bluuebunny/crossref_metadata_2025 huggingface dataset:
Children with type 1 diabetes have elevated high sensitivity C-reactive protein compared to a control group
Authors: Pérez-Segura Pilar , de Dios Olaya , Herrero Leticia , Vales-Villamarín Claudia , González-Aragón Isabel , Gavela-Pérez Teresa , Garcés Garmen , Soriano-Guillen Leandro
Published: March 2020

Objectives To compare high sensitivity C-reactive protein (hsCRP) levels in children with type 1 diabetes, healthy controls, and children with obesity. Additionally, we aimed to analyze the association between hsCRP levels and glycemic control measured by glycohemoglobin A (HbA1c) and anthropometric and biochemical variables. Methods We conducted a non-randomized descriptive study of children with type 1 diabetes matched for sex and age with a control group and group with obesity. We recorded anthropometric parameters and studied variables related to diabetes, blood pressure, lipid profile, and HbA1c. HsCRP was measured by ELISA.Results We included 49 children with type 1 diabetes, 46 controls, and 40 children with obesity. hsCRP levels were significantly higher in the group with type 1 diabetes compared to controls and nearly significantly lower than in the group comprising children with obesity. We found no correlation between hsCRP and HbA1C and characteristics of type 1 diabetes with the exception of albuminin creatinine ratio (ACR). Statistically significant association was found between hsCRP and BMI and waist circumference Z-score. Conclusions Children with type 1 diabetes have a higher hsCRP than healthy subjects; this difference is not associated with HbA1c, but is related to waist circumference, BMI, and ACR. Obesity prevention should be a priority when performing follow-up in children with type 1 diabetes.
TEAS treatment improves gastrointestinal function after abdominal surgery: study protocol for a prospective randomized controlled trial
Authors: Bai Yafan , Gao Chao , Li Wenjing , Du Yi , An Lixin
Published: March 2020

Background : Postoperative gastrointestinal (GI) dysfunction (PGD) is a common problem after abdominal surgery. PGD can increase the length of hospital stay and the economic burden and may even lead to some serious complications. Acupuncture and moxibustion are alternative therapies recommended for PGD. However, the effect of preventive application of acupuncture or transcutaneous electrical acupuncture stimulation (TEAS) is still uncertain. The purpose of this study is to investigate the efficacy of the continuous application of TEAS on GI function recovery in patients after abdominal surgery. At the same time, we will try to confirm the mechanism of TEAS through the brain-gut axis.Methods/design : This study is a prospective, single-center, two-arm, randomized controlled trial that will be performed in a general hospital. In total, 280 patients scheduled for gastric or colorectal cancer surgery will be stratified into two groups. The experimental group will receive TEAS stimulation at Hegu (L14) and Neiguan (PC6), Zusanli (ST36), and Shangjuxu (ST37) once a day for 30 min during and after surgery until GI function recovery. The sham group will receive pseudo-TEAS at sham acupoints. The primary outcome will be the recovery time of postoperative bowel sounds, flatus, bowel movements and the changes in perioperative brain-intestinal peptides. The secondary outcome will be postoperative pain, perioperative complications, and hospitalization duration.Discussion : The results of this study will demonstrate that continuous preventive application of TEAS can improve the GI function recovery in patients undergoing abdominal surgery and that this effect may act through brain-gut peptides.Trial registration: Chinese Clinical Trial Registry, ID: ChiCTR1900023263, Registered on 11 May 2019,http://www.chictr.org.cn
Effect of does parity order on litter homogeneity parameters
Authors: Pollesel Marta , Tassinari Marco , Frabetti Andrea , Fornasini Daniela , Cavallini Damiano
Published: March 2020

Background: In rabbits reproductive performance, litter size and litter weight at birth, growth rate and mortality rate are the main factors that help to define the productive potential and they are influenced by the parity order. Birth weight represents a basic parameter in the management of a rabbit farm, because it is linked to mortality rate and weaning weight. Litter size affects the weight gained by suckling rabbits at weaning and it is connected with the chance of kits to find an available teat during the suckling period. For these reasons, it is of prime importance to study individual newborn and an intra-litter homogeneity parameters. This experimental study aimed to consider the litter homogeneity weight at birth, both within each litter and in the whole population, in order to suggest a proper litter homogenization practice.Results: The 1st and 6th parity order showed respectively the lowest and highest values in litter size, born-alives, litter weight, born-alives weight and homogeneity. These parameters decreased in greater parity order. Not significant effects on still-borns number and mortality rate were recorded. All these litter homogeneity evaluation parameters appeared interesting in describe differences between parity orders.Conclusions: The results of this research confirm that does parity order influences litter size and born-alives weight, but also the intra- and inter-litter homogenization. Litter homogenization is crucial to ensure proportionate share of milk, more equal growth and better productive performances. Based on these results we suggest equalizing primiparous with primiparous litters, and, consequently, the following parity orders among them.
Automatic Facial Landmark Localization in Clinical Populations - Improving Model Performance with a Small Dataset
Authors: Guarin Diego L , Taati Babak , Hadlock Tessa , Yunusova Yana
Published: March 2020

Background Automatic facial landmark localization in videos is an important first step in many computer vision applications, including the objective assessment of orofacial function. Convolutional neural networks (CNN) for facial landmarks localization are typically trained on faces of healthy and young adults, so model performance is inferior when applied to faces of older adults or people with diseases that affect facial movements, a phenomenon known as algorithmic bias. Fine-tuning pre-trained CNN models with representative data is a well-known technique used to reduce algorithmic bias and improve performance on clinical populations. However, the question of how much data is needed to properly fine-tune the model remains. Methods In this paper, we fine-tuned a popular CNN model for automatic facial landmarks localization using different number of manually annotated photographs from patients with facial palsy and evaluated the effects of the number of photographs used for model fine-tuning in the model performance by computing the normalized root mean squared error between the facial landmarks positions predicted by the model and those provided by manual annotators. Furthermore, we studied the effect of annotator bias by fine-tuning and evaluating the model with data provided by multiple annotators. Results Our results showed that fine-tuning the model with as little as 8 photographs from a single patient significantly improved the model performance on other individuals from the same clinical population, and that the best performance was achieved by fine-tuning the model with 320 photographs from 40 patients. Using more photographs for fine-tuning did not improve the model performance further. Regarding the annotator bias, we found that fine-tuning a CNN model with data from one annotator resulted in models biased against other annotators; our results also showed that this effect can be diminished by averaging data from multiple annotators. Conclusions It is possible to remove the algorithmic bias of a\textbf{depth} CNN model for automatic facial landmark localization using data from only 40 participants (total of 320 photographs). These results pave the way to future clinical applications of CNN models for the automatic assessment of orofacial function in different clinical populations, including patients with Parkinson’s disease and stroke.
Clinical Efficacy of Intramedullary Fixation vs. Plate Fixation for Femoral Intertrochanteric Fractures
Authors: Zhou Yu , Xia Chongjun , Ma Xiaowei , Yu Xiaobing
Published: March 2020

Objective: To compare the clinical efficacy of proximal femoral intramedullary fixation and anatomical locking compression plate in the treatment of femoral intertrochanteric fractures among the elderly. Methods: In this retrospective study, 210 surgically treated patients with intertrochanteric fractures of the femur were analyzed and divided into groups A, B and C according to the surgical approach. Group A had interlocking compression nailing (INTERTAN) done (n=69); group B had γ-III interlocking intramedullary nailing (γ-III) done (n=73); and group C had proximal femoral anatomic locking plate (PFLP) done (n=68). All patients’ data were followed up completely, and their clinical outcomes were observed. Results: Group A and B were found to perform better than group C in operation time, bleeding volume, time of leaving bed, fracture healing time and hospitalization time (P < 0.05). Their respective incidences of postoperative complications were significantly lower than that of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). The Harris scores of groups A and B at 1, 3 and 6 months after operation were significantly higher than those of group C (P < 0.05). There were no significant differences between group A and group B (P > 0.05). Conclusions: In the treatment of femoral intertrochanteric fractures, intramedullary fixation influences little on blood circulation at the fracture end, accelerates fracture healing, and enhances hip joint function, which assists patients in recovering faster postoperatively. Moreover, it enables them to gain mobility at an early stage and reduces postoperative complications of fractures. Its short-term clinical effects are better than extramedullary fixation, which should be more widely adapted clinically.
CCL1 blockade alleviates human mesenchymal stem cell (hMSC)-induced pulmonary fibrosis in a murine sclerodermatous graft-versus-host disease (Scl-GVHD) model
Authors: Lim Ji-Young , Ryu Da-Bin , Kim Tae Woo , Lee Sung-Eun , Park Gyeongsin , Yoon Hyoung Kyu , Min Chang-Ki
Published: March 2020

BackgroundHuman chronic graft-versus-host disease (CGVHD) shares clinical characteristics with a murine sclerodermatous GVHD (Scl-GVHD, B10.D2 → BALB/c) model that is characterized by skin and lung fibrosis. In this study, bone marrow- or adipose tissue-derived human mesenchymal stem cells (hMSCs) were injected into the Scl-GVHD mice to address their therapeutic effect on CGVHD.MethodsLethally irradiated BALB/c mice were transplanted with B10.D2 T cell depleted bone marrow with or without spleen cells to generate Scl GVHD. hMSCs were intravenously treated on days 3, 5 and 7 post-transplantation. And the control antibody or CCL1 blocking antibody was subcutaneously injected into the same schedule as hMSCs. At 14 days after transplantation, the recipient mice sacrificed and their skin and lung analyzed.ResultsAfter early injection of hMSCs after transplantation, the clinical and pathological severity of Scl-GVHD in the skin was significantly attenuated, whereas the pathological score was exacerbated in the lungs. hMSCs migrated into the lungs but not into the skin. CD11b monocyte/macrophages and CD4 T cells were markedly decreased in skin tissues, whereas there was an early recruitment of CD11b cells, and subsequently increased infiltration of CD4 T cells, in the lungs. Importantly, hMSCs persistently up-regulated the expression of CCL1 in the lungs but not in the skin. Concurrent treatment of hMSCs with a CCL1-blocking antibody alleviated the severity of the lung histopathology score and fibrosis with preservation of the cutaneous protective effect against CGVHD. Infiltration of CD3 T cells and CD68 macrophages and up-regulation of chemokines were also decreased in lung tissues, along with recruitment of eosinophils and tissue IgE expression. In the skin, chemokine expression was further reduced after CCL1 blockade.ConclusionsThese data demonstrate that despite a protective effect against Scl-GVHD in the skin, administration of hMSCs exacerbated lung fibrosis associated with eosinophilia and airway inflammation through persistent CCL1 up-regulation. CCL1 blockade offers a potential treatment of pulmonary complications induced after treatment with hMSCs.
The spectrum of CYP21A2 gene mutations in patients with 2l-hydroxylase deficiency -induced congenital adrenal hyperplasia in a Chinese cohort
Authors: Liu Yang , Zheng Jie , Xu Xiaowei , Zhang Xinjie , Zhang Ying , Li Guoxu , Liu Geli , Cai Chunquan , Shu Jianbo
Published: March 2020

Background 21-hydroxylase deficiency (21-OHD) caused by the CYP21A2 gene mutations is the most popular form of congenital adrenal hyperplasia. It is an autosomal recessive disorder results in the defective synthesis of cortisol and aldosterone. The incidences of various CYP21A2 gene mutations and the genotype-phenotype correlations vary among different populations. Therefore, the aim of current study was to identify the spectrum of CYP21A2 gene mutations of patients from northern China and analyze the genotype-phenotype correlation.Methods The clinical and molecular data of 22 patients were analyzed in this study. Locus-specific polymerasechain reaction and Sanger sequencing were applied to identify gene micro-conversions, and multiplex ligation-dependent probe amplification as an alternative to Southern blotting was used to detect large fragment deletions/conversions. Then the genotypes were categorized in to Null, A, B, C and D groups to analyze the relationships between genotypes and phenotypes.Results Molecular defects were detected in 44 alleles (100%). Micro-conversion mutation IVS2-13A/C> G (70.5%) is most common in our cohort, followed by large gene deletions and conversions (22.7%). The other mutations present were p.R357W (4.5%) and E6 Cluster (2.3%). Genotypes of 22 patients (100%) were consistent with the predictive phenotypes.Conclusions In this study, we collected 22 21-OHD patients’ clinical and mutations data in Chinese population, especially in northern China. Micro-conversions were the most popular mutations and the frequencies were consistent with other cohorts. Moreover, thegenotypes and phenotypes in 21-OHDwere well correlated. This studyidentifiedthe mutation spectrum of CYP21A2gene and conduced to genetic counseling and prenatal diagnosis.
Effect of dietary pyrroloquinoline quinone disodium in sows on intestinal health of the offspring
Authors: Wang Chenxi , Zhang Boru , Zhang Hongyun , Yang Wei , Meng Qingwei , Shi Baoming , Shan Anshan
Published: March 2020

Background: Pyrroloquinoline quinone (PQQ) is a putative essential nutrient and redox modulator in microorganisms, cell and animal models. The objective of this study was to investigate the effects of pyrroloquinoline quinone disodium (PQQ·Na2) in sows during gestation and lactation on intestinal health in the offspring.Results: The activities of SOD and GSH-Px were significantly (P<0.05) increased by PQQ·Na2 supplementation, and MDA activity was decreased (P<0.05) in the plasma of piglets. CAT, SOD and GSH-Px activities were significantly (P<0.05) increased, and MDA activity was decreased (P<0.05) in the small intestine of piglets. The mRNA expression levels of SOD1, CAT and MGST1 in the jejunum were increased in newborn piglets (P<0.05), and the mRNA expression levels of HO1, SOD1, CAT, SOD2, GPX4, GPX1 and GCLC in the jejunum were increased in weaned piglets (P<0.05). The mRNA expression of ZO-1 was increased (P<0.05) in the jejunum of newborn piglets, and the mRNA expression of Occludin and ZO-1 was increased (P<0.05) in the jejunum of weaned piglets. The villous height of the duodenum and jejunum of weaned piglets was increased (P<0.05) by dietary PQQ·Na2. In weaned piglets, Bacteroidetes and Firmicutes were the most prevalent phyla in both the Con and PQQ·Na2 treatment groups, and the most prevalent genera were Alloprevotella and Bacteroides. At the phylum level, the abundance of Firmicutes was significantly increased (P<0.05), and the abundance of Proteobacteria was significantly decreased (P<0.05). At the genus level, the abundance of Alloprevotella was significantly increased (P<0.05), and the abundance of Actinobacillus and Escherichia was decreased (P<0.05).Conclusions: In conclusion, dietary supplementation with PQQ·Na2 in sows during gestation and lactation had positive effects on intestinal health in offspring.
Socioeconomic inequalities in women´s access to health care: has Ecuadorian health reform succeeded?
Authors: Quizhpe Edy , Sebastian Miguel San , Teran Enrique , Pulkki-Brännström Anni-Maria
Published: March 2020

Background Over the last twelve years, Ecuador has implemented a comprehensive health sector reform to ensure equitable access to health care services according to health needs. While there have been important achievements in terms of health care coverage, the effects of these reforms on socioeconomic inequalities in health care have not been analysed. This study assessed whether the health care reform implemented in the 2007 - 2017 decade contributed to reducing the socioeconomic inequalities in women´s health care access. Methods This study was based on two waves of the Living Standards Measurement Survey conducted in Ecuador in 2006 and 2014. Data from women of reproductive age (15 to 49 years) was analysed to evaluate health care coverage in three indicators: skilled birth attendance, cervical cancer screening and the use of modern contraceptives. Absolute risk differences were calculated between the heath care indicators and the socioeconomic variables using binomial regression analysis for each time period. The Slope Index of Inequality (SII) was also calculated for each socioeconomic variable and period. A multiplicative interaction term between the socioeconomic variables and period was included to assess the changes in socioeconomic inequalities in health care over time. Results Access to health care increased in the three studied outcomes during the health sector reform. Significant inequality reductions in skilled birth attendants were observed in all socioeconomic variables except in the occupational class. Cervical cancer screening inequalities increased according to education and occupation, but decreased by wealth. Only a decrease by education was observed for modern contraceptive use. Conclusions While most socioeconomic inequalities in skilled birth attendance decreased during the reform, this was not the case for inequalities in cervical cancer screening or the use of modern contraceptives. Further work is needed to address the social determinants of these health inequalities.
Frequency and Clinical Association of NY-ESO-1 Gene Expression in Diffuse Large B-cell Lymphoma.
Authors: Carrilo Irma Olarte , Peñafiel Christian Ramos , Peralta Enrique Miranda , Guerrero Efrain Garrido , JALOMA JUAN COLAZO , Tovar Adolfo Martinez
Published: March 2020

Background

Diffuse Large B-cell Lymphoma, a heterogeneous disease, is influenced by complex network of gene interactions. In current study, we aimed to evaluate the frequency of expression and determine the expression levels of the NY-ESO-1 gene in patients with DLBCL, as well as to examine its relationship with clinical parameters and survival.

Methods

We analyzed NY-ESO-1 gene expression levels using real-time quantitative RT-PCR (qRT-PCR) in 112 patients with DLBCL. The associations between the expression of the NY-ESO-1 gene and the clinical variables were evaluated using the chi-square test and Fisher’s exact test. Overall survival (OS) was determined using the Kaplan-Meier method.

Result

The results showed that the NY-ESO-1 gene was expressed in 46.4% (52/112) of patients with DLBCL, and NY-ESO-1 gene expression was associated with clinical parameters such as LDH, clinical stage, international prognostic index (IPI) (p≤0.05). High levels of NY-ESO-1 gene expression were correlated with advanced disease stages, and the survival rates after 5.3 years of tracking were lower in the patients expressing the NY-ESO-1 gene (66.4%) than in those not expressing the gene (23.1%).

Conclusion

In conclusion, the expression levels of the NY-ESO-1 gene in patients with DLBCL may be of great utility for diagnosing and determining the prognosis of this disease.
Proteomic and structural heart changes in obese rats are incompletely restored after weight loss
Authors: Liśkiewicz Arkadiusz , Marczak Łukasz , Bogus Katarzyna , Liśkiewicz Daniela , Przybyła Marta , Lewin-Kowalik Joanna
Published: March 2020

Background As a systemic disorder, obesity strongly affects the cardiovascular system, inducing cardiac overgrowth, which increases the risk of heart failure and death. Moreover, obesity is potentially curable, leading to the restoration of the heart phenotype, but it is not clear if all of the after-effects are reversed after weight loss. of the heart phenotype, but it is not clear if all of the after-effects are reversed after weight loss. Here we describe the proteomic and morphologic phenotype of the heart in a rat model of developmental obesity with an evaluation of whether the observed effects are persistent in spite of weight loss. Methods Developmental obesity with hyperlipidemia and insulin resistance was induced in young rats by exposure to a Western diet composed of human snacks. An histologic evaluation of the heart was performed to measure the size of the cardiomyocytes and amount of connective tissue discriminating the phenotype of obesity cardiomyopathy. The cardiac tissue and plasma were analyzed by global proteomic profiling. Based on these data, we targeted proteins for evaluation with the western blot. The histological and proteomic measurements were performed after weight loss to validate which features of obesity cardiomyopathy were persistent. Results Obesity cardiomyopathy was determined as cardiac hypertrophy associated with fibrosis, oversized myocytes, and mTOR upregulation. A plethora of molecular changes were observed, suggesting an effect on the utilization of metabolic substrates in the hearts of obese animals. This was confirmed by increased levels of ACSL-1, a key enzyme for fatty acid degradation and decreased GLUT-1, a glucose transporter. Immunological processes and lipid metabolism were also affected in the cardiac tissue and plasma. Weight loss led to the normalization of the heart’s size, but some after-effects of obesity such as connective tissue abundance and abnormal proteomic composition were still persistent. Conclusion In addition to morphological consequences, obesity cardiomyopathy involves many proteomic changes. Obesity treatment and weight loss provides for a partial repair of the heart’s architecture, but cardiac fibrosis and some proteomic alterations persist.
Separating Overlapping Bat Calls with a Bi-directional Long Short-term Memory Network
Authors: Zhang Kangkang , Liu Tong , Song Shengjing , Zhao Xin , Sun Shijun , Metzner Walter , Feng Jiang , Liu Ying
Published: March 2020

Background: Acquiring clear and usable audio recordings is critical for acoustic analysis of animal vocalizations. Bioacoustics studies commonly face the problem of overlapping signals, which can impede the structural identification of vocal units, but the issue is often ignored, as there is currently no satisfactory solution. This study presents a bi-directional long short-term memory (BLSTM) network to separate overlapping bat calls and reconstruct waveforms. The separation quality was evaluated using seven temporal-spectrum parameters. The applicability of this method for bat calls was assessed using six different species. In addition, clustering analysis was conducted with separated echolocation calls from each bat species. Results: All syllables in the overlapping calls were separated with high robustness across species. A comparison between the seven temporal-spectrum parameters showed no significant difference and negligible deviation between the extracted and original calls, indicating high separation quality. Clustering analysis also produced an accuracy of 93.8%, suggesting the reconstructed waveforms could be reliably used. Conclusions: The study extends the application of deep neural network to separate overlapping animal sound. These results suggest the proposed technique is a convenient and automated approach for separating overlapping calls using a BLSTM network. This powerful deep neural network approach has the potential to solve complex problems in bioacoustics.
Incorporation of InSAR and LandSat ETM+ with CGPS and SVM to assess the subsidence of Mexico City
Authors: Poreh Davod , Pirasteh Saied , Cabral-Cano Enrique
Published: March 2020

This study presents an enhanced analysis of the subsidence rates and their effects on Mexico City. As a result of excess water withdrawal, Mexico City is experiencing subsidence. To analyze this subsidence of Mexico City, we integrated and analyzed Interferometric Synthetic Aperture Radar (InSAR), Continuous Global Positioning Systems (CGPS), and optical remote sensing data. This study utilized 52 ENVISAT-ASAR, nine GPS stations, and one Landsat ETM+ image from the Mexico City area to gather a better understanding of the subsidence rates and its effects on Mexico City’s community The InSAR data covers the period between March 2002 until June 2010, and the GPS data span the period from 1998 until 2012. We find that the maximum of 352-mm change in Line Of Sight (LOS) direction supports the outcomes from previous studies. This study shows that the maximum rate of subsidence in Mexico City is 352 mm/yr. The finding of this study reveals a high amount of correlation (up to 0.98) between two independent geodetic methods. We also implemented the Support Vector Machine (SVM) analysis method based on Landsat ETM+ image to classify Mexico City’s population density. We used SVM to compare Persistent Scatterer Interferometry (PSI) subsidence rates with the buildings’ distribution densities. This study improves the existing method by incorporating 52 ENVISAT images, ETM+, SVM classification, and 9 CGPs. This integrated study shows that the fastest subsidence zone (i.e. areas greater than 100 mm/yr), which falls into the above-mentioned temporal baseline, occurs in the areas of high and moderate building distribution density.
Magnetic resonance imaging parameters of the greater tuberosity morphology in different types of chronic rotator cuff tears
Authors: Wang Anqi , Lu Hongzhang
Published: March 2020

Background: The purpose of this study was to explore the distinction and relation among different types of chronic rotator cuff tears, in terms of some magnetic resonance imaging (MRI) parameters that reflected the greater tuberosity morphology.Methods: This study retrospectively assessed 160 patients diagnosedwith chronic rotator cuff tears (including bursal-side, articular-side and full-thickness rotator cuff tears) and 48 controls diagnosed without rotator cuff tears by MRI. The types of rotator cuff tear were confirmed by shoulder MRI and arthroscopy. Oblique coronal sections of MRI were used to measure the parameters including greater tuberosity abduction angle(GTAA), greater tuberosity width index (GTWI), and greater tuberosity height index(GTHI).Results: GTAA in patients with articular-side and full-thicknessrotator cuff tearswere smaller than those in patients with bursal-side rotator cuff tears and in controls.GTWI and GTHI were present in greater proportions in patients with articular-side and full-thickness rotator cuff tearsthan in patients with bursal-side rotator cuff tears and in controls.There was no significant difference between the articular-side and full-thickness cuff tears regarding GTAA, GTWI, or GTHI. The same was true between bursal-side rotator cuff tears and the controls.Conclusions: The greater tuberosity abduction angles are smaller, and greater tuberosity are more convex outward and upwardin patients with articular-side or full-thickness rotator cuff tears, than those in patients with bursal-side rotator cuff tears or in controls.
Repurposing of Anti-malarial SynriamTM and testing its efficacy against Egyptian strain of Schistosoma hematobium
Authors: Yousof Hebat-Allah S. A. , El-Sayed Shaimaa H. , Elfar Eman , Khater Mona
Published: March 2020

Background: Trials for discovering an anti-malarial drug, which can compete Schistosomal infection in co-endemic areas, are ongoing. Some preliminary studies were done on Synriam (SYN), anti-malarial drug combination (arterolane maleate and piperaquine phosphate) released from Ranbaxy, to test its anti-schistosomal effect. However, in vitro incubation of SYN with different Schistosoma hematobium stages was not fully assessed. The aim of this study is to determine the anti-schistosomal in vitro effect of SYN on adult and juvenile stages of Schistosoma hematobium- Egyptian strain.Methods: The adult and juvenile worms were incubated with ascending concentrations of SYN and with praziquantel as positive control. Viability, survival, morphological and ultrastructural changes were assessed at different time points.Results: Higher concentrations of 60, 80 µg/ml showed rapid and lethal effects on adult and juvenile stages of both species, with prominent ultrastructural alterations. Concentrations of (10, 20, 40 µg/ml) showed mild to moderate effect on adult schistosomes. However, contrarily to praziquantel, larval immature stages responded significantly and rapidly to low concentration of SYN with 100% death rate.Conclusion: The present findings are consistent with the evaluation of anti-schistosomal therapeutic effect of SYN to be utilized in malaria co-endemic areas.
Construction of a Semi-automatic ICD-10 Coding System
Authors: Zhou Lingling , Cheng Cheng , Ou Dong , Huang Hao
Published: March 2020

Background The International Classification of Diseases, 10th Revision (ICD-10) has been widely used to describe the diagnosis information of patients. Automatic ICD-10 coding is important because manually assigning codes is expensive, time consuming and error prone. Although numerous approaches have been developed to explore automatic coding, few of them have been applied in practice. Our aim is to construct a practical, automatic ICD-10 coding machine to improve coding efficiency and quality in daily work. Methods In this study, we propose the use of regular expressions (regexps) to establish a correspondence between diagnosis codes and diagnosis descriptions in outpatient settings and at admission and discharge. The description models of the regexps were embedded in our upgraded coding system, which queries a diagnosis description and assigns a unique diagnosis code. Like most studies, the precision (P), recall (R), F-measure (F) and overall accuracy (A) were used to evaluate the system performance. Our study had two stages. The datasets were obtained from the diagnosis information on the homepage of the discharge medical record. The testing sets were from October 1, 2017 to April 30, 2018 and from July 1, 2018 to January 31, 2019. Results The values of P were 89.27% and 88.38% in the first testing phase and the second testing phase, respectively, which demonstrate high precision. The automatic ICD-10 coding system completed more than 160,000 codes in 16 months, which reduced the workload of the coders. In addition, a comparison between the amount of time needed for manual coding and automatic coding indicated the effectiveness of the system-the time needed for automatic coding takes nearly 100 times less than manual coding. Conclusions Our automatic coding system is well suited for the coding task. Further studies are warranted to perfect the description models of the regexps and to develop synthetic approaches to improve system performance.
The Implementation & Sustainment Facilitation Strategy improved implementation effectiveness and intervention effectiveness: Results from a cluster-randomized type 2 hybrid trial
Authors: Garner Bryan , Gotham Heather , Chaple Michael , Martino Steve , Ford James , Roosa Mathew , Speck Kathryn , Vandersloot Denna , Bradshaw Michael , Ball Elizabeth , Toro Alyssa , Griggs Christopher , Tueller Stephen
Published: March 2020

Background Substance use disorders (SUD) among people with HIV are both prevalent and problematic. In 2014, the Substance Abuse Treatment to HIV care (SAT2HIV) Project was funded to test the team-focused Implementation & Sustainment Facilitation (ISF) strategy as an adjunct to the staff-focused Addiction Technology Transfer Center (ATTC) strategy for integrating a motivational interviewing-based brief intervention (MIBI) for SUD within HIV community-based organizations (CBOs). This article presents the main findings from the project. Methods Using a cluster-randomized, type 2 hybrid trial design, 39 HIV-CBOs were randomized to either: 1) ATTC (n = 19); or 2) ATTC+ISF (n = 20). HIV-CBOs identified two staff to be prepared to implement the MIBI (N = 78 MIBI staff). Subsequently, during the implementation phase, HIV-CBOs in each condition randomized client participants (N = 824 client participants) to one of two intervention conditions: 1) usual care (UC; n = 415); or 2) UC+MIBI (n = 409). Both staff-level outcomes and client-level outcomes were examined. Results The ISF strategy had a significant impact on implementation effectiveness (i.e., the consistency and quality of implementation; β = 0.65, p = 01), but not on time-to-proficiency (β = - 0.02) or level-of-sustainment (β = 0.09). Additionally, the ISF strategy was found to have a significant impact on intervention effectiveness (i.e., the effectiveness of the MIBI), at least in terms of significantly decreasing the odds (odds ratio = 0.11, p = .02) of clients using their primary substance daily during follow-up. Conclusions The ATTC strategy was sufficient for the preparation of HIV-CBO staff to implement a MIBI for SUDs, yet the ISF strategy was found to be an effective adjunct to the ATTC strategy in terms of implementation effectiveness and intervention effectiveness. Based on these findings, it is recommended future efforts to integrate the project’s MIBI for SUD within HIV-CBOs use the ATTC+ISF strategy. However, given the ISF strategy did not have a significant impact on level-of-sustainment, which was similarly low in both implementation conditions, implementation research testing the extent to which the ATTC+ISF strategy can be significantly enhanced via effective sustainment strategies is warranted.
Immune modulation effects and safety of Lactobacillus casei variety rhamnosus in a chemotherapy-induced intestinal mucositis mouse model
Authors: Yeung Chun-Yan , Chiau Jen-Shiu Chiang , Cheng Mei-Lein , Chan Wai-Tao , Chang Szu-Wen , Jiang Chuen-Bin , Lee Hung-Chang
Published: March 2020

Background Intestinal mucositis remained one of the most deleterious side effects in cancer patients undergoing chemotherapy. 5-Fluorouracil (5-FU) treatment was reported to affect the abundance of gut microbiota. In this study, we hypothesize that the probiotics could preserve gut ecology, ameliorate inflammation and protect epithelium by maintaining the tight junction integrity via immune modulations of enterocytes and intestinal stem cells. Our aim is to characterize these changes and to investigate the immune modulation effects and safety of probiotic via a 5-FU-induced intestinal mucositis mouse model.Methods 5-FU-injected BALB/c mice were used. They were either orally administrated saline or probiotic suspension of Lactobacillus casei variety rhamnosus (Lcr35). Diarrhea score, serum pro-nflammatory cytokines, intestinal histology and T-cells subtypes were assessed. Immunostaining analysis for intestinal stem cells CD44 and Ki67 proliferation were processed. Samples of blood and internal organs were investigated for bacteria translocation.Results Diarrhea was attenuated significantly after oral Lcr35 administration. Serum pro-inflammatory cytokines were significantly increased in 5-FU group and were reversed by Lcr35. There was a tremendous rise of CD3+/CD8+ count in the 5-FU group. The CD8+ count was reversed in the 5-FU+Lcr35 group. 5-FU caused a significant decrease of CD3+CD4+/CD3+CD8+ ratio and was reversed by Lcr35. 5-FU significantly stimulated the expression of CD44 stem cells and was restored by Lcr35. We also found 5-FU could increase the number of Ki67 proliferative cells. No bacterial translocation was found in this study.Conclusions Our results showed 5-FU caused intestinal inflammation via Th1 and Th17 responses. 5-FU could stimulate stem cells and proliferation cells in a mouse model. We demonstrated chemotherapy could decrease immune competence. Probiotics were shown to modulate immune response. This is the first study to analyze the immune modulation effects and safety of Lactobacillus strains on enterocytes and intestinal stem cells in a 5-FU-induced mucositis mouse model. The model therefore seems well suited to study the effects of different probiotics on chemotherapy-induced mucositis, prior to performing clinical human studies.
The risk factors related to operative duration and its relationship with clinical outcome in pediatric patients undergone Roux-en-Y hepaticojejunostomy
Authors: Li Ang , Gao Kai , Liu Qingshuang , Chen Jingyu , Guo Chunbao
Published: March 2020

Background: The operative duration might be important for perioperative morbidity and the involvement has not been fully characterized in pediatric patients. We here determined the perioperative variables in association with operative duration and its influence on the clinical outcome in the pediatric patients.Methods: We retrospectively reviewed 701 patients who underwent elective choledochal cysts followed by Roux-en-Y hepaticojejunostomy between August 2010 and Aug 2019. Based on the median operating time (165 min), patients were separated into two groups, including a long-time group (>165 min) and a short-time group (<165 min). The independent risk factors for the operative time were determined usng the multivariable logistic regression analyses. To adjust for any potential selection bios, propensity score matching was performed for the long-time and short-time groups. In the 192 matched patients, perioperative outcomes, including postoperative recovery, complications measurement, and length of hospital stay were analyzed.Results: The operating time was often increased by excision difficulty caused by the lager choledochal cyst size (OR=1.56; 95% CI, 1.09-2.23; p<0.001), the greater BMI(OR=1.02; 95% CI, 1.00-1.15; p=0.018), older age (OR=1.17; 95% CI, 1.02-1.39; p=0.012) under multivariate analysis. The long-time surgical duration was associated with delay for gastrointestinal functional recovery, measured with the first defecation (p=0.027) and first bowel movement (p=0.019). Moreover, a significant decrease in serum albumin were presented in the long-time group compared with the short time group (p=0.0035). The total length of postoperative hospital stay was longer in patients with long-time group (7.51±2.03 days) than patients with short-time group (6.72±1.54 days, p = 0.006).Conclusions: Our data demonstrated that short operating time was associated with favorable postoperative results. The influencing factors for operating time could be ameliorated in the perioperative period to gain a better outcome after major abdominal operations.
Exploring Determinants of Hand Hygiene among Hospital Nurses: A Qualitative Study
Authors: Ghaffari Mohtasham , Rakhshanderou Sakineh , Safari-Moradabadi Ali , Barkati Hassan
Published: March 2020

Background: The present research is a qualitative one aiming to determine factors affecting hand-hygiene behavior of the nursing staff in Shariati Hospital of Tehran, Iran. Methods: This was a qualitative study performed using content analysis approach. Considering the aim of the study, 16 in-depth semi-structured interviews were held with the nursing staff of Shariati Hospital of Tehran University of Medical Sciences. A convenient sampling was performed and continued until data saturation and until no new codes and categories were obtained. Data were analyzed through a qualitative content analysis based on the Graham and landsman method. Directed qualitative content analysis was done in order to analyze the data. Results: The results of this study revealed 3 main themes in the Theory of Planned Behavior (TPB) (attitude, subjective norms and perceived behavioral control) and 8 main themes in the outside the framework (environment, perceptions, life style, morality, education, organizational culture, salience and personality). Conclusion: Due to the other factors also found in this study, an integration of theories and models for designing of interventions is recommended to increase adherence to hand hygiene behavior.
Barriers and challenges against the utilization of novel teaching methods for nursing students from the perspective of nursing instructors
Authors: bijani Mostafa , Moradi Zahra , Karimi Shahnaz , Fereidouni Zhila , Nikrooz Leila , Hatami Mahmood , Naghizadeh Mohammad Mehdi
Published: March 2020

Background: The first step in efficient application of novel teaching methods is identification of barriers and challenges in order to perform appropriate interventions. Various studies have emphasized the utilization of novel methods in instruction of nursing students. However, there are barriers and challenges against the use of these techniques. Therefore, the present study aimed to investigate the challenges and executive barriers against the utilization of novel approaches in instructing nursing students from the perspective of nursing instructors. Methods: In this descriptive-analytical study, 150 nursing instructors were selected through census from three nursing schools in Fars province, southwest of Iran in 2019. The study data were entered into the SPSS 22 software and were analyzed using statistical tests, frequency distribution, mean, standard deviation, t-test, and one-way ANOVA. Results: The effective challenges against the utilization of novel teaching methods were classified into three domains as follows: challenges related to students, challenges related to instructors, and structural-managerial challenges. Considering the challenges associated with students, the highest score was related to the students’ lack of familiarity with novel teaching methods. Regarding the challenges associated with instructors, the highest scores were related to the instructors’ unfamiliarity with novel teaching methods and lack of mastery and skills. Finally, the large number of students and lack of support and encouragement on the part of educational institutions obtained the highest scores in the field of structural-managerial challenges. The results of independent t-test revealed a significant relationship between gender and educational degree in all three domains (p<0.001). The results also showed a significant relationship between work experience and the scores of the three domains (p<0.001). Conclusion: Application of novel approaches in nursing education requires infrastructures as well as elimination of executive barriers. Instructors’ and students’ familiarity with novel techniques and their execution processes and educational institutions’ support could contribute to the effectiveness of these methods, as well.
The association between clinical phenotype of Parkinson’s disease and LRRK2 variants in China
Authors: cui shishuang , li gen , lin yiqi , he yixi , zhang pingchen , he guiying , sun qian , tan yuyan , chen shengdi
Published: March 2020

Introduction: LRRK2 G2385R and LRRK2 S1647T have been identified as the most common risk variants for PD in the Chinese population. The aim of the study was to explore the correlation of LRRK2 G2385R, LRRK2 S1647T and their haplotypes with symptoms. Method: Demographic variables, disease-related variables and motor and non-motor assessments was collected in the study. Peripheral blood samples were collected, and DNA was extracted. SNaPShot technique was used to analysis DNA genotype. Chi square test and ANOVA was used to test the between-group differences. Risk analysis was performed by logistic regression model or Cochran-Armitage model. Results: 502 PD patients were enrolled in the study. The scores of PDSS and MoCA were significant higher in LRRK2 S1647T variants carriers genotype after adjustment. The scores of BPI, attention in NMSS, cardiovascular in SCOPA-AUT was significant lower in LRRK2 G2385R variants carriers adjusted for H-Y stage and gender. LRRK2 ARG 2385 was associated with reduced risk of sialorrhea (p=0.049, additive model) and postural hypotension (p=0.030, additive model; OR=0.35, 95%CI: 0.10-0.89, adjusted P=0.050, dominant model). rs11564148A rs34778348A was also found associated with a reduced risk with postural hypotension adjusted for H-Y staging and gender. Conclusion: Our study indicated that LRRK2 S1647T variants carriers presented better motor symptoms, sleep quality and cognition. LRRK2 G2385R variants carriers presented better autonomic function and cognition and had a reduced risk of sialorrhea and postural hypotension. rs11564148A - rs34778348A was associated with reduced risk with postural hypotension.
The effect of driving simulator program on elderly drivers
Authors: Kim Deokju
Published: March 2020

Background: The purpose of the present study was to present evidence for driving interventions for the elderly by conducting programs that can improve visual perception and cognitive function in a driving simulator for elderly drivers and analyse their effects.Methods: Three elderly subjects who were 65 years or older, did not have physical and cognitive impairments, and were able to drive themselves participated in the present study. A total of 12 intervention sessions, of which subjects participated in 10 sessions of nine different visual perception and cognitive function programs available in a driving simulator, were conducted and pre- and post-program assessments were conducted (two assessments in total). The assessments included the evaluation of visual perception, frontal lobe function, concentration, safe driving behaviour, and self-efficacy.Results: The results showed positive effects of the driving simulator program on the visual perception, frontal lobe function, concentration, safe driving behaviour, and self-efficacy of all subjects. Changes in the simulator results showed remarkable improvement in the response evaluation, judgment evaluation, and predictive power evaluation, but showed difficulties in interference tasks and depth perception in common.Conclusions: The results showed positive effects of driving simulator training on the driving ability of the elderly, and consistent provision of such training is expected to improve the quality of life of the elderly by securing the safety of driving and actively supporting social participation.