bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular characteristics and virulence gene profiles of Staphylococcus aureus isolates in Hainan, China
Authors: Li Xuehan , Huang Tao , Xu Kai , Li Chenglin , Li Yirong
Published: October 2019

Background: There have been no reports regarding the molecular characteristics, virulence features, and antibiotic resistance profiles of Staphylococcus aureus ( S. aureus ) from Hainan, the southernmost province of China.
Methods: 227 S. aureus isolates, consisting of 76 methicillin-resistant S. aureus (MRSA) and 151 methicillin-susceptible S. aureus (MSSA), were collected in 2013-2014 and 2018-2019 in Hainan, and investigated for their molecular characteristics, virulence genes, antibiotic resistance profiles and main antibiotic resistance genes.
Results: Forty sequence types (STs) including three new STs (ST5489, ST5492 and ST5493), and 79 Staphylococcal protein A ( spa ) types were identified based on multilocus sequence typing (MLST) and spa typing, respectively. ST398 (14.1%, 32/227) was found to be the most prevalent, and the prevalence of ST398-MSSA increased significantly from 2013-2014 (5.5%, 5/91) to 2018-2019 (18.4%, 25/136). Seventy-six MRSA isolates were subject to staphylococcus chromosomal cassette mec (SCC mec ) typing. SCC mec- IVa was the predominant SCC mec type, and specifically, ST45-SCC mec IVa, an infrequent type in mainland China, was predominant in S. aureus from Hainan. The antibiotic resistance profiles and antibiotic resistance genes of S . aureus show distinctive features in Hainan. The resistant rates of the MRSA isolates to a variety of antibiotics were significantly higher than those of the MSSA isolates. The predominant erythromycin and tetracycline resistance genes were ermC (90.1%, 100/111) and tetK (91.8%, 78/85), respectively. Eleven virulence genes, including the Panton-Valentine leukocidin ( pvl ) and eta , were determined, and the frequency of eta and pvl were found to be 57.3% and 47.6%. Such high prevalence has never been seen in mainland China before.
Conclusion: S. aureus isolates in Hainan have unique molecular characteristics, virulence gene and antibiotic resistance profiles, and main antibiotic resistance genes which may be associated with the special geographical location of Hainan and local trends in antibiotic use.
The shape of the glucose response curve during an oral glucose tolerance test heralds β–cell function in a large Chinese population
Authors: Cheng Xinqi , Yang Na , Li Yuxiu , Sun Qi , Qiu Ling , Xu Lingling , Ping Fan , Li Wei , Zhang Huabing
Published: October 2019

Background The shape of the glucose response during an oral glucose tolerance test can detect β-cell function and insulin resistance. But there were few studies in Chinese, so we aimed to verify the utility of these connections in a large Chinese population. Methods A total of 11,866 times of 3-h OGTT were categorized to either a monophasic or a multiphasic group based on the shape of the glucose response. Homeostasis model assessments of fasting insulin resistance, Matsuda index, insulinogenic index and the disposition index were assessed by plasma glucose and serum insulin concentration obtained at fasting or during an OGTT. Results Individuals with a monophasic shape had significantly higher glucose, insulin, and had significantly lower insulin sensitivity and impaired β-cell function than multiphasic group. In addition, Individuals were younger with a multiphasic shape compared to those with a monophasic shape. Conclusion The monophasic OGTT glucose response curve could reflect impaired β-cell function in a large Chinese population.
Genome-wide identification of small heat shock protein (HSP20) gene family in grape and expression profile during berry development
Authors: Ji Xiao-Ru , Yu Yi-He , Ni Pei-Yi , Zhang Guo-Hai , Guo Da-Long
Published: October 2019

Background : Studies have shown that HSP20 (heat-shock protein 20) genes play important roles in regulating plant growth, development, and stress response. However, the grape HSP20 gene family has not been well studied.
Results : A total of 48 VvHsp20 genes were identified from the grape genome, which were divided into 11 subfamilies (CI, CII, CIII, CV, CVI, CVII, MI, MII, ER, CP and PX/Po) based on a phylogenetic analysis and subcellular localization. Further structural analysis showed that most of the VvHsp20 genes (93.8%) had no intron or only one intron, while genes that clustered together based on a phylogenetic tree had similar motifs and evolutionarily conserved structures. The HSP20s share a conservedα-crystalline domain (ACD) and the different components of the ACD domain suggest the functional diversity of VvHSP20s. In addition, the 48 VvHSP20 genes were distributed on 12 grape chromosomes and the majority of VvHSP20 genes were located at the proximal or distal ends of chromosomes. Chromosome mapping indicated that four groups of VvHSP20 genes were identified as tandem duplication genes. Phytohormone responsive, abiotic and biotic stress-responsive, and plant development-related cis-elements were identified from the cis-regulatory elements analysis of VvHSP20s. The expression profiles of VvHSP20s genes (VvHsp20-1, 11, 14, 17, 18, 19, 20, 24, 25, 28, 31, 39, 42, and 43) were largely similar between RNA-Seq and qRT-PCR analysis after hydrogen peroxide (H 2 O 2 ) treatment. The results showed that most VvHSP20s were down-regulated by H 2 O 2 treatment during fruit development. VvHSP20s genes were indeed found to be involved in the grape berry development and differences in their transcriptional levels may be the result of functional differentiation during evolution.
Conclusions : Our results provide valuable information on the evolutionary relationship of genes in the VvHSP20 family, which is useful for future studies on the functional characteristics of VvHSP20 genes in grape.
A modified intrascleral intraocular lens fixation technique with fewer anterior segment manipulations: 27-gauge needle-guided procedure with built-in 8-0 absorbable sutures
Authors: Yang Yuan , Yao Tengteng , Zhou Yali , Wang Yixiao , Wang Zhaoyang
Published: October 2019

Abstract
Background : To report a modified surgical technique for intrascleral intraocular lens (IOL) fixation with fewer anterior segment manipulations in eyes lacking sufficient capsular support.
Methods : Eyes from 14 patients who underwent 27-gauge needle-guided intrascleral IOL fixation with built-in 8-0 absorbable sutures were studied. The 8-0 absorbable sutures were inserted into 27-gauge round needles and used to create sclerotomies at the 4 o’clock and 10 o’clock positions under the scleral flap. The sutures were used to tie knots at the end of each haptic and guide haptic externalization through the sclerotomy. After externalization, a sufficient flange was created at the end of each haptic and fixed under the scleral flaps. The best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), IOL tilt and decentration, previous surgery history, and complications were determined.
Results: Fourteen cases were analyzed. The majority of eyes exhibited an improvement in the BCVA after surgery. When comparing the last follow-up to preoperative visual acuity, the mean change in BCVA was + 26.32 letters (p=0.011). Postoperative complications included postoperative hypotony in 3 eyes, ocular hypertension in 2 eyes. No cases of postoperative cystoid macular edema (CME), vitreous hemorrhage (VH), IOL dislocation, or endophthalmitis were observed.
Conclusions : The 27-gauge needle-guided intrascleral IOL fixation technique with built-in 8-0 absorbable sutures is easy to perform with fewer anterior chamber manipulations and achieves both anatomical and optical stability.
Contribution of aroma compounds to the antioxidant properties of roasted white yam (Dioscorea rotundata)
Authors: Lasekan Ola , Teoh Li Shing
Published: October 2019

Background The aroma chemistry and the contribution of the aroma compounds to the anti-oxidative properties of roasted yam have yet to be characterized. The growing popularity of roasted yam in regions where they are being consumed calls for a concerted effort to elucidate their aroma chemistry as well as their anti-oxidative properties. Results The aroma compounds in roasted white yam (Dioscorea rotundata) were isolated and identified using static headspace-gas chromatography-mass spectrometry (SH-GC-MS) and gas chromatography-olfactometry (GC-O). In addition, the anti-oxidative activities of the most abundant volatile heterocyclic compounds (2 pyrroles, 4 furans and 3 pyrazines) were evaluated on their inhibitory effect towards the oxidation of hexanal for a period of 30 days. Twenty-nine aroma-active compounds with a flavour dilution (FD) factor range of 2-256 and an array of odor notes were obtained. Among them, the highest odor activities (FD ≥ 128) factors were determined for 2-acetyl furan and 2-acetylpyrrole. Other compounds with significant FD factors ≥ 32 were; 2-methylpyrazine, ethyl furfural, and 5-hydroxy methyl furfural. Conclusion Results of the anti-oxidative activity showed that the pyrroles exhibited the greatest antioxidant activity among all the tested heterocyclic compounds. This was followed by the furans and the pyrazines which had the least antioxidant activity.
Factors Influencing Adherence to the New Intermittent Preventive Treatment of Malaria in Pregnancy Policy in Keta District of the Volta Region, Ghana
Authors: Vandy Alren O. , Peprah Nana Yaw , Jerela Joseph Yaw , Titiati Perfect , Manu Abubakar , Akamah Joseph , Maya Ernest T. , Torpey Kwasi
Published: October 2019

Background About 25% of pregnant women in malaria endemic areas are infected with malaria and this accounts for about 15% of maternal death globally. Intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) is one of the main strategies for prevention of malaria in pregnancy. A new recommendation was made by World Health Organization (WHO) that at least three doses of IPTp-SP should be administered before delivery. This study sought to determine the factors influencing adherence to the new IPTp-SP policy in Keta District, Volta region, Ghana. Methods A cross-sectional quantitative study among 375 nursing mothers at four selected health facilities in Keta district, Ghana was conducted using a structured questionnaire to interview participants. Data was analyzed using STATA 15. Chi-square was used to test bivariate association between categorical variables and adherence. Logistic regression analysis was used to examine sociodemographic, individual and institutional factors influencing adherence to IPTp-SP. Result About 82.1% of participants adhered to the WHO policy recommendations of at least three doses of IPTp-SP. However, only 17.1% received Ghana’s five dose coverage recommendation. The proportion of IPTp-SP coverage for IPTp1 was 98.9%; IPTp2 95.5%; IPTp3 80.8%; IPTp4 39.5%; IPTp5 17.1%. Conclusion Adherence to IPTp-SP was satisfactory according to WHO’s policy recommendation, however, majority of the participants had less than the five doses recommended in Ghana. Number of ANC visits and knowledge of malaria were the main determinants of adherence to IPTp-SP.
Development of a targeted client communication intervention to women using an electronic maternal and child health registry: a qualitative study
Authors: Bogale Binyam , Mørkrid Kjersti , O'Donnell Brian , Ghanem Buthaina , Ward Itimad Abu , Khader Khadija Abu , Isbeih Mervett , Frost Michael , Baniode Mohammad , Hijaz Taghreed , Awwad Tamara , Rabah Yousef , Frøen Frederik
Published: October 2019

Background

Targeted client communication (TCC) using text messages can inform, motivate and remind pregnant and postpartum women of timely utilization of care. The mixed results of the effectiveness of TCC interventions points to the importance of theory based co-design with users. The aim of this paper is to describe the planning, development, and evaluation of a theory based TCC intervention, tailored to pregnant and postpartum women and automated from the Palestinian electronic maternal and child health registry.Methods

We used the Health Belief Model to develop interview guides to explore women’s perceptions of antenatal care (ANC), with a focus on high-risk pregnancy conditions (anemia, hypertensive disorders in pregnancy, gestational diabetes mellitus, and fetal growth restriction) and timely ANC attendance, issues predefined by a national expert panel as being of high interest. We performed 18 in-depth interviews with women and eight with healthcare providers in public primary healthcare clinics in the West Bank and Gaza. Following the results from the Health Belief Model, we used concepts from the Model of Actionable Feedback, social nudging and Enhanced Active Choice to compose the TCC content to be sent via SMS. We assessed the acceptability and understandability of the draft text messages through unstructured interviews with local health promotion experts, healthcare providers, and pregnant women.Results

We found low awareness of the importance of timeliness in attending ANC and the benefits of ANC for pregnancy outcomes. We identified knowledge gaps and beliefs in the domains of low awareness of susceptibility to, and severity of, such complications in pregnancy. We composed actionable text messages aiming to increase utilization of ANC, following recommended message framing models and iteratively improved the contents with users to bridge the identified gaps. We developed algorithms to trigger tailored text messages with higher intensity for women with a higher risk profile documented in the electronic health registry.Conclusions

We developed an optimized text message based TCC intervention underpinned by behavior change theories and co-designed with users following an iterative process. The electronic maternal and child health registry can serve as a unique platform for TCC interventions.
Carriage Rate of Neisseria meningitidis, Antibiotic Susceptibility Pattern and Associated Risk Factors among Primary School Children in Gondar town, Northwest Ethiopia
Authors: Tefera Zelalem , Mekonnen Feleke , Tiruneh Moges , Belachew Teshome
Published: October 2019

Background: Globally, in 2012, 1.2 million estimated cases were reported with ~135,000 deaths annually. In Ethiopia, specifically in our study area, limited information is found on the oropharyngeal carriage, antimicrobial resistance pattern, and associated risk factors for N. meningitidis among school children. So, the aim of this study was to assess oropharyngeal carriage rate of N. meningitidis, antibiotic susceptibility pattern and determinants among primary school children in Gondar town, Northwest Ethiopia.
Methods: A cross sectional study was conducted from January to April, 2019 in Gondar town. Multi stage simple random sampling technique was used. A total of 524 oropharyngeal swabs were collected using sterile plastic cotton swabs. Modified Thayer Martin media was used for primary isolation. Antimicrobial susceptibility pattern was done based on Kirby-Bauer method on Muller-Hinton agar supplemented with 5% sheep blood. Multidrug resistance was defined as resistance of an isolate to two or more antimicrobial classes tested. Logistic regression model was used to see the association between dependent variables (Carriage rate of Neisseria meningitidis, Serogroups of Neisseria meningitidis and Antimicrobial susceptibility patterns) and independent variables (Socio-demographic data and risk factors). Variables with a P- value ≤ 0.2 during bivariable analysis was taken to multivariable analysis to check significant association of meningococcal carriage with risk factors. Finally, a P-value < 0.05 was considered as statistically significant. Data was summarized using numbers, percentages and tables.
Results: A total of 53(10.1%) (CI: 7.6-12.8) N. meningitidis isolates were identified. Serogroup A 13 (24.5%) was the most prevalent followed by Y/W135 11(20.7%) whereas serogroup B 4(7.6%) was the least identified serotype. Meningococcal isolates were resistant to ciprofloxacin (45.3%) and trimethoprim-sulfamethoxazole (73.6%). Overall, most of meningococcal isolates showed about 32(60.4%) multidrug resistance. Meningococcal carriage rate was significantly associated with family size, tonsillectomy, passive smoking, number of students per class, sharing utensils, history of visiting healthcare institutions, and indoor kitchen.
Conclusion: This study highlights the need for reinforcement of case-based, laboratory confirmed surveillance of N. meningitidis carriage in Ethiopian elementary school students to enable mapping of distribution of serotypes of the causative organisms across the country and determine the current potential necessity of vaccination.
Can Apela be a Novel Target in the Treatment of Chronic Lymphocytic Leukaemia?
Authors: Acik Didar Yanardag , Bankir Mehmet , Baylan Filiz Alkan , Aygün Bilal
Published: October 2019

Background: It has been shown that bcl2, bcl-XL and mcl-1 protein levels are high in chronic lymphocytic leukemia cells, and resultantly, apoptosis does not occur chronic lymphocytic leukemia cells. Apelin and apela (ELABELA/ELA/Toddler) are two peptide ligands for a class A G-protein coupled receptor called apelin receptor. Studies have shown that ELA inhibits apoptosis by inhibiting apoptotic proteins and activating anti-apoptotic proteins. Proteins and genes involved in apoptosis are valuable for targeted cancer therapy. We hypothesized that serum levels may be increased in patients with chronic lymphocytic leukemia based on the antiapoptotic effect of ELA. We compared serum apelin levels of healthy volunteers and patients with chronic lymphocytic leukemia. We aimed to draw attention to a new molecule worthy of research in targeted cancer treatment.
Methods: 42 untreated CLL patients and 41 healthy volunteers were included in the study. Serum ELA levels were measured by using enzyme-linked immunosorbent assay kits (Dhanghai Sunred Biological Technology co. Ltd), automated ELISA reader (Thermo Scientific, FİNLAND) and computer program (Scanlt for Multiscan F.C.2.5.1) in accordance with the manufacturer’s instructions. Statistical analysis was done by Statistical Package for Social Sciences for Windows 20 (IBM SPSS Inc., Chicago, IL) ve MedCalc programs. ELA and variables related to CLL were correlated with Spearman correlation anlysis test. ROC analysis and Youden index method were used to determine a cut off point for ELA. All p-values were 2-sided with statistical significance at 0.05 alpha levels.
Results: In our study, we found that serum ELA levels were significantly higher in patients with CLL.
Conclusions: This study highlights that ELA targeting may be a potential therapeutic option for treating CLL.
Keywords: Apela; apelinergic system; chronic lymphocytic leukaemia; apoptosis
Practical Value of Three-dimensional High Resolution Magnetic Resonance Vessel Wall Imaging in Identifying Suspicious Intracranial Vertebrobasilar Dissecting Aneurysms
Authors: Zhu Xianjin , Qiu Hancheng , Hui Ferdinand K , Zhang Yiqun , Liu Yun-e , Man Fengyuan , Jiang Wei-Jian
Published: October 2019

Background: Direct evidence of intimal flaps, double lumen and intramural haematomas (IMH) is difficult to detect on conventional angiography in most intracranial vertebrobasilar dissecting aneurysms (VBDAs). Our purpose was to assess the value of three-dimensional high-resolution magnetic resonance vessel wall imaging (3D HRMR VWI) for identifying VBDAs.
Methods: Between August 2013 and January 2016, consecutive patients with suspicious VBDAs were prospectively enrolled to undergo catheter angiography and VWI (pre- and post-contrast). The lesion was diagnosed as definite VBDA when presenting direct signs of dissection; as possible when only presenting indirect signs; and as segmental ectasia when there was local dilation and wall thickness similar to adjacent normal artery’s without mural thrombosis.
Results: Twenty-one patients with 27 lesions suspicious for VBDAs were finally included. Based on findings of VWI and catheter angiography, definite VBDA was diagnosed in 25 and 7 lesions (92.6%, vs 25.9%, p = 0.000), respectively; possible VBDA in 0 and 20 (0 vs 74.1%), respectively; and segmental ectasia in 2 and 0 (7.4% vs 0%), respectively. On VWI and catheter angiography, intimal flap was detected in 21 and 7 lesions (77.8% vs 25.9%, p=0.001), respectively; double lumen sign in 18 and 7 (66.7% vs 25.9%, p=0.003), respectively; and IMH sign in 14 and 0 (51.9% vs 0), respectively.
Conclusions: 3D HRMR VWI could detect direct dissection signs more frequently than catheter angiography. This may help obtain definite diagnosis of intracranial VBDAs, and allow accurate differentiation between dissecting aneurysm and segmental ectasia as well. Further prospective study with larger sample was required to investigate the superiority of HRMR VWI for definite diagnosis of intracranial VBDAs than catheter angiography
Interpreter proxy versus healthcare interpreter for administration of patient surveys following arthroplasty: a pilot study
Authors: Xue Daniel , Churches Timothy , Armstrong Elizabeth , Mittal Rajat , Naylor Justine M. , Harris Ian A.
Published: October 2019

Purpose: Clinical quality registries and other systems that conduct routine post-discharge surveillance of patient outcomes following surgery may have difficulty surveying patients who have limited proficiency in the language of the healthcare provider. Interpreter proxies (family and carers) are often used due to limited access to certified healthcare interpreters (due to cost or availability). The aim of this study was to assess the reliability of engaging interpreter proxies compared with certified healthcare interpreters for the administration of patient-reported health-related surveys for people with limited English proficiency (LEP).
Methods: People with LEP and due for a routine 6-month telephone follow-up post knee or hip arthroplasty were invited to participate. Participants were randomly allocated to having their first interview with an interpreter proxy or a certified healthcare interpreter followed by the second (crossover) interview within 2 weeks (range: 4 to 12 days) after the first interview using the alternative method. Agreement between the two methods was assessed using quadratic weighted Cohen's kappa, intraclass correlation and concordance correlation co-efficient where appropriate for EQ-5D health domains, total Oxford hip and knee scores, patient satisfaction, operation success, readmission, reoperation, and post-surgical complication responses. The mean of the differences between the same data items collected by each of the two methods was also calculated.
Results: 85 participants (96%) completed the study. There was substantial to excellent inter-rater agreement (kappa=0.69-0.87 and ICCs above 0.74) for all but one measure. The mean differences between family proxy and healthcare interpreter scores for each participant were small, ranging from 0.01 (score range of 1-5) to 0.72 (score range of 0-100).
Conclusion: These results suggest that using interpreter proxies is a reliable alternative to certified healthcare interpreters in conducting patient-reported health surveys, potentially making this process easier and cost effective for researchers and registries.
A Comparative Analysis of Diffusion-weighted Imaging and Ultrasound in Thyroid Nodules
Authors: Kong Weidan , Yue Xiuhui , Ren Jiliang , tao xiaofeng
Published: October 2019

Background: Diffusion-weighted imaging (DWI) and ultrasound are commonly used methods to examine thyroid nodules, but their comparative value is rarely studied. We evaluated the utility of DWI and ultrasound in differentiating benign and malignant thyroid nodules.
Methods: A total of 100 patients with 137 nodules who underwent both DWI and ultrasound before operation were enrolled. The T1 and T2 signal intensity ratio (SIR) of each thyroid nodule was calculated by measuring the mean signal intensity divided by that of paraspinal muscle. The apparent diffusion coefficient (ADC) value and the SIR of benign and malignant thyroid nodules were analyzed by two-sample independent t tests. The sensitivity, specificity, and accuracy of DWI and ultrasound were compared with chi-square tests.
Results: There was no significant difference in the SIR between benign and malignant thyroid nodules. The ADC value was significantly different. At the threshold value was 1.12 × 10 -3 mm 2 /s, the maximum area under the curve was 0.944. The sensitivity, specificity, and accuracy were 84.9%, 92.2%, and 87.6% respectively. The corresponding values of ultrasound diagnosis were 90.1%, 80.4%, and 86.9%.
Conclusions: Ultrasound has high sensitivity in differentiating benign and malignant thyroid nodules, and the ADC value has high specificity, but there is no statistical difference in sensitivity or specificity between the two modalities. DWI and ultrasound each have their own advantages in differentiating benign and malignant thyroid nodules.
Keywords
Thyroid nodules, Ultrasound, Diffusion-weighted imaging
Protocol for a phase III wait-listed cluster randomised controlled trial of an intervention for mental wellbeing through enhancing mental health literacy and improving work friendliness in Hong Kong
Authors: Lam Lawrence T. , Wong Prudence , Lam Mary K
Published: October 2019

Background Mental health has long been recognised as a major global health issue. Some work-related characteristics have been identified to be associated with common mental health problems, thus the workplace is an important venue for the prevention of mental health problems and promoting mental wellness. Burnout is one of the important aspects of workplace organisational stressor and, in recent years, the lack of Mental Health Literacy has also been identified as a fundamental issue. Studies have demonstrated that an improvement in Mental Health Literacy is an effective measure for enhancing mental wellbeing. It would be prudent to combine an organisation-directed component and the enhancement of mental health literacy in an intervention program. This trial is to examine the novel approach of an intervention aiming to provide an evidence-based prevention program. Methods This study utilised a wait-listed cluster randomised control trial design. Using the branch offices as the primary sampling units, employees from three large companies in different industries will be recruited. Upon enrolment and after the baseline assessment of the outcome measures, participants nested in the branch offices will be allocated to the intervention or wait-listed arms. The intervention program comprises of two main elements: an organisation-directed component and an individual-directed psychoeducation training. This intervention will be delivered by a senior social worker well-versed in workplace issues over a period of three months. The trail will determine if an integrated workplace mental health literacy and wellbeing program is effective in increasing the mental health literacy scores and reducing burnout and stress scores, as measured by standardised and validated scales. Discussion If the trial results are in line with the hypothesis that support the efficacy of the intervention program, it will provide an evidence-based approach for an effective Workplace Mental Wellbeing intervention program that could, not only enhance the understanding of mental health issues, but also reduce work-related burnout and stress as well as increase workers’ quality of life.
The effects of occupational pollutants on the reproductive health of female informal street traders in Warwick Junction, Durban, South Africa – a cross-sectional study
Authors: Hariparsad Sujatha , Naidoo Rajen
Published: October 2019

Background: Informal street traders are exposed on a daily basis to traffic emissions and biomass fuel smoke containing a variety of pollutants. These exposures are likely to place the female traders at increased risk for adverse reproductive outcomes. Aim The aim of this study was to compare the reproductive outcomes among street traders exposed to pollutants from their work-related activities and traders without such exposure. Methods: A cross-sectional study was conducted among 305 female traders selected from exposed and non-exposed areas within the Warwick Junction trading hub, located in Durban, South Africa. Validated reproductive questionnaires and clinical assessments were conducted on all participants. Adverse reproductive outcomes such as low birth weight, spontaneous abortions and infertility were assessed Results: The mean age of the traders was 43.6 years (SD:12.1), mostly single (63%) and worked in trading hub for an average of 14 years. There were 876 pregnancies reported in the total sample. Traders pregnant while working in in this location accounted for 120 pregnancies There was an increased risk of exposed traders having a low birth weight infant as compared to non-exposed traders (OR=3.7; CI: 1.8, 7.6). Exposed traders were also almost 3 times more likely to be infertile as compared to non-exposed traders (OR=2.6; CI: 1.6, 4.3). Conclusions: Working as a street trader may have a causal association with developing adverse reproductive outcomes in females. Recommendations to mitigate adverse exposures have been suggested which include short term safety interventions and better cooking practices and future long term policy interventions.
The effects of oral vitamin D supplementation on the prevention of peritoneal dialysis-related peritonitis: study protocol for a randomized controlled clinical trial
Authors: Zhang Yuhui , Xu Xiao , Pi Haichen , Yang Zhikai , Johnson David W , Dong Jie
Published: October 2019

Background: Vitamin D deficiency has been shown to be closely associated with peritoneal dialysis (PD)-related peritonitis. The aim of this study is to examine the feasibility of conducting a large, powered randomized controlled trial to determine the effects of vitamin D supplementation on the risk of PD-related peritonitis in patients who have already experienced an episode of peritonitis.
Methods: This prospective, open-label randomized controlled pilot trial with blinded end-points (PROBE) aims to determine the feasibility of oral vitamin D supplementation and to explore its effects on the risk of subsequent PD-related peritonitis among PD patients who have recovered from a recent episode of peritonitis. Eligible patients will be randomized 1:1 to either oral vitamin D supplementation (2000 IU per day; intervention group) or no vitamin D supplementation (control group) in addition to usual care according to International Society for Peritoneal Dialysis (ISPD) Guidelines. The sample size will be 30 for both groups. All participants will be followed for 12 months. The primary outcome is the assessment of feasibility (recruitment success, retention, adherence, safety) and fidelity (change in serum 25-hydroxy vitamin D level during follow-up) for a large, powered randomized controlled trial to determine the effects of vitamin D on the risk of PD-related peritonitis in the future. Secondary outcomes include time to peritonitis occurrence, recovery of peritonitis, peritonitis-related transition to hemodialysis, and peritonitis-related death (defined as death within 30 days of peritonitis onset).
Discussion: This is the first randomized controlled trail investigating the effects of vitamin D supplementation on the risk of subsequent PD-related peritonitis among patients on PD. The findings for this pilot study will determine the feasibility of conducting a full-scale randomized controlled trail, which may provide a new strategy for preventing PD-related peritonitis among PD patients.
Trial registration: Clinicaltrails.gov, NCT03264625, registered on 29 August 2017. https://www.clinicaltrials.gov/ct2/show/NCT03264625?term=NCT 03264625&rank=1, assessed on 1 July 2019.
Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: A systematic review and meta-analysis
Authors: He Yang , Zhang Jianhua , Shen Guofang , Liu Lin , Zhao Qingwei , Lu Xiaoyang , Yang Hongyu , Hong Dongsheng
Published: October 2019

Background : Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer.
Methods: Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs ,ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results: Seventeen studies, which included 44411 subjects, were included in our analyses.The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15%–20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs . The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545 -1.1562 ). Under sub-gro up analysis, the incidence of CVEs related to exemestane was high er than that of controls (OR=1.1564, 95% CI: 1.0656-1.2549) , but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot.
Conclusions: These results suggest that p atients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs . Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens.
Change in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder: a repeat cross sectional community survey in Nepal
Authors: Luitel Nagendra Prasad , Garman Emily C , Jord Mark JD , Lund Crick
Published: October 2019

Background: Despite the availability of evidence-based treatment, there is a substantial gap between the number of individuals in need of mental health care and those who receive treatment. The aim of this study was to assess changes in treatment coverage and barriers to mental health care among adults with depression and alcohol use disorder (AUD) before and after implementation of a district mental health care plan (MHCP) in Nepal. Methods: The repeat population-based cross-sectional community survey was conducted with randomly selected adults in the baseline (N=1983) and the follow-up (N=1499) surveys, 3 years and 6 months apart. The Patient Health Questionnaire and Alcohol Use Disorder Identification Test were used to screen people with probable depression and AUD. Barriers to seeking mental health care were assessed by using a standardized tool, the Barriers to Care Evaluation Scale (BACE). Results: The proportion of the participants receiving treatment for depression increased by 3.7 points (from 8.1% in the baseline to 11.8% in the follow-up) and for AUD by 5.2 points (from 5.1% in the baseline to 10.3% in the follow-up study), however, these changes were not statistically significant. There was no significant reduction in the overall BACE score in both unadjusted and adjusted models for both depression and AUD. The possible reasons for non-significant changes in treatment coverage and barriers to care could be that (i) the method of repeat population level surveys with a random sample was too distal to the intervention to be able to register a change and (ii) the study was underpowered to detect such changes. Conclusion: The study found non-significant trends for improvements in treatment coverage and barriers to mental health care following implementation of the district mental health care plan. The key areas for improvement in the current strategy to improve treatment coverage and barriers to mental health care included change in the content of the existing community sensitization program, particularly for changing attitude and intention of people with mental illness for seeking care.
A Longitudinal Analysis of Mental and General Health Status of Informal Carers in Australia
Authors: Mohanty Itismita , Niyonsenga Theo
Published: October 2019

Background: The study investigated the self-assessed mental and general health status of informal carers in Australia. It evaluated the influence of carer’s health behaviours, namely: physical activity, smoking and drinking status; along with their social connectedness and workforce engagement on their health status.
Methods: The study used a retrospective longitudinal design using data from the Household Income and Labour Dynamics of Australia survey, waves 5-15 (2005-2015). It included individuals aged 15 years and older from Australian households surveyed over a period of 11 years. The sample consisted of 23,251 individuals. The outcome measures included: Mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life. Using fixed effects regression and following individuals over time, the analysis took care of the issue of individuals self-selecting themselves as carers due to some predisposing factors such as age, poor health, socioeconomic status and sedentary behaviour.
Results: There were statistically significant carer-noncarer status differences in mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes. Aging had a modifying impact on carers’ mental and general health outcomes. Older carers coped better with their caregiving responsibilities than younger ones. Moreover, while physical activities had a positive influence on both mental and general health for non-carers, with more activities generating better health outcomes, it only had a modifying impact on carers’ mental health. Furthermore, the study found that moderate levels of social drinking had beneficial modifying impact on carers’ mental and general health.
Conclusion: This study added value to the literature on informal carers’ mental and general health in Australia by identifying some of the protective and risk factors. The study found the modifying effects of carers’ age, health behaviours such as physical activity, smoking and drinking status on their health. Finally, the study identified an apparent beneficial link between moderate levels of social drinking and carer health that needs to be further explored with more targeted future research.
Silicon application and related changes in soil bacterial community dynamics reduced ginseng black spot incidence in Panax ginseng in a short-term study
Authors: Li Meijia , Wang Qiuxia , Liu Zhengbo , Pan Xiaoxi , Zhang Yayu
Published: October 2019

Background This study analyzed the effect of silicon (Si) application on the occurrence of ginseng black spot caused by Alternaria panax . We explored the differences in soil physical and chemical factors and microbial community structure following Si application as well as the key factors that affected the occurrence of ginseng black spot in soil. Potted Panax ginseng plants were used to assess the effect of Si treatment on ginseng black spot. Soil physical and chemical properties were comprehensively analyzed. Bacterial communities were analyzed using Illumina HiSeq sequencing targeting the 16S rRNA gene.
Results After inoculation with A. panax , the morbidity (and morbidity index) of ginseng with and without Si was 52% (46) and 83% (77), respectively. Soil physical and chemical analysis showed that under the ginseng black spot inoculation, bacterial communities were mainly affected by pH and available potassium, followed by ammonium nitrogen and available Si. NMDS and PLS-DA analyses and the heat maps of relative abundance revealed that Si application elevated the resistance of ginseng black spot as regulated by the abundance and diversity of bacterial flora in rhizosphere soils. Heatmap analysis at the genus level revealed that A. panax + Si inoculations significantly increased the soil community abundance of Sandaracinus , Polycyclovorans , Hirschia , Haliangium , Nitrospira , Saccharothrix , Aeromicrobium , Luteimonas , and Rubellimicrobium and led to a bacterial community structure with relative abundances that were significantly similar to that of untreated soil.
Conclusions Short-term Si application also significantly regulated the structural impact on soil microorganisms caused by ginseng black spot. Our findings indicated that Si applications may possibly be used in the prevention and treatment of ginseng black spot.
Exosomal Bta-miR-185 and Bta-miR-378 Are Potential Markers for Quality Control of Milk Infected by Staphylococcus aureus
Authors: Ma Shaoyang , Tong Chao , Ibeagha-Awemu Eveline M. , Zhao Xin
Published: October 2019

MicroRNAs (miRNA) in milk-derived exosomes may reflect pathophysiological changes caused by mastitis. This study profiled miRNAs in milk exosomes and potential markers for quality control of milk infected by Staphylococcus aureus (S. aureus). Total RNA from milk exosomes was collected from healthy cows (n=3) and S. aureus infected cows (n=6). Two hundred ninety miRNAs (221 known and 69 novel ones) were identified. Among them, 22 known and 15 novel miRNAs were differentially expressed (DE). Target genes of DE miRNAs were significantly enriched in intracellular protein transport, endoplasmic reticulum and identical protein binding. Two miRNAs (bta-miR-378 and bta-miR-185) with high read counts and log2 fold changes (>3.5) were considered as potential milk exosome biomarker miRNAs for S. aureus mastitis and milk quality. One target gene (VAT1L) of bta-miR-378 and five target genes (DYRK1B, MLLT3, HP1BP3, NPR2 and PGM1) of bta-miR-185 were validated. DE miRNAs in exosomes from normal and S. aureus infected milk were identified. Two DE miRNAs could be used as potential biomarkers for the infection. The linkage between the validated target genes and diseases suggest that we should pay particular attention to exosome miRNAs from mastitic milk in terms of milk safety.
Mass screening for hepatitis B and C in the Southern Upper Egypt
Authors: Soliman Gamal , Elzalabany Mahmoud S. , Hassanein Tarek , Miller F. DeWolfe
Published: October 2019

Background : It is well documented that Egypt has the highest prevalence of hepatitis C virus (HCV) in the world. The recent development of fast acting, highly effective direct acting antiviral drugs (DAAs), has opened the possibility of treating and curing HCV infection in the Egyptian population on large scale.
Methods : A screening demonstration project was implemented in southern Egypt in and around the city of Luxor. Free screening and if indicated, treatment, was offered to those 16 years or older for anti-HCV antibody (anti-HCV) and hepatitis B virus surface antigen (HBsAg) using third generation enzyme immunoassays (Enzygnost® Anti-HCV and HbsAg). Statistical methods included estimation of odds ratios (OR) and 95% confidence intervals (95% CI).
Results: There was a large turnout of 67,042 persons who were screened in a 12-month period starting in June 2106. 31,965 males (47.7%) and 35,077 females (52.3%) were screened with a mean age of 43.6±14.3 years. 9,701 patients (14.5%) were positive for anti-HCV and 2,950 (4.4%) for HBsAg. Prevalence of anti-HCV was significantly higher in males than females (19.67% vs.9.73% OR=2.27; CI 2.2 to 2.4; p<0.001) and the same for HBsAg (6.2% vs. 2.8% OR=2.3; CI 2.2 to 2.5; p<0.001). The prevalence of anti-HCV was significantly associated with age (p<0.001), ranging from between 1-4% in individuals below the age of 40 years, then increased steadily to 42% at age 60 followed by a precipitous decline in age specific prevalence.
Conclusions: The results showed unanticipated patterns of anti-HCV and HBsAg by age and gender in contrast to previous reports on this unique HCV epidemic in Egypt. Moreover, the results provide essential information for effective planning, design, and evaluation for future Egyptian national mass screen and treatment programs.
Small RNA-seq analysis of exosomes from porcine uterine luminal fluid during peri-implantation
Authors: Hua Renwu , Wang Yueying , Lian Weisi , Li Wenchao , Xi Yu , Xue Songyi , Kang Tingting , Lei Minggang
Published: October 2019

Background The exosomes of uterine luminal fluid (ULF) mediate intrauterine communication between conceptus and uterus in pigs. The small RNAs of ULF exosomes are widely recognized as important factors that influence embryonic implantation in humans, mice, cattle and sheep. Therefore, it can be hypothesized that small RNAs of ULF exosomes are essential for implantation in pigs. Results Cup-shaped exosomes (diameters: 40–160 nm) of porcine ULF were isolated and characterized, and then PKH67 stained exosomes were taken up by endometrial epithelial cells and porcine trophectoderm cells. The expression of small RNAs in these exosomes on days 10 (D10), 13 (D13) and 18 (D18) of pregnancy was comprehensively profiled through sequencing. From nine libraries, a total of 152 known microRNAs (miRNAs), 43 novel miRNAs and 145 novel Piwi-interacting RNAs (piRNAs) were identified. Among these small RNAs, ssc-miR-21-5p, ssc-let-7a, ssc-let-7i-5p and ssc-let-7g were differentially and highly expressed during the three stages. Hierarchical cluster analysis and principal component analysis suggested that the expression profiles of small RNAs in D13 group were different from those in D10 and D18 groups. Bioinformatics analysis showed that the miRNAs differentially expressed in the comparisons between D10 and D13, D13 and D18, and D10 and D18 groups were involved in important molecular functions and pathways such as “G-protein coupled receptor activity” and “Insulin signaling pathway”. Conclusions Our results reveal that porcine ULF exosomes contain various small RNAs with potentially vital effects on implantation. This research also provides resources for studies of miRNAs and piRNAs in the cross-talk between embryo and endometrium.