bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the reasons why women prefer to give birth at home in rural northern Ghana: a qualitative study
Authors: Adatara Peter , Strumpher Johanita , Ricks Esmeralda
Published: August 2020

Background

Skilled birth care during childbirth is reported in the literature as one critical strategy for reducing maternal morbidity and mortality. Despite the importance of birth care provided by skilled birth attendants, women in rural areas of northern Ghana still give birth utilising the birth services provided by Traditional Birth Attendants. The aim of this study,therefore, was to explore and describe the reasons why a small group of rural women chose homebirth in rural northern Ghana.

Methods

A qualitative approach was adopted to explore the reasons why women prefer to deliver at home in rural areas of northern Ghana. Individual interviews were used to obtain a full description of factors and experiences of women associated with home births in rural areas in Ghana. The research population consisted of 10 women who utilised birth care services provided by Traditional Birth Attendants in a rural community of northern Ghana. Data collected from the interviews were transcribed verbatim and analysed to identify themes.

Results

This study, which was conducted among a small group of women, yielded interesting results on why these women still give birth at home in rural northern Ghana. It was found out that perceived poor quality of care and conduct of skilled birth attendants; the perception that women received better care from Traditional Birth Attendants; financial constraints and lack of access to healthcare facilities in the rural areas by these women accounted for majority of the reasons why women in rural northern Ghana still give birth at home.

Conclusion

The study highlighted some barriers experienced by participants to the utilisation of birth care services provided by skilled birth attendants in rural northern Ghana. Management of healthcare facilities should facilitate the implementation of supportive supervision in the maternity units to improve the quality of care and attitude delivered by skilled birth attendants in maternity care in rural communities.
Parental occupational exposure to pesticides and risk of childhood cancer in Switzerland: a census-based cohort study
Authors: Coste Astrid , Bailey Helen D. , Kartal-Kaess Mutlu , Renella Raffaele , Berthet Aurélie , Spycher Ben D.
Published: August 2020

Background

Pesticide exposure is a suspected risk factor for childhood cancer. We investigated the risk of developing childhood cancer in relation to parental occupational exposure to pesticides in Switzerland for the period 1990–2015.

Methods

From a nationwide census-based cohort study in Switzerland, we included children aged < 16 years at national censuses of 1990 and 2000 and followed them until 2015. We extracted parental occupations reported at the census closest to the birth year of the child and estimated exposure to pesticides using a job exposure matrix. Cox proportional hazards models, adjusted for potential confounders, were fitted for the following outcomes: any cancer, leukaemia, central nervous system tumours (CNST), lymphoma, non-CNS solid tumours.

Results

Analyses of maternal (paternal) exposure were based on approximately 15.9 (15.1) million-person years at risk and included 1891 (1808) cases of cancer, of which 532 (503) were leukaemia, 348 (337) lymphomas, 423 (399) CNST, and 588 (569) non-CNS solid tumours. The prevalence of high likelihood of exposure was 2.9% for mothers and 6.7% for fathers. No evidence of an association was found with maternal or paternal exposure for any of the outcomes, except for “non-CNS solid tumours” (High versus None; Father: adjusted HR [95%CI] =1.84 [1.31–2.58]; Mother: 1.79 [1.13–2.84]). No evidence of an association was found for main subtypes of leukaemia and lymphoma. A post-hoc analysis on frequent subtypes of “non-CNS solid tumours” showed positive associations with wide CIs for some cancers.

Conclusion

Our study suggests an increased risk for solid tumours other than in the CNS among children whose parents were occupationally exposed to pesticides; however, the small numbers of cases limited a closer investigation of cancer subtypes. Better exposure assessment and pooled studies are needed to further explore a possible link between specific childhood cancers types and parental occupational exposure to pesticides.
Effects of exercise combined with whole body vibration in patients with patellofemoral pain syndrome: a randomised-controlled clinical trial
Authors: Yañez-Álvarez Angel , Bermúdez-Pulgarín Beatriz , Hernández-Sánchez Sergio , Albornoz-Cabello Manuel
Published: August 2020

Background

Patellofemoral pain is a prevalent condition in the general population, especially in women, and produces functional impairment in patients. Therapeutic exercise is considered an essential part of the conservative management. The use of vibration platforms may help improve strength and function and reduce pain in patients with knee disorders. The aim of this investigation was to determine the effects of adding whole body vibration (vertical, vibration frequency of 40 Hz, with an amplitude from 2 to 4 mm) to an exercise protocol for pain and disability in adults with patellofemoral pain.

Methods

A randomised clinical trial was designed, where 50 subjects were randomly distributed into either an exercise group plus whole body vibration or a control group. Pain, knee function (self-reported questionnaire) and range of motion and lower limb functionality were assessed at baseline and at 4 weeks. The experimental group performed 12 supervised sessions of hip, knee and core strengthening exercises on a vibration platform 3 times per week during 4 weeks. The control group followed the same protocol but without vibration stimuli. Differences in outcome measures were explored using an analysis of the variance of 2 repeated measures. Effect sizes were estimated using Square Eta (η2). Significant level was set al P < 0.05.

Results

Statistically significant differences were found after intervention in favour of the experimental group in the between-groups comparison and in the interaction of the experimental group before and after treatment in terms of pain perception (P = 0.000; η2 = 0.63) and function outcomes scores (P = 0.000; η2 0.39 and 0.51 for lower limb functional scale and Kujala scores respectively).

Conclusion

A 4-week whole body vibration exercise programme reduces pain level intensity and improves lower limb functionality in patellofemoral pain patients and is more effective than exercise alone in improving pain and function in the short-term.

Trial registration

ClinicalTrials.gov (NCT04031248). This study was prospectively registered on the 24th July, 2019.
Falls prevention interventions for community-dwelling older people living in mainland China: a narrative systematic review
Authors: Ye Pengpeng , Liu Yishu , Zhang Jing , Peng Ke , Pan Xuru , Shen Yang , Xiao Shaoming , Armstrong Elizabeth , Er Yuliang , Duan Leilei , Ivers Rebecca , Keay Lisa , Tian Maoyi
Published: August 2020

Background

Falls in community-dwelling older people have been recognised as a significant public health issue in China given the rapidly growing aged population. Although there are several reviews documenting falls prevention programs for community-dwelling older adults, no systematic reviews of the scope and quality of falls prevention interventions in Mainland China exist. Therefore, the aim of this study was to systematically review falls prevention interventions for community-dwelling older people living in Mainland China.

Methods

We systematically reviewed literature from Chinese and English databases. All types of randomised controlled trials (RCTs) and quasi-experimental studies published from 1st January 1990 to 30th September 2019 were included. Observational studies and studies in care facilities and hospitals were excluded. Narrative synthesis was performed to summarise the key features of all included studies. Quality assessment was conducted using the Cochrane Risk of Bias Tool and ROBINS-I tool for randomised and non-randomised studies respectively.

Results

A total of 1020 studies were found, and 101 studies were included in the analysis. Overall, very few high quality studies were identified, and there was insufficient rigor to generate reliable evidence on the effectiveness of interventions or their scalability. Most interventions were multiple component interventions, and most studies focused on outcomes such as self-reported falls incidence or awareness of falls prevention.

Conclusion

There is an opportunity to undertake an evaluation of a rigorously-designed, large-scale falls prevention program for community-dwelling older people in Mainland China. To help mitigate the rising burden of falls in Mainland China, recommendations for future falls prevention interventions have been made. These include: (1) target disadvantaged populations; (2) incorporate personalised interventions; and (3) investigate the effectiveness of those under-explored interventions, such as psychological, social environment, management of urinary incontinence, fluid or nutrition therapy and surgery. The study results will also potentially provide a useful evidence base for other low-and-middle income countries in a similar situation.
Analysis of the effect of serious illness medical insurance on relieving the economic burden of rural residents in China: a case study in Jinzhai County
Authors: Li Yang , Duan Guangfeng , Xiong Linping
Published: August 2020

Background

In 2003, China established a New Rural Cooperative Medical System (NRCMS) for rural residents to alleviate the burden of medical expenses among rural residents. However, its reimbursement for high medical costs was insufficient. Therefore, China gradually established the Serious Illness Insurance System (SIMIS) based on NRCMS. After receiving payment through NRCMS, patients in rural areas who met the requirements of SIMIS policy would receive a second payment for their high medical expenses. This study aimed to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County.

Methods

The study used the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province, from 2013 to 2016. We adopted descriptive and regression discontinuity (RD) methods to analyze the payment effect of SIMIS. The RD analysis targeted patients (n = 7353) whose annual serious illness expenses were between CNY 10,000 (1414 USD) and CNY 30,000 (4242 USD), whereas the descriptive analysis was used for data of the patients compensated by SIMIS (n = 2720).

Results

The results of RD showed that the actual medical insurance payment proportion increased by about 2.5% (lwald = 0.025, P < 0.01), inside medical insurance self-payment proportion increased by about 2% (lwald = 0.020, P < 0.10), and outside medical insurance self-payment proportion decreased by about 1.6% (lwald = − 0.016, P < 0.05). The descriptive results showed that patients with serious illnesses mostly chose to go to a hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out-of-pocket medical expenses were still high.

Conclusion

The medical technology level of Jinzhai County could not meet the needs of patients with seriously illnesses, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of the rural residents was insufficient. The high out-of-pocket expenses increased the possibility that only people with good economic conditions could benefit from the reimbursement of SIMIS, resulting in inequity.
The burden of laboratory-confirmed pertussis in low- and middle-income countries since the inception of the Expanded Programme on Immunisation (EPI) in 1974: a systematic review and meta-analysis
Authors: Muloiwa Rudzani , Kagina Benjamin M. , Engel Mark E. , Hussey Gregory D.
Published: August 2020

Background

An effective vaccine againstBordetella pertussiswas introduced into the Expanded Programme on Immunisation (EPI) by WHO in 1974, leading to a substantial global reduction in pertussis morbidity and mortality. In low- and middle-income countries (LMICs), however, the epidemiology of pertussis remains largely unknown. This impacts negatively on pertussis control strategies in these countries. This study aimed to systematically and comprehensively review published literature on the burden of laboratory-confirmed pertussis in LMICs over the 45 years of EPI.

Methods

Electronic databases were searched for relevant literature (1974 to December 2018) using common and MeSH terms for pertussis. Studies using PCR, culture or paired serology to confirmBordetella pertussisandparapertussisin symptomatic individuals were included if they had clearly defined numerators and denominators to determine prevalence and mortality rates.

Results

Eighty-two studies (49,167 participants) made the inclusion criteria. All six WHO regions were represented with most of the studies published after 2010 and involving mainly upper middle-income countries (n = 63; 77%). PCR was the main diagnostic test after the year 2000.

The overall median point prevalence of PCR-confirmedBordetella pertussiswas 11% (interquartile range (IQR), 5–27%), while culture-confirmed was 3% (IQR 1–9%) and paired serology a median of 17% (IQR 3–23%) over the period. On average, culture underestimated prevalence by 85% (RR = 0.15, 95% CI, 0.10–0.22) compared to PCR in the same studies.

Risk of pertussis increased with HIV exposure [RR, 1.4 (95% CI, 1.0–2.0)] and infection [RR, 2.4 (95% CI, 1.1–5.1)]. HIV infection and exposure were also related to higher pertussis incidences, higher rates of hospitalisation and pertussis-related deaths.

Pertussis mortality and case fatality rates were 0.8% (95% CI, 0.4–1.4%) and 6.5% (95% CI, 4.0–9.5%), respectively. Most deaths occurred in infants less than 6 months of age.

Conclusions

Despite the widespread use of pertussis vaccines, the prevalence of pertussis remains high in LMIC over the last three decades. There is a need to increase access to PCR-based diagnostic confirmation in order to improve surveillance. Disease control measures in LMICs must take into account the persistent significant infant mortality and increased disease burden associated with HIV infection and exposure.
Understanding long-term HIV survivorship among African American/Black and Latinx persons living with HIV in the United States: a qualitative exploration through the lens of symbolic violence
Authors: Freeman Robert , Gwadz Marya , Wilton Leo , Collins Linda M. , Dorsen Caroline , Hawkins Robert L. , Silverman Elizabeth , Martinez Belkis Y. , Leonard Noelle R. , Applegate Amanda , Cluesman Sabrina
Published: August 2020

Background

Persons living with HIV (PLWH) are living longer, although racial/ethnic and socioeconomic status (SES) disparities persist. Yet, little is known about the experience of living with and managing HIV over decades. The present study took a qualitative approach and used the lens of symbolic violence, a type of internalized, non-physical violence manifested in the power differential between social groups. We focused on adult African American/Black and Latinx (AABL) PLWH from low-SES backgrounds.

Methods

Data were drawn from two studies with AABL PLWH in New York City (N = 59). After providing signed informed consent, participants engaged in in-depth semi-structured interviews on aspects of HIV management. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using directed qualitative content analysis.

Results

Participants in the two studies were comparable on sociodemographic and background characteristics. They had lived with HIV for 20 years, on average (range 3–33 years). All were from low-SES backgrounds and most were African American/Black and men. Participants experienced a convergence of multiple social exclusions, harms, and stigmas, consistent with symbolic violence, which contributed to disengagement from HIV care and discontinuation of HIV medications. We organized results into five sub-themes: (1) participants were “ground down” over time by material, social, and emotional challenges and this diminished self-worth and, at times, the will to live; (2) social isolation and self-isolation, based in part on feeling devalued and dehumanized, served as stigma-avoidance strategies and mechanisms of social exclusion; (3) stigmatizing aspects of patient-provider interactions, both experienced and anticipated, along with (4) restricted autonomy in HIV care and other settings (e.g., parole) reduced engagement; and (5) poor HIV management was internalized as a personal failure. Importantly, resilience was evident throughout the five sub-themes.

Conclusions

Symbolic violence is a useful framework for understanding long-term HIV management and survivorship among AABL PLWH from low-SES backgrounds. Indeed, forms of symbolic violence are internalized over time (e.g., experiencing devaluation, dehumanization, loss of self-worth, and anticipated stigma), thereby impeding successful HIV management, in part because avoiding HIV care and discontinuing HIV medications are primary coping strategies. Results have implications for interventions in community and health care settings.
Characterizing street-connected children and youths’ social and health inequities in Kenya: a qualitative study
Authors: Embleton L. , Shah P. , Gayapersad A. , Kiptui R. , Ayuku D. , Braitstein P.
Published: August 2020

Background

Street-connected children and youth (SCY) in Kenya disproportionately experience preventable morbidities and premature mortality. We theorize these health inequities are socially produced and result from systemic discrimination and a lack of human rights attainment. Therefore, we sought to identify and understand how SCY’s social and health inequities in Kenya are produced, maintained, and shaped by structural and social determinants of health using the WHO conceptual framework on social determinants of health (SDH) and the Convention on the Rights of the Child (CRC) General Comment no. 17.

Methods

This qualitative study was conducted from May 2017 to September 2018 using multiple methods including focus group discussions, in-depth interviews, archival review of newspaper articles, and analysis of a government policy document. We purposively sampled 100 participants including community leaders, government officials, vendors, police officers, general community residents, parents of SCY, and stakeholders in 5 counties across Kenya to participate in focus group discussions and in-depth interviews. We conducted a thematic analysis situated in the conceptual framework on SDH and the CRC.

Results

Our findings indicate that SCY’s social and health disparities arise as a result of structural and social determinants stemming from a socioeconomic and political environment that produces systemic discrimination, breaches human rights, and influences their unequal socioeconomic position in society. These social determinants influence SCY’s intermediary determinants of health resulting in a lack of basic material needs, being precariously housed or homeless, engaging in substance use and misuse, and experiencing several psychosocial stressors, all of which shape health outcomes and equity for this population.

Conclusions

SCY in Kenya experience social and health inequities that are avoidable and unjust. These social and health disparities arise as a result of structural and social determinants of health inequities stemming from the socioeconomic and political context in Kenya that produces systemic discrimination and influences SCYs’ unequal socioeconomic position in society. Remedial action to reverse human rights contraventions and to advance health equity through action on SDH for SCY in Kenya is urgently needed.
Relation between FCGRIIB rs1050501 and HSV-1 specific IgG antibodies in Alzheimer’s disease
Authors: Costa Andrea Saul , Agostini Simone , Guerini Franca Rosa , Mancuso Roberta , Clerici Mario , Pandey Janardan P.
Published: August 2020

Background

Alzheimer’s Disease (AD) is a chronic neurodegenerative disorder characterized by extracellular plaques, intracellular neurofibrillary tangles and neuronal loss in the central nervous system (CNS). Pathogens are suspected to have a role in the development of AD; herpes simplex virus type 1 (HSV-1), in particular, is suggested to be a risk factor for the disease. The gamma receptor for the Fc portion of IgG molecules (FCGRs) plays a crucial role in regulating immune responses, and among FCGRs, FCGRIIB is endowed with an inhibitory function. Notably, the rs1050501 polymorphism of FCGRIIB gene associates with autoimmune diseases and with neuronal uptake and interneuronal accumulation of amyloid beta in animal AD models.

Methods

Genotype and allelic distribution of ApoE4 and FCGRIIB rs1050501 were evaluated in a case–control population of 225 AD patients, 93 MCI individuals and 201 sex and age matched healthy controls (HC). HSV-1 total IgG titers and IgG subclasses were detected and quantified in a subgroup of the main study population by ELISA.

Results

Genotype and allelic distribution of FCGRIIB was comparable in the study population. HSV-1-specific antibody titers were significantly higher in AD and MCI compared to HC (p < 0.01 for both); IgG3 titers, in particular, were increased in MCI compared to AD (p = 0.04). Analyses of possible correlations between the FCGRIIB rs1050501 genotype polymorphism and IgG subclasses showed that the presence of IgG3 was more frequent in MCI carrying the FCGRIIB TT (94.1%) compared to those carrying the CT genotype (63.6%) (p = 0.03).

Conclusion

Results herein show an association between humoral immune response against HSV-1 and FCGRIIB rs1050501 genetic variation in the first stage of the disease.
Temperature and predator-mediated regulation of plasma cortisol and brain gene expression in juvenile brown trout (Salmo trutta)
Authors: Filipsson Karl , Bergman Eva , Greenberg Larry , Österling Martin , Watz Johan , Erlandsson Ann
Published: August 2020

Background

Temperature affects many aspects of performance in poikilotherms, including how prey respond when encountering predators. Studies of anti-predator responses in fish mainly have focused on behaviour, whereas physiological responses regulated through the hypothalamic-pituitary-interrenal axis have received little attention. We examined plasma cortisol and mRNA levels of stress-related genes in juvenile brown trout (Salmo trutta) at 3 and 8 °C in the presence and absence of a piscivorous fish (burbot,Lota lota).

Results

A redundancy analysis revealed that both water temperature and the presence of the predator explained a significant amount of the observed variation in cortisol and mRNA levels (11.4 and 2.8%, respectively). Trout had higher cortisol levels in the presence than in the absence of the predator. Analyses of individual gene expressions revealed that trout had significantly higher mRNA levels for 11 of the 16 examined genes at 3 than at 8 °C, and for one gene (retinol-binding protein 1), mRNA levels were higher in the presence than in the absence of the predator. Moreover, we found interaction effects between temperature and predator presence for two genes that code for serotonin and glucocorticoid receptors.

Conclusions

Our results suggest that piscivorous fish elicit primary stress responses in juvenile salmonids and that some of these responses may be temperature dependent. In addition, this study emphasizes the strong temperature dependence of primary stress responses in poikilotherms, with possible implications for a warming climate.
Continuous supplementary tactile feedback can be applied (and then removed) to enhance precision manipulation
Authors: Cappello Leonardo , Alghilan Waleed , Gabardi Massimiliano , Leonardis Daniele , Barsotti Michele , Frisoli Antonio , Cipriani Christian
Published: August 2020

Background

Human sensorimotor control of dexterous manipulation relies on afferent sensory signals. Explicit tactile feedback is generally not available to prosthetic hand users, who have to rely on incidental information sources to partly close the control loop, resulting in suboptimal performance and manipulation difficulty. Recent studies on non-invasive supplementary sensory feedback indicated that time-discrete vibrational feedback delivered upon relevant mechanical events outperforms continuous tactile feedback. However, we hypothesize that continuous tactile feedback can be more effective in non-routine manipulation tasks (i.e., tasks where the grip force is modified reactively in response to the sensory feedback due to the unpredictable behavior of the manipulated object, such as picking and holding a virtual fragile object) if delivered to highly sensitive areas. We further hypothesize that this continuous tactile feedback is not necessary during all the duration of the manipulation task, since adaptation occurs.

Methods

We investigated the effectiveness of continuous tactile feedback in precision manipulation, together with a new sensory feedback policy, where the continuous tactile feedback is gradually removed when the grasp reaches a steady state (namely, transient tactile feedback). We carried out an experiment in a virtual-reality setting with custom tactile feedback devices, which can apply continuous pressure and vibrations, attached to the thumb and index finger. We enrolled 24 healthy participants and instructed them to pick and hold a fragile virtual cube without breaking it. We compared their manipulation performance when using four different sensory feedback methods, i.e., no tactile feedback, discrete vibrations, continuous tactile feedback, and transient tactile feedback. The latter consisted of gradually removing the continuous feedback in the static phase of the grasp.

Results

Continuous tactile feedback leads to a significantly larger number of successful trials than discrete vibrational cues and no feedback conditions, yet the gradual removal of the continuous feedback yields to comparable outcomes. Moreover, the participants preferred the continuous stimuli over the vibrational cues and the removal in the static phase did not significantly impact their appreciation of the continuous tactile feedback.

Conclusions

These results advocate for the use of continuous supplementary tactile feedback for fine manipulation control and indicate that it can seamlessly be removed in the static phase of the grasp, possibly due to the mechanism of sensory adaptation. This encourages the development of energy-efficient supplementary feedback devices for prosthetic and telemanipulation applications, where encumbrance and power consumption are burdensome constraints.
Disease burden of chronic hepatitis B and complications in China from 2006 to 2050: an individual-based modeling study
Authors: Zheng Yang , Wu Jie , Ding Cheng , Xu Kaijin , Yang Shigui , Li Lanjuan
Published: August 2020

Background

Chronic hepatitis B has become a major public health problem in China. An accurate depiction of the disease burden has not yet been thoroughly conducted. We aimed to project the disease burden of chronic hepatitis B virus (HBV) infection and related complications by modeling various scenarios.

Method

An individual-based Markov model was used to predict disease burden from 2006 through 2050. We simulated 5 scenarios with different annual incidences, diagnoses and nucleotide analog (NA) treatment rates as well as treatment eligibility, which included a natural history without diagnosis or NA therapy, a base case, a World Health Organization (WHO)-proposed target case and two ideal cases.

Result

The natural history scenario is projected to have the fewest HBsAg losses (27.59 million) and highest number of HBV-related deaths (27.19 million). With improved diagnosis and treatment rates of NA therapy, ideal cases have fewer HBV-related deaths (14.46–14.77 million) than do WHO-proposed cases (15.13 million) and base cases (16.89 million), but the proportion of HBsAg loss is similar among them. With a reduction in new infections, the prevalence of chronic HBV in 2050 is expected to be a minimum of 27.03–27.49 million under WHO and ideal cases.

Conclusion

Ideal scenarios 1 and 2 contribute to the lowest disease burden of HBV and its complications in the future, in which new infection control is more effective than increasing diagnosis, treatment rate and treatment eligibility. However, considering the large existing chronic HBV infected population and the low HBsAg loss rate of NA therapy, it is still difficult to avert the increasing trend of cumulative cirrhosis, DC, HCC, LT, and HBV-related death in all scenarios. If new high-potency drugs are not developed, the disease burden of chronic HBV will remain high in the future.
Medicinal dietary plants of the Yi in Mile, Yunnan, China
Authors: Sun Jingxian , Xiong Yong , Li Yanhong , Yang Qingsong , Chen Yijian , Jiang Mengyuan , Li Yukui , Li Hongrui , Bi Zizhen , Huang Xiangzhong , Lu Shugang
Published: August 2020

Background

The Yi is the largest ethnic group in Yunnan Province (China), with a population of five million. The Yi people tend to live in mountainous areas, and their culture includes a unique dietary system for treating and protecting people against illnesses. Medicinal plants occupy an essential place in the Yi diet because they play a key role in health and the prevention and treatment of diseases. However, few studies have addressed these medicinal dietary plants and their importance in the Yi’s daily lives. The aim of this study was to (1) investigate the medicinal dietary plants used by the Yi in Mile City, (2) document the traditional knowledge held about these plants, (3) identify species with important cultural significance to the Yi in Mile City, and (4) analyze the special preparation methods and consumption habits of these plants.

Methods

Field investigations were performed in six villages in Mile City, Honghe Hani and Yi Autonomous Prefecture, Yunnan, from July 2017 to May 2018. Information was collected using direct observation, semi-structured interviews, key informant interviews, individual discussions, and focus group discussions. The use value (UV) and frequency of utilization index (FUI) of these plants were analyzed. Plant samples and voucher specimens were collected for taxonomic identification.

Results

This study documented 124 species belonging to 62 families and 102 genera. These plants included angiosperms (117 spp.), gymnosperms (3), pteridophytes (2), lichen (1), and fungus (1). The 20 species with the highest UV were noted as being particularly important to the Yi people’s daily life in Mile City. The primary medicinal preparation method for plants recorded in the study was decoction. The most commonly used plant parts were fruits and roots. The most frequently used edible parts were fruits, and the most frequently used medicinal parts were roots. The medicinal parts were used to treat diseases such as rheumatism, edemas, kidney deficiency, spleen deficiency, gastritis, parasites, and so on.

Conclusion

A wide variety of medicinal dietary plants are used by the Yi people in Mile City. Those plants, which have both rich nutritional and medicinal value, occupy an essential part of the Yi dietary and medicine culture. Ethnobotanical surveys of medicinal dietary plants provide a theoretical reference for the conservation and sustainable use of the plant resources and could contribute to the protection of the Yi food culture and traditional medicine in Mile City. In addition, this information provides a sound basis for developing and using Yi ethnic medicine and health products.
Examining the effect of the individual characteristics of implementers and the interaction of multiple relationships on the structure of psychosocial intervention teams
Authors: Ramos-Vidal Ignacio , Palacio Jorge , Villamil Ilse , Uribe Alicia
Published: August 2020

Background

Teams’ structure may undergo modifications due to the individual attributes of actors and collective-level variables. This research aims to understand the effect of extensive experience working in the program and the simultaneous interaction among different relationships in the network structure of a team of implementers. The Psychosocial Care Program for Victims of Conflict is implemented by psychologists, social workers, and community advocates.

Methods

A cross-sectional study was carried out. Multivariate analysis, quadratic assignment procedures, and graphic visualization are used to (a) determine how seniority affects the professionals’ level of centrality in the program and (b) clarify how the interaction among professionals favors new relationships.

Results

Longer-lasting professionals in the program report stronger network bonding, predisposition to work, and information exchange. The nonparametric permutation test indicates an intense association between the information requests submitted and received and between the predisposition to work network and the network of received information requests. The results are discussed to optimize the teams implementing the intervention programs.

Conclusions

Network analysis is a powerfull tool to evaluate program implementation processes. Analyzing the interactions among multiples relationships that emerge between members of multidisciplinary teams allows knowing how certain relationships (e.g., information exchange) triggering other kind of relationships (e.g., users referral). The implementers who have been collaborating in the program for a long time are key informants who can facilitate the process of adaptation of newly incorporated professionals.
Rifampin combination therapy in staphylococcal prosthetic joint infections: a randomized controlled trial
Authors: Karlsen Øystein Espeland , Borgen Pål , Bragnes Bjørn , Figved Wender , Grøgaard Bjarne , Rydinge Jonas , Sandberg Lars , Snorrason Finnur , Wangen Helge , Witsøe Eivind , Westberg Marianne
Published: August 2020

Background

The evidence supporting rifampin combination therapy in prosthetic joint infections (PJI) is limited due to the lack of controlled studies. The aim of this study is to evaluate the effect of adding rifampin to conventional antimicrobial therapy in early staphylococcal PJIs treated with debridement and retention of the implant (DAIR).

Methods

In this multicenter randomized controlled trial, 99 patients with PJI after hip and knee arthroplasties were enrolled. They were randomly assigned to receive rifampin or not in addition to standard antimicrobial treatment with cloxacillin or vancomycin in case of methicillin resistance. The primary endpoint was no signs of infection after 2 years of follow-up.

Results

Forty-eight patients were included in the final analyses. There were no differences in patient characteristics or comorbidities between the two groups. There was no significant difference in remission rate between the rifampin combination group (17 of 23 (74%)) and the monotherapy group (18 of 25 (72%), relative risk 1.03, 95% confidence interval 0.73 to 1.45, p = 0.88).

Conclusion

This trial has not proven a statistically significant advantage by adding rifampin to standard antibiotic treatment in acute staphylococcal PJIs.

Trial registration

The Regional Ethics Committee and the Norwegian Medicines Agency approved the study (EudraCT 2005-005494-29), and the study was registered at ClinicalTrials.gov at Jan 18, 2007 (NCT00423982).
Preoperative identification of clinicopathological prognostic factors for relapse-free survival in clinical N1 non-small cell lung cancer: a retrospective single center-based study
Authors: Aragaki Masato , Kato Tatsuya , Fujiwara-Kuroda Aki , Hida Yasuhiro , Kaga Kichizo , Wakasa Satoru
Published: August 2020

Background

Given the difficulty in preoperatively diagnosing lymph node metastasis, patients with Stage I–III non-small cell lung cancer (NSCLC) are likely to be included in the clinical N1 (cN1) group. However, better treatment options might be selected through further stratification. This study aimed to identify preoperative clinicopathological prognostic and stratification factors for patients with cN1 NSCLC.

Methods

This retrospective study evaluated 60 patients who were diagnosed with NSCLC during 2004–2014. Clinical nodal status had been evaluated using routine chest computed tomography (CT) and/or positron emission tomography (PET). To avoid biasing the fluorodeoxyglucose uptake values based on inter-institution or inter-model differences, we used only two PET systems (one PET system and one PET/CT system). Relapse-free survival (RFS) and overall survival (OS) were the primary study outcomes. The maximum standardized uptake value (SUVmax) was calculated for each tumor and categorized as low or high based on the median value. Patient sex, age, histology, tumor size, and tumor markers were also assessed.

Results

Poor OS was associated with older age (P = 0.0159) and high SUVmax values (P = 0.0142). Poor RFS was associated with positive carcinoembryonic antigen (CEA) expression (P = 0.0035) and high SUVmax values (P = 0.015). Multivariate analyses confirmed that poor OS was independently predicted by older age (hazard ratio [HR] = 2.751, confidence interval [CI]: 1.300–5.822; P = 0.0081) and high SUVmax values (HR = 5.121, 95% CI: 1.759–14.910; P = 0.0027). Furthermore, poor RFS was independently predicted by positive CEA expression (HR = 2.376, 95% CI: 1.056–5.348; P = 0.0366) and high SUVmax values (HR = 2.789, 95% CI: 1.042–7.458; P = 0.0410). The primary tumor’s SUVmax value was also an independent prognostic factor for both OS and RFS.

Conclusions

For patients with cN1 NSCLC, preoperative prognosis and stratification might be performed based on CEA expression, age, and the primary tumor’s SUVmax value. To enhance the prognostic value of the primary tumor’s SUVmax value, minimizing bias between facilities and models could lead to a more accurate prognostication.
Application value of NIPT for uncommon fetal chromosomal abnormalities
Authors: Yin Lianli , Tang Yinghua , Lu Qing , Pan Aiping , Shi Mingfang
Published: August 2020

Objective

To investigate the clinical value of noninvasive prenatal testing (NIPT) for fetal chromosomal deletion, duplication, and sex chromosome abnormalities.

Methods

The study included 6239 pregnant women with singletons in the first and second trimester of pregnancy who received NIPT from December 2017 to June 2019. For pregnant women at high risk of deletion, duplication, and sex chromosome abnormalities indicated by NIPT, amniocentesis was recommended for karyotype analysis and chromosome copy number variation detection to verify the NIPT results and analyze chromosome abnormalities. Women at low risk and with no other abnormal results continued with their pregnancies.

Results

Among the 6239 pregnant women who received NIPT, there were 15 cases of chromosomal deletion (12 cases confirmed by amniocentesis), 16 cases of chromosomal duplication (9 cases confirmed by amniocentesis), and 17 cases of sex chromosome abnormalities (11 cases confirmed by amniocentesis). Of these cases, 32 were finally confirmed by amniotic fluid cell karyotype analysis. The coincidence rate was 66.7% (32/48). There were no abnormalities found for the remaining low risk pregnant women during follow-up.

Conclusion

NIPT has good application value in predicting fetal chromosomal deletion, duplication, and sex chromosome abnormalities. It can improve the detection rate of fetal chromosomal abnormalities, but further prenatal diagnosis is needed.
Network pharmacology reveals the multiple mechanisms of Xiaochaihu decoction in the treatment of non-alcoholic fatty liver disease
Authors: Hu Qichao , Wei Shizhang , Wen Jianxia , Zhang Wenwen , Jiang Yinxiao , Qu Caiyan , Xiang Junbao , Zhao Yanling , Peng Xi , Ma Xiao
Published: August 2020

Background

Non-alcoholic fatty liver (NAFLD) is a chronic disease worldwide, which poses a huge threat to human health. Xiaochaihu decoction is a well-known traditional Chinese medicine prescription. It has been proven effective in treating NAFLD but its mechanism is still unclear.

Objective

Multiple mechanisms of Xiaochaihu decoction are explored by identifying and connecting potential targets and active ingredients in the treatment of NAFLD.

Methods

Active ingredients and related targets of seven herbs were collected from TCMSP database. The related targets of NAFLD were obtained from Genes cards database, TDD and OMIM database. The intersected targets of disease targets and drug targets were input into STRING database to construct protein-protein interaction network. DAVID database was used for GO enrichment analysis and KEGG enrichment analysis.

Results

After screening and removal of duplicates, a total of 145 active ingredients and 105 potential targets were obtained. PPI network manifested that AKT1, IL6, JUN MAPK8 and STAT3 were the key target proteins. The results of GO enrichment analysis mainly involved cytokine receptor binding, cytokine activity, and heme binding. The results of KEGG analysis suggested that the mechanism mainly involved in AGE-RAGE signaling pathway in diabetic complications, Hepatitis C, fluid shear stress and atherosclerosis. The signaling pathways were further integrated as network manner, including AGE-RAGE signaling pathway in diabetic complications, Fluid shear stress and atherosclerosis, Insulin resistance, HIF-1 signaling pathway, Th17 cell differentiation and IL-17 signaling pathway. The network contained immunity regulation, metabolism regulation and oxidative stress regulation.

Conclusion

Xiaochaihu decoction plays a key role in the treatment of NAFLD with multiple targets and pathways. Immunity regulation, metabolism regulation and oxidative stress regulation consist of the crucial regulation cores in mechanism.

Graphical abstract

Design and workflow of this study
Evaluation of the efficacy and safety of the use of acupuncture for the adjuvant treatment of patients with post-stroke cognitive impairment: protocol for a randomized controlled trial
Authors: Liu Ruijia , Yu Xudong , Wang Jisheng , Liu Ye , Liu Bowen , Li Xinwei , Wang Yue , Cao Tianyu , Yuan Hongwei
Published: August 2020

Background

Post-stroke cognitive impairment (PSCI) is a series of syndromes that meet the diagnostic criteria for cognitive impairment that appear after a stroke. The treatment of PSCI with oral drugs alone is not ideal and has obvious side effects. Therefore, complementary and alternative treatments are needed for patients with insufficient or significant side effects of oral medications. Therefore, we will evaluate the clinical effectiveness and safety of acupuncture in the treatment of PSCI.

Methods/design

In this study, patients will be randomly divided into two groups. Intervention group: acupuncture combined with oral medication. Control group: Western medicine treatment plan. All participants will continue to receive conventional drug treatment. The selection of outcomes will be evaluated by Mini Mental State Examination Scale (MMSE) at week 12. The scale will be conducted by two well-trained reviewers who will conduct joint MMSE inspections on participants. The test time will be selected 3 days before treatment and once 4 weeks after treatment. After the MMSE test, the two raters scored independently, and the average of the two was used as the final score.

Discussion

This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of acupuncture for patients with PSCI.

Trial registration

ClinicalTrials.gov ChiCTR2000029926. Registered on 17 February 2020 http://www.chictr.org.cn/showproj.aspx?proj=49356
Humic-acid-driven escape from eye parasites revealed by RNA-seq and target-specific metabarcoding
Authors: Noreikiene Kristina , Ozerov Mikhail , Ahmad Freed , Kõiv Toomas , Kahar Siim , Gross Riho , Sepp Margot , Pellizzone Antonia , Vesterinen Eero J. , Kisand Veljo , Vasemägi Anti
Published: August 2020

Background

Next generation sequencing (NGS) technologies are extensively used to dissect the molecular mechanisms of host-parasite interactions in human pathogens. However, ecological studies have yet to fully exploit the power of NGS as a rich source for formulating and testing new hypotheses.

Methods

We studied Eurasian perch (Perca fluviatilis) and its eye parasite (Trematoda, Diplostomidae) communities in 14 lakes that differed in humic content in order to explore host-parasite-environment interactions. We hypothesised that high humic content along with low pH would decrease the abundance of the intermediate hosts (gastropods), thus limiting the occurrence of diplostomid parasites in humic lakes. This hypothesis was initially invoked by whole eye RNA-seq data analysis and subsequently tested using PCR-based detection and a novel targeted metabarcoding approach.

Results

Whole eye transcriptome results revealed overexpression of immune-related genes and the presence of eye parasite sequences in RNA-seq data obtained from perch living in clear-water lakes. Both PCR-based and targeted-metabarcoding approach showed that perch from humic lakes were completely free from diplostomid parasites, while the prevalence of eye flukes in clear-water lakes that contain low amounts of humic substances was close to 100%, with the majority of NGS reads assigned toTylodelphys clavata.

Conclusions

High intraspecific diversity ofT. clavataindicates that massively parallel sequencing of naturally pooled samples represents an efficient and powerful strategy for shedding light on cryptic diversity of eye parasites. Our results demonstrate that perch populations in clear-water lakes experience contrasting eye parasite pressure compared to those from humic lakes, which is reflected by prevalent differences in the expression of immune-related genes in the eye. This study highlights the utility of NGS to discover novel host-parasite-environment interactions and provide unprecedented power to characterize the molecular diversity of cryptic parasites.
Impact of COVID-19 pandemic and the lockdown on invasive meningococcal disease
Authors: Taha Muhamed-Kheir , Deghmane Ala-Eddine
Published: August 2020

Objective

Few data are available on the association between SARS-CoV-2 and secondary bacterial infections. Such an association was described for flu and invasive meningococcal disease (IMD). We aimed exploring such a correlation between COVID-19 and IMD as well as the impact of the lockdown on IMD.

Results

We compared IMD cases received at the French National Reference Centre for meningococci and Haemophilus influenzae that are sent as part of the mandatory reporting of IMD. We compared these data during the period 01 January-15 May 2020 to those from the same period in 2018 and 2019. IMD cases that were associated with respiratory presentations significantly increased in 2020 compared to 2018 (P = 0.029) and 2019 (P = 0.002), involved elderly and were due to unusual isolates. However, IMD cases due to hyperinvasive isolates decreased during the lockdown. Enhancing IMD surveillance and anti-meningococcal vaccination in elderly should be addressed.