birth and intrauterine demise rate were 2.6% and 1.2%, respectively, after amniocentesis. Sixty-six fetuses with aneuploidy (5.1%) and sixty-seven fetuses with pathogenic copy number variations (5.1%) were identified by chromosomal microarray analysis. One pathogenic copy number variation was detected by whole-exome sequencing. The maximal diagnostic yield (36.1%) was in the subgroup of fetuses with the abnormal noninvasive prenatal test, following by multiple abnormalities (23.8%). And 35.8% of the pregnancies were finally terminated.Conclusions: Due to the high detection rates of advanced genetic technologies and safety of the invasive procedure, it is reasonable to recommend late amniocentesis as an effective and credible method to detect late-onset fetal abnormalities. However, chromosomal microarray and whole-exome sequencing may result in uncertain results like variants of uncertain significance. Therefore, comprehensive genetic counseling is necessary.
First Prompt Optical Observations of Nearest Fast Radio Burst new New Astromomical Method
Authors: Lipunov Vladimir , Kornilov V. , Gorbovskoy E. , Zhirkov Kirill , Chasovnikov Aristarkh , Tiurina N. , Budnev Nikolay , Gress O. , Rebolo Rafael , Serra-Ricart Miquel , Sergienko Yuri , Yurkov Vladimir , Gabovich Alexander , Tlatov Andrey , Gorbunov Igor , Vlasenko Daniil , Balanutsa Pavel , Balakin Filipp , Topolev Vladislav , Vladimirov V. , Kuznetsov Artem , Grinshpun Valeria , Minkina Ekaterina
Published: October 2020

With the discovery of gamma ray bursts1,2, it became clear that our Universe flickers with superfast catastrophic events, sometimes lasting for a thousandths of a second. These ultra-fast transients - the peculiar one-day butterflies of the Universe - shine so brightly that they are noticed even on the other end of the Universe and, moreover, by very small telescopes. But in the radio range, the sky remained silent until the beginning of the 21st century. Only in 2007, radio astronomers analyzing archival observations of the Parkes Radio Telescope first encountered fast transients 3,4 . About a hundred such sources have already been discovered. We report the first optical observation of the closest radio burster FRB 180916.J0158+655-8 synchronously with a radio burst. In total, we obtained about 155,093 images at MASTER Global Robotic Net9*. In the course of our observations, we found a new method for detecting objects deep below the noise level. In addition, using the new method, we found the excess of photons in the FRB direction at a level of 23 m associated with the emission of the host galaxy.
AGREEing on the Management of Idiopathic Steroid-sensitive Nephrotic Syndrome in Children: A Systematic Review of Clinical Practice Guidelines
Authors: Alhasan Khalid Abdulaziz , Khalifah Reem Al , Aloufi Majed , Almaiman Weiam , Hamad Muddathir , Abdulmajeed Naif Fahad , Salloum Abdullah Al , Kari Jameela A. , AlJelaify Muneera , Bassrawi Rolan K. , Hussain Turki Al , Alherbish Adi , Talhi Abdulhadi Al , Temsah Mohamad-Hani , Sethi Sidharth Kumar , Raina Rupesh , Joseph Reny , Amer Yasser Sami
Published: October 2020

Background: Nephrotic syndrome is the most common kidney disease in children worldwide. Our aim was to critically appraise the quality of recent Clinical Practice Guidelines (CPGs) for idiopathic steroid-sensitive nephrotic syndrome (SSNS) in children in addition to summarize and compare their recommendations. Methods: Systematic review of CPGs. We identified clinical questions and eligibility criteria and searched and screened for CPGs using bibliographic and CPG databases. Each included CPG was assessed by four independent appraisers using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE-II) instrument. We summarized recommendations in a comparison matrix. Results: Our search retrieved 282 citations, of which three CPGs were eligible and appraised: Kidney Disease: Improving Global Outcomes (KDIGO) 2012, Japan Society for Pediatric Nephrology (JSPN) 2014, and American Academy of Pediatrics (AAP) 2009. Among these, the overall assessment of two evidence-based CPGs scored > 70% (KDIGO and JSPN), which was consistent with their higher scores in the six domains of the AGREE II Instrument. In domain 3 (rigor of development), KDIGO, JSPN, and AAP scored 84%, 74%, and 41%, respectively. In domain 5 (applicability), they scored 22%, 16%, and 19%, respectively, and in domain 6 (editorial independence), they scored 94%, 65%, and 88%, respectively. Conclusions: The methodological quality of the KDIGO CPG was superior, followed by JSPN and AAP CPGs with the relevant recommendations for use in practice. Systematic review registration: The protocol was registered in the Center for Open Science (OSF) DOI: 10.17605/OSF.IO/6QTMD.
Defining Optimal Dosing of Nimodipine in Aneurysmal Subarachnoid Hemorrhage: Study Protocol for a Systematic Review
Authors: bellapart judith , Laupland Kevin B , Malacova Eva , Lipman Jeffrey , Roberts Jason A , Paratz Jennifer
Published: October 2020

Background: Nimodipine has been first line prophylaxis of cerebral vasospasm after subarachnoid hemorrhage for more than three decades, but its level of evidence has become controversial and essential questions regarding its pharmacological properties and its precise mechanism of action remain unclear. The level of evidence for Nimodipine was established in times when subarachnoid hemorrhage patients had their aneurysm secured in a delayed phase and when intravascular coiling was not established, these two clinical scenarios differ from current practice questioning the applicability of its therapeutic regimen. This review aims to investigate the strength of nimodipine as a prophylaxis for cerebral vasospasm within a contemporary context and to propose pathways for future research in nimodipine. Methods: We will search electronic databases including Medline, Embase, Cochrane, Web of Science and PubMed using a defined search strategy. Two authors will independently rate the quality of the searched evidence using the Chalmers scale for the scoring of studies ‘quality. Discrepancies will be assessed by a third independent author. All studies will be described in a table of studies’ characteristics and data extraction completed. Meta-analysis will be performed if there are two or greater homogeneous outcomes that suffices for reporting on measures of variability. Discussion: The results rising from this systematic review may guide further clinical trials focused on nimodipine dosing with the view of optimizing therapy for better neurological outcomes.Systematic review registration: PROSPERO ID = CRD42020188319
Glutathione S-transferase A2 (GSTA2) Promotes Hepatocellular Carcinoma Recurrence After Liver Transplantation Through Modulating Reactive Oxygen Species Metabolism
Authors: NG Kevin Tak-Pan , Yeung Oscar Wai-Ho , Lam Yin Fan , Liu Jiang , Liu Hui , Pang Li , Yang Xin Xiang , Zhu Ji Ye , Zhang Wei yi , Lau Matthew YH , Qiu Wen Qi , Shiu Hoi Chung , Lai Man Kit , Lo Chung Mau , Man Kwan
Published: October 2020

BackgroundAn inevitable hepatic injury at the early phase after liver transplantation vitally affects the late phase hepatocellular carcinoma (HCC) recurrence. However, their linkage and underlying risk factors of HCC recurrence are unclear. This study aimed to clarify the clinical impact and functional roles of glutathione S-transferase A2 (GSTA2) in affecting HCC recurrence after liver transplantation.MethodsExpression significance and prognostic value of hepatic and circulating GSTA2 in HCC recipients were examined. The polymorphism of GSTA2 transcript was analysed by Sanger sequencing. The functions and molecular mechanisms of GSTA2 in the proliferation and metastasis of HCC were characterized by molecular, cellular and animal experiments. ResultsThe GSTA2 expression was significantly correlated with the early phase hepatic and systemic injury and reactive oxygen species (ROS) level after liver transplantation. Importantly, the level of the early phase circulating GSTA2 protein was a significant predictor of HCC recurrence and survival of HCC recipients. Heterogeneous single nucleotide polymorphism at G335C of GSTA2 was significantly associated with poor survival of HCC recipients. The GSTA2 expression was positively correlated with the aggressiveness of HCCs. Overexpression of GSTA2, by endogenous or exogenous approaches, could enhance the proliferation and invasion of HCCs through activating epithelial-mesenchymal-transition promoting proteins. Targeted inhibition of GSTA2 remarkably suppressed the proliferation and metastasis of HCCs. Increased level of GSTA2 could compensate the H2O2-induced ROS stress and therefore protect the HCC cells from damage. Alteration of GSTA2 expression in HCC cells could influence the activation of ROS-associated JNK and AKT signaling pathways and the expression of ROS-associated genes in responding to the H2O2 condition. ConclusionsOur research discovered GSTA2 to be the significant risk factor of HCC recurrence via providing a favorable ROS environment for HCC to survival and progress. This study presents a novel functional biomarker for combating HCC recurrence after liver transplantation.
Retention in HIV Care and Associated Factors Among Youths Aged 15-24 Years in Rural Southwestern Uganda
Authors: Muwanguzi Moses , Lugobe Henry Mark , Ssemwanga Elastus , Lule Allan Phillip , Atwiine Elizabeth , Kirabira Vincent , Stella Ann K , Ashaba Scholastic , Rukundo Godfrey Zari
Published: October 2020

Background: Retention in HIV care contributes to antiretroviral therapy adherence, which is a key factor for improved treatment outcomes and prevention of drug resistance. However, HIV treatment among the youths is characterized by loss to follow up, poor adherence to ART, risk of treatment failure and high mortality rates compared to young children and adults. There is limited information about factors contributing to poor retention of youths in rural settings in Uganda. We aimed to determine the extent of retention in HIV care, level of and associated factors among youths aged 15-24 years in rural southwestern Uganda.Methods: A cross-sectional study was conducted among youths aged 15-24 years who were receiving care at the HIV clinic at Kabuyanda HC IV who had been in care for at least 1 year before the study. We used a researcher administered questionnaire to collect sociodemographic information and retention. We collected information on HIV related stigma using the 40-item Berger Stigma Scale. We used the SPSS chi-square test and regression analysis assess the association between predictors and retention HIV care, at 95% level of confidence and at a level of significance of 0.05. Retention in HIV care was, defined as having sought care at least once per quarter in the 12 months prior to the study. Results: We enrolled 102 participants with mean age of 20.95 (SD±3.07) years. Two thirds (65.7%) of the youths had been retained in HIV care in the previous 12 months. Retention in HIV care was significantly associated with female gender (AOR: 0.15, 95%CI 0.03-0.69, p=0.015), being a ‘Mukiga’ by tribe (AOR: 5.77, 95%CI 1.76-18.91, p=0.004) and being married or in a relationship (AOR: 0.18, 95%CI 0.06-0.53, p=0.002). The association between HIV related stigma and retention in HIV care was non-statistically significant.Conclusion: Retaining adolescents and young adults in HIV care in rural southwestern Uganda is still much lower than the WHO target of 90%. Being female and married or in a relationship are associated with good retention in HIV care. Interventions targeting adolescents and young adults are necessary to improve retention in HIV care to the WHO target of 90%.