bluuebunny/crossref_metadata_2025 huggingface dataset:
Cambios psicosociales, salud y calidad de vida de padres de niños con parálisis cerebral.
Authors: Perez Edinson M.
Published: December 2019

La parálisis cerebral es un transtorno de movimientos y posturas, además de otras disfunciones que limitan el desarrollo de actividades de la vida diaria; en niños, esta condición demanda cuidados y crianza especiales por parte de los padres, los cuales experimentan una serie de cambios y necesidades en sus ámbitos personal, familiar, laboral y social, desde el momento en que reciben el diagnóstico clínico y a lo largo del desarrollo del niño. En este proceso, los padres presentan frecuentemente síntomas de ansiedad, estrés, depresión, alteración del sueño y transtornos musculoesqueléticos, a todo lo cual se suma el bajo nivel de calidad de vida que experimentan. Varios estudios demuestran que los cambios psicosociales, de salud y calidad de vida de los padres son resultado tanto de las características del niño con parálisis cerebral, como de los rasgos personales de los padres y/o de factores ambientales y contextuales de la familia. Los sistemas de salud deben, por lo tanto asistir adecuadamente a los padres, en paralelo con el tratamiento de los niños afectados con parálisis cerebral y de acuerdo al contexto en el que se desenvuelven.
Salud y Enfermedad Mental. Del Corpus Hippocraticum a una aproximación termodinámica
Authors: Rojas-Malpica Carlos , De Lima-Salas Miguel Ángel , Eblen-Zajjur Antonio , Téllez-Pacheco Pedro
Published: December 2019

Se establece una relación entre conceptos básicos acerca de salud y enfermedad mental en los Tratados Hipocráticos y los elementos actuales de la termodinámica y de la cibernética, enlace que se formula a través de los aportes de autores como Maturana y Valera (autopoiesis y teleonomía) o Bergson (regularidades vs indeterminsmos). Se definen y caracterizan los fenómenos anancásticos y los estocásticos, destacándose su relación complementaria. Con un enfoque termodinámico se define a la enfermedad mental como una estructura que se impone hegemónicamente sobre el resto de las actividades mentales y consume la energía que regula el metabolismo restante de la persona afectada. Se aportan evidencias clínicas de las bondades de esta óptica, presentándose, por ejemplo, la ansiedad como una “crisis entrópica” y la depresión como “interferencia de la teleonomía”, al tiempo que los trastornos obsesivo-compulsivos son descritos desde una perspectiva cibernética. A lo largo del texto se le confiere mayor relevancia a la noción de la enfermedad mental como “pathos hegemónico” que absorbe recursos energéticos y disminuye las posibilidades de adaptación del afectado a su medio externo y de éxito en el afrontamiento de sus propias tensiones.
Nouvelles stratégies alimentaires précoces au service de la production avicole
Authors: MÉTAYER-COUSTARD Sonia , PETIT Angélique , QUENTIN Maxime , TESSERAUD Sophie
Published: December 2019

Le développement de l’embryon d’oiseau dépend de l’environnement dans lequel il baigne et des nutriments disponibles. La période de démarrage (1ère semaine post-éclosion) est souvent délicate avec parfois des mortalités post-natales importantes dues aux délais d’alimentation et aux conditions d’ambiance et de transport sub-optimales. Les liens entre la nutrition parentale, la composition de l’œuf et le comportement ultérieur des animaux, leurs performances, et leur sensibilité aux maladies sont bien établis. Des supplémentations en nutriments de l’œuf via l’alimentation maternelle ou via des injections in ovo (« in ovo feeding ») représentent alors des stratégies innovantes pour optimiser l’apport de nutriments à l’embryon. La finalité de telles approches est d’optimiser les apports nutritionnels des reproductrices ou des embryons en développement dans le but d’obtenir des poussins de meilleure qualité en termes de robustesse, croissance et/ou composition corporelle en tirant parti de la plasticité embryonnaire d’utilisation des nutriments. La manipulation très précoce de l’environnement dans lequel l’embryon se développe est très prometteuse pour analyser l'influence des conditions précoces sur l'élaboration des phénotypes à long terme que ce soit sur des critère de croissance, composition corporelle, caractéristiques tissulaires, robustesse vis-à-vis de challenges ou adaptation à des conditions d’élevage différentes. Outre les bénéfices observés pour les animaux, ces stratégies alimentaires tentent de répondre aussi à des intérêts environnementaux et économiques.
Artificial Neural Network Modeling of Cyclic Steam Injection Process in Naturally Fractured Reservoirs
Authors: Ersahin Ahmet , Ertekin Turgay
Published: December 2019

The enhanced oil recovery (EOR) technology can be instrumental in achieving the maximum rate of return from a hydrocarbon reservoir. One of the widely implemented EOR methodologies is the cyclic steam injection (CSI) which is a thermal recovery process aiming to reduce the oil viscosity and increase the production in naturally fractured heavy-oil reservoirs. However, commercial software used for CSI modeling can be difficult to learn and implement, also can be time-consuming and costly. This paper describes three artificial neural network (ANN) based models that have been trained for accurate and fast CSI performance evaluation with easy implementation.

In this study, to model the CSI process, a commercial numerical model is used synchronously with the ANN models. Our goal is to discuss smart proxy models’ mimicking ability of the commonly used numerical models. Three ANN models have been trained with different network topologies, and transfer functions using a data set consists of 1,428 cases:

Forward model: to predict performance indicators and viscosity contours. Inverse Model 1: to predict CSI design parameters. Inverse Model 2: to predict significant reservoir properties.

The results from the trained ANN models have been compared with the results generated by the available commercial software. It was observed that ANN models can provide the results within a few seconds while it takes more than 30 minutes in some cases for the commercial software. The computational time for the numerical model being extensive, the number of trials to be conducted to find the optimum parameters for the CSI operations can be prohibitively expensive. The trained ANN-based models are capable of providing results within a rather low error margin. The developed ANN-based models are controlled by a user-friendly graphical user interface (GUI), which decreases the time expended on learning and executing the software.
The Prevalence of Lower Urinary Tract Symptoms Based on Individual and Clinical Parameters in Patients with Multiple Sclerosis
Authors: Nazari Fatemeh , Shaygannejad Vahid , Sichani Mehrdad Mohammadi , Gharaagozlou Marjan Mansourian , Hajhashemi Valiollah
Published: December 2019

Background: Most patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS. Methods: This cross-sectional study was performed on 602 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Multistage random cluster sampling was performed and the informed consent form was signed by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS) and DASS-21 questionnaire. The data were analyzed using descriptive and inferential statistical tests in SPSS. Results: The prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P < 0.050). There was no significant difference between women and men in terms of the prevalence of other symptoms (P > 0.050). A significant difference was observed in the degree of LUTS with age, marital status, marriage duration, education, illness duration, clinical course, disability, anxiety, depression, and stress (P < 0.05). Moreover, logistic regression analysis revealed that there was a higher probability of a urinary problems among patients with MS and a high EDSS score [0.67 (0.507-0.903), P = 0.008]. Conclusions: A high prevalence of LUTS was found among patients with MS. There was a higher probability of a urinary tract problem among patients with MS and a high EDSS score. Therefore, it is recommended that the health system take the necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS. Keywords: Multiple sclerosis, prevalence, urinary symptoms
Daily Almond Consumption in Cardiovascular Disease Prevention via LDL-C Change in the U.S. Population: a Cost-Effectiveness Analysis
Authors: Wang Jifan , Bravatti Michelle A. Lee , Johnson Elizabeth J. , Raman Gowri
Published: December 2019

Background Heart disease is the leading cause of death in the United States. The U.S. Food and Drug Administration approved the health claim that 1.5 ounces (42.5 grams) of nut intake may reduce the risk of cardiovascular disease. Previous studies have focused on the cost-effectiveness of other foods or dietary factors on primary cardiovascular disease prevention, yet not in almond consumption. This study aimed to examine the cost-effectiveness of almond consumption in cardiovascular disease primary prevention. Perspective & Setting This study assessed the cost-effectiveness of consuming 42.5 grams of almond from the U.S. healthcare sector perspective. Methods A decision model was developed for 42.5 grams of almond per day versus no almond consumption and cardiovascular disease in the U.S. population. Parameters in the model were derived from the literature, which included the probabilities of increasing low-density lipoprotein cholesterol, developing acute myocardial infarction and stroke, treating acute myocardial infarction, dying from the disease and surgery, as well as the costs of the disease and procedures in the U.S. population, and the quality-adjusted life years. The cost of almonds was based on the current price in the U.S. market. Sensitivity analyses were conducted for different levels of willingness-to-pay, the probabilistic sensitivity analysis, ten-year risk prevention, different costs of procedures and almond prices, and patients with or without cardiovascular disease. Results The almond strategy had $363 lower cost and 0.02 higher quality-adjusted life years gain compared to the non-almond strategy in the base-case model. The annual net monetary benefit of almond consumption was $1,421 higher per person than no almond consumption, when the willingness to pay threshold was set at $50,000 for annual health care expenditure. Almond was more cost-effective than non-almond in cardiovascular disease prevention in all the sensitivity analyses. Conclusion Consuming 42.5 grams of almonds per day is a cost-effective approach to prevent cardiovascular disease in the short term and potentially in the long term.
Dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia
Authors: Mulugeta Yeshalem , Alem Getu Degu , Belachew Tefera
Published: December 2019

Background: Optimal dietary practice is a critical requisite for maternal nutrition. However, the majority of Ethiopian pregnant women have inadequate nutrient intakes. These may be due to their poor dietary habits. Identifying factors affecting the dietary practices of pregnant women is crucial to design appropriate interventions. In this country, the dietary practices of pregnant women and determinants are not well studied. Therefore, the purpose of this study was to assess the dietary practices and associated factors among pregnant women in West Gojjam Zone, Northwest Ethiopia. Methods: A community-based cross-sectional study was carried out among 712 pregnant women from May to August 2018. Quantitative data complemented with a qualitative method. Pregnant women were selected using a cluster sampling technique. Structured questionnaires were utilized for data collection. Data were entered into Epi-Info version 7.2.2 and exported to SPSS version 23 software for analysis. Data were described using frequencies and mean. A logistic regression analysis was done. For the qualitative data, three focus group discussions and 17 key-informant interviews were conducted. Focus group discussion participants were mothers, husbands and health professionals. Typical case and homogeneous sampling techniques were used for the key-informant interviews and focus group discussions, respectively. Qualitative data were collected using interview and focus group discussion guides. Thematic analysis was used for the qualitative data. Results: Only 19.9% of respondents had appropriate dietary practices. On the multivariable logistic regression analyses, being food secure [AOR=2.25, 95% CI: (1.1, 4.5)], having high edible crop production [AOR=2.00, 95% CI: (1.2, 3.2)] and favorable attitude [AOR=1.69, 95% CI: (1.1, 2.6)] were significantly associated with the appropriate dietary practices of pregnant women. In the qualitative study lack of knowledge on maternal diet, cultural prohibition and knowledge gap of professionals were barriers that interfere with dietary practices during pregnancy. Conclusion: Pregnant women in the study area are found to have suboptimal dietary practices. Therefore, health professionals should give regular nutrition counseling using cards and role models for promoting diversified food production and consumption to meet the nutrient requirements during pregnancy.
Evolutionary history of two cryptic species of Northern African jerboas
Authors: Moutinho Ana Filipa , Serén Nina , Paupério Joana , Silva Teresa Luísa , Martínez-Freiría Fernando , Sotelo Graciela , Faria Rui , Mappes Tapio , Alves Paulo Célio , Brito José Carlos , Boratyński Zbyszek
Published: December 2019

Background Evidence suggests that complex paleoclimatic and geological events help shape species distributions, thus affecting their evolutionary history. In Sahara-Sahel, climatic oscillations shifted the desert extent during the Pliocene-Pleistocene interval, triggering the diversification of several species. Here, we investigated how these biogeographical and ecological events have shaped patterns of genetic diversity and divergence in African Jerboas, desert specialist species. We focused on two sister and cryptic species, Jaculus jaculus and J. hirtipes , where we (1) evaluated their genetic differentiation, (2) reconstructed their evolutionary and demographic history; (3) tested the level of gene flow between them, and (4) assessed their ecological niche divergence. Results The analyses based on 231 individuals sampled throughout North Africa, 8 sequence fragments (one mitochondrial and seven single copy nuclear DNA, including two candidate genes for fur coloration: MC1R and Agouti ), 6 microsatellite markers and ecological modelling revealed: (1) two distinct genetic lineages with overlapping distributions, in agreement with their classification as different taxa, J. jaculus and J. hirtipes , with (2) low levels of gene flow and strong species delimitation, (3) high genetic diversity but no apparent geographic population structure within species, suggesting long-distance migration between remote locations, and (4) low level of large-scale ecological divergence between the two taxa, suggesting species micro-habitat specialization. Conclusions Overall, our results suggest a speciation event that occurred during the Pliocene-Pleistocene transition. The contemporary distribution of genetic variation suggests ongoing population expansions, demonstrating the ability of these species for fast and long-range dispersal. Despite the largely overlapping distributions at a macrogeographic scale, our genetic results suggest that the two species remain reproductively isolated, as only negligible levels of gene flow were observed. The overlapping ecological preferences at a macro-geographic scale and the ecological divergence at the micro-habitat scale suggest that local adaptation may have played a crucial role in the speciation process of these species.
The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis
Authors: Huang Zhen-Dong , Gu Hui-Yun , Zhu Jie , Luo Jie , Shen Xian-Feng , Deng Qi-Feng , Zhang Chao , Li Yan-Bing
Published: December 2019

Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods : Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results : A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection ( RR =0.50, 95%CI: 0.33 to 0.75 ), postoperative length of stay ( MD =-2.53, 95%CI: -3.42 to -1.65 ) , time until first postoperative flatus ( MD =-0.64, 95%CI: -0.84 to -0.45 ) and time until first postoperative defecation ( MD =-1.10, 95%CI: -1.74 to -0.47 ) in patients who received ERAS, compared to conventional care . However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P=0.10), surgical site infection (P=0.42), postoperative anastomotic leakage (P=0.45), readmissions (P=0.31) and ileus (P =0.25). Conclusions : ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.
Transcriptomic analysis of the testicular fusion in Spodoptera litura
Authors: Chen Yaqing , Ou Jun , Liu Yucheng , Wu Qiong , Wen Liang , Zheng Sichun , Li Sheng , Feng Qili , Liu Lin
Published: December 2019

Background Lepidoptera is one group of the largest plant-feeding insects and Spodoptera litura (Lepidoptera: Noctuidae) is one of the most serious agricultural pests in Asia countries. An interesting and unique phenomenon for gonad development of Lepidoptera is the testicular fusion. Two separated testes fused into a single one during the larva-to-pupa metamorphosis, which is believed to contribute to sperm production and the prevalence in field. To study the molecular mechanism of the testicular fusion, RNA sequencing (RNA-seq) experiments of the testes from 4-day-old sixth instar larvae (L6D4) (before fusion), 6-day-old sixth instar larvae (L6D6, prepupae) (on fusing) and 4-day-old pupae (P4D) (after fusion) of S. litura were performed.Results RNA-seq data of the testes showed that totally 12,339 transcripts were expressed at L6D4, L6D6 and P4D stages. A large number of differentially expressed genes (DEGs) were up-regulated from L6D4 to L6D6, and then more genes were down-regulated from L6D6 to P4D. The DEGs mainly belongs to the genes related to the 20E signal transduction pathway, transcription factors, chitin metabolism related enzymes, the families of cytoskeleton proteins, extracellular matrix (ECM) components, ECM-related protein, its receptor integrins and ECM-remodeling enzymes. The expression levels of these genes that were up-regulated significantly during the testicular fusion were verified by qRT-PCR. The matrix metalloproteinases (MMPs) were found to be the main enzymes related to the ECM degradation and to contribute to the testicular fusion. The testis was not able to fuse if MMPs inhibitor GM6001 was injected into the 5th abdomen region.Conclusions The transcriptome and DEGs analysis of the testes at L6D4, L6D6, P4D stages provided genes expression information related to the testicular fusion in S. litura . These results indicated that cytoskeleton proteins, ECM-integrin interaction genes and ECM-related proteins was involved in cell migration, adhesion and fusion during the testicular fusion. The ECM degradation enzymes MMPs probably play a critical role in the fusion of testis.
Cross-sectional study of associations between normal body weight with central obesity and hyperuricemia in Japan
Authors: Shirasawa Takako , Ochiai Hirotaka , Yoshimoto Takahiko , Nagahama Satsue , Watanabe Akihiro , Yoshida Reika , Kokaze Akatsuki
Published: December 2019

Background Several studies have shown that normal weight with central obesity (NWCO) is associated with cardiovascular disease risk factors such as hypertension, dyslipidemia and diabetes. However, the relationship between NWCO and hyperuricemia has not been studied in detail. Methods We investigated the association between NWCO and hyperuricemia among Japanese adults aged 40-64 years who had undergone periodic health examinations between April 2013 and March 2014. Obesity was defined as a body mass index (BMI) ≥25 kg/m 2 and central obesity was determined as a waist-to-height ratio (WHtR) ≥0.5. We classified the participants into the following groups based according to having obesity and central obesity: normal weight (BMI 18.5-24.9 kg/m 2 ) without (NW; WHtR <0.5) and with (NWCO) central obesity, and obesity without (OB) and with (OBCO) central obesity. Hyperuricemia was defined as serum uric acid >7.0 and ≥6.0 mg/dL in men and women, respectively, or under medical treatment for hyperuricemia. Alcohol intake was classified as yes (daily and occasional consumption) and none (no alcohol consumption). Odds ratios (OR) and 95% confidence intervals (CI) for hyperuricemia were calculated using a logistic regression model. Results We analyzed data derived from 96,863 participants (69,241 men and 27,622 women). The prevalences of hyperuricemia in men and women were respectively, 21.4% and 11.0%, and of participants with NWCO respectively 15.6% and 30.0%. The adjusted OR for hyperuricemia was significantly increased in OBCO compared with NW, regardless of sex (men: OR, 2.12; 95%CI; 2.03-2.21; women: OR, 3.54; 95%CI, 3.21-3.90) and were statistically significant in NWCO compared with NW (men: OR, 1.44; 95%CI, 1.36-1.52; women: OR, 1.41; 95%CI, 1.27-1.57). The results were similar regardless of alcohol consumption. Conclusions We found that NWCO and OBCO were associated with hyperuricemia in middle-aged Japanese men and women. Middle-aged Japanese adults with normal weight but having central obesity should be screened using a combination of BMI and WHtR and educated about how to prevent hyperuricemia.
Ectopic expression of citrus UDP-GLUCOSYL TRANSFERASE gene enhances anthocyanin and proanthocyanidins contents and confers high light tolerance in Arabidopsis
Authors: Rao Muhammad Junaid , Xu Yuantao , Huang Yue , Tang Xiaomei , Deng Xiuxin , Xu Qiang
Published: December 2019

Background Citrus fruits are consumed freshly or as juice to directly provide various dietary flavonoids to humans. Diverse metabolites at different levels are present among Citrus genera and many flavonoids biosynthetic genes were induced after abiotic stresses. To better understand the underlying mechanism, we designed experiments to overexpress a UDP-GLUCOSYL TRANSFERASE gene from Citrus sinensis (sweet orange) to evaluate its possible function in metabolism and response to stress.Results Our results demonstrated that overexpression of Cs-UGT78D3 resulted in high accumulation of proanthocyanidins in the seed coat and a dark brown color to transgenic Arabidopsis seeds. In addition, the total contents of flavonoid and anthocyanin were significantly enhanced in the leaves of overexpressed lines. Gene expression analyses indicated that many flavonoid (flavonol) and anthocyanin genes were up-regulated by 4-15 folds in transgenic Arabidopsis. Moreover, after 14 days of high light stress treatment, the transgenic Arabidopsis lines showed strong antioxidant activity and higher total contents of anthocyanins and flavonoids in leaves compared with the wild type.Conclusion Our study concluded that the citrus Cs-UGT78D3 gene is involved in proanthocyanidins accumulation in seed coats and confers tolerance to high light stress by accumulating the total anthocyanin and flavonoid contents with better antioxidant potential (due to photoprotective activity of anthocyanin) in the transgenic Arabidopsis.
Government Spending, Recession, and Suicide: Evidence from Japan
Authors: Matsubayashi Tetsuya , Sekijima Kozue , Ueda Michiko
Published: December 2019

Backgrounds Austerity has been shown to have an adverse influence on people’s mental health and suicide rates. Most existing studies have focused on the governments’ reactions to a single event, for example, the Great Recession of 2008.Methods This study focused on significant changes in fiscal policy between 2001 and 2014 in Japan. The size of expenditures by national and local governments decreased dramatically between 2001 and 2006 under the neoliberal reform and then increased after the global economic crisis and the Great East Japan Earthquake. Using the data from 47 prefectures between 2001 and 2014, we tested whether more spending by the local governments was associated with a lower suicide rate in their jurisdiction. We also investigated whether this relationship was particularly salient during a more severe recession.Results Our analysis revealed that an increase of 1% in the per capita local government expenditures was associated with a decrease of 0.2% in the suicide rates among males and females aged between 40 and 64 and that this correlation was strengthened as the unemployment rate increased, particularly among males.Conclusions Government’s reaction to economic crises can either exacerbate or mitigate the negative impact of the economic recession on people’s mental health and suicide rates.
Tumor Characteristics and Treatment Outcomes of Older Women with Breast Cancer in Jordan
Authors: Abdel-Razeq Hikmat , Rahman Fadwa Abdel , Al-Masri Hanan , Abdulelah Hazem , Nasser Mahmoud Abu , Salam Mourad , Taqash Ayat
Published: December 2019

Background : Less than 10% of newly diagnosed breast cancer in our region are diagnosed in women 70 years or older. Treatment plans of such patients is less clear and have poor outcomes. In this paper, we describe clinical presentation, tumor characteristics and treatment outcomes in such patients. Methods : Consecutive patients aged 65 years or older with pathologically-confirmed diagnosis of breast cancer were included. Medical records and hospital databases were searched for patients’ characteristics and treatment outcomes. Results : A total of 553 patients, median age 70 (range: 65-91) years, were included. On presentation, 114 (20.6%) patients had metastatic disease and was mostly visceral (81; 71.1%). Patients with non-metastatic disease had poor pathological features including node-positive in 244 (55.6%), GIII in 170 (38.7%) and lymphovascular invasion in 173 (39.4%). Patients were treated less aggressively; 144 (32.8%) patients with early-stage disease and 98 (86.0%) with metastatic disease never had chemotherapy. After a median follow up of 45 months, 5-year overall survival for the whole group was 67.6%. Survival was better for patients with non-metastatic disease (78.8% vs. 25.4%, P<0.001) and for those with node-negative compared to node-positive disease (85.4% vs. 74.1%, P=0.002). On Cox regression, only positive lymph nodes were associated with poor outcome in patients with non-metastatic disease (Hazard Ratio [HR], 1.75; 95% CI: 1.006-3.034, P=0.048). Conclusions : Older Jordanian women with breast cancer present with more aggressive features and advanced-stage disease that reflect poorly on treatment outcomes. Because of comorbidities and poor performance status, some patients were not aggressively treated.
Transcriptomic and proteomic analyses between small yellow follicles and the smallest hierarchical follicles reveal a role of VLDLR in chicken follicle selection
Authors: Chen Qiuyue , Wang Yiya , Liu Zemin , Guo Xiaoli , Sun Yi , Kang Li , Jiang Yunliang
Published: December 2019

Background Follicle selection in chicken refers to the process of selecting one from a group of small yellow follicles (SY, 6-8mm in diameter) to enter the 12-15 mm hierarchical follicles (usually F6 follicles), which is a an important process affecting laying performance in the poultry industry. Although transcripromic analysis on chicken ovarian follicles was reported, integrated analysis on chicken follicles around selection by using both transcripromic and proteomic approaches was still lacking. In this study, we compared the proteomes and transcriptomes of SY and F6 follicles of laying hens and found some genes involved in chicken follicle selection.Results Transcriptomic analysis revealed 855 differentially expressed genes (DEGs) between SY follicles and F6 follicles of laying hens, among which 202 were upregulated and 653 were downregulated. Proteomic analysis revealed 259 differentially expressed proteins (DEPs), including 175 upregulated and 84 downregulated proteins. Among the identified DEGs and DEPs, the expression changes of seven genes including VLDLR1,WIF1, NGFR, AMH, BMP15, GDF6 and MMP13 , and nine proteins including VLDLR, VTG1, VTG3, PSCA, APOB, APOV1, F10, ZP2 and ZP3L2 were validated. In addition VLDLR expression was significantly down-regulated in F6 follicles compared with SY follicles, was signifcantly higher in the GCs than in the TCs and was stimulated by FSH in GCs of both hierarchical and prehierarchical follicles.Conclusions By comparing the proteomes and transcriptomes of SY follicles and F6 of laying hens, we identified some differentially expressed proteins/genes that might play certain roles in chicken follicle selection. These data may contribute to identification of the functional genes and proteins involved in chicken follicular development and selection.
Care after pancreatic resection according to an algorithm for early detection and minimally invasive management of pancreatic fistula versus current practice (PORSCH-trial): design and rationale of a nationwide stepped-wedge cluster randomized trial
Authors: Smits Francina J , Henry AC , Eijck CH van , Besselink MG , Busch OR , Arntz M , Bollen TL , Delden OM van , Heuvel D van den , Leij C van der , Lienden KP van , Moelker A , Bonsing BA , Rinkes IHM Borel , Bosscha K , Dam RM van , Festen S , Koerkamp B Groot , Harst E van der , de Hingh I , Kazemier G , Liem M , Kolk BM van der , de Meijer VE , Patijn GA , Roos D , Schreinemakers JM , Wit F , Werkhoven CH van , Molenaar IQ , Santvoort HC van
Published: December 2019

Background Pancreatic resection is a major abdominal operation with 50% risk of postoperative complications. A common complication is pancreatic fistula, which may have severe clinical consequences such as postoperative bleeding, organ-failure and death. The objective of this study is to investigate whether implementation of an algorithm for early detection and minimally invasive management of pancreatic fistula may improve outcomes after pancreatic resection.Methods This is a nationwide stepped-wedge, cluster randomized, superiority trial, designed in adherence to the CONSORT guidelines. During a period of 22 months, all Dutch centers performing pancreatic surgery will cross over in a randomized order from current practice to best practice according to the algorithm. This evidence- and consensus based algorithm will provide daily multilevel advice on the management of patients after pancreatic resection (i.e. indication for abdominal imaging, antibiotic treatment, percutaneous drainage and removal of abdominal drains). The algorithm is designed to aid early detection and minimally invasive step-up management of postoperative pancreatic fistula. Outcomes of current practice will be compared with outcomes after implementation of the algorithm. The primary outcome is a composite of major complications (i.e. postpancreatectomy bleeding, new-onset organ failure and death) and will be measured in a sample size of at least 1600 patients undergoing pancreatic resection. Secondary endpoints include the individual components of the primary endpoint and other clinical outcomes, healthcare resource utilization and costs analysis. Follow-up will be up to 90 days after pancreatic resection.Discussion It is hypothesized that a structured nationwide implementation of a dedicated algorithm for early detection and minimally invasive step-up management of postoperative pancreatic fistula will reduce the risk of major complications and death after pancreatic resection, as compared to current practice.
Epidemiology and risk factors of infective endocarditis in a tertiary hospital in China from 2007 to 2016
Authors: Wu Zhenzhu , Chen Yi , Xiao Tingting , Niu Tianshui , Shi Qingyis , Xiao Yonghong
Published: December 2019

Background: To explore the trends in epidemiology and risk factors related to the prognosis of infective endocarditis in a teaching hospital over the past ten years. Methods: A retrospective cohort study was performed. A total of 407 consecutive patients were included. The clinical characteristics and risk factors related to the prognosis of infective endocarditis during this period were analyzed. Results: A total of 407 patients with infective endocarditis were included, the average age was 48 ±16 years old with an increasing trend and in-hospital mortality rate was 10.6% and one-year mortality rate was 12.2%. Among patients with underlying heart disease, congenital heart disease was the most common(25.8%), followed by rheumatic heart disease which showed a decreased trend during this period (P<0.001). There were 222(54.5%) positive blood cultures and streptococci (44.1%) was the main pathogens with an increasing trend. There were 403 patients (99%) with surgical indications, but only 234 patients (57.5%) received surgical treatment. Hemodialysis (P = 0.041, OR = 4.697, 95% CI 1.068-20.665), pulmonary hypertension (P = 0.001, OR = 5.308, 95% CI 2.034-13.852), Pitt score ≥ 4 (P <0.001, OR = 28.5, 95% CI 5.5-148.1) and vegetation length＞30mm (P = 0.011, OR = 13.754, 95% CI 1.832-103.250) were independent risk factors for in-hospital mortality. Conclusions: There was no significant change in the overall incidence of IE, the clinical features of IE have changed slightly during the past ten years. Streptococci IE was still the predominant. IE patients with hemodialysis, pulmonary hypertension, Pitt score ≥ 4 and vegetation length＞30mm had an worse in-hospital outcome.
A novel association of CCDC80 with gestational diabetes mellitus in pregnant women: a propensity score analysis from a case-control study
Authors: Liu Lei , Hu Jiajin , Wang Ningning , Liu Yang , Wei Xiaotong , Gao Ming , Ma Yanan , Wen Deliang
Published: December 2019

Background: Gestational diabetes mellitus (GDM) is a growing global epidemic. Our study aims to confirm the association between circulatory coiled-coil domain-containing 80 (CCDC80) in pregnant women with GDM, to investigate the discriminatory power of CCDC80 on GDM, and to explore the relationships between this molecular level and clinical cardiometabolic parameters. Methods: A 1:2 matched case-control study with 61 GDM patients and 122 controls was conducted using a propensity score matching protocol. All participants were screened from a multicenter prospective pre-birth cohort: Born in Shenyang Cohort Study (BISCS). During 24 and 28 weeks of gestation, follow-up individuals underwent an oral glucose tolerance test (OGTT) and blood sampling for cardiometabolic characterization. Results: Following propensity score matching adjustment for clinical variables, including maternal age, gestational age, body mass index, SBP and DBP, plasma CCDC80 levels were significantly decreased in patients with GDM when compared with controls (0.25±0.10 vs. 0.31±0.12 ng/ml, P =0.003). Conditional multi-logistic regression analyses after adjustments for potential confounding factors revealed that CCDC80 was a strong and independent protective factor for GDM (ORs <1). In addition, the results of the ROC analysis indicated the CCDC80 exhibited the capability to identify pregnant women with GDM (AUC=0.633). Finally, multivariate regression analyses showed that CCDC80 levels were positively associated with AST, monoamine oxidase, complement C1q, LDL-C, apolipoprotein A1and B, and negatively associated with blood glucose levels at 1 h post- OGTT. Conclusions: Biomarker CCDC80 could be of great value for the development of prediction, diagnosis and therapeutic strategies against GDM in pregnant women.
Bacteroides thetaiotaomicron-derived outer membrane vesicles promote regulatory dendritic cell responses in health but not in inflammatory bowel disease
Authors: Durant Lydia , Stentz Régis , Noble Alistair , Brooks Johanne , Gicheva Nadezhda , Reddi Durga , O’Connor Matthew J. , Hoyles Lesley , McCartney Anne L. , Man Ripple , Pring E. Tobias , Dilke Stella , Hendy Philip , Segal Jonathan P , Lim Dennis N.F. , Misra Ravi , Hart Ailsa L. , Arebi Naila , Carding Simon R. , Knight Stella C.
Published: December 2019

Background: Bacteroides thetaiotaomicron (Bt) is a prominent member of the human intestinal microbiota that, like all Gram-negative bacteria, naturally generates nanosized outer membrane vesicles (OMVs) which bud off from the cell surface. Importantly, OMVs can cross the intestinal epithelial barrier to mediate microbe-host cell crosstalk involving both epithelial and immune cells to help maintain intestinal homeostasis. Here we have examined the interaction between Bt OMVs and blood or colonic mucosa-derived dendritic cells (DC) from healthy individuals and patients with Crohn’s disease (CD) or ulcerative colitis (UC). Results: In healthy individuals, Bt OMVs stimulated significant (p<0.05) IL-10 expression by colonic DC, whereas in peripheral blood-derived DC they also stimulated significant (p<0.001 and p<0.01, respectively) expression of IL-6 and the activation marker CD80. Conversely, in UC Bt OMVs were unable to elicit IL-10 expression by colonic DC. There were also reduced numbers of CD103+ DC in the colon of both UC and CD patients compared to controls, supporting a loss of regulatory DC in both diseases. Furthermore, in CD and UC, Bt OMVs elicited a significantly lower proportion of DC which expressed IL-10 (p<0.01 and p<0.001, respectively) in blood compared to controls. These alterations in DC responses to Bt OMVs were seen in patients with inactive disease, and thus are indicative of intrinsic defects in immune responses to this commensal in inflammatory bowel disease (IBD). Conclusions: Overall, our findings suggest a key role for OMVs generated by the commensal gut bacterium Bt in directing a balanced immune response to constituents of the microbiota locally and systemically during health which is altered in IBD patients.
Oxidative stress and gut-derived lipopolysaccharides in children affected by Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections.
Authors: Loffredo Lorenzo , Spalice Alberto , Salvatori Francesca , Giovanna De Castro , Guido Cristiana Alessia , Zicari Anna Maria , Ciacci Paolo , Battaglia Simona , Brindisi Giulia , Ettorre Evaristo , Nocella Cristina , Salvatori Guglielmo , Duse Marzia , Violi Francesco , Carnevale Roberto
Published: December 2019

Backgroundpaediatric autoimmune neuropsychiatric disorders associated with streptococcal infections syndrome (PANDAS) identifies patients with acute onset of obsessive-compulsive and tic disorders. The objective of this study was to assess NOX2 activity, as well as serum 8-iso-prostaglandin F2α (iso-PGF2α) and lipopolysaccharide (LPS) derived from Gram-negative bacteria in the gut of patients with PANDAS. Methodsa cross sectional study was performed to compare serum activity of soluble NOX-2-dp (sNOX-2-dp), blood levels of isoprostanes and LPS in 60 consecutive subjects, including 30 children affected by PANDAS and 30 controls (CT) matched for age and gender. Serum zonulin was used to assess gut permeability. Resultscompared with CT, PANDAS children had higher values of sNOX-2-dp, 8-iso-PGF2-alpha and LPS. Simple linear regression analysis showed that sNOX2-dp was signiﬁcantly correlated with serum LPS (Rs=0.359; p=0.005), zonulin (Rs=0.444; p<0.001) and iso-PGF2α (Rs=0.704; p<0.001). LPS signiﬁcantly correlated with serum zonulin (Rs=0.610; p<0.001), and iso-PGF2α (Rs=0.591; p=0.001). A multiple linear regression analysis was performed to define the independent predictors of sNOX-2-dp. Isoprostanes and zonulin emerged as the only independent predictive variables associated with sNOX2-dp (R2=68%).Conclusionthis study provides the first report attesting that children affected by PANDAS have high NOX2 activation, oxidative stress and circulating levels of LPS that could be potentially implicated in the process of neuroinflammation.
Role of the ADCY9 gene in cardiac abnormalities of the Rubinstein-Taybi syndrome
Authors: Wu Yueheng , Xia Yu , Li Ping , Qu Hui-Qi , Liu Yichuan , Yang Yongchao , Lin Jijin , Zheng Meng , Tian Lifeng , Wu Zhuanbin , Huang Shufang , Qin Xianyu , Zhou Xianwu , Chen Shaoxian , Liu Yanying , Wang Yonghua , Li Xiaofeng , Zeng Hanshi , Hakonarson Hakon , Zhuang Jian
Published: December 2019

Background： Rubinstein–Taybi syndrome (RSTS) is a rare, congenital, plurimalformative, and neurodevelopmental disorder. Previous studies have reported that large deletions contribute to more severe RSTS phenotypes than those caused by CREBBP point mutations, suggesting a concurrent pathogenetic role of flanking genes, typical of contiguous gene syndromes, but the detailed genetics are unclear. Results：This study presented a rare case of Rubinstein-Taybi (RT) syndrome with serious cardiac abnormalities. Based on the clinical and genetic analysis of the patient, the ADCY9 gene deletion was highlighted as a plausible explanation of cardiac abnormalities. In adcy9 morphant zebrafish, cardiac malformation was observed. Immunofluorescence study disclosed increased macrophage migration and cardiac apoptosis. RNA sequencing in zebrafish model highlighted the changes of a number of genes, including increased expression of the mmp9 gene which encodes a matrix metalloproteinase with the main function to degrade and remodel extracellular matrix. Conclusions：In this study, we identified a plausible new candidate gene ADCY9 of CHD through the clinical and genetic analysis of a rare case of Rubinstein-Taybi (RT) syndrome with serious cardiac abnormalities. By functional study of zebrafish, we demonstrated that deletion of adcy9 is the causation for the cardiac abnormalities. Cardiac apoptosis and increased expression of the MMP9 gene are involved in the pathogenesis.
Effect of Sulfadoxine-Pyrimethamine doses for prevention of malaria during pregnancy in hypoendemic area in Tanzania
Authors: Mikomangwa Wigilya Padili , Minzi Omary , Mutagonda Ritah , Baraka Vito , Mlugu Eulambius M. , Aklillu Eleni , Kamuhabwa Appolinary A.R.
Published: December 2019

Background: Malaria in pregnancy increases the risk of deleterious maternal and birth outcomes. The use of ≥3 doses of sulfadoxine-pyrimethamine (SP) for intermittent preventive treatment of malaria (IPTp-SP) is recommended for preventing the consequences of malaria during pregnancy. However, the effect of IPTp-SP doses in low malaria transmission settings is not well established. This study assessed the effect of SP doses for prevention of malaria during pregnancy in low transmission settings. Methods: A cross-sectional study that involved consecutively selected 1,161 pregnant women was conducted at Mwananyamala regional referral hospital in Dar es Salaam. Assessment of the uptake of IPTp-SP was done by extracting information from antenatal clinic cards. Maternal venous blood, cord blood, placental blood and placental biopsy were collected for assessment of anaemia and malaria. High performance liquid chromatography with ultraviolet detection (HPLC-UV) was used to detect and quantify sulfadoxine (SDX). Dried blood spots (DBS) of placental blood were collected for determination of sub-microscopic malaria using polymerase chain reaction (PCR).Results: In total, 397 (34.2%) pregnant women reported to have used sub-optimal doses (≤2) while 764(65.8%) used optimal doses (≥3) of IPTp-SP at the time of delivery. The overall prevalence of placental malaria as determined by histology was 3.6%. Submicroscopic placental malaria was detected in 1.4% of the study participants. Women with peripheral malaria had six times risk of maternal anaemia than those who were malaria negative (aOR, 5.83; 95% CI, 1.10-30.92; p = 0.04). The overall geometric mean plasma SDX concentration was 10.76± 2.51μg/mL. Sub-optimal IPTp-SP dose was not associated with placental malaria, premature delivery and foetal anaemia. The use of ≤2 doses of IPTp-SP increased the risk of maternal anaemia by 1.36 fold compared to ≥3 doses (aOR, 1.36; 95%CI, 1.04-1.79; p = 0.02).Conclusion: The use of <2 doses of IPTp-SP increased the risk of maternal anemia. However, sub-optimal doses (≤2 doses) were not associated with increased the risk of malaria parasitaemia, foetal anaemia and preterm delivery among pregnant women in low malaria transmission setting. The use of optimal doses (≥3doses) of IPTp-SP and complementary interventions should continue even in areas with low malaria transmission.
Clinical efficacy of artemisinin-lumefantrine and status of antifolate drug resistance markers in western Kenya
Authors: kishoyian gabriel m , Njagi Eliud N.M. , Orinda George O. , Thiongo Kevin , Kimani Francis T. , Matoke-Muhia Damaris
Published: December 2019

Background: The development of Plasmodium falciparum resistance to sulfadoxine-pyrimethamine (SP) necessitated its replacement with artemether-lumefantrine (AL) in Kenya. However, the delayed parasite clearance following treatment with artemisinin derivatives has now spread in the Greater Mekong Sub region and may emerge or spread to other malaria endemic regions. Since parasites resistance to drugs is correlated with specific gene mutations, molecular markers associated with antimalarial drugs offer a powerful tool to monitor the emergence and spread of resistance. In this study, we assessed the clinical efficacy of AL following its adoption and the current levels of antifolate drug resistant markers after its ban in Kenyan health facilities. Methods: We conducted a therapeutic efficacy study between May and November 2015 in Chulaimbo sub-County, Kisumu, Kenya. A total of 76 patients ≥6 and ≤60 months of age with confirmed Plasmodium falciparum mono-infection were enrolled, treated with AL and followed up for a period of 28 days. Study endpoints were adequate clinical and parasitological response (ACPR) on the 28 day and known SP molecular markers of resistance were also determined. Results: The study showed that 97% of the participants had cleared parasitemia within 48 hours with an adequate clinical and parasitological response (ACPR) of 100% clearance on day 3. On Pfdhfr/Pfdhps mutants, N51I was identified in the P. falciparum isolates with a prevalence of 94% while C59R and S108N had 92% each. The prevalence of mutation at Pfdhps codons A437G and K540E stood at 94% and 91% respectively. Conclusion: AL was found to be highly efficacious since no plasmodium falciparum parasites were observed after day 3 making it a drug of choice in Kenya. Evidence of quintuple mutations frequency is high in the study population threatening the future use of SP.