bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the performance of diagnostic methods for soil transmitted helminths in the Amhara National Regional State, Northwest Ethiopia
Authors: Fenta Abebe , Hailu Tadesse , Alemu Megbaru , Nibret Endalkachew , Amor Arancha , Munshea Abaineh
Published: October 2020

Background

Soil-transmitted helminths are more prevalent in tropics and sub-tropics including Ethiopia. Despite their high prevalence, direct saline microscopy with its low sensitivity has been used as a diagnostic method in almost all health facilities in Ethiopia. Alternative diagnostic methods which have higher sensitivity are not yet implemented. Therefore, this study aimed to compare and evaluate the performance of diagnostic methods for soil transmitted helminths.

Methods

A cross-sectional study among 520 school children was conducted from October to December, 2019 in Amhara National Regional State. The study participants were selected using systematic random sampling technique. Stool samples were processed via formol ether concentration, Kato-Katz, spontaneous tube sedimentation and agar plate culture techniques. Data was entered into Epi-data version 3.1 and analysis was done using SPSS version 20.0. The sensitivity, specificity, and negative predictive value were calculated against the combined result. Strength of agreement of the diagnostic methods was determined by Kappa value.

Results

The Overall prevalence of soil transmitted helminths was 40.8% using combination of methods. The prevalence 24.4, 22.5, and 32.4%, respectively was recorded by using formol ether concentration, Kato-Katz and spontaneous tube sedimentation. The highest prevalence of hookworm (29.2%) was detected by the agar plate culture. The sensitivity and negative predictive value of formol ether concentration were 57.9 and 78.4%, for Kato-Katz thick smear 55.2 and 76.4%, for spontaneous tube sedimentation were 79.2 and 87.5% to soil transmitted helminths detection, respectively. The sensitivity and negative predictive value of agar plate culture to hookworm detection were 86.4 and 93.5%, respectively.

Conclusion

Spontaneous tube sedimentation shows higher sensitivity in the detection of soil transmitted helminth infections. Agar plate culture method also indicated better performance for hookworm detection than other methods. Therefore, the employment of spontaneous tube sedimentation technique for routine laboratory and agar plate culture for research purposes will significantly aid in accurate diagnosis of parasitic infections.
Prevalence of seropositivity of selected herpesviruses in patients with multiple sclerosis in the North of Jordan
Authors: Kofahi Raid M. , Kofahi Hassan M. , Sabaheen Suhib , Qawasmeh Majdi Al , Momani Aiman , Yassin Ahmed , Alhayk Kefah , El-Salem Khalid
Published: October 2020

Background

Multiple sclerosis (MS) is a neurological disease that is caused by an autoimmune response that results in the neuron’s demyelination in the central nervous system. The exact etiology of MS is not clear; however, several environmental and genetic factors are believed to participate in its initiation and development, including exposure to viruses. This study aims to investigate the association between the seropositivity and antibody titer of selected herpesviruses and MS in Jordanian MS patients.

Method

In this study, 55 MS patients and 40 age- and gender-matching apparently healthy volunteers were recruited from two main hospitals in the north of Jordan. MS patients were grouped into three types of MS based on the clinical presentation of the disease. Blood samples were collected from the participants and the IgG antibodies for human herpesvirus 6 (HHV-6), Epstein-Barr virus (EBV) nuclear antigen (EBNA), EBV viral capsid antigen (VCA) and varicella-zoster virus (VZV) were assayed by ELISA. The prevalence of seropositivity and the antibody level for each of the antibodies were compared between MS patients and controls and between the three types of MS.

Results

There was no significant difference in the prevalence of seropositivity and in the levels of antibodies for HHV-6, EBNA and VCA between MS patients and controls and between the three types of MS. In contrast, the number of seropositive patients and the level of IgG antibodies for VZV were significantly higher in MS patients compared to the control.

Conclusion

This study showed that patients with MS in the north of Jordan were more likely to be seropositive for VZV than the general population. Based on this finding, we recommend further studies to evaluate the seropositivity to VZV to be carried out in other parts of Jordan and the greater middle east to find out if there is a correlation between MS and previous infection with VZV.
Predictors and clinical features of methotrexate (MTX) therapy for ectopic pregnancy
Authors: Zhang Jing , Zhang Yu , Gan Lu , Liu Xiao-ying , Du Shan-ping
Published: October 2020

Background

Ectopic pregnancy is a major life- and fertility-threatening women’s health concern. As a result of advances in examination technology, an increasing number of ectopic pregnancies can be diagnosed early and treated with medical methods instead of surgery. The aim of this study was to summarize the clinical features and identify the predictors of success of methotrexate (MTX) treatment of ectopic pregnancy.

Methods

This was a retrospective study of 238 ectopic pregnancies treated with MTX in the Department of Gynecology of Shaanxi Provincial People’s Hospital from January 2017 to December 2017.

Results

Patients were divided into two groups: the successful treatment group (n = 166) and the failed treatment group (n = 72). The overall success rate of MTX therapy for ectopic pregnancy was 69.75%. The mean initial beta-human chorionic gonadotropin (β-hCG) level was significantly lower in the successful treatment group than in the failed treatment group (2538.08 IU/L versus 3533.17 IU/L, P = 0.000). The treatment success rate of the group with an initial β-hCG concentration less than 4000 IU/L was significantly higher than that of the group with an initial β-hCG concentration greater than 4000 IU/L. However, the success rate of the group with an initial β-hCG concentration greater than 4000 IU/L was still relatively high (54.55%). β-hCG levels were significantly increased on the 4th day in the failed treatment group (P = 0.000). Compared to the initial β-hCG level, the day-4 β-hCG level increased by more than 8.21%, indicating that the treatment was effective. The diagnostic sensitivity was 88.6%, the specificity was 74.5%, and the area under the receiver operating characteristic (ROC) curve was 0.863 (95% confidence interval (CI): 0.805–0.920).

Conclusions

MTX therapy as a treatment option is safe and effective for asymptomatic, hemodynamically stable patients with ectopic pregnancies who are interested in conservative treatment, regardless of the serum β-hCG level or adnexal mass size. The change in the β-hCG level between the initial day and the 4th day is an effective and early predictive tool for the success of MTX therapy for ectopic pregnancy.
The efficacy of aspirin and metformin combination therapy in patients with rectal aberrant crypt foci: a double-blinded randomized controlled trial
Authors: Higurashi Takuma , Arimoto Jun , Ashikari Keiichi , Takatsu Tomohiro , Misawa Noboru , Yoshihara Tsutomu , Matsuura Tetsuya , Fuyuki Akiko , Ohkubo Hidenori , Nakajima Atsushi
Published: October 2020

Background

The incidence and mortality rates of colorectal cancer (CRC) continue to increase worldwide. Therefore, new preventive strategies are needed to lower the burden of this disease. Previous studies reported that aspirin could suppress the development of sporadic colorectal adenoma. In addition, metformin is a biguanide derivative that is long widely used for the treatment of diabetes mellitus and has recently been suggested to have a suppressive effect on carcinogenesis and cancer cell growth. Both drugs exhibit a chemopreventive effect, but their efficacy is limited.

Aberrant crypt foci (ACF), defined as lesions containing crypts that are larger in diameter and stain more darkly with methylene blue than normal crypts, are more prevalent in patients with cancer and adenomas, and considered a reliable surrogate biomarker of CRC. Thus, we designed a prospective trial as a preliminary study prior to a CRC chemoprevention trial to evaluate the chemopreventive effect of aspirin combined with metformin on colorectal ACF formation in patients scheduled for polypectomy.

Methods

This study is a double-blind randomized controlled trial that will be conducted in patients with both colorectal ACF and colorectal polyps scheduled for polypectomy. Eligible patients will be recruited for the study and the number of ACF in the rectum will be counted at the baseline colonoscopy. Then, the participants will be allocated to one of the following two groups; the aspirin plus placebo group or the aspirin plus metformin group. Patients in the aspirin plus placebo group will receive oral aspirin (100 mg) and placebo for 8 weeks, and those in the aspirin plus metformin group will receive oral aspirin (100 mg) and metformin (250 mg) for 8 weeks. After 8 weeks of administration, polypectomy will be performed to evaluate changes in the number of ACF, and the cell-proliferative activity in the normal colorectal mucosa and colorectal polyps.

Discussion

This is the first study proposed that will explore the effect of aspirin combined with metformin on the formation of colorectal ACF in humans.

Trial registration

This trial has been registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000028259. Registered 17 July 2017.
Massive hemorrhage after percutaneous kidney biopsy caused by renal artery malformation: a case report and literature review
Authors: Liang Dong , Zhang Hui , Yang Min , Ji Hong , Chen Gang , Yu Ning , Zhang Xiaomin
Published: October 2020

Background

Accessory renal artery (ARA) is the most common site for anatomical variation of renal supply artery. Rare studies reported interventional embolization for the management of massive hemorrhage caused by ARA injury after percutaneous kidney biopsy (PKB).

Case presentation

We describe a 35-year-old man who developed massive hemorrhage after PKB leading to shock. Digital subtraction angiography (DSA) showed hemorrhage in the ARA at the inferior pole of the right kidney and hemostasis was noticed after renal artery embolization.

Conclusions

We proposed that much attention should be paid to the presence of ARA before PKB. In addition, digital subtraction angiography combined with superselective embolization is the best choice for the treatment of renal artery injury.
Comparison of the 3D-printed operation guide template technique and the free-hand technique for S2-alar-iliac screw placement
Authors: Zhao Yonghui , Ma Yulong , Liang Jinlong , Luo Haotian , Cai Xingbo , Xu Yongqing , Lu Sheng
Published: October 2020

Background

To compare the safety and accuracy of the 3D-printed operation guide template technique and the free-hand technique in the placement of the S2-alar-iliac (S2AI) screw.

Methods

We conducted a retrospective analysis of 47 patients undergoing S2AI screw placement in our hospital, divided into the 3D-printed operation guide template group and the free-hand screw placement group. The duration of single S2AI screw placement was documented in all patients. A postoperative CT scan was performed to assess screw placement effectiveness according to the distance from the screw tip to the breach of the cortical bone wall.

Results

In total, 42 screws were placed in the guide template group, with an average screw placement duration of 151.6 ± 44.8 s. Screw placement grading was as follows: 40 screws in grade 0, two in grade 1, and none in grades 2 and 3. This grading resulted in excellent and good rates of 95.2% and 100%, respectively. In total, 52 screws were placed in the free-hand group, with an average screw placement duration of 138.3 ± 45.9 s. Screw placement grading was as follows: 42 screws in grade 0, seven in grade 1, three in grade 2, and none in grade 3. This grading resulted in excellent, good and acceptable rates 80.8%, 94.2% and 100%, respectively. Screw placement duration did not significantly differ between the groups (p > 0.05). The excellent rate of screw placement was greater in the guide template group than in the free-hand group (p < 0.05), but the good and acceptable rates did not significantly differ between the two groups (p > 0.05).

Conclusion

Both techniques can be applied to S2AI screw placement. The 3D-printed guide technique is superior to the free-hand technique in terms of safety and accuracy.
Social support in early-stage breast cancer patients with fatigue
Authors: Sørensen Hege Lilleskare , Schjølberg Tore Kr. , Småstuen Milada Cvancarova , Utne Inger
Published: October 2020

Background

A large number of women with breast cancer suffer from fatigue, and social support is described as having a positive impact on health in stressful life situations. The aim of this study is to evaluate social support in a sample of early-stage breast cancer outpatients with fatigue during treatment, and to evaluate the association between cancer-related fatigue and social support and between social support and demographic and treatment characteristics.

Method

This cross-sectional study includes 160 outpatients with early-stage breast cancer and cancer-related fatigue. The patients were recruited from clinics at a university-based cancer centre in Norway. The research instruments included The Social Provisions Scale (SPS), which measures ‛attachment’, ‛social integration’, ‛reassurance of worth’, and ‛nurturance’, and a fatigue questionnaire (FQ), which measures total, physical and mental fatigue. Data were analysed using descriptive statistics and linear regression analysis.

Results

Median total score for SPS was 59 (min/max = 39/64). Significant associations were found between mental fatigue and the provisions ‛reassurance of worth’ (B = − 0.34, 95% CI = [− 0.60; − 0.08]) and ‛nurturance’ (B = 0.20, 95% CI = [0.08; 0.31]). In addition, an association was found between social support and living with someone (B = 6.09, 95% CI = [4.07; 8.11]). No associations were found between physical fatigue and social support or between social support and treatment variables.

Conclusions

To a large extent, breast cancer patients with fatigue in this study experienced social support from their surroundings. The fact that there were significant associations between mental fatigue and two of the provisions of SPS suggests that social support is more closely related to mental fatigue than to physical fatigue. Findings from this study suggest that living with someone is important for the experience of social support during treatment for breast cancer. Clinicians need to evaluate demographic characteristics in relation to social support in early-stage breast cancer patients with fatigue.
Determinants of response to inhaled extrafine triple therapy in asthma: analyses of TRIMARAN and TRIGGER
Authors: Singh Dave , Virchow Johann Christian , Canonica Giorgio Walter , Vele Andrea , Kots Maxim , Georges George , Papi Alberto
Published: October 2020

Background

A number of single-inhaler triple therapies are being developed for asthma, including the extrafine formulation of beclometasone dipropionate (BDP), formoterol fumarate (FF), and glycopyrronium (G). Given asthma is a heterogenous disease, we investigated whether the clinical response to the addition of the long-acting muscarinic antagonist component within inhaled triple therapy was impacted by a range of clinical characteristics.

Methods

These were pre-specified and post-hoc sub-group analyses of TRIMARAN and TRIGGER, which were double-blind, 52-week studies comparing medium-strength (100/6/10 µg; TRIMARAN) and high-strength (200/6/10 µg; TRIGGER) BDP/FF/G with the respective BDP/FF strengths in adults with uncontrolled asthma and a history of ≥ 1 exacerbation. Co-primary endpoints were pre-dose forced expiratory volume in 1 s (FEV1) at Week 26 and the rate of moderate-to-severe exacerbations over 52 weeks. Key secondary endpoints: peak FEV1 at Week 26 and average morning peak expiratory flow over the first 26 weeks in each study, and severe exacerbation rate over 52 weeks (pooled data).

Results

Baseline clinical characteristics (pre-specified analyses) had no consistent effect on the lung function improvements with BDP/FF/G. For the exacerbation endpoints, sub-groups with higher reversibility gained greatest relative benefit from BDP/FF/G versus BDP/FF. In post-hoc analyses with patients sub-grouped by screening blood eosinophil values, in TRIMARAN the greatest relative effect of BDP/FF/G versus BDP/FF on the lung function endpoints was in the ≤ 300 cells/µL group; in TRIGGER, eosinophil levels did not markedly influence the relative efficacy of BDP/FF/G versus BDP/FF. Eosinophil levels did not influence relative efficacy on moderate-to-severe or severe exacerbations.

Conclusion

Overall, the relative efficacy of extrafine BDP/FF/G versus BDP/FF was not influenced by a range of clinical characteristics. However, some patient sub-groups gained additional benefit from BDP/FF/G for certain endpoints. In particular, for exacerbations the relative efficacy of BDP/FF/G was greater in more reversible patients.

Trial registration ClinicalTrials.gov: TRIMARAN, NCT02676076 (registered February 8, 2016, https://clinicaltrials.gov/ct2/show/NCT02676076?term=NCT02676076&draw=2&rank=1,); TRIGGER, NCT02676089 (registered February 8, 2016, https://clinicaltrials.gov/ct2/show/NCT02676089?term=NCT02676089&draw=2&rank=1)
Decline in cognitively complex everyday activities accelerates along the Alzheimer’s disease continuum
Authors:   for the Alzheimer Disease Neuroimaging Initiative, National Alzheimer’s Coordinating Center, the Harvard Aging Brain Study, the Alzheimer Dementia Cohort, Dubbelman Mark A. , Jutten Roos J. , Tomaszewski Farias Sarah E. , Amariglio Rebecca E. , Buckley Rachel F. , Visser Pieter Jelle , Rentz Dorene M. , Johnson Keith A. , Properzi Michael J. , Schultz Aaron , Donovan Nancy , Gatchell Jennifer R. , Teunissen Charlotte E. , Van Berckel Bart N. M. , Van der Flier Wiesje M. , Sperling Reisa A. , Papp Kathryn V. , Scheltens Philip , Marshall Gad A. , Sikkes Sietske A. M.
Published: October 2020

Background

Impairment in daily functioning is a clinical hallmark of dementia. Difficulties with “instrumental activities of daily living” (IADL) seem to increase gradually over the course of Alzheimer’s disease (AD), before dementia onset. However, it is currently not well established how difficulties develop along the preclinical and prodromal stages of AD. We aimed to investigate the trajectories of decline in IADL performance, as reported by a study partner, along the early stages of AD.

Methods

In a longitudinal multicenter study, combining data from community-based and memory clinic cohorts, we included 1555 individuals (mean age 72.5 ± 7.8 years; 50% female) based on availability of amyloid biomarkers, longitudinal IADL data, and clinical information at baseline. Median follow-up duration was 2.1 years. All amyloid-positive participants (n = 982) were classified into the National Institute on Aging–Alzheimer’s Association (NIA-AA) clinical stages ranging from preclinical AD (1) to overt dementia (4+). Cognitively normal amyloid-negative individuals (n = 573) served as a comparison group. The total scores of three study-partner reported IADL questionnaires were standardized.

Results

The rate of decline in cognitively normal (stage 1) individuals with and without abnormal amyloid did not differ (p = .453). However, from stage 2 onwards, decline was significantly faster in individuals on the AD continuum (B [95%CI] = − 0.32 [− 0.55, − 0.09],p = .007). The rate of decline increased with each successive stage: one standard deviation (SD) unit per year in stage 3 (− 1.06 [− 1.27, − 0.85],p < .001) and nearly two SD units per year in stage 4+ (1.93 [− 2.19, − 1.67],p < .001). Overall, results were similar between community-based and memory clinic study cohorts.

Conclusions

Our results suggest that the rate of functional decline accelerates along the AD continuum, as shown by steeper rates of decline in each successive NIA-AA clinical stage. These results imply that incremental changes in function are a meaningful measure for early disease monitoring. Combined with the low-cost assessment, this advocates the use of these functional questionnaires for capturing the effects of early AD-related cognitive decline on daily life.
Effect of transgenic cotton continuous cropping on soil bacterial community
Authors: Tian Wen-hui , Yi Xiao-long , Liu Shan-shan , Zhou Chao , Wang Ai-ying
Published: October 2020

Purpose

In agricultural practices, continuous cultivation of genetically modified crops with high commercial value has a definite impact on soil microbial diversity. Soil microorganisms directly define the operational degree and function realization of the soil ecosystem. To understand the safety of environmental release, we studied the effects of continuous cropping of transgenic cotton on the diversity of bacterial communities in the rhizosphere soil.

Methods

We have applied a high-throughput sequencing method and compared the bacterial community structure as well as diversity of rhizosphere soil of the transgenic cotton line (25C-1) and its parent cotton line (TH2).

Result

Structural analysis of the bacterial community showed that Arthrobacter and Sphingomonas are significantly enriched after continuous cropping of transgenic cotton lines and had a positive impact on the soil’s ecological environment. Interestingly, parameters of the physical and chemical properties of soil used for the continuous cropping of the two cotton lines for 3 consecutive years show no detectable change, other than total nitrogen. Notably, Spearman’s correlation analysis suggests that total nitrogen is the key environmental factor that affects the bacterial community of the soil used to cultivate the transgenic cotton.

Conclusion

We did not find a notable difference in species diversity between the two samples. However, the proportions of beneficial bacteria (Arthrobacter and Sphingomonas) increased and the total nitrogen content has changed in 3 years. These results provide necessary insights into the function and role of bacteria in transgenic cotton. This study will help future investigators assess the potential ecological risks of genetically modified plants.
Body stalk anomaly presenting as an emergency in Ethiopia: a case report
Authors: Jidha Tafese Dejene , Wakjira Tekle , Mekonnen Tigist
Published: October 2020

Background

Body stalk anomaly is a generally lethal malformation of the thorax and/or abdomen. It is often associated with limb defects. The intrathoracic and abdominal organs lie outside the abdominal cavity. These are contained within a sac composed of amnioperitoneal membrane attached directly to the placenta. The umbilical cord may be totally absent or extremely shortened. Severe kyphoscoliosis is often present. This case is reported to highlight this rare malformation and its clinical presentation.

Case presentation

We present a case of a 27-year-old primigravida Oromo woman who had been amenorrheic for 9 months. She presented with an urge to bear down of 10 hours and passage of liquor of the same duration. The patient was referred from a district primary hospital with a diagnosis of preterm labor and hand prolapse. A lower uterine segment cesarean section was performed at Jimma University Medical Center for an indication of active first stage of labor with nonreassuring fetal heart rate pattern (fetal bradycardia) and hand prolapse to effect an anomalous fetus that had only a rudimentary right lower extremity and liver and intestine found outside the abdominal cavity contained within a sac composed of transparent membrane attached directly to the placenta. The umbilical cord was very short, measuring about 7 cm. The fetus had severe scoliosis. It also had a heartbeat upon extraction, which stopped after 5 minutes of delivery. The placenta and fetal body parts together weighed 2400 g.

Conclusion

Termination of pregnancy is usually offered because this abnormality is generally considered lethal. If the pregnancy is continued undetected as in our patient’s case, vaginal delivery is recommended, given the highly lethal nature of this anomaly. Good prenatal screening and counseling are recommended for early detection and management.
NKX6.1 transcription factor: a crucial regulator of pancreatic β cell development, identity, and proliferation
Authors: Aigha Idil I. , Abdelalim Essam M.
Published: October 2020

Understanding the biology underlying the mechanisms and pathways regulating pancreatic β cell development is necessary to understand the pathology of diabetes mellitus (DM), which is characterized by the progressive reduction in insulin-producing β cell mass. Pluripotent stem cells (PSCs) can potentially offer an unlimited supply of functional β cells for cellular therapy and disease modeling of DM. Homeobox protein NKX6.1 is a transcription factor (TF) that plays a critical role in pancreatic β cell function and proliferation. In human pancreatic islet, NKX6.1 expression is exclusive to β cells and is undetectable in other islet cells. Several reports showed that activation of NKX6.1 in PSC-derived pancreatic progenitors (MPCs), expressing PDX1 (PDX1+/NKX6.1+), warrants their future commitment to monohormonal β cells. However, further differentiation of MPCs lacking NKX6.1 expression (PDX1+/NKX6.1−) results in an undesirable generation of non-functional polyhormonal β cells. The importance of NKX6.1 as a crucial regulator in MPC specification into functional β cells directs attentions to further investigating its mechanism and enhancing NKX6.1 expression as a means to increase β cell function and mass. Here, we shed light on the role of NKX6.1 during pancreatic β cell development and in directing the MPCs to functional monohormonal lineage. Furthermore, we address the transcriptional mechanisms and targets of NKX6.1 as well as its association with diabetes.
Identification of microflora related to growth performance in pigs based on 16S rRNA sequence analyses
Authors: Li Xin-Jian , Wang Mingyu , Xue Yahui , Duan Dongdong , Li Cong , Han Xuelei , Wang Kejun , Qiao Ruimin , Li Xiu-Ling
Published: October 2020

Intestinal microorganisms have been shown to be important factors affecting the growth performance of pigs. Therefore, to investigate the effect of the intestinal microflora structure on the growth performance of pigs, samples from Duroc (n = 10), Landrace (n = 9) and Yorkshire (n = 21) pigs under the same diet and feeding conditions were collected. The fecal microbial composition was profiled via 16S ribosomal RNA (rRNA) gene sequencing. We also analyzed their growth performance. We found that Duroc and Landrace pigs had significant differences in average daily gain (ADG), feed efficiency ratio (FER), growth index (GI), and number of days taken to reach 100 kg (P < 0.05). Moreover, through analysis of the intestinal flora, we also identified 18 species of intestinal flora with significant differences between Duroc and Landrace pigs (P < 0.05). To eliminate the influence of genetic background, the differential intestinal flora of 21 Yorkshire pigs with differences in growth performance was analyzed. The results showed that there were significant correlations between Barnesiella, Dorea, Clostridium and Lactobacillus and pig growth performance. To explore the effect of the intestinal flora on the growth performance of pigs at the molecular level, Lactobacillus, which is the most abundant in the intestine, was selected for isolation and purification and cocultured with intestinal epithelial cells. qPCR was used to determine the effect of Lactobacillus on MC4R gene expression in intestinal epithelial cells. The results showed that Lactobacillus inhibited MC4R gene expression in these cells. The results provide a useful reference for further study of the relationship between the intestinal flora and pig growth performance.
Impact of systematic screening for AmpC-hyperproducing Enterobacterales intestinal carriage in intensive care unit patients
Authors: Manquat Elsa , Le Dorze Matthieu , Pean De Ponfilly Gauthier , Benmansour Hanaa , Amarsy Rishma , Cambau Emmanuelle , Soyer Benjamin , Chousterman Benjamin Glenn , Jacquier Hervé
Published: October 2020

Background

Empirical antimicrobial therapy (EAT) is a challenge for community-acquired, hospital-acquired and ventilator-associated pneumonia, particularly in the context of the increasing occurrence of third-generation cephalosporin-resistant Enterobacterales (3GCR-E), including extended-spectrum beta-lactamase Enterobacterales (ESBL-E) and high-level expressed AmpC cephalosporinase-producing Enterobacterales (HLAC-E). To prevent the overuse of broad-spectrum antimicrobial therapies, such as carbapenems, we assessed the performance of screening for intestinal carriage of HLAC-E in addition to ESBL-E to predict 3GCR-E (ESBL-E and/or HLAC-E) presence or absence in respiratory samples in ICU, and to evaluate its potential impact on carbapenem prescription.

Materials and methods

This monocentric retrospective observational study was performed in a surgical ICU during a 4-year period (January 2013–December 2016). Patients were included if they had a positive culture on a respiratory sample and a previous intestinal carriage screening performed by rectal swabbing within 21 days. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and likelihood ratios were calculated for the screening for intestinal carriage of ESBL-E, HLAC-E and 3GCR-E (ESBL-E and/or HLAC-E) as predictor of their absence/presence in respiratory samples. Impact of HLAC-E and ESBL-E reporting on EAT was also studied.

Results

765 respiratory samples, retrieved from 468 patients, were analyzed. ESBL-E prevalence was 23.8% in rectal swab and 4.4% in respiratory samples. HLAC-E prevalence was 9.0% in rectal swabs and 3.7% in respiratory samples. Overall, the 3GCR-E prevalence was 31.8% in rectal swabs and 7.7% in respiratory samples. NPVs were 98.8%, 98.0% and 96.6% for ESBL-E, HLAC-E and 3GCR-E, respectively. Over the study period, empirical antimicrobial therapy was initiated for 315 episodes of respiratory infections: 228/315 (72.4%) were associated with negative intestinal carriage screening for both HLAC-E and ESBL-E, of whom 28/228 (12.3%) were treated with carbapenems. Of 23/315 (7.3%) cases with screening for positive intestinal carriage with HLAC-E alone, 10/23 (43.5%) were treated with carbapenems.

Conclusion

Systematic screening and reporting of HLAC-E in addition to ESBL-E in intestinal carriage screening could help to predict the absence of 3GCR-E in respiratory samples of severe surgical ICU patients. This could improve the appropriateness of EAT in ICU patients with HAP and may prevent the overuse of carbapenems.
Assessing risk of bias in human environmental epidemiology studies using three tools: different conclusions from different tools
Authors: Eick Stephanie M. , Goin Dana E. , Chartres Nicholas , Lam Juleen , Woodruff Tracey J.
Published: October 2020

Background

Systematic reviews are increasingly prevalent in environmental health due to their ability to synthesize evidence while reducing bias. Different systematic review methods have been developed by the US National Toxicology Program’s Office of Health Assessment and Translation (OHAT), the US Environmental Protection Agency’s (EPA) Integrated Risk Information System (IRIS), and by the US EPA under the Toxic Substances Control Act (TSCA), including the approach to assess risk of bias (ROB), one of the most vital steps which is used to evaluate internal validity of the studies. Our objective was to compare the performance of three tools (OHAT, IRIS, TSCA) in assessing ROB.

Methods

We selected a systematic review on polybrominated diphenyl ethers and intelligence quotient and/or attention deficit hyperactivity disorder because it had been endorsed by the National Academy of Sciences. Two reviewers followed verbatim instructions from the tools and independently applied each tool to assess ROB in 15 studies previously identified. We documented the time to apply each tool and the impact the ROB ratings for each tool had on the final rating of the quality of the overall body of evidence.

Results

The time to complete the ROB assessments varied widely (mean = 20, 32, and 40 min per study for the OHAT, IRIS, and TSCA tools, respectively). All studies were rated overall “low” or “uninformative” using IRIS, due to “deficient” or “critically deficient” ratings in one or two domains. Similarly, all studies were rated “unacceptable” using the TSCA tool because of one “unacceptable” rating in a metric related to statistical power. Approximately half of the studies had “low” or “probably low ROB” ratings across all domains with the OHAT and Navigation Guide tools.

Conclusions

Tools that use overall ROB or study quality ratings, such as IRIS and TSCA, may reduce the available evidence to assess the harms of environmental exposures by erroneously excluding studies, which leads to inaccurate conclusions about the quality of the body of evidence. We recommend using ROB tools that circumvents these issues, such as OHAT and Navigation Guide.

Systematic review registration

This review has not been registered as it is not a systematic review.
Periodic solution for neutral-type inertial neural networks with time-varying delays
Authors: Xu Mei , Du Bo
Published: October 2020

In this paper the problems of the existence and stability of periodic solutions of neutral-type inertial neural networks with time-varying delays are discussed by applying Mawhin’s continuation theorem and Lyapunov functional method. Finally, two numerical examples are given to illustrate our theoretical results.
Contamination of SARS-CoV-2 in patient surroundings and on personal protective equipment in a non-ICU isolation ward for COVID-19 patients with prolonged PCR positive status
Authors: Wei Li , Huang Wenzhi , Lu Xiaojun , Wang Yantong , Cheng Linzhi , Deng Rong , Long Haiyan , Zong Zhiyong
Published: October 2020

Objectives

We performed an environmental sampling study to investigate the environmental contamination of SARS-CoV-2 by COVID-19 patients with prolonged PCR positive status of clinical samples.

Methods

We sampled the air from rooms for nine COVID-19 patients with illness or positive PCR > 30 days, before and after nasopharyngeal/oropharyngeal swabbing and before and after nebulization treatment. We also sampled patients’ surroundings and healthcare workers’ personal protection equipment (PPE) in a non-ICU ward. SARS-CoV-2 was detected by PCR.

Results

Eighty-eight samples were collected from high-touch surfaces and floors in patient rooms and toilets, with only the bedsheets of two patients and one toilet positive for SARS-CoV-2. All air samples (n = 34) were negative for SARS-CoV-2. Fifty-five samples collected from PPE were all negative.

Conclusion

Contamination of near-patient surroundings was uncommon for COVID-19 patients with prolonged PCR positive status if environmental cleaning/disinfection were performed rigorously. Airborne transmission of SARS-CoV-2 was unlikely in these non-ICU settings.
Molecular repertoire of Deinococcus radiodurans after 1 year of exposure outside the International Space Station within the Tanpopo mission
Authors: Ott Emanuel , Kawaguchi Yuko , Kölbl Denise , Rabbow Elke , Rettberg Petra , Mora Maximilian , Moissl-Eichinger Christine , Weckwerth Wolfram , Yamagishi Akihiko , Milojevic Tetyana
Published: October 2020

Background

The extraordinarily resistant bacteriumDeinococcus radioduranswithstands harsh environmental conditions present in outer space.Deinococcus radioduranswas exposed for 1 year outside the International Space Station within Tanpopo orbital mission to investigate microbial survival and space travel. In addition, a ground-based simulation experiment with conditions, mirroring those from low Earth orbit, was performed.

Methods

We monitoredDeinococcus radioduranscells during early stage of recovery after low Earth orbit exposure using electron microscopy tools. Furthermore, proteomic, transcriptomic and metabolomic analyses were performed to identify molecular mechanisms responsible for the survival ofDeinococcus radioduransin low Earth orbit.

Results

D. radioduranscells exposed to low Earth orbit conditions do not exhibit any morphological damage. However, an accumulation of numerous outer-membrane-associated vesicles was observed. On levels of proteins and transcripts, a multi-faceted response was detected to alleviate cell stress. The UvrABC endonuclease excision repair mechanism was triggered to cope with DNA damage. Defense against reactive oxygen species is mirrored by the increased abundance of catalases and is accompanied by the increased abundance of putrescine, which works as reactive oxygen species scavenging molecule. In addition, several proteins and mRNAs, responsible for regulatory and transporting functions showed increased abundances. The decrease in primary metabolites indicates alternations in the energy status, which is needed to repair damaged molecules.

Conclusion

Low Earth orbit induced molecular rearrangements trigger multiple components of metabolic stress response and regulatory networks in exposed microbial cells. Presented results show that the non-sporulating bacteriumDeinococcus radioduranssurvived long-term low Earth orbit exposure if wavelength below 200 nm are not present, which mirrors the UV spectrum of Mars, where CO2effectively provides a shield below 190 nm. These results should be considered in the context of planetary protection concerns and the development of new sterilization techniques for future space missions.
More pilot trials could plan to use qualitative data: a meta-epidemiological study
Authors: Baldeh Tejan , MacDonald Tonya , Kosa Sarah Daisy , Lawson Daeria O. , Stalteri Rosa , Olaiya Oluwatobi R. , Alotaibi Ahlam , Thabane Lehana , Mbuagbaw Lawrence
Published: October 2020

Background

Pilot trials often use quantitative data such as recruitment rate and retention rate to inform the design and feasibility of a larger trial. However, qualitative data such as patient, healthcare provider, and research staff perceptions of an intervention may also provide insights for a larger trial.

Methods

As part of a larger study investigating the reporting of progression criteria in pilot studies, we sought to determine how often pilot studies planned to use qualitative data to inform the design and feasibility of a larger trial and the factors associated with plans to use qualitative data. We searched for protocols of pilot studies of randomized trials in PubMed between 2013 and 2017.

Results

We included 227 articles. Only 92 (40.5%; 95% confidence interval [CI] 34.1–47.2) reported plans to collect qualitative data. The factors associated with collecting qualitative data were large studies (defined as sample size ≥ 60; adjusted odds ratio [aOR] 2.77; 95% CI 1.47–5.23; p = 0.002) and studies from Europe (aOR 3.86; 95% CI 1.68–8.88; p = 0.001) compared to North America and the rest of the world. Pilot trials with pharmacological interventions were less likely to plan to collect qualitative data (aOR 0.20; 95% CI 0.07–0.58; p = 0.003).

Conclusions

Qualitative data is not used enough in pilot trials. Large pilot trials, pilot trials from Europe, and pilot trials of non-pharmacological interventions are more likely to plan for qualitative data.
Trichoderma: a beneficial antifungal agent and insights into its mechanism of biocontrol potential
Authors: Mukhopadhyay Ria , Kumar Deepak
Published: October 2020

Background

Agriculture is an indispensable part of any country to feed the millions of people but it is under constant threat of pests. To protect the crops from this huge yield loss recently, chemical pesticides are used. Though chemical pesticides have shown effective results in killing the crop pests, it causes negative impact on the environment as well as humans. So to find an eco-friendly alternative, biological control methods are being used.

Main body

Biological control is a great renaissance of interest and research in microbiological balance to control soil-borne plant pathogens and leads to the development of a better farming system. In biological control, genus Trichoderma serves as one of the best bioagents, which is found to be effective against a wide range of soil and foliar pathogens. Genus Trichoderma is a soil inhabiting green filamentous fungus, which belongs to the division Ascomycota. The efficacy of Trichoderma depends on many abiotic parameters such as soil pH, water retention, temperature and presence of heavy metals. The biocontrol potential of Trichoderma spp. is due to their complex interaction with plant pathogens either by parasitizing them, secreting antibiotics or by competing for space and nutrients. During mycoparasitic interactions, production of hydrolytic enzymes such as glucanase, chitinase and protease and also signalling pathways are initiated by Trichoderma spp. and the important ones are Heterotrimeric G protein, MAP kinase and cAMP pathway. G protein and MAPK are mainly involved in secretion of antifungal metabolites and the formation of infection structures. cAMP pathway helps in the condition and coiling of Trichoderma mycelium on pathogenic fungi and inhibits their proliferation.

Short conclusion

Trichoderma being an efficient biocontrol agent, their characteristics and mechanisms should be well understood to apply them in field conditions to restrict the proliferation of phytopathogens.
Zinner’s syndrome, radiological diagnosis for a rare syndrome with non-specific clinical presentation: case report
Authors: Soliman Ahmed Atef , Alshukami Anwar Ali , AlZuber Walaa Hussein
Published: October 2020

Background

Zinner’s syndrome is a rare congenital malformation involving the seminal vesicle that mostly shows cystic transformation. Embryogenesis of the kidney, ureter, seminal vesicle, and vas deferens can be altered if an insult occurs during the first trimester mainly between the 4th and the 13th gestational week. Cystic lesions of the seminal vesicle may present with a mass effect. Associated ipsilateral renal agenesis is a characteristic feature in more than 50% of patients as the seminal vesicles and ureteral buds originate from the mesonephric (Wolffian) duct. For management, the transrectal ultrasound provides good visualization of the seminal vesicles and the rest of the pelvic structures providing a good guidance for aspiration of the cysts.

Case presentation

We present a case of a seminal vesicle fluid-filled tubular lesion. The patient first complained of vague abdominal pain with lower abdominal fullness. He was clinically evaluated, and radiological evaluation was performed using different modalities, and finally, the patient took his decision to live with it without any intervention at present.

Conclusions

The combination of seminal vesicle cysts and ipsilateral renal agenesis, is a rare urological anomaly with an insult during the 1st trimester is to be considered as the first suspicion. Usual manifestations are caused by the seminal vesicle cysts that cause mass effect and irritation to the surroundings in the form of urinary bladder irritation and in sometimes obstruction as well as pain/discomfort in the perineum and scrotum. Epididymitis is frequently occurring as a complication. Treatment mainly consists of removing the seminal vesicle cyst/tubular lesion.
In-vitro antioxidant, anti-cancer, and anti-inflammatory activities of selected medicinal plants from western Nepal
Authors: Pandey Bishnu Prasad , Adhikari Kapil , Pradhan Suman Prakash , Shin Hee Jeong , Lee Eun Kyeong , Jung Hye Jin
Published: October 2020

Background

This study was focused on the measurement of anticancer properties of six medicinal plants from western Nepal in three cell lines; HeLa, Hep3B, and HCT116, and anti-inflammatory properties in RAW 264.7 cell line through NO, PGE2, and TNF-α production. In addition, the phytochemical screening, total phenolic, flavonoid content, and antioxidant properties were evaluated.

Results

The qualitative phytochemical analysis revealed the presence of different secondary metabolite and range of total phenolic and total flavonoid content. The highest antioxidant activities were observed in Bergenia pacumbis against both DPPH (IC50 = 25.97 ± 0.19 μg/mL) and ABTS (IC50 = 14.49 ± 0.40 μg/mL). Furthermore, the highest antiproliferative effect against cervical, liver, and colon cancer cell lines were observed in Melia azedarach as IC50 values of 10.50, 5.30, and 1.57 μg/mL respectively, while the strongest anti-metastatic potential on liver cancer cell line was found in Pleurospermum benthamii. In addition, P. benthamii showed the most potent anti-inflammatory effect in RAW264.7 murine macrophage cells.

Conclusion

This study provided the evidence for M. azedarach and P. benthamii to have great anticancer potential and finding builds the enough scientific backgrounds in future to isolate and purify the bioactive compounds for further applications.
Dose-Dependent Effect of Platinum-Based Chemotherapy on the Risk of Metachronous Contralateral Testicular Cancer
Authors: Blok Joost M. , Groot Harmke J. , Huele Eline H. , de Wit Ronald , Horenblas Simon , Nuver Janine , Groenewegen Gerard , Bosch J.L.H. Ruud , Witjes J. Alfred , Tromp Jacqueline M. , de Brouwer Peter J.M. , van den Berg Hetty A. , Vanneste Ben G.L. , Smilde Tineke J. , Aarts Maureen J.B. , Gietema Jourik A. , Meijer Richard P. , Schaapveld Michael
Published: October 2020

PURPOSE

Patients with testicular germ cell tumor (TGCT) are at increased risk of developing a contralateral TGCT (CTGCT). Although some studies suggest that prior treatment with platinum-based chemotherapy affects CTGCT risk, a relationship between CTGCT risk and platinum dose has not previously been assessed. We analyzed the association between the number of platinum-based chemotherapy cycles and CTGCT risk.

PATIENTS AND METHODS

The risk of developing a metachronous CTGCT was evaluated in a nationwide cohort of 4,755 patients diagnosed with primary TGCT in the Netherlands between 1989 and 2007. Standardized incidence ratios were computed to compare CTGCT incidence with expected TGCT on the basis of TGCT incidence in the general population. The cumulative incidence of CTGCT was estimated in the presence of death as competing risk. The effect of treatment with platinum-based chemotherapy on CTGCT risk was assessed using multivariable Cox proportional hazards regression models.

RESULTS

CTGCT was diagnosed in 136 patients (standardized incidence ratio, 14.6; 95% CI, 12.2 to 17.2). The cumulative incidence increased up to 20 years after primary diagnosis, reaching 3.4% (95% CI, 2.8% to 4.0%) after 20 years of follow up. The risk of developing a CTGCT decreased with age (hazard ratio [HR], 0.93; 95% CI, 0.90 to 0.96), was lower after nonseminomatous germ cell tumor (HR, 0.58; 95% CI, 0.35 to 0.96) and decreased with every additional cycle of chemotherapy (HRper cycle, 0.74; 95% CI, 0.64 to 0.85).

CONCLUSION

Approximately one in every 30 survivors of TGCT will develop a CTGCT, with CTGCT incidence increasing up to 20 years after a primary TGCT. Treatment with platinum-based chemotherapy shows a dose-dependent inverse association with CTGCT risk.
SARS-CoV-2 (COVID-19) and the Endocrine System
Authors: Lundholm Michelle D , Poku Caroline , Emanuele Nicholas , Emanuele Mary Ann , Lopez Norma
Published: October 2020

As SARS-CoV-2 (COVID-19) overtakes the world, causing moderate to severe disease in about 15% of infected patients, COVID-19 is also found to have widespread effects throughout the body with a myriad of clinical manifestations including the endocrine system. This manuscript reviews what is known about the impact of COVID-19 on the pathophysiology and management of diabetes (both outpatient and inpatient) as well as pituitary, adrenal, thyroid, bone, and gonadal function. Findings in this area are evolving, and long-term effects of infection remain an active area of further research.