bluuebunny/crossref_metadata_2025 huggingface dataset:
Glioma SOX2 expression decreased after adjuvant therapy
Authors: Yu Wei , Ren Xiaoqiu , Hu Chunxiu , Tan Yinuo , Shui Yongjie , Chen Zexin , Zhang Lili , Peng Jiaping , Wei Qichun
Published: October 2019

Objectives

SOX2 is regarded as an important marker in stem cell. The change of SOX2 expression after adjuvant therapy in high grade glioma (HGG) remains unknown so far. Few patients with recurrent glioma have opportunity to undergo operation once again, so the recurrent glioma samples are scarce. This study tries to analyze SOX2 expression in paired primary and recurrent HGG, aims to better understand the transformation law of SOX2 after adjuvant therapy in HGG.Methods

Twenty-four recurrent HGG patients who undergone a second resection were included. 16 patients received adjuvant therapy, the remaining 8 patients didn’t receive any adjuvant therapy at all. The protein expression of SOX2 in paired primary and recurrent HGG was tested by immunohistochemistry. The statistical analysis was conducted by IBM SPSS Statistics 19.0.Results

In primary HGG, SOX2 expression of 3+,2+,1+ and 0+ were seen in 20 (83.3%), 1 (4.2%), 1 (4.2%) and 2 cases (8.3%), respectively. The expression of SOX2 was decreased in recurrent HGG compared to the paired primary sample (p=0.001). The decrease of SOX2 was often seen in patients received chemotherapy, radiotherapy or both (p=0.003). Patients with SOX2 high expression in primary glioma had a longer median PFS than those with SOX2 low expression with marginal statistic significance (12.7 vs. 5.4 months, p=0.083). For cases with SOX2 high expression in the primary glioma, those had SOX2 low expression after recurrence seemed to have worse prognosis as compared to patients with stable SOX2 high expression (PFS: 10.4 vs. 14.9 months, p=0.036; OS: 27.0 vs 49.5 months, p=0.005).Conclusions

This is the first study comparing the protein expression of SOX2 in recurrent HGG and its paired primary tumor. SOX2 high expression is common in brain HGG, a tendency of decreased SOX2 expression in recurrent gliomas was evidenced. Lower SOX2 expression was seen in those patients who received adjuvant chemotherapy and/or radiotherapy. Patients with low SOX2 expression in primary HGG usually have poorer prognosis, those with SOX2 expression decreased in recurrent HGG had worse outcome.
The influence of balanced complex chromosomal rearrangements on preimplantation embryonic development potential and molecular karyotype
Authors: Li Gang , Shi Weiyi , Niu Wenbin , Xu Jiawei , Guo Yihong , Su Yingchun , Sun Yingpu
Published: October 2019

Background: Balanced complex chromosome rearrangements (BCCR) are balanced chromosomal structural aberrations that involve two or more chromosomes and at least three breakpoints. It is very rare in the population. The objective is to explore the difference of influence of three types of BCCR on early embryonic development and molecular karyotype.
Results: Twelve couples were recruited including four couples of three-way rearrangements carriers (group A), three couples of double two-way translocations carriers (group B) and five couples of exceptional CCR carriers (group C). A total of 243 oocytes were retrieved in the seventeen preimplantation genetic testing (PGT) cycles, and 207 of these were available for fertilization. After intracytoplasmic sperm injection, 181 oocytes normally fertilized.The rates of embryos forming on day3 in three groups were 87.88%, 97.78% and 77.14%, which was significantly different (P=0.01). Compared with group B, the rate of embryo formation was statistically significantly lower in group C (P=0.01). Furthermore, the rates of high-quality blastocysts in three group were 14.71%, 48.15% and 62.96%, respectively, which was significantly different (P=0.00). Compared with group B and C, the rate of high-quality blastocysts in group A was statistically significantly lower (P=0.00; P=0.00).
Comprehensive chromosome analysis was performed on 83 embryos, including 75 trophectoderm cells and 8 blastomeres. Except 7 embryos failed to amplify, 9.01% embryos were diagnosed as euploidy, and 90.91% were diagnosed as abnormal. As for group A, the euploid embryo rate was 10.71% and the abnormal embryo rate was 89.29%. In group B, the euploid embryo rate was 3.85%, the abnormal embryo rate was 96.15%. The euploid embryo rate was 13.04%, the abnormal embryo rate was 86.96% in group C. There were no significant differences among the three groups (P = 0.55).
Conclusions: The double two-way translocations couples have more chance to get balanced or normal embryos probably, and there may be more high-quality blastocysts in exceptional CCRs, but the blastocyst formation rate was similar among the three type of BCCR. Different types of BCCR maybe have little effect on the embryonic molecular karyotype. The difference of influence of BCCR on early embryonic development and molecular karyotype should be further studied.
Incidence and associated factors of laryngospasm among pediatric patients who undergone surgery under general anesthesia, in university of Gondar Compressive Specialized Hospital, Northwest Ethiopia, 2019: Cross sectional study
Authors: Chekol Wubie Birlie , Melese Debas Yaregal
Published: October 2019

Objective: laryngospasm is a glotiss closure due to reflex constriction of the laryngeal muscles. It mainly happened at induction, maintenance and emergence phases of general anaesthesia (GA).Considerable research have been done previously but, consequences of laryngospasm, various results and gate opener values of previous studies intiated us to do this research. So this study was aimed to assess the incidence and associated factors of laryngospasm among pediatric patients who undergone surgery under GA.Methods:institutional based cross sectional study was conducted on pediatric patients from February to August, 2019 in university of Gondar comprehensive specialised hospital (UOGCSH). Data were entered and analaysed with SPSS version 20.Variables with P value less than 0.2 in bivariate analysis was fitted in to multivariable logistic regression analysis to identify factors associated with laryngospasm. Both crude and adjusted odds ratio with 95% CI were calculated to show the strength of association. In multivariable analysis, P value of less than 0.05 were considered as statistically significant.Results: The incidence of laryngospasm among pediatric patients who undergone surgery under GA was 57 (18.39%) . Of this 34 (59.6%) were happened during emergence, 12 (21.1%) during maintenance and 11 (19.3%) during induction phase of GA. In multivariable analysis, airway anomalies (AOR : 14.64,95%CI:1.71,125.04) , orophyrangeal secretion (AOR : 2.45,95%CI:1.19,5.06), attempts of airway devices insertion (AOR : 2.47,95%CI:1.16,5.22), upper respiratory tract infection (AOR : 2.91,95%CI:1.008,8.41) and inadequate depth of anesthesia (AOR : 7.92,95%CI:2.7,23.22) were significantly associated with incidence of laryngospasm. Conclusion: laryngospasm at induction, maintainance and emergence phases of GA was high in UOGCSH. Inadequate depth of anaesthesia, upper respiratory tract infection, airway anomalies, multiple attempts of airway device insertion, and orophyrangeal secretion were predictors of laryngospasm. So it is better to have patient optimisation for patients having URTI and airway anomalies, reduce the attempts of airway device insertion and adequate depth of anesthesia as well as adequate suctioning of oropharynx.
Cumulative Incidence of Hepatocellular Carcinoma and Hepatitis B Surface Antigen Seroclearance after Nucleos(t)ide analogue-induced Hepatitis B e Antigen Seroclearance
Authors: Lee Hyun Woong , Lee Jung Il , Kim Saein , Kim Sora , Chang Hye Young , Lee Kwan Sik
Published: October 2019

Background: Hepatitis B e antigen (HBeAg) seroclearance has been considered as the treatment endpoint in HBeAg-positive patients with chronic hepatitis B. Although HBeAg seroclearance has been accomplished, some aspects are yet unclear. We investigated the cumulative incidence of hepatocellular carcinoma (HCC) and evaluated hepatitis B surface antigen (HBsAg) seroclearance in patients undergoing nucleos(t)ide analogue (NA)-induced HBeAg seroclearance. Methods: In this retrospective cohort study, 203 HBsAg- and HBeAg-seropositive patients that experienced NA (entecavir or tenofovir)-induced HBeAg seroclearance were recruited. Patients with documented HBeAg seroclearance were followed-up every 6 months. Baseline characteristics and laboratory results were recorded. Results: The mean age at HBeAg seroclearance was 40 years (range, 20-84), and the mean follow-up duration was 5 years (range, 2-11). The cumulative incidence of HCC was 1.5% to 11.5% at 1 to 8 years after HBeAg seroclearance. Cirrhosis was the only significant factor for HCC development (hazard ratio [HR], 24.651; confidence interval [CI], 3.018 to 201.365; P = 0.003). The cumulative incidence of HBsAg seroclearance was 3.5% to 18.7% after 1 to 8 years from HBeAg seroclearance. Conclusions: A significant proportion of patients developed HCC after NA-induced HBeAg seroclearance. The presence of liver cirrhosis at the time of HBeAg seroclearance serves as an independent factor for HCC development. Some patients with NA-induced HBeAg seroclearance achieved HBsAg seroclearance.
Where do we go from here? - Opportunities and barriers to the career development of Trial Managers: a survey of UK-based trial management professionals
Authors: Mitchell Eleanor Jane , Goodman Kirsteen , Hartley Suzanne , Hickey Helen , McDonald Alison , Meadows Helen , Rhodes Shelley , Taylor Jodi , Wakefield Natalie , Farrell Barbara
Published: October 2019

Background
Clinical trials commonly have a dedicated trial manager and effective trial management is essential to the successful delivery of high quality trials. Trial managers have diverse experience and currently there is no standardised structured career pathway. The UK Trial Managers’ Network (UKTMN) surveyed its members to understand what is important to them with respect to career development, since this would be important in the development of any initiative intended to develop a skilled workforce.
Methods
We conducted an online survey of UKTMN members, who are trial management professionals, working on academic-led trials in the UK. Members were asked what they perceive as opportunities and barriers to career development. Two reminders were sent to facilitate completion of the survey and responders were offered the opportunity to enter a prize draw for waived fees at the UKTMN annual meeting. Data was analysed descriptively using Stata (version 15.1) and free-text responses were reviewed for themes.
Results
The survey was sent to 819 UKTMN members; 433 responses were received, though 13 were from non-UKTMN members, thus 420 respondents’ data were included in analyses. Respondents were representative of UKTMN membership, however more responses were received by trial managers based in registered Clinical Trials Units (CTUs). The top three opportunities for career development were: i) training, ii) helping design trials, iii) undertake relevant qualifications. The top three barriers were: i) funding, ii) few opportunities to get involved in development activities aside from managing a trial and iii) unclear organisational career pathway. Almost all respondents (401/420, 95.4%) considered career development either very or quite important. Although all respondents had a day-to-day role in managing trials, there was huge disparity between job titles.
Conclusion
Career development is important to trial managers yet there is a lack of a structured pathway. The enablers and disablers to career development for trial managers should be clearly considered by the clinical trial community and, in particular, employers, sponsors and funders in order to develop a highly skilled workforce of trial managers, who are key to the delivery of trials.
The characteristics of spatial-temporal distribution and cluster of tuberculosis in Yunnan Province, China, 2005-2018.
Authors: Chen Jinou , Qiu Yubing , Yang Rui , Li Ling , Hou Jinglong , Lu Kunyun , Xu Lin
Published: October 2019

Background

Tuberculosis (TB) makes a big challenge to public health, especially in high TB burden counties of China and Greater Mekong Subregion (GMS). The aim of this study was to identify the spatial-temporal dynamic process and high-risk region of notified pulmonary tuberculosis (PTB), sputum smear-positive tuberculosis (SSP-TB) and sputum smear-negative tuberculosis (SSN-TB) cases in Yunnan, the south-western of China between years of 2005 to 2018. meanwhile, to evaluate the similarity of prevalence pattern for TB among GMS.

Methods

Data for notified PTB were extracted from the China Information System for Disease Control and Prevention (CISDCP) correspond to population information in 129 counties of Yunnan between 2005 to 2018. Seasonally adjusted time series defined the trend cycle and seasonality of PTB prevalence. Kulldorff’s space-time scan statistics was applied to identify temporal, spatial and spatial-temporal PTB prevalence clusters at county-level of Yunnan. Pearson correlation coefficient and hierarchical clustering were applied to define the similarity of TB prevalence among borders with GMS.

Result

There were a total of 381 855 notified PTB cases in Yunnan, and the average prevalence was 59.1 per 100 000 population between 2005 to 2018. A declined long-term trend with seasonality of a peak in spring and a trough in winter for PTB was observed. Spatial-temporal scan statistics detected the significant clusters of PTB prevalence, the most likely cluster concentrated in the northeastern angle of Yunnan between 2011 to 2015 ( RR =2.6, P <0.01), though the most recent cluster for PTB and spatial cluster for SSP-TB was in borders with GMS. There were six potential TB prevalence patterns among GMS.

Conclusion

This study detected aggregated time interval and regions for PTB, SSP-TB, and SSN-TB at county-level of Yunnan province. Similarity prevalence pattern was found in borders and GMS. The localized prevention strategy should focus on cross-boundary transmission and SSN-TB control.
Growth Retardation among Children in Southern Iran: A 7-year Population Based Cohort Study
Authors: Fatemi Mohammad Javad , Fararouei Mohammad , Moravej Hossein , Dianatinasab Mostafa
Published: October 2019

Background Growth retardation is a common health problem, which requires early prevention and detection. This study was conducted to define the approximate age at which stunting starts among the Iranian boys and girls.Method The second phase of a population based cohort nested case-control study on 400 children who were followed from birth to 7 years of age. This study was performed to define the pattern of growth among stunted and normal children and to reveal the age at which stunting starts in each gender.Results For boys the height was relatively similar between the two groups until the age 6 months at which the difference in height between normal and stunted children starts to become significantly large (difference= 0.70 cm, P=0.04). For girls, height in the two groups is relatively similar until the age of 9 months at which the difference starts to become significantly large (difference=0.97 cm, P=0.01). No significant difference in the weight of the girls was observed between the normal and stunted groups during the study period (difference=283.21 gr, P>0.05). However, boys from the stunted group were lighter since almost the same time that they started to become significantly shorter (difference= 1265.19 gr, P=0.001).Conclusions Soon after birth (at about 6 months of age), the growth pattern of some (stunted) children starts to stumble and divert from normal. Six month is the age at which mothers start weaning with withdrawing breast milk and start supplementary foods and adult diet. A specially designed study is needed to understand the actual reason for observing such a phenomenon among Iranian children.
Effects of initial periodontal therapy on the prevalence of Epstein-Barr virus DNA and Porphyromonas gingivalis in Japanese chronic periodontitis patients
Authors: Kato Ayako , Ikeda Yorinobu , Imai Kenichi , Ogata Yorimasa
Published: October 2019

Background Initial periodontal therapy (IPT) is cornerstone of periodontal therapy and the first step to control of periodontal risk factors. Scaling and root planing are used to treat root surface irregularities and remove virulent factors caused by periodontal pathogens. This procedure also incorporated into periodontal surgery. To elucidate the effects of IPT on prevalence of Epstein-Barr virus (EBV) DNA and Porphyromonas gingivalis , we used subgingival plaque samples from chronic periodontitis (CP) patients.Methods Seventeen CP patients were recruited and determined measured periodontal status clinical parameters such as by probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP) and an X-ray examination, and subgingival plaque samples were collected from two periodontal sites with PD of < 3 mm (healthy sites: HS) or > 5 mm (periodontitis sites: PS) at first visit and after IPT. Plaque samples were subjected to a real-time PCR to detect EBV DNA and P. gingivalis.Results EBV DNA and P. gingivalis were detected 9 (52.9%) and 14 (82.3%) sites within the subgingival samples from HS, and 13 (76.5%) and 14 (82.3%) sites within the PS at first visit. After IPT, number of detections of EBV DNA and P. gingivalis were decreased to 5 (29.4%) and 13 (76.5%) sites within the subgingival samples from HS, and 9 (52.9%) and 10 (58.8%) sites within the PS. Significant improvements in PD and BOP were observed after IPT in PS. Coexistence of EBV DNA and P. gingivalis in the subgingival samples from PS at first visit (12 sites; 70.6%) were significantly decreased after IPT (6 sites; 35.3%).Conclusion These results suggest that the IPT was effective in improvement of clinical parameters such as PD and BOP and reducing the coexistence of EBV and P. gingivalis in the subgingival plaque from PS. However, IPT could not eradicate the EBV and P. gingivalis . Further research would be necessary for improving the periodontal treatment strategy.
Substance P aggravates periodontitis by upregulating HIF-1 α and RANKL / OPG ratio
Authors: Yan Kaixian , Lin Qin , Tang Kailiang , Liu Shuang , Du Yi , Yu Xijiao , Li Shu
Published: October 2019

Background Both substance P (SP) and hypoxia-inducible factor 1 alpha (HIF-1α) get involved in inflammation and angiogenesis. But the interrelation between SP and HIF-1α in rat periodontitis is still little known. Methods Ligation‐induced rat periodontitis was established to observe the expression of SP and HIF-1α by immunohistochemistry. Gingival fibroblasts and bone marrow macrophages (BMMs) were respectively cultured and stimulated with Porphyromonas gingivalis lipopolysaccharide (LPS). 10 nM SP with or without 1µg/ml LPS was added to elaborate the relationship between SP and HIF-1α in gingival fibroblasts. The effect of SP on osteoclastogenesis was tested by TRAP staining. Western blotting was applied to investigate the expressions of HIF-1α, osteoprotegerin (OPG) and receptor activator of NF-κB ligand (RANKL). Results The expression levels of HIF-1α and SP were higher in periodontitis than normal tissues. SP could upregulate the level of HIF-1α and RANKL/OPG ratio in LPS-stimulated gingival fibroblasts. SP with or without LPS also facilitated RANKL induced osteoclastogenesis. Conclusion Substance P aggravates periodontitis by increasing HIF-1α and RANKL / OPG ratio.
Single-visit versus multiple-visits endodontic treatment of apical periodontitis: A meta-analysis of outcome assessed by intra oral radiographs
Authors: Manshadi Bahar Dehghan , Bårdsen Asgeir
Published: October 2019

The established multiple-visit treatment for necrotic teeth with apical periodontitis has been challenged by single-visit treatment. However, there is no clear support for the one or the other treatment in the literature. The aim of this meta-analysis was to investigate if non-surgical primary root canal treatment carried out in single-visit or multiple-visit makes any difference in terms of radiographic healing in necrotic teeth with apical periodontitis. The null hypothesis was: there is no difference in the rate of apical healing for the two treatment modalities The literature search was organized through the National Centre for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM the National Library of Medicine (NLM)) using PubMed database and EMBASE Ovid to select articles with single-visit or multiple-visit included teeth with pulp necrosis and apical periodontitis. Of the 60 identified studies, only eight studies were included in current meta-analysis. The main reasons for exclusions were teeth with other diagnosis except necrotic pulp and apical periodontitis, studies with no comparison between single- and multiple-visit endodontics within the same study and studies without healing rate appearance. Results from each of the included studies were entered into the statistical program Stata, Version 15 (Texas, USA). The odds ratio (OR) and the 95% confidence interval for each study were calculated (dependent variable: single-visit/multiple-visit, independent variables: healed/not healed based on intra oral radiographs) with the random effect model. There was no significant difference in radiographic evidence of periapical healing between single-visit endodontics and multiple-visit treatment modalities, of the primary root canal treatment in necrotic teeth with apical periodontitis (OR = 1.10, 95% CI: 0.67-1.83) as evaluated on intra oral radiographs. Thus, the null hypothesis could not be rejected.
No evidence of a synergistic effect of HIV infection and diabetes mellitus type 2 on fat distribution, plasma adiponectin or inflammatory markers.
Authors: Hove-Skovsgaard Malene , Abildgaard Julie , Gelpi Marco , Gaardbo Julie , Kolte Lilian , Ullum Henrik , Trøseid Marius , Lindegaard Birgitte , Nielsen Susanne Dam
Published: October 2019

Background Altered fat distribution and chronic inflammation are found in both persons living with HIV (PLWH) and persons with diabetes mellitus type 2 (DM2) and are known risk factors for CVD. We aimed to investigate if a synergistic effect of HIV infection and DM2 was found on fat distribution and inflammation. Methods A cross-sectional study was performed including PLWH with HIV RNA <200 copies/mL (18 with DM2 (HIV + DM2+), 18 without DM2 (HIV + DM2-)) and uninfected persons (19 with DM2 (HIV-DM2+) and 25 without DM2 (HIV-DM2-)). We measured fat distribution using dual-energy X-ray absorptiometry scan. Plasma concentrations of adiponectin, interleukin-6 (IL-6), tumor necrosis factor-alfa (TNF- α) and soluble CD14 (sCD14) was measured using snap-frozen plasma. Results HIV+DM2+ and HIV+DM2- had comparable trunk/limb fat ratio. In contrast, HIV+DM2+ had a higher trunk/ limb fat ratio than HIV-DM2+ and HIV-DM2- (p=0.013 and p<0.001, respectively). However, HIV+DM2+ and HIV-DM2+ had comparable amount of trunk fat mass (kg) (p=0.254). A lower concentration of plasma adiponectin and higher concentration of IL-6 was found in HIV+DM2+ than in HIV+DM2-(p=0.037 and p=0.039) and in HIV-DM2- (p=0.001 and p=0.012). In contrast, plasma adiponectin and IL-6 concentrations were comparable in HIV+DM2+ and HIV-DM2+ (p=0.345 and p=0.825). Concentration of sCD14 was comparable in HIV+DM2+ and HIV+DM2–(p=0.850), but elevated in HIV+DM2+ compared to HIV-DM2+ (p<0.001) and HIV-DM2- (p=0.007). No statistical interactions were found between HIV infection and DM2 for any of the depending variables. Conclusion A synergistic effect of HIV and DM2 was not found for any of the outcomes. However, HIV+DM2+ had features related to both HIV infection and DM2+ with a high trunk/limb ratio, high trunk fat mass, low concentration of plasma adiponectin and elevated concentrations of IL-6 and sCD14. This could contribute to elevated risk of CVD.
Tick-borne pathogens in Ixodidae ticks collected from privately-owned dogs in Italy: a country-wide molecular survey
Authors: Zanet Stefania , Battisti Elena , Pepe Paola , Ciuca Lavinia , Colombo Liliana , Trisciuoglio Anna , Ferroglio Ezio , Cringoli Giuseppe , Rinaldi Laura , Maurelli Maria Paola
Published: October 2019

Background Ticks and tick-borne diseases are increasingly recognized as a cause of disease in dogs worldwide. The epidemiology of ticks and tick-transmitted protozoa and bacteria has changed due to the spread of ticks to urban and peri-urban areas and the movement of infected animals, posing new risks for animals and humans. This countrywide study reports information on distribution and prevalence of pathogens in ticks collected from privately-owned dogs in Italy. We analyzed 2681 Ixodidae ticks, collected from 1454 pet dogs from Italy. Specific PCR protocols were used to detect i) Piroplasms of the genera Babesia and Theileria , ii) Gram-negative cocci of the family Anaplasmataceae and iii) Borrelia burgdorferi s.l. Sequencing of positive amplicons allowed for species identification.Results Babesia / Theileria spp. DNA was detected in 435 tick-pools (Minimum Infection Rate (MIR) = 27.57%; 95% confidence interval (CI) = 25.42-29.82%) with higher prevalence in Ixodes ricinus and Rhipicephalus sanguneus group. The zoonotic B. venatorum was the most prevalent species (MIR = 7.54%; 95% CI = 6.34-8.95%). Anaplasma and Ehrlichia species were detected in 165 tick-pools (MIR = 10.46%; 95% CI = 9.26-11.79%) and specifically, A. phagocytophilum was identified with MIR = 5.07% (95% CI = 4.09-6.27%). Borrelia burgdorferi s.l. and B. afzelii were detected with MIR = 0.38% (95% CI = 0.17-0.83%) and MIR = 0.25% (95% CI 0.1-0.65%) respectively.Conclusions Zoonotic pathogens were the most frequently detected in ticks collected from privately-owned dogs which might be used as markers of pathogens presence and distribution.
Infant Feeding Mode Predicts the Costs of Healthcare Services in One Region of Canada: a Data Linkage Study
Authors: Taylor Alicia Kimberlyn , Chowdhury Sharmeen , Gao Zhiwei , Nguyen Hai Van , Midodzi William , Gill Nicole , Halfyard Beth , Allwood-Newhook Leigh-Anne , Twells Laurie Kathleen
Published: October 2019

Background Few studies have examined the association between infant feeding mode (IFM) and costs related to healthcare service use (HSU) in Canada. The aim of this study is to evaluate differences in HSU and its associated costs by IFM, in an infant’s first year of life in one region of Newfoundland and Labrador, Canada.Methods Data from a prospective cohort study were linked to administrative databases to examine HSU during an infant’s first year of life. The cohort study collected information on peri- and postnatal variables, including IFM during three stages that covered pregnancy through the first year postnatally. Consenting mothers provided their infants health insurance number for a data linkage to examine HSU by the infant. Outcomes included: hospital admissions, emergency room, family doctor and specialist visits. IFM was categorized as exclusively breastfed, mixed fed and exclusively formula fed. Descriptive statistics and multivariate analysis were performed to examine the relationship between IFM, maternal and child characteristics and costs associated with HSU.Results The sample included 160 mother infant dyads who consented to the data linkage. Mothers were Caucasian (95.6%), 26 years or older (95%), partnered (97.5%), living in a household with income greater than $30,000 CAN (98.1%) with a post-secondary education (97.5%). At one month 67% were exclusively breastfeeding, 20% were mixed feeding, and 13% were exclusively formula feeding. Overall $315,235 was spent on healthcare service use for the sample of healthy full-term infants during their first year of life. Generalized linear modelling was performed to assess the effect of IFM on costs associated with HSU adjusting for confounders. When compared to exclusive breastfeeding, exclusive formula and mixed feeding were found to be significant predictors of the total costs associated with HSU during the first year of life (p <0.05), driven by costs of hospital admissions.Conclusions Due to the human and economic burden associated with not breastfeeding, policies and programs that support and encourage breastfeeding should be a priority for governments and regional health authorities.
Modulating effect of vitamin D status on serum anti-adenovirus 36 antibody amount in obese children: National Food and Nutrition Surveillance
Authors: Nikooyeh Bahareh , Hollis Bruce , Neyestani Tirang Reza
Published: October 2019

Background. Among the causative factors of obesity, a rather newly proposed theory is viral infections. The association of ADV-36 infection and obesity has been reported by some research groups in children. We hypothesized that the association between ADV-36 infection and adiposity may be mediated by sub-optimal vitamin D status of the host. To examine this hypothesis, we conducted a case control study on children and adolescents with normal weight, over weight and obesity. Methods. In total, 91 (normal weight: 33, overweight: 33, obese: 25) apparently healthy children aged 5-18 years were randomly selected from the registered population at National Food and Nutrition Surveillance Program (NFNS). The groups were matched based on age and sex. Anthropometric, biochemical and serological assessments were performed. Results. The amount of anti-ADV36-Ab increased whereas circulating concentrations of calcidiol decreased across BMI categories with higher amounts in normal weight than in overweight and obese children (31.0±16.4, 22.5±10.5 and 21.9±9.8 nmol/L, respectively, p=0.004). Logistic regression analysis revealed that for each unit increment of anti-ADV36-Ab, the chance of increase in weight was 8.5 times (OR: 8.5, p=0.029). Interestingly, when 25(OH)D was introduced into the model, anti-ADV36-Ab was no longer the predictor of weight increment and the chance of increase in weight reduced 5% for each unit increase in calcidiol concentration (OR: 0.95, p=0.012). Conclusion. It is suggested that ADV36-induced lipogenesis and weight gain may be mediated by vitamin D deficiency in obese children. Further studies are warranted.
Potential impact of expanded MUAC-only programs on targeting of acutely malnourished children and ready-to-use-therapeutic-food allocation: lessons from cross-sectional surveys
Authors: Guesdon Benjamin , Couture Alexia , Pantchova Danka , Bilukha Oleg
Published: October 2019

Background Some of the recently piloted innovative approaches for the management of acute malnutrition in children use the “expanded MUAC-only” approach, with Mid Upper Arm Circumference (MUAC) <125mm as the sole anthropometric criterion for screening and admission, classification of cases into moderate or severe using the 115mm cut-off, and use Ready-to-Use-Therapeutic-Food (RUTF) for the management of both moderate (MAM) and severe (SAM) cases of acute malnutrition. Our study aimed at exploring the potential impact of this “expanded MUAC-only” program scenario on the eligibility for treatment and RUTF allocation, as compared with the existing WHO normative guidance.Methods We analyzed data from 550 population representative cross-sectional cluster surveys conducted since 2007. We retrieved all children classified as SAM and MAM according to currently used case definitions, and calculated the proportions of SAM children who would be excluded from treatment, misclassified as MAM, or whose specific risks (because of having both MUAC and weight-for height deficits) would be ignored. We also analyzed the expected changes in the number and profile of children meant to receive RUTF according to the new approach.Results We found that approximately one quarter of SAM children would not be detected and eligible for treatment under the “expanded MUAC-only” scenario, and another 20% would be classified as MAM. A further 17% of the total SAM children would be admitted and followed only according to their MUAC or oedema status, while they also present with a severe weight-for height deficit on admission. Considering MAM targeting, about half of the MAM children would be left undetected. This scenario also shows a 2.5 time increase in the number of children targeted with RUTF, with approximately 70% of MAM and 30% of SAM cases among this new RUTF target.Conclusions This empirical evidence suggests that adoption of “expanded MUAC-only” programs would likely lead to a priori exclusion from treatment or misclassifying as MAM a large proportion of SAM cases, while redirecting programmatic costs in favor of those less in need. It underscores the need to explore other options for improving the impact of programs addressing the needs of acutely malnourished children.
Time To Recovery From Moderate Acute Malnutrition And Its Predictors Among 6-59 Months Children Targeted For Supplementary Feeding In Shalla District, West Arsi Zone, Ethiopia, 2018.
Authors: Sadeta Kebede Kumsa , silassie Wondwosen Tekle
Published: October 2019

Abstract Background-Globally, acute malnutrition accounts for >50% cases of childhood mortality in under 5 children each year. Moderate acute malnutrition treatment would be to reduce child mortality and morbidity. Study done in Ethiopia showed treatment food share, lack of water and other factor suggested to cause lower chance of recovery at end of 16 week as per Ethiopian acute malnutrition treatment guide line. Methods- Retrospective cohort study design was conducted among children aged 6–59 months which were treated in targeted supplementary feeding program. A total of 402 children were selected from eight health posts by systematic random sampling. Data were collected by reviewing registration records and interview from January 1-10/2018. Data were analyzed using SPSS version 20, bivariate and multivariate statistical methods were used to analyze and describe the data and p < 0.05 was considered as significant. Results-the overall average timely recovery was 15 week (SD,3.3). Children treated by super cereal were 2.44 times more likely to recover timely than children treated by corn soybean blend (AHR 2.44; 95% CI 1.85-3.21). Children that had regular follows up has 48% (AHR 1.48; 95% CI 1.09-2.00) more chance of recovery than intermittent treatment follow up, children’s from sever food in secured family had 51% lower chance to recover than moderate food insecured house hold (AHR 0.49; 95% CI 0.21-0.11) and, admission MUAC³11.6 cm had 1.18 times higher proportion of recovery than admission MUAC = 11.5 cm (AHR 1.18; 95% CI 1.13-1.12). Children who have no transport access has 2 times lower proportion of recovery than who have access (AHR 0.5; 95% CI 0.38-0.64). Conclusion- the mean time to recovery was 15 week which is consistent with the national standard 16 weeks. Type of treatment foods, treatment follow up status, and admission mid upper arm circumference had significant association with time recovery moderate acute malnutrition treatment.
Economic costs incurred by the patients with Multiple Sclerosis at different levels of the disease: a cross-sectional study in northwest Iran
Authors: Imani Ali , Gharibi Farid , Khezri Ali , Joudyian Nasrin , Dalal Koustuv
Published: October 2019

Background Multiple sclerosis (MS) causes significant economic burden to the patients, families, health systems and society. This study aimed to estimate the economic costs incurred by patients with multiple sclerosis at different levels of the disease.Method This was a cross-sectional study, using the Expanded Disability Status Scale (EDSS) tool for assessing the disease level of 300 (=N) patients in East Azerbaijan province, Iran. To estimate the cost of MS, a questionnaire with its validity and reliability (CVR 92% and CVI 87%) and pilot test (Cronbach's alpha score 0.89) was used. The data were collected by interviewing patients and reviewing their clinical records. Linear regression and ANOVA were used to assess the relationship between disease levels and incurred costs.Results The results revealed that the mean annual cost for patients is 97,521,740 IRR (equivalent to 2,321.94 USD) and the mean score of EDSS in patients was 3.14. The annual cost incurred by patients with mild, moderate and severe levels of disease were 83,918,150 IRR (998.05 USD), 137,772,660 IRR (3,280.30 USD) and 119,962,670 IRR (2,856.25 USD) respectively. Also, there was a significant relationship between total cost and disease severity in such a way that any increase in EDSS degree is led to 8,139,260 IRR (193.79 USD) added cost for patients.Conclusion The study results could be helpful for Iranian health managers to solve problems which are facing patients and their families.
Role of regulatory T-cells on ischemic stroke outcome: new clinical evidences
Authors: Santamaría-Cadavid María , Rodríguez-Castro Emilio , Rodríguez-Yáñez Manuel , Arias-Rivas Susana , López-Dequidt Iria , Pérez-Mato María , Rodríguez-Pérez Manuel , López-Loureiro Ignacio , Hervella Pablo , Campos Francisco , Castillo José , Iglesias-Rey Ramón , Sobrino Tomás
Published: October 2019

Background: Recent preclinical studies have shown that regulatory T (Treg) cells play a key role in the immune response after ischemic stroke (IS). However, the role of Treg-cells in human acute IS has been poorly investigated. Our aim was to study the relationship between circulating Treg-cells and outcome in human IS patients.Methods Methods: A total of 204 IS patients and 22 control subjects were recruited. The main study variable was good functional outcome at 3 months (modified Rankin scale ≤2) considering infarct volume, Early Neurological Deterioration (END) and risk of infections as secondary variables. The percentage of circulating Treg-cells was measured at admission, 48, 72h and at day 7 after stroke onset.Results Results: Circulating Treg-cell levels were higher in IS patients compared to control subjects. Treg-cells at 48h were independently associated with good functional outcome (OR, 3.5; CI: 1.9-7.8) after adjusting by confounding factors. Patients with lower Treg-cells at 48h showed higher frequency of END and risk of infections. In addition, a negative correlation was found between circulating Treg-cells at 48h (r=-0.414) and 72h (r=-0.418) and infarct volume. Conclusions: These findings suggest that Treg-cells may participate in the recovery of IS patients. Therefore, Treg-cells may be considered a potential therapeutic target in acute ischemic stroke.
Cardiovascular dysautonomia and cognitive impairment in Lewy body disease
Authors: Oka Hisayoshi , Umehara Tadashi , Nakahara Atsuo , Matsuno Hiromasa
Published: October 2019

Background Cognitive impairment may be correlated with cardiovascular dysautonomia, including blood pressure (BP) dysregulation, in Parkinson’s disease (PD), but the association between these factors in dementia with Lewy bodies (DLB) is uncertain. This study aimed to clarify whether cardiovascular dysautonomia had an influence on cognitive function in Lewy body disease or not. Methods 99 patients with de novo PD (n=75) and DLB (n=24) were evaluated using the Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Cardiac 123I-metaiodobenzylguanidine (MIBG) scintigraphy, orthostatic hypotension (OH), supine hypertension (SH), postprandial hypotension (PPH), nocturnal BP fall in 24-hour ambulatory blood pressure monitoring (ABPM) and constipation were estimated. Associations of these factors with cognitive and executive dysfunction were examined. Results In DLB, MIBG uptake was reduced and OH, PPH and SH were severely disturbed, compared to PD. The nocturnal BP fall in ABPM was lower in DLB, and the failure of nocturnal BP fall in PD was associated with MMSE, after adjustment for other clinical features. FAB was significantly associated nocturnal BP fall, age and SH in PD, but no significant correlations among factors were found for DLB. Conclusion The significant association between nocturnal BP dysregulation and cognitive or executive decline in PD might be due to impaired microvascular circulation or invasion of α-synuclein in the CNS. The lack of a correlation of BP insufficiency with cognitive impairment in DLB suggests initial involvement of Lewy body pathology in the neocortex, regardless of Lewy body invasion of the autonomic nervous system.
The Development of a Return to Work Intervention Programme for Stroke Survivor (SReTWIP): A Delphi Survey
Authors: Olaoye Olumide Ayoola , Soeker Shaheed Moghammad , Rhoda Anthea
Published: October 2019

Background Even though clearly defined pathways for vocational re-entry are well recognized for conditions such as mental health, musculoskeletal dysfunction and traumatic brain injury, none has been identified for stroke as there have been a lack of consensus regarding such clear pathways to vocational re-entry and the essential contents of RTW interventions for stroke survivors. As part of a larger study aimed to design a RTW programme for stroke survivors, this study described the concluding process through which Stroke Return to Work Intervention Programme (SReTWIP) was developed.Methods Experts in the field of neurorehabilitation and vocational rehabilitation (VR) from 6 countries participated in a 3-round Delphi survey by e-mail to design a RTW programme for stroke survivor. Concept mapping was used to triangulate findings from the Delphi with previous phases of the larger study. Content thematic analysis was conducted on quantitative data while descriptive statistic was used to analyse quantitative data.Results Fifteen experts with a mean age of 44.73±9.48 years and mean duration of practice of 18.26±8.71 years responded to this study. The developed RTW programme, SReTWIP, is a 12 week programme that consisted of four interconnected phases of intervention: an assessment phase, clinic-based work and non-work specific intervention phase, a work test placement phase and a client full participation in worker role phase. The panelist generally agreed on a set of implementation strategies that involve the use of interdisciplinary team, the tailoring of intervention to meet stroke survivor’s needs, as well as the use of case management approach.Conclusion The SReTWIP is the first step in developing a VR pathway that could ultimately enhance the RTW rates and quick resumption of the worker role of stroke survivors. The stroke survivor can move along the different phases of the SReTWIP after achieving competency in a preceding phase. Future work will include a feasibility study with other key stakeholders involved in RTW such as employers, informal caregivers and the stroke survivors before its implementation.
Basic Characterization of Plant Actin Depolymerizing Factors: A Simplified, Streamlined Guide
Authors: Sengupta Sonali , Rajasekaran Kanniah , Baisakh Niranjan
Published: October 2019

Actin depolymerizing factors (ADFs) are small monomeric actin-binding proteins that alter the oligomeric state of cellular actin. Members of the ADF family can bind both the G-actin and F-actin in plants, and their functions are regulated by cellular pH, ionic strength and availability of other binding partners. Actin depolymerization activity is reportedly essential for plant viability. By binding to the ADP-bound form of actin, ADFs severe actin filaments and thereby provide more barbed filament ends for polymerization. They also increase the rate of dissociation of F-actin monomer by changing the helical twist of the actin filament. These two activities together make ADF the major regulator of actin dynamics in plant cell. Therefore, it is essential to measure the binding and depolymerization activity of the plant ADFs. Here, we present a simplified, streamlined step-by-step protocol to quickly measure these important functions of the ADF proteins in vitro.
The influences of Morphine or Ketamine pre-treatment on hemodynamic, acid-base status, biochemical markers of brain damage and early survival in rats after asphyxial cardiac arrest
Authors: Kuklin Vladimir , Akhatov Nurlan , Kondratiev Timofei , Konkayev Aidos , Baigenzhin Abai , Konkayeva Maiya , Karibekov Temirlan , Barlow Nicholas , Tveita Torkjel , Dahl Vegard
Published: October 2019

Background : In different models of hypoxia, blockade of opioid or N-methyl-D-aspartate (NMDA) receptors shows cardio- and neuroprotective effects with a consequent increase in animal survival. The aim of the study was to investigate effects of pre-treatment with Morphine or Ketamine on hemodynamic, acid-base status, early survival, and biochemical markers of brain damage in a rat model of asphyxial cardiac arrest (ACA).
Methods: Under anaesthesia with Thiopental Sodium 60 mg/kg, i.p., Wistar rats (n=42) were tracheostomized and catheters were inserted in a femoral vein and artery. After randomization, the rats were pre-treated with: Morphine 5 mg/kg i.v. (n=14); Ketamine 40 mg/kg iv (n=14); or equal volume of i.v. NaCl 0.9% as a Control (n=14). ACA was induced by corking of tracheal tube for 8 min, and defined as a mean arterial pressure (MAP) < 20 mmHg. Resuscitation was started at 5 min after cardiac arrest (CA). Invasive MAP was recorded during experiments. Arterial pH and blood gases were sampled at baseline (BL) and 10 min after CA. At the end of experiments, all surviving rats were euthanised, brain and blood samples for measurement of Neuron Specific Enolase (NSE), s100 calcium binding protein B (s100B) and Caspase-3 (CS-3) were retrieved.
Results: At BL no differences between groups were found in hemodynamic or acid-base status. After 3 min of asphyxia, all animals had ()cardiac arrest (MAP < 20 mm Hg). Return of spontaneous circulation (MAP > 60 mmHg) was achieved in all animals within 3 min after CA. At the end of the experiment, the Ketamine pre-treated group had increased survival (13 of 14; 93%) compared to the Control (7 of 14; 50%) and Morphine (10 of 14; 72%) groups ( p=0.035). Biochemical analysis of plasma concentration of NSE and s100B as well as an analysis of CS-3 levels in the brain tissue did not reveal any differences between the study groups.
Conclusion: In rats after ACA, pre-treatment with Morphine or Ketamine did not have any significant influence on hemodynamic and biochemical markers of brain damage. However, significantly better pH level and increased early survival were found in the Ketamine pre-treated group.
A systematic review identifying common data items in neonatal trials and assessing their completeness in routinely recorded United Kingdom national neonatal data
Authors: Jawad Sena , Modi Neena , Prevost A Toby , Gale Chris
Published: October 2019

Background
We aimed to test whether a common set of key data items reported across high impact neonatal clinical trials could be identified, and to quantify their completeness in routinely recorded United Kingdom neonatal data held in the National Neonatal Research Database (NNRD).
Methods
We systematically reviewed neonatal clinical trials published in four high impact medical journals over 10 years (2006-2015) and extracted baseline characteristics, stratification items, and potential confounders used to adjust primary outcomes. Completeness was examined using data held in the NNRD for identified data items, for infants admitted to neonatal units in 2015. The NNRD is a repository of routinely recorded data extracted from neonatal Electronic Patient Records (EPR) of all admissions to National Health Service (NHS) Neonatal Units in England, Wales and Scotland. We defined missing data as an empty field or an implausible value. We reported common data items as frequencies and percentages alongside percentages of completeness.
Results
We identified 44 studies involving 32,095 infants and 126 data items. Fourteen data items were reported by more than 20% of studies. Gestational age (95%), sex (93%) and birth weight (91%) were the most common baseline data items. The completeness of data in the NNRD was high for these data with greater than 90% completeness found for 9 of the 14 most common items.
Conclusion
High impact neonatal clinical trials share common data items. In the United Kingdom, these items can be obtained at a high level of completeness from routinely recorded data held in the NNRD. The feasibility and efficiency using routinely recorded EPR data, such as that held in the NNRD, for clinical trials, rather than collecting these items anew, should be examined.
Registration
PROSPERO registration number CRD42016046138, registered prospectively 17 th August 2016