bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing the Efficacy of Two-Week Therapy With Bismuth Quadruple Versus Levofloxacin Concomitant Regimen for Helicobacter Pylori Infection in Syrian Patients. A Randomized Controlled Trial.
Authors: Alhalabi Marouf Muhammad , Alassi Mohammed Waleed , Cheha Khaled
Published: October 2020

Background: The eradication rate of Helicobacter Pylori infection with standard triple therapy either clarithromycin or levofloxacin has declined due to antimicrobial resistance. The aim of this research was to estimate the eradication rate of bismuth quadruple and levofloxacin concomitant regimens as empirical first-line regimens in a referral hospital in Syria.Settings and Design: an open‑label parallel blind randomized controlled trial.Methods: Researchers randomly assigned naïve patients with H pylori infection with a 1:1 ratio into two groups. We give group A (bismuth subsalicylate 524 mg four times a day, and doxycycline 100 mg tinidazole 500 mg and esomeprazole 20 mg, each twice daily for 14 days). We give group B (levofloxacin 500 mg every day, tinidazole 500 mg, amoxicillin 1000 mg and esomeprazole 20 mg each twice daily for 14 days). Researchers used a computer program to generate randomized numbers. We concealed the sequence in an opaque envelope until the intervention was assigned. medical laboratory doctors were blinded to treatment allocation. Statistical analysis: chi-square test for categorical variables, t-test for continuous data.Results: Researchers allocated seventy-eight patients. Thirty-eight patients completed the follow‑up in bismuth regimen, and thirty-nine patients in concomitant levofloxacin. Thirty patients in the bismuth regimen were cured, the eradication rate was 78.94% according to per-protocol analysis, and 76.92% according to intention‑to‑treat analysis. While in concomitant levofloxacin thirty-two patients were cured, the eradication rate was 82.05% according to intention‑to‑treat analysis (P = 0.780). Researchers didn’t report serious adverse events in both groups. Odds ratio with 95% confidence interval according to the intention‑to‑treat analysis was 1.371 [0.454-4.146]. While the odds ratio with a 95% confidence interval according to per-protocol analysis was 1.22 [0.394-3.774].Conclusions: Both treatment regimens had acceptable eradication rates. Researchers suggest using both regimens as empirical first-line therapy in treating Helicobacter Pylori gastric infection in the Syrian population. No serious adverse events were recorded.Trial registration: Researchers This study was registered as a standard randomized clinical trial (Clinicaltrial.gov, identifier‑NCT04348786, date:29-January-2020, https://clinicaltrials.gov/ct2/show/NCT04348786).
Qualitative Study to Assess the Attitudes and Perception of Employers Towards Employees with Alcohol Use Disorder (AUD): Evidence from an Emerging Economy
Authors: Dordoye Eugene Kobla , Afun Lilian Ama , Alalbila Thelma Mpoku
Published: October 2020

BackgroundThe disease addiction to chemical substances or drugs such as alcohol (ethanol, C2H5OH) is still not recognised by many medical practitioners as a diagnostic nosology in Ghana. It is usually considered a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUDs).MethodA qualitative approach of in-depth interviews and observations which described the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of ten private and public hospitals in the Greater-Accra Metropolis was adopted. The face-to face interviews conducted using a an interview guide were audio-recorded and later transcribed. On average, the interview lasted between 45 and 60 minutes.ResultsFindings from the 10 interviews revealed that psychological factors accounted for AUD regardless of the nature of their work. In spite of prevalence of AUD in some hospitals, it was interesting to know that majority of these facilities had no employee assistance programmes (EAPs) and the few that had some policies on AUD were not implementing them.ConclusionThis paper focused on some aspect of HR managers’ perceived attitude toward an aspect of their mental well-being which is AUD. However, there are other pertinent issues that are crucial to employee total well-being that can be addressed in future research.
Identification of an Independent Immune-Genes Prognostic Index for Breast Cancer
Authors: Rong Deng , yun Yu , chen Lin , Yuxiang Dong , Yitong Pan , Yuhan Zhang , Junyi Wang , chen Chen , Jianing Lu
Published: October 2020

Objective: There are increasing evidences that the immune micro-environment of breast cancer (BC) seriously affects the clinical outcome. This study aims to explore the role of tumor immune genes in the prognosis of BC patients.Methods: We obtained the list of 2498 immune genes from ImmPort database. In addition, we obtained gene expression data and clinical characteristics data of BC patients from the TCGA database. The prognostic correlation of the differential genes was analyzed through Survival package. Cox regression analysis was performed to analyze the prognostic effect of immune genes. According to the regression coefficients of prognostic immune genes in regression analysis, an immune risk scores model was established. Gene set enrichment analysis (GSEA) was performed to probe the biological correlation of immune gene scores. P< 0.05 was considered to be statistically significant. Results: In total, 556 immune genes were differentially expressed in normal tissues and BC tissues (p<0. 05). In univariate cox regression analysis, a total of 66 immune genes were statistically significant for survival risk, of which 30 were associated with overall survival (P<0.05). Through lasso regression analysis, a 15 immune genes risk scores model was established. KM survival analysisrevealed that high immune risk scores represented worse survival (p<0.001). ROC curve indicated that the immune genes risk scores model had good a reliability in predicting prognosis (5-year OS, AUC=0.752). The established risk model showed splendid AUC value in the validation dataset (3-year over survival (OS) AUC=0.685, 5-year OS AUC=0.717, P=0.00048). Moreover, immune risk scoreswere proved to be an independent influencing factor for BC patients. Finally, we found that 15 immune genes and risk scores had significant clinical correlations, and were involved in a variety of carcinogenic pathways.Conclusion:In a word, our study provides a new perspective for the expression of immune genes in BC. In addition, the immune risk scores have considerable advantages in predicting the survival of BC, which ares associated with a variety of oncogenic pathways.
Effectiveness of ketamine-propofol sedation for reducing respiratory adverse events compared to propofol sedation: A Meta-Analysis of randomized controlled trials
Authors: Wen Ting , Chen Shibiao , Zhao Lili , Zhang Yang
Published: October 2020

ObjectiveThe objective of our review was to determine whether ketamine-propofol had an advantage in reducing respiratory adverse events compared to propofol for procedural sedation.MethodsElectronic databases including Web of Science, The Cochrane Library, PubMed, Medline, Embase, Google Scholar were searched to identify potential studies. All randomized controlled studies from their inception to May 2020 comparing ketamine-propofol sedation with propofol sedation were identified. Pooled analysis and subgroup analysis were conducted using Stata software. The quality assessment of all included studies was completed by using the Cochrane Collaboration's tool for assessing risk of bias.ResultsA total of 21 studies involving 3669 individuals were included. The most common respiratory adverse events (all reported per 100 sedations) were: hypoxia(KP 10.9%; P 17.0%), respiratory depression(KP 6.9%; P 14.9%), central apnea(KP 5.9%; P 8.0%). Pooling these 21 studies, subjects with ketamine-propofol had significant lower incidence of respiratory adverse events than those with propofol (RR: 0.55, 95% CI: 0.41–0.74). When stratified by study population, no significant difference was observed in reducing respiratory adverse events between ketamine-propofol sedation and propofol sedation among children (RR: 0.74, 95% CI: 0.46–1.20). However, significant differences were discerned definitely among adults(RR: 0.48, 95% CI: 0.39–0.60).ConclusionIn summary, Our results suggested hypoxia, respiratory depression, central apnea were most common respiratory adverse events in propofol sedation. However, ketamine-propofol sedation had an advantage in reducing the incidence of respiratory adverse events compared with propofol sedation, especially in adults.
Conditional Pten Knockout in Parvalbumin- or Somatostatin-positive Neurons Sufficiently Leads to Autism-related Behavioral Phenotypes
Authors: Shin Sangyep , Santi Andrea , Huang Shiyong
Published: October 2020

Disrupted GABAergic neurons have been extensively described in brain tissues from individuals with autism spectrum disorder (ASD) and animal models for ASD. However, the contribution of these aberrant inhibitory neurons to autism-related behavioral phenotypes is not well understood. We examined ASD-related behaviors in mice with conditional Pten knockout in parvalbumin (PV)-expressing or somatostatin (Sst)-expressing neurons, two common subtypes of GABAergic neurons. We found that mice with deletion of Pten in either PV-neurons or Sstneurons displayed social deficits, repetitive behaviors and impaired motor coordination/learning. In addition, mice with one copy of Pten deletion in PV-neurons exhibited hyperlocomotion in novel open fields and home cages. We also examined anxiety behaviors and found that mice with Pten deletion in Sst-neurons displayed anxiety-like behaviors, while mice with Pten deletion in PV-neurons exhibited anxiolytic-like behaviors. These behavioral assessments demonstrate that Pten knockout in the subtype of inhibitory neurons sufficiently gives rise to ASD-core behaviors, providing evidence that both PV- and Sst-neurons may play a critical role in ASD symptoms.
Development and Validation for Prognostic Nomogram of Epithelial Ovarian Cancer Recurrence based on Circulating Tumor Cells and Epithelial–Mesenchymal Transition : A Prospective Study
Authors: Yang Jiani , Ma Jun , Jin Yue , Cheng Shanshan , Huang Shan , Zhang Nan , Wang Yu
Published: October 2020

BackgroundThe aim was to determine value of circulating tumor cells(CTCs) undergoing epithelial–mesenchymal transition(EMT) in risk stratification of epithelial ovarian cancer(EOC) recurrence.MethodsCTCs were prospectively analyzed among 118 patients with pathological diagnosed EOC from June 2017 to October 2019. We used CanPatrol CTC-enrichment technique to detect CTCs from blood samples and then classify their subpopulations into epithelial, mesenchymal and hybrids. To construct nomogram based on prognostic factors selected by Cox regression analysis, 88 patients were randomly assigned to a training group, and the rest 30 patients were included in external validation group. Risk stratification was performed through Kaplan–Meier survival analysis.ResultsBy multivariate regression screening, both CTC counts(HR, 1.187; 95%CI, 1.098-1.752; p=0.012) and M-CTC(HR, 1.098; 95%CI, 1.047-1.320; p=0.009) were demonstrated as independent prognosis factors for EOC recurrence. Apart from CTCs, other variables including pathological grade, FIGO stage, lymph node metastasis, ascites and CA-125 were also collected(p < 0.005) to construct nomogram. The C-index of the internal and external validation for nomogram was 0.913 and 0.874. The AUC of ROC curves for nomogram with/without CTCs was 0.8705 and 0.8097, taking CTC counts and M-CTC into separation, the values were 0.8075 and 0.8262. Finally, the survival curves of risk stratification based on CTC counts(p=0.0241), M-CTC(p=0.0107), nomogram with(p=0.0021) and without(p=0.0002) CTCs were drawn with significant difference.ConclusionOverall, CTCs could serve as a novel factor for EOC prognosis. Nomogram model constructed by CTC counts, M-CTC and other clinical parameters could predict EOC recurrence and perform risk stratification for clinical decision-making.
Downregulation of NEAT1 sensitizes gemcitabine-resistant pancreatic cancer cells to gemcitabine through modulation of the miR-506-3p/ZEB2/EMT axis
Authors: Fu Xiaowei , Deng Xueqiang , Xiao Weidong , Huang Bo , Yi Xuan , Zou Yeqing
Published: October 2020

BackgroundChemoresistance is a major cause of treatment failure in pancreatic cancer (PC). It has been demonstrated that epithelial-to-mesenchymal transition (EMT) is closely related to drug resistance in PC; however, the underlying mechanisms are not yet fully understood. Recently found evidence has suggested that nuclear-enriched abundant transcript 1 (NEAT1) is involved in the development of chemoresistance. However, the role and mechanism of NEAT1 in PC gemcitabine resistance remain unknown.MethodsTwo independent gemcitabine-resistant (GR) PC cell lines, PANC-1/GR and SW1990/GR, were established. Transwell assays were used to validate whether GR cells acquired EMT. qRT-PCR and western blot were performed to detect the expression levels of NEAT1, miR-506-3p, and ZEB2 in GR cells. MTT and cell apoptosis assays were conducted to evaluate the sensitivity of GR cells to gemcitabine. Rescue experiments were employed to investigate whether NEAT1 mediates drug resistance of GR cells through modulation of the miR-506-3p/ZEB2/EMT axis. Furthermore, a mouse xenograft model was established to confirm these findings.ResultsGR cells displayed markedly enhanced migration and invasion abilities, decreased expression of E-cadherin, and upregulation of N-cadherin, Vimentin, Snail, ZEB1, and ZEB2. Furthermore, elevated expression of NEAT1 was observed in GR cells. Downregulation of NEAT1 sensitized GR cells to gemcitabine. More importantly, we demonstrated that downregulation of NEAT1 enhanced the sensitivity of GR cells to gemcitabine by reversing the EMT process. NEAT1 regulated ZEB2 expression by sponging miR-506-3p, and the function of NEAT1 in GR cells was dependent on miR-506-3p. These findings were further confirmed in a nude mouse xenograft model.ConclusionsTaken together, downregulation of NEAT1 sensitized the GR PC cells to gemcitabine through modulation of the miR-506-3p/ZEB2/EMT axis. These results provide a new direction for improving the chemotherapeutic effects in PC.
Prognostic Validity of the American Joint Committee on Cancer Eighth Edition Staging System for Well-Differentiated Pancreatic Neuroendocrine Tumors: A Retrospective Multinational Multicenter Study
Authors: Wang Hebin , Ding Ding , Qin Tingting , Liu Jun , Zhang Hang , Zhao Junfang , Wu Chien-Hui , Javed Ammar , Wolfgang Christopher , Guo Shiwei , Chen Qinmin , Zhao Weihong , Shi Wei , Zhu Feng , Guo Xingjun , Li Xu , Peng Feng , He Ruizhi , Xu Simiao , Jin Jikuan , Wu Yi , Nuer Abula , Edil Barish , Tien Yu-Wen , Jin Gang , Zheng Lei , He Jin , Liu Jianhua , Liu Yahui , Wang Min , Qin Renyi
Published: October 2020

Background:There is no widely-accepted staging system for pancreatic neuroendocrine tumors (pNETs). The aim of this study was to validate the American Joint Committee on Cancer (AJCC) 8th edition staging system for well-differentiated (G1/G2) pNETs.Methods:A multicenter dataset (n=1086) was used to evaluate the application of the AJCC 7th and 8th, the European Neuroendocrine Tumor Society (ENETS), and the modified ENETS (mENETS) staging systems for well-differentiated pNETs.Results:The proportion of patients with stage III tumors was extremely low (1.1%) according to the AJCC 7th staging system. For the ENETS staging system, patients with stage IIIA disease had worse estimated mean survival than patients with stage IIIB disease (78.9 vs. 107.3 months). When comparing with patients in stage I, the AJCC 7th, ENETS, and mENETS staging systems showed good performance in discriminating between stages; however, there was no significant difference in some stages when the reference was defined as the earlier stage. When the reference was defined as stage I or the earlier stage, there was a significant inter-stage difference in the AJCC 8th staging system.Conclusions:The AJCC 8th staging system is more suitable for pNETs than other TNM staging systems and may be adopted in clinical practice.
The Interaction Relationship Between The Diversification of Health Care Support Activities and The Health Care Services Outreach: Evidence from Microfinance Institutions in Vietnam
Authors: Ha Duong Van , Ha Van Duong , Ha Pham Trong Khang
Published: October 2020

Background: One of the main ways to strengthen the health-system capacity by the intersectoral approaches is to promote social health by linking microfinance with healthcare support activities. The aim of the study was to discover the interaction relationship between the diversification of health care support activities and the health care services outreach of formal microfinance institutions (MFIs) in Vietnam. This study proposes policy measures that could be implemented by the policy makers, managers of MFIs to diversify the health care support activities and to promote the health care services outreach.Methods: This study used the panel data regression method from 2010 to 2019 of all formal MFIs in Vietnam, the study found out the interaction relationship between the diversification of health care support activities and the health care services outreach of formal MFIs in Vietnam.Results: The results showed that number of branches and the health care services outreach had positive relationships with the diversification of health care support activities; productivity had a negative impact on the diversification of health care support activities. The diversification of health care support activities, and productivity had positive relationships with the health care services outreach; number of branches had a negative impact on the health care services outreach. At the same time, this study found bidirectional interactions and the causal relationship between the diversification of health care support activities and the health care services outreach of formal MFIs in Vietnam.Conclusions: This study found bidirectional interactions and the causal relationship between the diversification of health care support activities and the health care services outreach. The study results encourage and provide opportunities to diversify the health care support activities and to promote the health care services outreach of formal MFIs in Vietnam.
Optimized and Non-Optimized Personal Protective Equipment use During the COVID-19 Pandemic in Thailand: A National Cross-Sectional Survey in a Resource-Limited Setting
Authors: Moolasart Visal , Manosuthi Weerawat , Thienthong Varaporn , Jaemsak Uajai , Pantool Pimonamorn , Chottanapund Suthat
Published: October 2020

Background: Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2). COVID-19 is highly contagious, potentially fatal, and a global public health concern. Combining optimized personal protective equipment (PPE) use and hand hygiene is the best strategy for preventing COVID-19 in health care workers (HCWs).Methods: We conducted a national cross-sectional survey of HCWs in the infection control program in Thailand between May 5, 2020 and May 15, 2020. The primary objective was the prevalence of optimized PPE use amongst HCWs. The secondary objective was identification of the independent predictors of optimized PPE use. Results: Seven hundred and fifty-six HCWs responded. Five HCWs were excluded because of non responsible of care team, and 751 were included in the final analysis. The prevalence of optimized PPE use was 22 % (168/751), 78% (583/751) were non-optimized PPE use, 35% (263/751) over-used PPE, and 43% (320/751) under-used PPE. In univariate analysis, optimized PPE use was significantly associated with age, education level, knowledge of appropriate negative pressure room selection and knowledge of apparently milder symptom severity in children than adults. In multivariate analysis, independent predictors of optimized PPE use were knowledge of appropriate negative pressure room selection (aOR=1.95, 95% CI=1.18-3.22) , the difference in symptom severity between children and adults (aOR=0.55, 95% CI=0.37-0.81) and education level (aOR=1.54, 95% CI=1.04-2.27).Conclusion: The prevalence of optimized PPE use amongst HCWs was 22 %. Independent predictors of optimized PPE use were COVID-19 knowledge-based factors and education level.Continued education is advised among Thai HCWs.
Gynaecological health burden among women in the Niger Delta region of Nigeria: A hospital based analysis
Authors: Onyije Felix Monday , Azubuike Ngokere Ajuluchukwu , Ebi Ligha Aloysius , Ovie Avwioro Godwin , Osaro Mgbere
Published: October 2020

BackgroundIncreasingly, residents of the Niger Delta region of Nigeria are reporting health impacts that they believe are linked to environmental pollutions relating to oil and gas activities. Hence, this study aimed to assess the gynaecological health burden among women in the Niger Delta region receiving medical care at the Rivers State University Teaching Hospital (RSUTH) in Port Harcourt, Nigeria. MethodsData used for this study (n=697) were obtained from the RSUTH, Port Harcourt, Nigeria and covered the period between 2010 and 2014. The data were generated from patients who had partial or total hysterectomy or diagnosed of gynaecological lesion between 2010 and 2014. We extracted from the records, age, type of lesions and the origin of the tissue. Data obtained from this study were subjected to both descriptive and inferential statistics. All tests performed were two-tailed, with a probability value of .05 used as the statistical significance level. All statistical analyses were conducted using SAS 9.4 version (SAS Institute, Cary, NC, USA). ResultsThe distribution of the gynaecological lesions differed significantly (p<0.001) by year of diagnosis, developmental stage, age category and types of lesion. Leiomyoma was the highest number of lesions identified (56.0%, n=390), followed by ovarian cyst (10.0%, n=70) and retained product of conception (8.0%, n=56). Women of age group 30-39 years and 40-49 years had the highest number of lesions during the period with a range of 21-71% and 17-34 %, respectively.ConclusionThe preponderance and characteristics of gynaecological lesions in our study sample point to the potential public health consequences, and strong need for creation of awareness campaigns and mass health screenings in the Niger Delta region of Nigeria.
Parkinson Mice Show Functional and Molecular Changes in the Gut Long before Motoric Disease Onset
Authors: Gries Manuela , Christmann Anne , Schulte Steven , Weyland Maximilian , Rommel Stephanie , Martin Monika , Baller Marko , Röth Ralph , Schmitteckert Stefanie , Unger Marcus , Liu Yang , Sommer Frederik , Mühlhaus Timo , Schroda Michael , Timmermans Jean-Pierre , Pintelon Isabel , Rappold Gudrun A. , Britschgi Markus , Lashuel Hilal , Menger Michael D. , Laschke Matthias W. , Niesler Beate , Schäfer Karl-Herbert
Published: October 2020

Background:There is increasing evidence that Parkinson’s disease (PD) might start in the gut, thus involving and compromising also the enteric nervous system (ENS). At the clinical onset of the disease the majority of dopaminergic neurons in the midbrain is already destroyed, so that the lack of early biomarkers for the disease represents a major challenge for developing timely treatment interventions. Here, we use a transgenic A30P-α-synuclein-overexpressing PD mouse model to identify appropriate candidate markers in the gut before hallmark symptoms begin to manifest. Methods:Based on a gait analysis we defined 2-month-old A30P mice as pre-symptomatic (psA30P), since they are not showing any motoric impairments of the skeletal neuromuscular system. Mice at this particular age were further used to analyze functional and molecular alterations in both, the gastrointestinal tract and the ENS, to identify early pathological changes. We examined gastrointestinal motility, molecular composition of the ENS, as well as the expression of regulating miRNAs. Moreover, we applied A30P-α-synuclein challenges in vitro to simulate PD in the ENS. Results:A retarded gut motility and early molecular dysregulations were found in the myenteric plexus of psA30P mice. We found that i.e. neurofilament light chain, vesicle-associated membrane protein 2 and calbindin 2, together with the miRNAs that regulate them, are significantly altered in the psA30P, thus representing potential biomarkers for early PD. Many of the dysregulated miRNAs found in the psA30P mice are reported to be changed in PD patients as well, either in blood, cerebrospinal fluid or brain tissue. Interestingly, the in vitro approaches delivered similar changes in the ENS cultures as seen in the transgenic animals, thus confirming the data from the mouse model. Conclusions:These findings provide an interesting and novel approach for the identification of appropriate biomarkers in men.
Association between Unmet Needs for Informal support and Diabetes-related Distress among People Living with Type 2 Diabetes in Vietnam: A Cross-sectional Study
Authors: Khong Diep Thi , Xuan Bai Nguyen , Duc Cuong Le , Gammeltoft Tine , Søndergaard Jens , Meyrowitsch Dan Wolf , Bygbjerg Ib Christian , Nielsen Jannie
Published: October 2020

Background: Diabetes-related distress (DRD) in people with type 2 diabetes (T2D) is associated with reduced quality of life. Lower levels of DRD were found in people who received informal support. The prevalence of T2D in Vietnam is rapidly increasing. Yet, the prevalence of DRD and its association with informal social support have not been investigated. The present investigate the prevalence of DRD and its association with unmet needs for informal support in people with T2D in Vietnam. Methods: A total of 806 people, age ³40 years, diagnosed with T2D in Thai Binh, Vietnam, completed a questionnaire-based cross-sectional survey. DRD was self-reported, based on the Problem Areas In Diabetes scale 5 (PAID 5). We assessed 6 types of unmet needs for informal support from family/friends/community including: (i) Transport and company when visiting health facilities; (ii) Reminders to take medication; (iii) Purchase and preparation of food; (iv) Reminders to engage in physical exercise; (v) Emotional support; and (vi) Financial support. Multivariable logistic regression was used to model DRD as an outcome of each type of unmet need for informal support, and as an outcome of the number of unmet needs for informal support, adjusted for three sets of covariates. Results: The prevalence of DRD in people with T2D was 50.0%. Odds for DRD were higher among those who had unmet needs for emotional support and financial support as compared to those with met needs (OR=2.59, CI95%: 1.19-5.63 and OR= 1.63, CI95%: 1.10 -2.40, respectively). People who had more than one type of unmet need was not a higher risk of DRD as compared to those with only one type of unmet need. Conclusions: Half of the people with T2D had DRD. DRD was associated with unmet needs for emotional and financial support. The findings suggest that in order to prevent or reverse DRD, family members and others providing informal support should be included in health programs and interventions targeting people with T2D in Vietnam and similar settings.
Effect of Postpartum Depression on Exclusive Breast-Feeding Practices in Sub-Saharan Africa Countries: Systematic Review and Meta-analysis
Authors: Handiso Demelash Woldeyohannes , Ifa Yohannes Tekalegn , Sahiledengle Biniyam Sahiledengle , Makango Dejene Ermias , Wontamo Tekele Ejajo , Mwanri Lillian Mwanri
Published: October 2020

Background: Postpartum depression (PPD) is a serious mood disorder that affects behavioural, physical and mental health of women and newborn after childbirth. Although a wide range of research have been conducted on maternal and infant health outcomes, the effect of postpartum depression on exclusive breastfeeding practices remains ambiguous, and needs addressing. The aim of this study was to assess the effect of postpartum depression on exclusive breast feeding practices in sub-Saharan African countries.Methods: PubMed, Google Scholar, Science Direct and Cochrane Library were systematically searched for relevant articles published between 2001 and 2020. STATA version 14 was used to calculate the pooled odd ratio with 95% confidence intervals (95% CI). The DerSimonian and Laird random effects meta-analysis was used to measure the effect of postpartum depression on exclusive breast feeding practices. The heterogeneity and publication bias were assessed by using I2 test statistics and Egger’s test, respectively. This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis.Result: A total of 1482 published articles and Grey literatures were retrieved from different databases. Additional articles were from the reference list of identified reports and articles. After assessment of obtained articles, studies not meeting the inclusion criteria were excluded. Twenty six studies involving 30021 population met the inclusion criteria were included in this review. In sub Saharan Africa the overall estimated level of postpartum depression was 18.6% (95% CI: 13.8, 23.4). This review found that postpartum depression had no significant effect on exclusive breast feeding practices (OR = 0.46, 95% CI: 0.18, 1.14). Conclusion: In Sub Saharan Africa, the prevalence of postpartum depression was higher than WHO report of 2018. This review reveled that maternal postpartum depression has no significant effect on exclusive breast feeding practices. Thus, the investigators strongly recommend the researchers to conduct primary studies using strong study design in sub-Saharan Africa.
“I came to escort someone”: Men’s experiences of antenatal care services in Urban Ghana. A qualitative study
Authors: Ampim Gloria Abena , Blystad Astrid , Kpoor Albert , Haukanes Haldis
Published: October 2020

BackgroundMale involvement in maternal healthcare has been widely recognized as important for positive health outcomes for expectant mothers and their unborn babies, but few studies have explored men’s experiences of maternal health services. The purpose of this paper is to explore men’s involvement in antenatal care in urban Ghana and to discuss how men navigate their roles in a space that has been constructed as feminine. The study draws upon theories of gender, place and space.MethodsA qualitative exploratory study using semi-structured interviews, focus group discussion and observation was conducted in Accra, Ghana. Expectant fathers and health workers were interviewed and observation was conducted at a selected public hospital in Accra. ResultsThe findings suggest that the few men who attend antenatal care with their expecting partners get involved to a limited extent in activities at the clinic. Beyond a few who take an active role, most men stay on the outskirts of the hospital grounds, and rarely participate in the consultation with their partner and nurse-midwife. Men still view their presence as important, both to acquire knowledge, and as a source of emotional, financial and physical support for their partners. On the health workers’ side, the study found that there was no clear agenda for engaging men at the clinic, and nurses / midwives felt the lack of staff who could engage more directly with the men. ConclusionThe study indicates that most expecting fathers feel too shy and uncomfortable to locate themselves in the female space that makes up antenatal care / maternity wards. Health workers do not feel they have the necessary resources to involve men in a fruitful way. Thus, men do not engage in the activity as hoped but remain on the outskirts of the maternity clinic. However, if men continue to negotiate their involvement at the clinic and become more assertive in their roles, the maternity clinic as a female space could, with time, be transformed into a space where both expecting mothers and fathers can be active and engaged to the benefit of all.
Leeches as the intermediate host for strigeid trematodes – genetic diversity and taxonomy of the genera Australapatemon Sudarikov, 1959 and Cotylurus Szidat, 1928
Authors: Pyrka Ewa , Kanarek Gerard , Zaleśny Grzegorz , Hildebrand Joanna
Published: October 2020

BackgroundLeeches (Hirudinida) play a significant role as intermediate hosts in the circulation of trematodes in the aquatic environment. However, the species richness, molecular diversity and phylogeny of larval stages of Strigeidae trematodes (tetracotyle) occurring in this group of aquatic invertebrates remain poorly understood. In the present work, on the basis of recently obtained sequences of several molecular markers we analysed several aspects of the ecology, taxonomy and phylogeny of the genera Australapatemon and Cotylurus, which utilise leeches as intermediate hosts.MethodsFrom April 2017 to September 2018, 153 leeches were collected from several sampling stations in small rivers with slow-flowing waters and related drainage canals located in three regions of Poland. The distinctive forms of tetracotyle metacercariae collected from leeches supplemented with adult Strigeidae specimens sampled from a wide range of water birds were analysed using the 28S rDNA partial gene, ITS2 region and the COI fragment.ResultsAmong investigated leeches, metacercariae of the tetracotyle type were detected in the parenchyma and musculature of 62 specimens (prevalence 40.5%) with a mean intensity reaching 19.9 ind. The taxonomic generic affiliation of metacercariae derived from leeches revealed the occurrence of two Strigeidae genera: Australapatemon Sudarikov, 1959 and Cotylurus Szidat, 1928. Phylogenetic reconstructions based on the partial 28S rRNA gene, ITS2 region and partial COI gene confirmed the separation of the Australapatemon and Cotylurus clades. Unfortunately, regarding currently available molecular data and our results, it is not possible to precisely define the taxonomic position of the recently sequenced tetracotyle of Australapatemon. On the other hand, on the basis of the obtained sequences, supplemented with previously published data, the metacercariae of Cotylurus detected in leeches were identified as two species: C. strigeoides Dubois, 1958 and C. syrius Dubois, 1934. This is the first record of C. syrius from the intermediate host.ConclusionsThe results suggest the separation of ecological niches and life cycles between C. cornutus (Rudolphi, 1808) and C. strigeoides/C. syrius with potential serious evolutionary consequences for a wide range of host–parasite relationships. Moreover, phylogenetic analyses corroborated the polyphyletic character of C. syrius, the unclear status of C. cornutus and the separate position of Cotylurs raabei Bezubik, 1958 within Cotylurus. The data demonstrate the inconsistent and confusing taxonomic status of the sequenced tetracotyle of Australapatemon, resulting, in our opinion, from the limited availability of fully reliable, comparative sequences of related taxa in GenBank.
Neutrophil-to-Lymphocyte Ratio is Associated With Increased Cerebral Blood Flow Velocity in Acute Bacterial Meningitis
Authors: Giede-Jeppe Antje , Atay Selim , Koehn Julia , Mrochen Anne , Luecking Hannes , Hoelter Philip , Volbers Bastian , Huttner Hagen B. , Hueske Lena M. , Bobinger Tobias
Published: October 2020

ObjectiveIn community-acquired bacterial meningitis(CABM) intracranial vascular alterations are devastating complications which are triggered by neuroinflammation and result in worse clinical outcome. The neutrophil-to-lymphocyte ratio(NLR) represents a reliable parameter of the inflammatory response. So far, in CABM-patients the association between NLR and elevated cerebral blood flow velocity(CBFv) remains unclear.MethodsThis study included all (CABM)-patients admitted to a German tertiary center between 2006-2016. Patient demographics, in-hospital measures and neuroradiological data were retrieved from institutional databases. CBFv was assessed by transcranial Doppler sonography transcranial doppler(TCD). Patients’, radiological and laboratory characteristics were compared between patients with/without elevated CBFv. Multivariate-analysis investigated parameters independently associated with elevated CBFv. Receiver operating characteristic(ROC-)curve analysis was undertaken to identify the best cut-off for NLR to discriminate between increased CBFv.Results108 patients with CABM were identified. 27.8%(30/108) showed elevated CBFv. These patients had a worse clinical status on admission(Glasgow Coma Scale:12[9-14vs.14[11-15]; p=0.005) and required more often intensive care (30/30[100%]vs.63/78[80.8%];p=0.01).The causative pathogen was S. pneumoniae in 70%. These patients developed more often cerebrovascular complications with delayed cerebral ischemia(DCI) within hospital stay(p=0.031). A significantly higher admission-NLR was observed in patients with elevated CBFv(median[IQR]:elevated CBFv:24.0[20.4-30.2]vs. normal CBFv:13.5[8.4-19.5];p<0.001). After adjusting for significant parameters in univariate testing, NLR on admission was significantly associated with increased CBFv(Odds ratio[95%CI]:1.042[1.003-1.084];p=0.036). ROC-analysis identified a NLR of 20.9 as best cut-off value to discriminate between elevated CBFv(area under the curve=0.713, p<0.0001,Youden's Index=0.441;elevated CBFv:NLR>20.9 19/34[55.9%]vs.NLR<20.9 11/74[14.9%];p<0.001).ConclusionsIntracranial vascular complications are common among CABM-patients and are a risk factor for unfavorable outcome at discharge. NLR is independently associated with elevated CBFv.
Early detection of COVID-19 mortality risk using non-invasive clinical characteristics
Authors: Mahdavi Mahdi , Choubdar Hadi , Zabeh Erfan , Rieder Michael , Safavi-Naeini Safieddin , Khanlarzadeh Vida , Jobbagy Zsolt , Ghorbani Amirata , Abedini Atefeh , Kiani Arda , Lashgari Reza , Kamrani Ehsan
Published: October 2020

With no effective treatment currently available and maximum preventive measures already in place, more interventions in the clinical field are needed to decrease COVID-19 patient mortality. Early prediction of mortality risk in COVID-19 patients can decrease mortality by assuring efficient resource allocation and treatment planning. This study conducts an early prediction of COVID-19 prognosis using laboratory, clinical, and demographic data collected from patients in the first day of admission. Three machine learning models were developed to investigate and compare the prediction power of invasive and noninvasive biomarkers. The results suggest that early mortality prediction of patients via non-invasive biomarkers provides significant accuracy and can be used as a triage assisting tool without the need for
additional costs or waiting time of laboratory tests.
Development of EphA2 siRNA-loaded lipid nanoparticles and combination with a small-molecule histone demethylase inhibitor in prostate cancer cells and tumor spheroids
Authors: Oner Ezgi , Kotmakci Mustafa , Baird Anne-Marie , Gray Steven G. , Butuner Bilge Debelec , Bozkurt Emir , Kantarci Ayse Gulten , Finn Stephen P.
Published: October 2020

Background: siRNAs hold a great potential for cancer therapy, however, poor stability in body fluids and low cellular uptake limit their use in the clinic. To enhance the bioavailability of siRNAs in tumors, novel, safe, and effective carriers are needed. Results: Here, we developed cationic solid lipid nanoparticles (cSLNs) to carry siRNAs targeting EphA2 receptor tyrosine kinase (siEphA2), which is overexpressed in many solid tumors including prostate cancer (PCa). Using DDAB cationic lipid instead of DOTMA reduced nanoparticle size and enhanced both cellular uptake and gene silencing in PCa cells. DDAB-cSLN showed better cellular uptake efficiency with similar silencing compared to commercial transfection reagent Dharmafect-2. After verifying the efficacy of siEphA2-loaded nanoparticles, we further evaluated a potential combination with a histone lysine demethylase inhibitor, JIB-04. Silencing EphA2 by siEphA2-loaded DDAB-cSLN did not affect the viability (2D and 3D), migration, and clonogenicity of PC-3 cells alone. However, upon co-administration, there was a decrease in the aforementioned cellular responses due to JIB-04. Furthermore, JIB-04 decreased EphA2 expression, and thus, silencing efficiency of siEphA2-loaded nanoparticles was further increased with co-treatment. Conclusions: We have successfully developed a novel siRNA-loaded lipid nanoparticle for targeting EphA2. Moreover, detailed preliminary results of the effects of JIB-04, alone and in combination with siEphA2, on PCa cells and tumor spheroids were presented for the first time. Our delivery system provides high transfection efficiency and shows a great promise for targeting other genes and cancer types in further in vitro and in vivo studies.
The Physics of Detonation Chemistry: A Radical Theory in Predicting the Deflagration to Detonation Transition
Authors: Kumar V R Sanal , Chandrasekaran Nichith , Sankar Vigneshwaran , Sukumaran Ajith , Mani Sivabalan , kumar Tharikaa Ramesh , Padmanabhan Sathyan , Baskaran Roshan Vignesh , Natarajan Vishnu , Doddi Hema Sai Nagaraju , Nejaamtheen Mohammed Niyasdeen , Rafic Sulthan Ariﬀ Rahman Mohamed , Baskaran Roshan Vignesh , Murugesh Pavithra , Mariappan Amrith , K. Thianesh U. , moorthi Anand , Elumalai Mohan , R.S. Bharath , Oommen Charlie , Radhakrishnan Pradeep Kumar , Choudhary Shiv Kumar
Published: October 2020

The theoretical finding of the Sanal-flow-choking [PMCID: PMC7267099] is a methodological advancement in predicting the deflagration-to-detonation-transition (DDT) in the real-world-fluid flows (continuum/non-continuum) with credibility.[1,2] Herein, we provide a proof of the concept of the Sanal-flow-choking and streamtube-flow-choking causing DDT in wall-bounded and free-external flows. Once the streamlines compacted, the considerable pressure difference attains inside the streamtube and the flow gets accelerated to the constricted region for satisfying the continuity condition set by the conservation law of nature. If the shape of the streamtube in the internal/external flow is similar to the convergent-divergent (CD) duct the phenomenon of the Sanal-flow-choking and supersonic flow development occurs at a critical-total-to-static pressure ratio (CPR) in yocto to yotta scale systems and beyond, which leads to shock wave generation or detonation as the case may me. At the lower critical detonation or hemorrhage index, the CPR of the reacting flow and the critical blood-pressure-ratio (BPR) of the subjects (human being/animal) are unique functions of the heat-capacity-ratio (HCR) of the evolved gas in the CD duct. In silico results are presented herein to establish the proof of the concept of the Sanal-flow-choking and streamtube-flow-choking causing shock-wave/detonation in diabatic flow systems and asymptomatic-hemorrhagic-stroke in biological systems. The physics of detonation chemistry presented herein sheds light for exploring supernova explosions.[107]
Unilateral Pedicle Fracture Accompanying Spondylolisthesis and Contralateral Spondylolysis: A Case Report
Authors: Liu Xiaofeng , Baiketuerxun Palihati , Zhang Junxin , Liu Tao
Published: October 2020

Study design Case reportObjective To report a rare case with unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis. Summary of Background Data Unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis is rare. Most are association with major trauma, previous spine surgery, osteopetrosis or stress-related activities.Methods We report a patient with spontaneous pedicle fracture associated with contralateral spondylolysis and spondylolisthesis at the L5 level, complaining severe back pain, radicular lower limb pain and intermittent claudication. The pathophysiological mechanism is discussed, and a review of relevant literature is included.Results This patient was successfully treated by decompression laminectomy with transforaminal lumbar interbody fusion (TLIF) and pedicle screw fixation. To our knowledge, cases like this have rarely been reported in the literature.Conclusions Unilateral pedicle stress fracture in patients with spondylolytic spondylolisthesis is rare. It may be related to redistribution of forces in an unstable neural arch resulting from defect in the contralateral pars interarticularis. Our experience suggests that limited decompression and instrumented fusion surgery led to a successful outcome.
Identification of the ASPM-miR-26b-5p network associated with the aggressive traits of HCC cells
Authors: Li Hong-Guang , Gao Heng-Jun , Liu Fang-Feng , Liu Jun
Published: October 2020

Background: Even though earlier reports have revealed that abnormal spindle-like microcephaly associated (ASPM) exert essential roles in diverse malignancies, its relationship between specific microRNAs (miRNAs) in regulation of hepatocellular carcinoma (HCC) progression has never been elaborated. Methods: Bioinformatics analysis detected differentially expressed genes in HCC and normal. qRT-PCR was performed to detect expression of miR-26b-5p in HCC tissues and cells. HCC cells were transfected with plasmids and their proliferative ability and colony formation were detected with loss-of-function assay. The invasion of HCC cells was determined using Transwell assay. The expression of ASPM was detected by western blotting. Luciferase reporter gene assay was performed to detect the interaction between miR-26b-5p and ASPM. ASMP silencing cells were injected into mice to establish xenograft tumor model.Results: Herein, we proved that ASPM was upregulated in HCC and higher level of ASPM was significantly associated with worse survival in HCC patients. ASPM silencing restrained HCC cell proliferation, migration and invasion capacities in vitro. In vivo, downregulation of ASPM also suppressed HCC cells growth. Mechanistic analyses illustrated that ASPM was a directly target of miR-26b-5p. The expression of ASPM was negatively modulated by miR-26b-5p. Rescues assays displayed that miR-26b-5p inhibited HCC cells growth and invasion via modulating the expression of ASPM. Conclusions: Our work validated that miR-26b-5p restrained the aggressiveness of HCC cells through targeting ASPM.
Transcription Elongation Factor A-Like 7, regulated by miR-758-3p inhibits the malignant process of melanoma through decreasing the expression levels of c-Myc and AKT1
Authors: Liu Xilin , Song Xianji , Li Hong
Published: October 2020

Background: The ectopic expression of transcription elongation factor A (SII)-like 7 (TCEAL7) has been observed in several kinds of cancers, but its role in melanoma is still unclear. This study was carried out to investigate TCEAL7 role in melanoma progression, and uncover the underlying mechanisms. Methods: TCEAL7 expression level in melanoma tissues and cells were determined by using RT-PCR and western blotting. CCK-8, transwell chambers, flow cytometry, starch assay and tumorigenesis assay were applied to detect cell growth, invasion, apoptosis, migration and tumorigenesis, respectively. Results: A low expression level of TCEAL7 was observed in melanoma tissues and cells, which associated with malignant process and poor prognosis. TCEAL7 negatively modulated AKT1, AKT2 and c-Myc expression and inhibited cancer progression via decreasing AKT1 and c-Myc expression. In addition, TCEAL7 was negatively modulated by miR-758-3p which promoted melanoma progression. Moreover, TCEAL7 overexpression abolished miR-758-3p-mediated melanoma progression. Conclusion: This study demonstrated that TCEAL7, regulated by miR-758-3p inhibited the malignant process of melanoma through decreasing the expression levels of c-Myc and AKT1.