bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison and Clinical Characteristics of COVID-19 in Different Time Period in Wuhan, China
Authors: Yang Ruhao , Wei Jie , Hu Weihua , Xiong Jun , Liu Menglin , Hu Ke
Published: June 2020

Background SARS-CoV-2 is making deadly impact on the human lives all over the world. Therefore, we aimed to analyze the changes involved in clinical characteristics of COVID-19 patients over time. Methods We conducted a retrospective study to compare the patients whose onset of illness in January with the patients whose onset of illness in February in Wuhan, China.Results Among enrolled 896 patients, the median age was 60 years (47-69 years), 685 (76.5%) were categorized into group A (patients with illness onset in January), and 211 (23.5%) were categorized into group B (patients with illness onset in February). Compared with group B, group A had a higher rate of fever (p<0.001), the lower rate of asymptomatic (p<0.001). Group A had a higher incidence of neutrophilia (p=0.043), elevated D-miner (p<0.001), increased LDH (p=0.002), but lower incidence of normal CT scan (p=0.001). CD3 cells (p=0.015) and CD4 cells p=0.04) count significantly reduced in group A. Critical patients decreased (p=0.005) and mild patients increased (p=0.001) in group B. The fatality rate significantly decreased in group B (p=0.028).Conclusions The condition of patients with onset of illness in January were more serious than patients with onset of illness in February. It indicates that virulence showed reducing effect, but more basic research is required to support the hypothesis.
Effectiveness of Exercise Training on Mental Health, Physical Activity Level and Social Participation in People Living with HIV/AIDS: A Systematic Review and Meta-Analysis
Authors: Ibeneme Sam Chidi , Uwakwe Victor C , Myezwa Hellen , Irem Franklin Onyedinma , Ezenwankwo Fortune Elochukwu , Ajidahun Tunde Adedayo , Ezuma Amarachi Destiny , Okonkwo Uchenna Prosper , Fortwengel Gerhard
Published: June 2020

Background: Exercise training may increase physical activity(PA) level, improve social participation and mental health in people living with HIV/AIDS(PLWHA). Thus, a systematic review was conducted to answer the review question: what is the effectiveness of physical exercise training on mental health, physical activity level and social participation in PLWHA? Method: Eight databases namely: PubMed, Emcare, Cochrane Library, Embase, CINAHL, AMED, PsycoINFO and MEDLINE – were systematically searched from 1990 till August 2019. This review includes only studies published in English language, on adults (>18years) and are either on HAART/HAART-naïve; only RCTs that gave exercise intervention and assessed mental health, physical activity level and social participation on HIV/AIDS patients. The primary outcomes were mental health, PA level and social participation, while the secondary outcomes included psychological disorders. Results: Meta-analysis of the five (out of seven) included studies for depression that met the inclusion criteria (n=346 participants) comprising males/females aged≥18 years, show a significant overall effect (SMD=-0.89,[95%CI:-1.77,-0.01],Z=1.97,p=0.05) of exercise compared to the control group at post-intervention. However, statistical heterogeneity was high (I2=91%,X2=53.14,df=5,p<0.00001). The removal of two papers during sensitivity analysis for missing data/baseline differences showed a large significant effect (SMD=-1.01,[95%CI:-1.45,-0.57],Z=4.48,p=<0.00001). The statistical heterogeneity was low (I2=39%,X2=4.94,df=3,p=0.18). The results demonstrate a significant trend towards a decrease in depressive symptoms for participants in the exercise compared to no exercise group; aerobic exercise compared to normal routine activity group; aerobic and resistance exercise compared to other control groups. Narrative synthesis demonstrates the beneficial effects of exercise training on outcome measures: anxiety and cognitive function, apart from other psychological benefits. There was limited and no RCTs on the effects of exercise on physical activity level and social participation, respectively.Conclusion: Combined exercise (Aerobic exercise+Strength training; 80mins/session; 3X/week for 12weeks.) + routine counselling OR Aerobic exercise training+counselling 40mins per session; 3X/week for 6weeks OR Combined exercise: Aerobic and Resistance exercise training 50mins/session; 2X/week for 6weeks OR Combined exercise: Aerobic and Resistance exercise training 60mins/session; 3X/week for 24weeks OR Aerobic exercise training 60mins per session; 3X per week for 12weeks may improve mood disorders while therapeutic exercise(2X per week for 6weeks) may improve psychological wellbeing.
Epidemiology of Nosocomial Carbapenem-resistant Klebsiella Pneumonia Bloodstream Infections in South China: Factors Related to the Patient Mortality
Authors: xie xiaona , Cai Xueding , Wan Tingting , Shao Lianyou , Chen Lijiang , Yao Dan , Ding Cheng , Li Guoping , Wang Liangxing , Huang Xiaoying
Published: June 2020

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) causing Bloodstream infection (BSI) are associated with high rates of mortality. Nevertheless, only a few studies regarding the epidemiology of CRKP BSI in south China. The purpose of this study was to describe the epidemiology, clinical characteristics, and the mortality of risk factors associated with CRKP causing bloodstream infection.Methods: A retrospective study of patients with CRKP BSI was recruited from teaching hospital in south China from January 2016 to December 2018. Clinical data were collected from medical records.Results: In total, 90 patients with CRKP BSI were enrolled in the study, while 57% (51/90) of the CRKP BSI were obtained from ICU. Most CRKP BSIs originated from hospitals (81; 85%), while the rest (9; 10%) were healthcare-associated. In univariate analysis, gastrointestinal hemorrhage (p=0.029), Pitt bacteremia score (P=0.045), Charlson comorbidity index (p=0.018) and Corticosteroids use (p=0.036) and Septic shock (p=0.001) were associated with the risk factors for mortality. In a multivariate analysis, septic shock (adjusted odds ratio [aOR] 5.591, 95% confidence interval [CI] 1.405-22.246, P=0.015) and Corticosteroids use (aOR 4.148, 95% CI 1.331-12.928, P=0.014) were independently predictors of mortality.Conclusion: Our data showed that the morbidity and mortality of CRKP BSIs patient from ICU and non-ICU was no significant difference. Standardizing operation and improving nurse quality may play an important role in CRKP BSI patient in intensive care unit. Septic shock and Corticosteroids use were the independent factors of CRKP BSI patient mortality. However, the study did not show an association between invasive procedures and the development of CRKP BSI.
Optimal Preparation of High-entropy Boride-silicon Carbide Ceramics
Authors: Zhang Yan , Sun Shi-Kuan , Guo Wei-Ming , Xu Liang , Zhang Wei , Lin Hua-Tay
Published: June 2020

High-entropy boride-silicon carbide (HEB-SiC) ceramics were fabricated by using boride-based powders prepared from borothermal and boro/carbothermal reduction methods. The effects of processing routes of HEB powders were examined between borothermal reduction and boro/carbothermal reduction. HEB-SiC ceramics with nearly relatively full density (>98%) were prepared after spark plasma sintering at 2000oC. It was demonstrated that the addition of SiC led to the slightly microstructure coarsening. The HEB-SiC ceramics prepared from boro/carbothermal reduction powders showed the fine-grained microstructure and higher Vickers’ hardness but lower fracture toughness values as compared with the same composition prepared from borothermal reduction powders. These results indicated that the selection of the powder processing method and the addition of SiC phase could contribute to the optimal preparation of high-entropy boride based ceramics.
The Value of Continuous Nursing in Patients After Cardiac Mechanical Valve Replacement
Authors: Li Sai-lan , Zhou Sheng-huo , Lin Yanjuan
Published: June 2020

Objective: The purpose of this study was to explore the value of continuous nursing in patients after cardiac valve replacement. Methods: The clinical data of 116 patients after cardiac mechanical valve replacement from January 2017 to January 2018 were analysed retrospectively. According to the nursing mode, the patients were divided into two groups: the continuous nursing group (group A, n=56) and the conventional nursing group (group B, n=60). Results: The continuous nursing group exhibited significantly decreased SAS and SDS scores 1 year after surgery compared to the preoperative SAS and SDS scores(P<0.05). The SAS and SDS scores of the continuous nursing group were significantly better than those of the traditional nursing group 1 year after surgery(P<0.05). There were 4 patients with anticoagulant complications after discharge in the continuous nursing group, and 13 cases of anticoagulant complications in the conventional nursing group. There was a significant difference between the two groups. Conclusion: Continuous nursing improves patient compliance with treatment and reduces the occurrence of postoperative anticoagulation complications. The patient also receives proper psychological evaluations, which relieve patient anxiety and depression.
The Effect of Postpartum Depression on Infant Feeding Practice in Sub-Saharan African Countries: Systematic Review and Meta-analysis
Authors: Handiso Demelash Woldeyohannes , Tekalegn Yohannes , Sahiledengle Biniyam , Ermias Dejene
Published: June 2020

Background: Postpartum depression (PND) is a type of mood disorder that affects women after childbirth. Despite the detailed research related to these maternal and infant health outcomes, the relationship between postpartum depression and infant breastfeeding remains ambiguous. Hence, the aim of this study was to assess the effect of maternal postpartum depression on infant feeding practice in Sub-Saharan African Countries.Method: This systematic review and meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles. STATA version 14 was used to calculate the pooled effect size with 95% confidence intervals (95% CI) of postpartum depression on infant feeding practice using the DerSimonian and Laird random effects meta-analysis. The heterogeneity and publication bias was assessed by using I2 test statistics and Egger’s test respectively.Result: Total of 1058 published and unpublished article were retrieved from different data bases. Finally four studies fulfilled the inclusion criteria for this systematic review and meta- analysis. This meta-analysis found that postpartum depression has no significant effect on the infant feeding practices (OR = 0.46, 95% CI: 0.18, 1.14).Conclusion: We did not find sufficient evidence to conclude the effect of postpartum depression on infant feeding practice. Thus, the investigators strongly recommend the researchers to conducted randomised control trail studies in Sub-Sahara African countries.
Prevalence of Eclampsia and its Maternal-fetal outcomes at Ghandi Memorial Hospital, Addis Ababa Ethiopia, 2019. Retrospective study
Authors: Yeshambel Addisu , Anmut Walellign
Published: June 2020

Background: Eclamptic disorder of pregnancy is one of the common problems in sub-Saharan countries and forms one of the deadly triads along with hemorrhage and infection which complicates maternal and fetal outcomes of pregnancy. To assess the prevalence of eclampsia and its maternal and fetal outcome in Ghandi Memorial Hospital, Addis Ababa Ethiopia, 2019.Methods: A descriptive retrospective cross-sectional study was used on randomly selected 185 women who attended delivery at Ghandi memorial Hospital from 1st of September 2017 to –last of August 2018. Data were analyzed using SPSS version 25 software. Descriptive statistics were used to calculate frequencies and percentages and data was presented using texts and, tables. Results: Out of the 2,973 deliveries, the prevalence of eclampsia was found to be 16.1%. About 89.7% had reported a history of prior pregnancy-induced hypertension and 73.5% induced their current pregnancy following eclampsia. From mothers required interventions to terminate the pregnancy by induction, 47.8% ended by cesarean section secondary to non-reassuring fetal status (29.2%). The majority (91.9%) had taken magnesium sulfate for the management of convulsion and 86.5% had taken hydralazine for hypertension management. Abruption of the placenta (96.2%), postpartum-hemorrhage (89.2%), and HEELP syndrome (83.8 %) were major maternal adverse outcomes reported, and 33% of pregnancy was ended as stillbirth followed by low birth weight (28.6%). Over 53.6% of delivered babies had an APGAR score of less 4 and 30.4% of neonates required admission to nursery/NICU referral. Conclusion: The prevalence of eclampsia was high, with corresponding high maternal and perinatal morbidity and mortality. Increasing early detection before pregnancy, antenatal screening, and use of magnesium sulfate to control convulsions will reduce the disorder and associated morbidity and mortality for both mother and fetus.
Low serum apolipoprotein A 1 is an indicator of severity in patients with coronavirus disease 2019
Authors: Yang Yayun , Zhu Zhe , Fan Lingyan , Ye Shuyuan , Lou Kehong , Hua Xin , Huang Zuoan , Shi Qiaoyun , Gao Guosheng
Published: June 2020

Background: Recently, dyslipidaemia was observed in patients with coronavirus disease 2019 (COVID-19), especially in severe cases. This study aimed to explore the predictive value of blood lipid levels for COVID-19 severity.Methods: All patients with COVID-19 admitted to HwaMei Hospital, University of Chinese Academy of Sciences, from January 23 to April 20, 2020, were included in this retrospective study. General clinical characteristics and laboratory data (including blood lipid parameters) were obtained, and their predictive values for the severity were analysed.Results: In total, 142 consecutive patients with COVID-19 were included. The non-severe group included 125 cases, and 17 cases were included in the severe group. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein A1 (ApoA1) at baseline were significantly lower in the severe group. ApoA1 and interleukin-6 (IL-6) were recognized as independent risk factors for COVID-19 severity. ApoA1 had the highest area under the receiver operator characteristic curve (AUC) among all the single markers (AUC: 0.896, 95% CI: 0.834-0.941). Moreover, the risk model established using ApoA1 and IL-6 enhanced the predictive value (AUC: 0.977, 95% CI: 0.932-0.995). On the other hand, ApoA1 levels were elevated in the severe group during treatment, and there was no significant difference between the severe and non-severe groups during the recovery stage of the disease.Conclusion: The blood lipid profile in severe COVID-19 patients is quite different from that in non-severe cases. Serum ApoA1 could severe as a good indictor to reflect the severity of COVID-19.
Prognostic Impact of Remnant-like Particle Cholesterol in Patients with Differing Glucose Metabolic Status: an Observational Cohort Study from China
Authors: Zhao Qi , Zhang Ting-Yu , Cheng Yu-Jing , Ma Yue , Xu Ying-Kai , Yang Jia-Qi , Zhou Yujie
Published: June 2020

Background: It is uncertain whether remnant-like particle cholesterol (RLP-C) could predict residual risk in patients under different glucose metabolic status. The study aimed to evaluate the relationship between RLP-C and adverse prognosis in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI) and identify the potential impact of glucose metabolism on the predictive value of RLP-C.Methods: The study enrolled 2419 patients with NSTE-ACS who underwent PCI at Beijing Anzhen Hospital from January to December 2015. RLP-C was calculated as follows: total cholesterol (TC) minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The primary endpoint was a composite of events as follows: all-cause death, non-fatal myocardial infarction (MI), and ischemia-driven revascularization.Results: RLP-C was significantly associated with adverse prognosis in the total population [hazard ratio (HR) 1.291 per 1-SD increase of RLP-C, 95% confidence interval (CI) 1.119-1.490, p <0.001], independent of confounding risk factors. However, subgroup analysis showed that increasing RLP-C was shown to be associated with higher risk of adverse event only in the diabetic population [HR 1.385 per 1-SD increase of RLP-C, 95% CI 1.183-1.620, p <0.001]. RLP-C failed to be a significant determinant of adverse prognosis in the pre-diabetic and non-diabetic population. The addition of RLP-C to baseline model significantly enhanced the predictive value for adverse event both in total and diabetic population.Conclusions: Higher RLP-C level is a significant and independent predictor of adverse prognosis in diabetic patients with NSTE-ACS who underwent PCI.
A possible link between improper use of carbapenems and prevalence of carbapenem-resistant Klebsiella Pneumoniae in a hospital
Authors: Chai Zhonglin , Yang Yuxin , Liu Jia , Murad Muhammad , Min Zongsu , Lu Jing
Published: June 2020

Background: The emergence of carbapenem-resistant Enterobacteriaceae made the treatment difficult, which has become a major issue of public health. A sharp increase of carbapenem-resistance rate in Klebsiella pneumoniae was observed in a maternity and child health care hospital in Zunyi, China, in 2014.To investigate the cause and epidemiology of the carbapenem-resistant Klebsiella pneumoniae (CRKp) in the affected hospital.Methods: In 2015-2016, CRKp isolated from all the clinical samples were analyzed to identify the carbapenem-resistance genes. They were then fingerprinted in order to determine their genetic relationship. Clinical data such as usage of imipenem in 2012-2016 and the nosocomial infection surveillance data were analyzedResults: Thirty five isolates of CRKp out of 4328 various pathogens were obtained and blaNDM-1 was identified to be the most common resistant gene present in the CRKp isolates. The fingerprint analysis identified 15 major clusters of CRKp isolates. The bacteria with close proximity relationship tended to be from the same wards. However, a few CRKp isolates from different wards were found to be genetically highly related. The clinical data showed a significantly higher usage of carbapenems in 2012-2013, before the CRKp rate sharply increased in 2014. The nosocomial infection surveillance showed unexpected high rate of failures to meet the requirement of the hospital environment hygiene and hand hygiene in the neonatal ward.Conclusion: The increasing isolation rate of CRKp was associated with poorly regulated usage of carbapenems, impropriate medical practices and the poor hospital environmental hygiene and hand hygiene.
Influence of Severity of Infection on the Effect of Appropriate Antimicrobial Therapy for Acinetobacter baumannii Bacteremic Pneumonia
Authors: Kang Fang-Yu , How Chorng-Kuang , Wang Yung-Chih , Cheng Aristine , Yang Ya-Sung , Kuo Shu-Chen , Liu Chang-Pan , Liu Yuag-Meng , Chen Te-Li , Lee Yi-Tzu
Published: June 2020

BackgroundThe impact of appropriate antimicrobial therapy for A. baumannii bacteremic pneumonia has not been well established due to the inclusion of the three phenotypically indistinguishable Acinetobacter species and confounding factors including underlying diseases and severity of infection. This retrospective study aimed to evaluate the impact of appropriate antimicrobial therapy on 14-day mortality in A. baumannii bacteremic pneumonia patients after adjusting for risk factors. MethodsThis study was conducted at five medical centers in Taiwan between July 2012 and June 2016. A. baumannii species identification was performed using reference molecular methods. Risk factors for 14-day mortality were analyzed via logistic regression. The interaction between the Acute Physiology and Chronic Health Evaluation (APACHE) II score and appropriate antimicrobial therapy was assessed using the logistic model. ResultsA total of 336 patients with monomicrobial A. baumannii bacteremic pneumonia were included in this study. The overall 14-day mortality rate was 47.3%. The crude mortality of appropriate antimicrobial therapy was 35.9% (57 of 151 patients). Appropriate antimicrobial therapy was associated with a lower mortality after multivariate adjustment (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.34-0.97; p = 0.04), and the effect was influenced by APACHE II score (OR for interaction term, 0.0098; 95% CI, 0.0005-0.1885; p = 0.002). Further analysis demonstrated that appropriate antimicrobial therapy significantly reduced 14-day mortality among the patients with an APACHE II score >35 (OR 0.0098; 95% CI 0.0005-0.1885). ConclusionAppropriate antimicrobial therapy decreases 14-day mortality of the most severely ill patients with A. baumannii bacteremic pneumonia.
Carriage of ESBL-producing Gram-negative bacteria by houseflies captured in a hospital and its suburban surroundings in Ethiopia
Authors: Tufa Tafese B , Fuchs Andre , Wienemann Tobias , Eggers Yannik , Abdissa Sileshi , Schneider Marlen , Jensen Björn-Erik Ole , Bode Johannes G. , Pfeffer Klaus , Häussinger Dieter , Mackenzie Colin , Orth Hans Martin , Feldt Torsten
Published: June 2020

Background: Local data from the Asella Referral and Teaching Hospital in the town of Asella, Ethiopia reveal a high prevalence of extended-spectrum β-lactamase- (ESBL) producing Gram-negative bacteria in clinical isolates. To investigate a possible route of transmission, we determined the colonization rate of houseflies with ESBL-producing Gram-negative bacteria in the hospital compound and in the town of Asella. Methods: Houseflies were collected in August 2019 from the neonatal intensive care unit (NICU), the orthopedic ward, the hospital’s waste disposal area, and from a butchery situated 1.5 km from the hospital. After trapping, the flies were macerated and suspended in sterile normal saline. The suspensions were inoculated on MacConkey agar and incubated overnight. Species identification and antimicrobial susceptibility testing were performed using Vitek®-MS and VITEK® 2. Results: In total, 103 bacterial isolates were obtained from 85 flies (NICU: 11 isolates from 20 flies, orthopedic ward: 10 isolates from 20 flies, waste disposal area: 37 isolates from 26 flies, butchery: 45 isolates from 27 flies). The prevalence of ESBL-producing bacteria in collected flies was 82%, 90%, and 59% in NICU, orthopedic ward and the waste disposal area, respectively and 2% (1/45) in the butchery. The difference between flies trapped inside and outside the hospital compound was statistically significant (p≤0.001). The frequency of ESBL was 67% (6/9) in Raoultella spp. 67% (4/6) in Kluyvera spp., 56% (5/9) in Enterobacter spp., 50% (5/10) in E. coli and Citrobacter spp., and 44% (8/18) in Klebsiella spp.. Of the 41 ESBL-genes detected, 83% were CTX-M-like, 80% TEM-like, 22% SHV-like, and 2% CTX-M-2-like. ESBL-producing bacteria showed higher rates of antimicrobial resistance against ciprofloxacin (66% vs. 5%), gentamicin (68% vs. 3%), piperacillin-tazobactam (78% vs. 5%), and trimethoprim-sulfamethoxazole (88% vs. 16%), compared to non-ESBL-producing bacteria. Conclusion: A high proportion of the hospital’s housefly population were colonized with pathogenic ESBL-producing bacteria, but not houseflies collected at a distance of 1.5 km from the hospital. Houseflies can be potential vectors for transmission of multidrug-resistant (MDR) bacteria within hospitals. Further studies are needed to determine the source of MDR colonization in houseflies and possible impact of the high rate of MDR for nosocomial infections.
Pelvic injury prognosis is more closely related to vascular injury severity than anatomical fracture complexity: The WSES classification for pelvic trauma makes sense
Authors: Wu Yu-Tung , Cheng Chi-Tung , Tee Yu-San , Fu Chih-Yuan , Liao Chien-Hung , Hsieh Chi-Hsun
Published: June 2020

Background: The most common cause of death in cases of pelvic trauma is exsanguination caused by associated injuries but not the pelvic injury per se. For patients with relatively isolated pelvic trauma, the impact of the vascular injury severity on the outcome remains unclear. We hypothesized that, in addition to the fracture pattern complexity, the severity of the pelvic vascular injury plays a more decisive role in the outcome. Methods: The medical records of patients with pelvic fracture at a single center between Jan 2016 and Dec 2017 were retrospectively reviewed. Those with an abbreviated injury scale (AIS) score ≥3 in areas other than the pelvis were excluded. Lateral compression (LC) type 1 fractures and anteroposterior compression (APC) type 1 fractures according to the Young-Burgess classification and ischial fractures were defined as simple pelvic fractures, while other fracture types were considered complicated pelvic fractures. Based on CT, the vascular injury severity was defined as minor (fracture with or without hematoma) or severe (hematoma with contrast pooling/extravasation). The patient demographics, clinical parameters, and outcome measures were compared between the groups. Results: Twenty-six of the 155 patients had a severe vascular injury. Those with severe vascular injuries had poorer hemodynamics, a higher injury severity score (ISS), required more blood transfusions, and had a longer ICU stay (3.81 vs. 0.86 days, p=0.000) and total hospital stay (20.7 vs. 10.1 days, p=0.002) than those with minor vascular injuries. In contrast, those with complicated pelvic fractures (LC II/III, APC II/III, vertical shear and combined type fracture) required a similar number of transfusions and had a similar length of ICU stay compared to those with simple pelvic fractures (LC I, APC I and ischium fracture), but they had a longer total hospital stay (13.6 vs. 10.3 days, p=0.034). These findings were similar even if only patients with an ISS >=16 were considered. Conclusions: Our results indicate that even in patients with relatively isolated pelvic injuries, the vascular injury severity is more closely correlated to the outcome than the type of anatomical fracture. Therefore, a more balanced classification of pelvic injury that takes both the fracture pattern and hemodynamic status into consideration, such as the WSES classification, seems to have better utility for clinical practice.
Identification of key modules and hub genes regulating drought stress response in rice drought sensitive line PY6 by weighted gene co-expression network analysis
Authors: Yu Baiyang , Liu Jianbin , Wu Di , Liu Ying , Cen Weijian , Wang Shaokui , Li Rongbai , Luo Jijing
Published: June 2020

Background: Drought stress is an adverse factor with deleterious effects on several facets of rice growth. However, the mechanism underlying drought resistance in rice remains unclear. In order to genetically understand the potential molecular mechanism for drought response in rice, a drought sensitive Chromosome Segment Substitution Line (CSSL) PY6, which was constructed by the introgression of genomic segments of drought sensitive variety LAMBAYEQUE1 into drought-resistance variety PR403 via backcrossing, was used to map the QTL locus dss-1 for its sensitive phenotype, and to reveal the impact of dss-1 on the transcriptional profiling of PY6 via RNA-seq and WGCNA (weighted gene co-expression network analysis) analysis. Results: The genetic linkage analysis showed that dss-1 was located on the short arm of chromosome 1 of rice. In contrast to PR403, the over-accumulation of H 2 O 2 and MDA that might result in drought sensitive phenotype was observed in PY6 under drought stress. In the analysis of RNA-seq data, the identified differentially expressed genes (DEGs) mainly enriched in photosynthesis-related GO terms and exhibited a down-regulation pattern of their expressions in both PY6 and PR403 in response to drought stress, indicating that the photosynthesis was greatly inhibited in rice. Further WGCNA analysis constructed a co-expression network with 26 gene modules in which 4 and 3 modules that were highly correlated with H 2 O 2 and MDA, respectively. Likewise, the GO analysis of the differentially expressed hub genes (DEHGs) enriched in H 2 O 2 -correlated modules showed that the photosynthesis related GO terms were consistently over-represented. Furthermore, functional annotation of DEHGs in H 2 O 2 and MDA correlated modules revealed a cross talk between abiotic and biotic stresses. This was reflected by the differential expression alterations of hub genes which were annotated as encoding MYBs, laccases, WRKYs, and PRs family proteins, and ZFP36 were notably observed between PY6 and PR403 in response drought stress. Conclusions: Collectively, we speculated that drought-induced the inhibition of photosynthesis lead to the accumulation of H 2 O 2 and MDA that can trigger the reprogramming the profiling of transcriptome in rice. This included the differential regulation of hub genes that involve in ROS eliminated pathways to prevent the damage of rice plants from oxidative stress.
Pharmacy Preparedness and Response for the Prevention and Control of COVID-19 in Aksum, Ethiopia; a Qualitative Exploration
Authors: Kasahun Gebremicheal Gebreslassie , Kahsay Gebremichael Mulu , Asayehegn Amha Teklu , Demoz Gebre Teklemariam , Desta Desilu Mahari , Gebretekle Gebremedhin Beedemariam
Published: June 2020

Background
Novel Coronavirus is a global pandemic affecting all walks of life and it significantly changed the health system practices. Pharmacists are at the front line and have long been involved in combating this public health emergency. Therefore, the study was aimed to explore pharmacy preparedness and response to prevent and control coronavirus disease 2019 (COVID-19).
Methods
A qualitative study was conducted in six pharmacies in Aksum, Ethiopia in May, 2020. We conducted six in-depth interviews with purposively selected key informants. Direct observation measures were made to assess the activities made in the medicine retail outlets for the prevention and control of the pandemic. Interview data were audio-recorded, translated and transcribed verbatim. Thematic analysis was employed to analyze the data and OpenCode version 4.02 software was used to facilitate the data analysis.
Results
The thematic analysis has resulted in seven major themes. Good preparedness measures were undertaken to control and prevent COVID-19. Participants had good knowledge about the pandemic disease and reported they had used different resource materials to update themselves. Preparing of alcohol-based hand-rub; availing finished sanitizers and alcohol; and advising clients to maintain physical distancing were the major counseling information being delivered to prevent the disease. Some tendencies of irrational drug use and false claims of COVID-19 were observed at the beginning of the pandemic. Interview informants had reported they were working with relevant stakeholders and appropriate patient education and support were given to combat the pandemic disease.
Conclusion
The study revealed necessary pharmacy services has been rendered to all clients. However, availability of drugs and medical supplies were scarce which negatively affected the optimal delivery of pharmacy services. The government and other responsible bodies should work together to solve such problems and contain the pandemic disease.
The Dose Effect of Maternal Milk on Bronchopulmonary Dysplasia in Very Low Birth Weight Infants
Authors: Xu Yan , Yu Zhangbin , Li Qianqian , Zhou Jinjun , Yin Xiaoguang , Ma Yuelan , Yin Yujie , Jiang Shanyu , Zhu Rongping , Wu Yue , Han Liangrong , Gao Yan , Xue Mei , Qiao Yu , Zhu Lingling , Tu Wenjuan , Wu Mingfu , Wan Jun , Wang Weiyuan , Deng Xiaoyi , Li Shuangshuang , Wang Sannan , Chen Xiaoqing , Zhou Qin , Wang Jinxiu , Cheng Rui , Wang Jun , Han Shuping
Published: June 2020

Background
Human breast milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, limited multicenter research has been reported on the association between the dose of maternal milk and BPD in China. In this study, we aimed to evaluate the dose effects of maternal milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants.
Methods
We conducted a retrospective cohort study of preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. Multivariate analysis was performed to compare the effect on neonatal outcomes of daily graded doses of maternal milk throughout the first 4 weeks of life versus a reference group receiving no maternal milk. Models were adjusted for potential confounding variables.
Results
Of 964 included infants, 279 (28.9%) received exclusive preterm formula, another 128 (13.3%) received 1–24 ml/kg, 139 (14.4%) received 25–49 ml/kg, and 418 (43.4%) received ≥ 50 ml/kg maternal milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of maternal milk daily (≥ 50 ml/kg) had lower incidences of BPD (27.5% in ≥ 50 ml/kg maternal milk vs. 40.1% in formula), moderate and severe BPD (8.9% in ≥ 50 ml/kg maternal milk vs. 16.1% in formula), necrotizing enterocolitis (NEC; 3.8% in ≥ 50 ml/kg maternal milk vs. 10.8% in formula), late-onset sepsis (LOS; 9.3% in ≥ 50 ml/kg maternal milk vs. 19.7% in formula), and extrauterine growth retardation (EUGR; 38.5% in ≥ 50 ml/kg maternal milk vs. 57.6% in formula). Logistic regression indicated that those receiving ≥ 50 ml/kg/day maternal milk had lower odds of BPD (adjusted odds ratio [AOR] 0.453; 95% confidence interval [CI]: 0.309, 0.666), moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979).
Conclusions
A daily threshold amount of ≥ 50 ml/kg maternal milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants.
Trial registration:
ClinicalTrials.gov Identifier: NCT03453502
Surgical Management and Functional Outcome of Primary Convexity Subdural Empyema With Inter-hemispheric Extension: A Case Report and Literature Review
Authors: Ahmed Moayad Moawia Zain Elabdin , Alias Shahd A.Y , Ali Mukashfi E. A. , Mohammed Zakaria Ibrahim
Published: June 2020

Background:Subdural empyema is the collection of pus beneath the dura matter, commonly manifests as a complication of oto-rhino-laryngeal infection and rarely locates in the inter-hemispheric subdural space either as an isolated collection or as extension from the convexity of the cerebral hemisphere.Case presentation:A case of right fronto-parietal convexity subdural empyema with inter-hemispheric extension in 19 years old male is presented patient presented with fever, left sided convulsions, hemiparesis and blurring of vision. Despite the use of broad spectrum antibiotics based on cultures, surgical intervention with craniotomy was the definitive intervention needed for good recovery.Conclusion:Subdural empyema located in inter-hemispheric area represents rare form of subdural empyema. The best investigation to choose to diagnose these lesions is definitely magnetic resonance imaging of the brain .craniotomy is the surgical intervention of choice in most of the cases and almost lead to complete evacuation of the collection followed by the use of empirical antibiotic for six weeks duration, both means of treatment are used in order to reach better functional outcome.
α-Linolenic acid induces clearance of Tau seed via Actin-remodeling in Microglia
Authors: Desale Smita Eknath , Chinnathambi Subashchandrabose
Published: June 2020

Background Tau seeds exhibit a detrimental role in the spread of disease in Alzheimer’s disease. These species are found to be neurotoxic and activate microglia. However, the activation of microglia in pro-inflammatory response further elevates neurodegeneration. Omega-3 dietary fatty acids, on the other hand; exert an anti-inflammatory response by microglia. Along with the receptor expression, omega-3 fatty acids influence various important cellular functions. The role of omega-3 fatty acids on actin remodeling, which is the basis of cellular functions such as migration and phagocytosis is not known. Here in this study, we focus on effect of dietary supplement of ALA on extracellular Tau internalization and assisted actin polymerization for the process. ALA is found to induce membrane ruffling and phagocytic cup formation along with cytoskeletal rearrangement to induce lamellipodia and filopodia at the front end to move forward and assist the cell to identify the target. ALA is observed to promote the internalization of Tau and necessary actin remodeling for phagocytosis. Methods α-Linolenic (ALA) acid has been used for the study. ALA was dissolved in 100% ethanol and solubilized at 50°C for 2 hours. The human Tau aggregates was prepared in vitro for the internalization study in microglia in presence of α-Linolenic acids (ALA) via fluorescence microscopy with Apotome. The studied the role α-Linolenic acids (ALA) actin remodeling in cellular processes in presence of Tau seed. The study of actin structures lamellipodia, filopodia, and membrane ruffling along with Iba-1 and Arp2/3 complex was observed on ALA exposure. Results Extracellular Tau species are found to internalize more presence of ALA in microglia. The extensive polarization and migration was observed as indicated by extensive lamellipodia and filopodia formation. The formation of extensive actin branching in lamellipodia and membrane ruffling was studied with the help of ARP2/3 complex for nucleating actin network. The high density of ARP2/3 complex at the leading ends of migratory microglia confirmed the extensive branching of actin filaments on ALA exposure. Enhanced formation of lamellipodia and filopodia helps in migration and internalization of tau seed. The actin dynamics supports the phagocytosis process. Conclusion Our approach provides the insights of beneficial role of ALA as anti-inflammatory dietary supplement to treat AD. ALA induces internalization of Tau and necessary actin remodeling for phagocytosis.
Understanding Steps and Challenges to Take-home Naloxone and Buprenorphine/naloxone Implementation in Québec Emergency Rooms: Suboxed Project
Authors: Talbot Annie , Khemiri Rania , Londei-Leduc Luc , Robin Christine , Marcotte Suzanne , Therrien Guenièvre , Goulet Geneviève , Beaudet-Hillman Geneviève , Ouellette Christine , Brissette Suzanne , Sako Aïssata , Martin Marcel , Lauzon Pierre
Published: June 2020

BackgroundDeaths attributable to drug abuse are on the rise across Canada. It is estimated that there were more than 13,900 opioid-related deaths from January 2016 to June 2019 in the country. Emergency departments (EDs) are often on the frontline of care provided to people at risk of opioid overdose within Québec’s healthcare system. A variety of programs to implement take-home naloxone distribution and/or the provision of opioid agonist treatment for ED patients who are at risk for overdose have been created in the United States and in Europe. However, few EDs in Canada have developed protocols for the provision of take-home naloxone and/or opioid agonist treatment by ED doctors.MethodsA clinical algorithm for take home naloxone (THN) and prescription of buprenorphine/naloxone (B/N) was implemented in three EDs of Québec, Canada. This first phase of the SuboxED project required selecting clinical experts, describing the patient population, and creating partnerships with pharmacists and opioid agonist treatment clinics.Results:The clinical experts developed tools based on literature reviews and national and international guidelines. They also created educational tools and trained over 328 ED clinical staff. In addition, SuboxED ensured that a supply of take-home naloxone and B/n was available in the three ED sites for the study.ConclusionImplementing the proposed clinical algorithm for THN and prescription of B/N was challenging: drug supply and ED staff’s buy-in were among the most notable difficulties of SuboxED. Planning training sessions at three different institutions, each with its own governance structure and clinical culture, local realities and harm reduction priorities was complicated. Engaging already overworked ED teams consistently working in a gridlocked environments, revealed in itself to be a difficult endeavour.In the next phase of SuboxED, we will focus on data collection and analysis to evaluate both the implementation of the protocol through a retrospective review of electronic health records and satisfaction surveys of patients and healthcare professionals.Trial registration: noneContribution to the literatureIn the midst of the opioid overdose crisis, initiating a clinical algorithm for take-home naloxone and prescription of B/n in three operationally different Canadian emergency departments was feasible.Implementing a clinical algorithm for take-home naloxone and prescription of B/n is challenging; significant barriers involve drug supply, ED staff buy-in, training, engaging already overworked ED team.
Antiretroviral Therapy Based Hiv Prevention Targeting Young Female-Sex Workers: A Mixed Method Approach to Understand the Implementation of Prep in a Rural Area of Kwazulu-Natal, South Africa
Authors: Chimbindi Natsayi , Mthiyane Nondumiso , Zuma Thembelihle , Baisley Kathy , Pillay Deenan , McGrath Nuala , Harling Guy , Sherr Lorraine , Birdthistle Isolde , Floyd Sian , Dreyer Jaco , Nakasone Sarah , Seeley Janet , Shahmanesh Maryam
Published: June 2020

Introduction: Pre-exposure prophylaxis (PrEP) has the potential to alter the HIV epidemic in South Africa. Between 2016 and 2018 PrEP was rolled-out for 18-24 year-old female-sex workers (FSW) in a rural KwaZulu-Natal subdistrict with very high HIV incidence among adolescent girls and young women (AGYW). Using a ‘framework of access’ model, we describe PrEP access, awareness and uptake for AGYW, including community members’ attitudes towards PrEP for young people.Methods: We enrolled a cohort of 2184 AGYW aged 13-22 living within the subdistrict and quantitatively measured their eligibility, awareness and uptake of PrEP and other HIV prevention interventions in 2017 and 2018. We supplemented this insight with in depth exploration by conducting 19 group discussions with young people and community members, nine stakeholder key informant interviews, 58 in-depth interviews with 15-24 year-olds and 33 with implementing partners, and participatory observations. All interviews were recorded, transcribed and analysed using thematic analysis.Results: PrEP awareness increased from 2% to 9% from 2017 to 2018. Among 965 AGYW sexually-active by 2018, 13.4% (95%CI: 11.4-15.7%) reported transactional sex and 10.6% (95%CI: 8.8-12.7%) sex for money. Of these latter 194 PrEP-eligible AGYW, 21 were aware of PrEP, but none had ever used it. Wider community members were generally unaware of PrEP but imagined it would benefit young people, HIV-serodiscordant couples and those in long-distance relationships. Youth saw PrEP as a positive alternative to condoms since it “will be in their system” and not get in the way of sex. Teachers and healthcare providers were more apprehensive: worrying that PrEP would lower personal responsibility for sexual health.Conclusions: Although PrEP awareness increased and it was generally acceptable, uptake was low even among eligible AGYW, i.e., who reported FSW activity. Condom use remained undesirable suggesting a need to include PrEP in offers of alternative HIV prevention technologies to comdoms. The targeted nature of public-sector PrEP for FSW may have limited the reach, and the future broader roll-out, of PrEP in this setting. Inclusive approaches to PrEP provision integrated with wider sexual healthmay help improve demand and access to PrEP.
Investigation of Robustness of Radiomics Features Generated With Grey Level Co-occurrence Matrix (GLCM) for Positron Emission Tomography (PET) Image Analysis
Authors: Tamal Mahbubunnabi
Published: June 2020

Background: Quantification of heterogeneous radiotracer uptake in PET has the potential to be used as a biomarker of prognosis. Textural features accounting for both spatial and intensity information have recently been applied to FDG-PET images and used to predict treatment response. However, textural features have been predicted to strongly depend on volume. Other factors affecting textural features such as segmentation and quantization have previously been investigated on clinical data while image contrast and noise have not been assessed systematically. This study aims to investigate the relationships between textural features and these factors using phantom data.Methods: The torso NEMA phantom was first filled with 18F solutions to yield different contrasts between the six hot spheres (0.5-27 cm3) and the colder uniform background (2:1, 4:1, 8:1) and scanned on the TrueV PET-CT scanner for 120min. Images were reconstructed using OSEM (4 iterations, 21 subsets) for different scan durations (15-120min) and smoothed with a 4-mm Gaussian filter. The phantom with two heterogeneous spherical inserts (8.2 and 18.8 cm3) was then scanned and reconstructed using same protocol for contrast 4:1 only. All spheres were delineated using three approaches 1) the exact boundaries based on their known diameters, 2) 40% fixed threshold and 3) adaptive threshold. Textural features were derived from the co-occurrence matrix using different quantization levels (8-256). Results: Some textural features (contrast, dissimilarity, entropy, correlation) increase while others (homogeneity, energy) decrease with quantization at different rates depending on sphere volume. When using the exact delineation, contrast and scan duration (noise) have a lesser effect on textural features than sphere volume. When applying the same exact regions on the uniform background (no partial volume), the relationships between textural features and volume are comparable to when applied to the respective spheres except for correlation. Textural features are indirectly related to noise and contrast via segmentation with adaptive threshold being superior compared to the fixed threshold. Conclusion:Among the six textural features, homogeneity and dissimilarity are the most suitable for measuring PET tumour heterogeneity with quantization 64 if regions are segmented using methods that are robust to noise and contrast variations. To use these textural features as prognostic biomarkers, changes in textural features between baseline and treatment scans should always be reported along with the changes in volumes.
Psychometric properties of the Spanish version of the Fear of COVID-19 Scale (FCV-19S)
Authors: Barrios Iván , Ríos-González Carlos , O’Higgins Marcelo , González Israel , García Oscar , Díaz Noelia Ruiz , Castaldelli-Maia João Mauricio , Ventriglio Antonio , Torales Julio
Published: June 2020

Globally, mental health impairments have been described based on the fear of the infection generated by the COVID-19 pandemic. The aim of this study is to test the psychometric properties of the Spanish validation the Fear of COVID-19 Scale (FCV-19S), which has been recently developed to measure fear quantitatively. Participants were recruited through an Internet-based survey. 1077 subjects were included. To establish construct validity, an exploratory factor analysis was performed using the KMO test, which was adequate, and the Bartlett sphericity test, which was significant (p <.0001). The CFI, NFI, GFI, TLI and RMSEA indices were used to evaluate the model and showed good adjustment. Cronbach’s alpha showed valid internal consistency (α=0.86). This validation is supported by significant correlation (p <.001) with the HADS scale for anxiety and depression and with the Fear Questionnaire scale for specific phobia. In conclusion, the Spanish version of the FCV-19S is a 7-item scale with two dimensions, psychological symptoms (items 1, 2, 4, and 5) and physiological symptoms (items 3, 6, and 7) with robust psychometric properties.