bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between Cytomegalovirus End-organ Diseases andModerate-to-Severe Dementia: A Population-Based Cohort Study
Authors: Lee Kyoung Hwa , Kwon Da Eun , Han Kyung Do , La Yeonju , Han Sang Hoon
Published: April 2020

Background: The association between cytomegalovirus (CMV) and dementia remains controversial. Previous studies have suggested that CMV serostatus, as assessed by serum immunoglobulin G, plays a role in neurodegeneration with cognitive impairment. We aimed to evaluate the association between CMV tissue-invasive end-organ diseases and moderate-to-severe dementia.Methods: The ICD 10th revision codes from the National Health Insurance Database covering the entire population of the Republic of Korea were used to classify patients into exposed (n = 687, age ≥40 years, with CMV disease) and unexposed (n = 3,435, without CMV disease) groups, matched by age and sex at a 1:5 ratio of exposed: unexposed. All non-HIV-1-infected subjects selected during 2010–2014 with a washout period of the previous 4 years were followed up until December 2016 to identify newly diagnosed cases of moderate-to-severe dementia. Results: Multivariate regression model (M3) adjusted for age, sex, low income, body mass index, transplantation status, malignant neoplasms, end-stage renal disease on dialysis, type 2 diabetes mellitus, hypertension, and dyslipidaemia showed a significantly higher incidence of dementia (odds ratio: 1.9; 95% confidence interval: 1.2–2.8) in the exposed group than that in the unexposed group. The risk of vascular dementia (2.9, 1.1–7.5) was higher than that of Alzheimer’s disease (1.6, 1.0–2.6) in the exposed group in M3. In M3, patients aged 40–59 years with CMV diseases had a significantly higher risk of all kinds of dementia than those aged 60-79 and ≥80 years (11.7, 2.5–49.4 vs. 1.8, 1.1–3.2 vs. 1.3, 0.5–2.8; P=0.025). Conclusions: CMV diseases may be associated with the risk of moderate-to-severe dementia.
Ethnomedicinal knowledge of a marginal hill community of Central Himalaya: Diversity, usage pattern and conservation concerns
Authors: Ojha S. N. , Tiwari Deepti , Anand Aryan , Sundriyal R.C.
Published: April 2020

Background Indigenous communities use wild plants to cure human ailments since ancient times, such knowledge has significant potential for formulating new drugs and administering future health care. Considering this the present study was undertaken to assess use value, diversity, and conservation concerns of medicinal plants used in traditional herbal care system of a marginal hill community in Bageshwar district of Uttarakhand in the Central Himalayan region of India. Methodology Extensive surveys were made in 73 villages to gather information on ethnomedicinal use of plant species used in traditional herbal healing system. A total of 100 respondents were identified (30 herbal healers called ‘ Vaidyas’ and 70 non-healers/natives) and interviewed using semi-structured questionnaires, target interviews and group discussion. Some important indices such as the use value index (UV), relative frequency citation (RFC), cultural importance index (CI), and informant consensus factor (F ic ) were calculated for the medicinal plants included in the present study. Result It was recorded that the community use a total of 70 species with 64 genera and 35 families for curing various ailments. Family Lamiaceae recorded maximum number of medicinal plants. 21 species used most extensively in traditional health care system. The major parts of the identified plants used for treatment of various ailments were root/rhizome and leaf. The most common methods used for preparation of these plants were decoction and infusion. Ocimum basilicum L., Cannabis sativa L., Citrus aurantifolia (Christm) Sw., Curcuma longa L.and Setaria italic L. had the highest rate of use report. RFC value ranged between 0.03 to 0.91 with highest values for Setaria italica, Zingiber officinale, Ocimum basilicum, and Rephanus sativus . The traditional knowledge is passed verbally to generations and needs to be preserved for the future bio-prospecting of plants that could be a potential cure to any future disease. Conclusion In recent years the community has access to modern hospitals and medicinal facilities, although a considerable number still prefer medicinal plants for curing select ailments. It is suggested that these ethnomedicial species need to be screened and evaluated further for their effectiveness for pharmacological activity. Also, significant efforts are required to conserve traditional knowledge and natural habitats of wild medicinal plants.
Malaria knowledge and experiences with community health workers among recently pregnant women in Malawi
Authors: Malpass Ashley , Chinkhumba Jobiba , Davlantes Elizabeth , Munthali John , Wright Katherine , Ramsey Kathryn , Troell Peter , Kayange Michael , Kachale Fannie , Mathanga Don P. , Chatata Dziko , Gutman Julie R
Published: April 2020

Background The World Health Organization recommends three or more doses of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) to mitigate the negative effects of malaria in pregnancy (MIP). Many pregnant women in Malawi are not receiving the recommended number of doses. Community delivery of IPTp (cIPTp) is being piloted as a new approach to increase coverage. This survey assessed recently pregnant women’s knowledge of MIP and their experiences with community health workers (CHWs) prior to implementing cIPTp. Methods Data were collected via a household survey in Ntcheu and Nkhata Bay Districts, Malawi, from women aged 16-49 years who had a pregnancy resulting in a live birth in the previous 12 months. Survey questions were primarily open response and utilized review of the woman’s health passport whenever possible. Analyses accounted for selection weighting and clustering at the health facility level and explored heterogeneity between districts.Results A total of 370 women were interviewed. Women in both districts found their CHWs to be helpful (77.9%), but only 35.7% spoke with a CHW about antenatal care and 25.8% received assistance for malaria during their most recent pregnancy. A greater proportion of women in Nkhata Bay than Ntcheu reported receiving assistance with malaria from a CHW (42.7% vs 21.9%, p=0.01); women in Nkhata Bay were more likely to cite IPTp-SP as a way to prevent MIP (41.0% vs 24.8%, p=0.02) and were more likely to cite mosquito bites as the only way to spread malaria (70.6% vs 62.0% p=.03). Women in Nkhata Bay were more likely to receive 3+ doses of IPTp-SP (IPTp3) (59.2% vs 41.8%, p=0.0002). Adequate knowledge was associated with increased odds of receiving IPTp3, although not statistically significantly so (adjusted odds ratio = 1.50, 95% confidence interval 0.97- 2.32, p-value 0.066). Conclusions Women reported positive experiences with CHWs, but there was not a focus on MIP. Women in Nkhata Bay were more likely to be assisted by a CHW, had better knowledge, and were more likely to receive IPTp3+. Increasing CHW focus on the dangers of MIP and implementing cIPTp has the potential to increase IPTp coverage.
Does zero-profile anchored cage accompanied by a higher postoperative subsidence compared with cage-plate construct? A meta-analysis
Authors: Lu Yingjie , Fang Yuepeng , Shen Xu , Lu Dongdong , Zhou Liyu , Gan Minfeng , Zhu Xuesong
Published: April 2020

Background: The zero-profile anchored cage (ZP) has been widely used for its lower occurrence of dysphagia. However, it is still controversial whether it has the same stability as the cage-plate construct (CP) and increases the incidence of postoperative subsidence. We compared the rate of subsidence after anterior cervical discectomy and fusion (ACDF) with ZP and CP to determine whether the zero-profile device had a higher subsidence rate.Methods: We performed a meta-analysis of studies that compared the subsidence rates of ZP and CP. An extensive and systematic search covered the Medline, Embase and Web of Science databases according to the PRISMA guidelines and identified ten articles that satisfied our inclusion criteria. Relevant clinical and radiological data were extracted and analyzed by RevMan 5.3 software.Results: Ten trials involving 626 patients were included in this meta-analysis. The incidence of postoperative subsidence in the ZP group was significantly higher than that in the CP group [15.1% (89/588) vs. 8.8% (51/581), OR = 1.97 (1.34, 2.89), P = 0.0005]. In the subgroup analysis, we found that the definition of subsidence did not affect the higher subsidence rate in the ZP group. Considering the quantity of operative segments, there was no significant difference in the incidence of subsidence between the two groups after single-level fusion (OR 1.43, 95% CI 0.61-3.37, P = 0.41). However, the subsidence rate of the ZP group was significantly higher than that of the CP group (OR 2.61, 95% CI 1.55-4.40, P = 0.0003) after multilevel (≥ 2-level) procedures. There were no significant differences in intraoperative blood loss, JOA score, NDI score, fusion rate or cervical alignment in the final follow-up between the two groups. In addition, the CP group had a longer operation time and a higher incidence of dysphagia than the ZP group at each follow-up time. Conclusion: Based on the limited evidence, we suggest that ZP has a higher risk of postoperative subsidence than CP, although with elevated swallowing discomfort. A high-quality, multi-center randomized controlled trial is required to validate our results in the future.
iTRAQ-based quantitative proteomics analysis of cantaloupe (Cucumis melo var. saccharinus) after cold storage
Authors: Song Wen , Tang Fengxian , Cai Wenchao , Zhang Qin , Zhou Fake , Ning Ming , Tian Huan , Shan Chunhui
Published: April 2020

Background: Cantaloupe is susceptible to cold stress when it is stored at low temperatures, resulting in the loss of edible and commercial quality. To ascertain the molecular mechanisms of low temperatures resistance in cantaloupe, a cold-sensitive cultivar, Golden Empress-308 (GE) and a cold-tolerant cultivar, Jia Shi-310 (JS), were selected in parallel for iTRAQ quantitative proteomic analysis. Results: The two kinds of commercial cultivars were exposed to a temperature of 0.5℃ for 0, 12 and 24 days. We found that the cold-sensitive cultivar (GE) suffered more severe damage as the length of the cold treatment increased. Proteomic analysis of both cultivars indicated that the number of differentially expressed proteins (DEPs) changed remarkably during the chilly treatment. JS expressed cold-responsive proteins more rapidly and mobilized more groups of proteins than GE. Furthermore, metabolic analysis revealed that more amino acids were up-regulated in JS during the early phases of low temperatures stress. The DEPs we found were mainly related to carbohydrate and energy metabolism, structural proteins, reactive oxygen species scavenging, amino acids metabolism and signal transduction. The consequences of phenotype assays, metabolic analysis and q-PCR validation confirm the findings of the iTRAQ analysis. Conclusion: We found that the prompt response and mobilization of proteins in JS allowed it to maintain a higher level of cold tolerance than GE, and that the slower cold responses in GE may be a vital reason for the severe chilling injury commonly found in this cultivar. The candidate proteins we identified will form the basis of future studies and may improve our understanding of the mechanisms of cold tolerance in cantaloupe.
Modeling Observations with a Detection Limit using a Truncated Normal Distribution with Censoring
Authors: Williams Justin R. , Kim Hyung-Woo , Crespi Catherine M.
Published: April 2020

Background: When data are collected subject to a detection limit, observations below the detection limit may be considered censored. In addition, the domain of such observations may be restricted; for example, values may be required to be non-negative. Methods: We propose a method for estimating population mean and variance from censored observations that accounts for known domain restriction. The method finds maximum likelihood estimates assuming an underlying truncated normal distribution. Results: We show that our method, tcensReg, has lower bias, Type I error rates, and mean squared error than other methods commonly used for data with detection limits such as Tobit regression and single imputation under a range of simulation settings from mild to heavy censoring and truncation. We further demonstrate the consistency of the maximum likelihood estimators. We apply our method to analyze vision quality data collected from ophthalmology clinical trials comparing different types of intraocular lenses implanted during cataract surgery. All of the methods yield similar conclusions regarding non-inferiority, but estimates from the tcensReg method suggest that there may be greater mean differences and overall variability. Conclusions: In the presence of detection limits, our new method tcensReg provides a way to incorporate known domain restrictions in dependent variables that substantially improves inferences.
A Comparison of Efece Systems With Tension Band Wiring for Patella Fracture Fixation in Cadavers
Authors: Karadeniz emre , keskinöz elif nedret
Published: April 2020

Background: EFECE Systems are newly-defined internal fixation systems, which are suitable for patella fracture fixation. The aim of this study was to compare the fixation strength of EFECE Systems with tension band wiring for transverse patellar fracture simulation on fresh frozen cadaver models. Methods: Quadriceps tendon-patella-patellar tendon (QT-P-PT) complex was prepared from human cadavers. After simulation of a transverse patella fracture, in Group 1, 5 patella were fixed with a pair of 1.2 mm EFECE wires and 4 EFECE devices. In Group 2, 5 patella were fixed with a pair of 1.2 mm Kirschner wires (K-wire) and a cerclage wire according to the tension band technique.Using a testing device with custom-made jaws, increasing distraction force was applied to these QT-P-PT complexes. Extension of these complexes with the distraction forces was observed. The maximum distraction force and the elongation during maximum force were evaluated. Results: After 5 experiments with the EFECE Systems, there was no EFECE wire breakage or EFECE wire-EFECE device catching failure. The median maximum force was 740 N (720-810N). During maximum distraction force the median extension was 2.5 mm (1.6-2.5 mm).After 5 experiments with the tension band technique, there was no K-wire breakage. The median maximum force was 330 N (240-510N). During this maximum distraction force the median extension was 3.4 mm (2.2-3.8 mm).Conclusions: Based on the biomechanical advantages, patella fracture treatment with EFECE systems may constitute a reasonable alternative in the treatment of patella fractures.
Magnitude of Home Delivery and Associated Factors Among Child Bearing Age Mothers in Sherkole District, Benishangul Gumuz Regional State-Western-Ethiopia
Authors: Gebremariam Resom Berhe , Nigusie Adane
Published: April 2020

Background: The World Health Organization estimates that globally only 43 percent of women have access to skilled care during deliveries and the rest are exposed to unskilled delivery service. A recent Ethiopian Demographic and Health Survey report stated that maternal death was 412 per 100,000 in 2016.This still indicate that maternal health remains a major public health problem in Ethiopia irrespective of the government’s measure to institutional delivery.Methods: - A community based cross sectional study was conducted among women aged 15-49 years in Sherkole district, Benishangul Gumuz region from January to June 2018. A total of 451 randomly selected women were included in the study. Stratified sampling followed by simple random sampling technique was used to select the study participants. Data were collected using pretested and structured questionnaires. Bivariate and multivariate logistic regression models were fitted to identify factors associated with home delivery among women in the child bearing age. An adjusted odds ratio with 95% confidence interval was computed to determine the level of significance. Results: The magnitude of home delivery was 353 (80%) and were assisted by non-skilled birth attendants. Mothers whose husband choose the place of delivery [AOR: 5.6, 95% CI (2.1-15.2), Mothers’ occupation ([AOR: 0.21 95% C I (0.08-0.57), ANC visit [AOR: 95 CI: 5.1(1.6-15.8), decision making [AOR: 95 CI: 0.3(0.01-0.7)] and traditional remedies [AOR: 95%CI: 0.03(0.01-0.09)] were significantly associated with home delivery.Conclusions: Based on the findings of the survey, it was concluded that the overall magnitude of home delivery was found to be high. Therefore, it is recommended that promotion of antenatal care follow-up with maternal and child health information particularly on delivery complications or danger signs needs due attention and remedial actions.
A retrospective cohort investigation of seroprevalence of Marburg virus and ebolaviruses in two different ecological zones in Uganda
Authors: Nyakarahuka Luke , Schafer Ilana J. , Balinandi Stephen , Mulei Sophia , Tumusiime Alex , Kyondo Jackson , Knust Barbara , Lutwama Julius J , Rollin Pierre , Nichol Stuart , Shoemaker Trevor
Published: April 2020

Background: Uganda has experienced seven Ebola Virus Disease (EVD) outbreaks and four Marburg Virus disease (MVD) outbreaks between 2000 and 2019. We investigated the seroprevalence and risk factors for Marburg virus and ebolaviruses in gold mining communities around Kitaka gold mine in Western Uganda, and compared them to non-mining communities in Central Uganda.Methods: A questionnaire was administered and human blood samples were collected from three exposure groups in Western Uganda (gold miners, household members of miners, non-miners living within 50 km of Kitaka mine). The unexposed controls group sampled was community members in Central Uganda far away from any gold mining activity which we considered as low-risk for filovirus infection. ELISA serology was used to analyse samples, detecting IgG antibodies against Marburg virus and ebolaviruses (filoviruses). Data was analysed in STATA software using risk ratios and odds ratios. Results: Miners in western Uganda were 5.4 times more likely to be filovirus seropositive compared to the control group in central Uganda (RR=5.4; 95% CI 1.5 – 19.7) whereas people living in high-risk areas in Ibanda and Kamwenge disricts were 3.6 more likely to be seropositive compared to control group in Luweeero district (RR=3.6; 95% CI 1.1 – 12.2) . Among all participants, filovirus seropositivity was 2.6% (19/724) of which 2.5% (18/724) was to Sudan virus and 0.1 % (1/724) to Marburg virus. One individual seropositive for Sudan virus also had IgG antibodies reactive to Bundibugyo virus. The risk factors for filovirus seropositivity identified included mining (AOR=3.4; 95% CI 1.3-8.5), male sex (AOR=3.1; 95% CI 1.01 - 9.5), going inside mines (AOR=3.1; 95% CI 1.2 - 8.2), cleaning corpses (AOR=3.1; 95% CI 1.04 - 9.1) and contact with suspect filovirus cases (AOR=3.9, 95% CI 1.04 -14.5). Conclusions: These findings indicate that filovirus outbreaks may go undetected in Uganda and people involved in artisan gold mining are more likely to be exposed to infection with either Marburg virus or ebolaviruses, likely due to increased risk of exposure to bats. This calls for active surveillance in known high-risk areas for early detection and response to prevent filovirus epidemics.
A convenient clinical nomogram for predicting the cancer-specific survival of individual patients with small-intestine adenocarcinoma
Authors: Wang Na , Yang Jin , Lyu Jun , Liu Qingqing , He Hairong , Liu Jie , Li Li , Ren Xuequn , Li Zhendong
Published: April 2020

Background: The objective of this study was to develop a practical nomogram for predicting the cancer-specific survival (CSS) of patients with small-intestine adenocarcinoma . Methods: Patients diagnosed with small-intestine adenocarcinoma between 2010 and 2015 were selected for inclusion in this study from the Surveillance, Epidemiology, and End Results (SEER) database. The selected patients were randomly divided into the training and validation cohorts at a ratio of 7:3. The predictors of CSS were identified by applying both forward and backward stepwise selection methods in a Cox regression model . The performance of the nomogram was measured by the concordance index (C-index), the area under receiver operating characteristic curve (AUC) , calibration plots, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI) , and decision-curve analysis (DCA). Results: Multivariate Cox regression indicated that factors including age at diagnosis, sex, marital status, insurance status, histology grade, SEER stage, surgery status, T stage, and N stage were independent covariates associated with CSS. These factors were used to construct a predictive model, which was built and virtualized by a nomogram. The C-index of the constructed nomogram was 0.850. The AUC values indicated that the established nomogram displayed better discrimination performance than did the seventh edition of the American Joint Committee on Cancer TNM staging system in predicting CSS. The IDI and NRI also showed that the nomogram exhibited superior performance in both the training and validation cohorts. Furthermore, the calibrated nomogram predicted survival rates that closely corresponded to actual survival rates, while the DCA demonstrated the considerable clinical usefulness of the nomogram. Conclusion: We have constructed a nomogram for predicting the CSS of small-intestine adenocarcinoma patients . This prognostic model may improve the ability of clinicians to predict survival in individual patients and provide them with treatment recommendations.
High incidence of surgical site infection may be related to suboptimal case selection for non-selective arterial embolization during resuscitation of patients with pelvic fractures: A retrospective study
Authors: Lai Chih-Yang , Tseng I-Chuan , Su Chun-Yi , Hsu Yung-Heng , Chou Ying-Chao , Chen Huan-Wu , Yu Yi-Hsun
Published: April 2020

Background : In most institutions, arterial embolization (AE) remains a standard procedure to achieve hemostasis during the resuscitation of patients with pelvic fractures. However, the actual benefits from AE are controversial. Methods : We retrospectively reviewed data from patients who were treated for closed pelvic fractures at a single center between 2014 and 2017. Data regarding the AE and clinical parameters were analyzed to determine whether poor outcomes could be predicted. Results : During the study period, 545 patients were treated for closed pelvic fractures, including 131 patients who underwent angiography and 129 patients who underwent AE. Nonselective bilateral internal iliac artery embolization (nBIIAE) was the major AE strategy (74%). Relative to the non-AE group, the AE group had higher values for the injury severity score, shock at hospital arrival, and unstable fracture patterns. Furthermore, relative to the non-AE group, the AE group was more likely to require osteosynthesis and experience surgical site infection (SSI). Fourteen patients (10.9%) experienced late complications following the AE intervention, including 3 men who had impotence at the 12-month follow-up visit and 11 patients who experienced SSIs after undergoing AE and osteosynthesis (incidence of SSI: 11/75 patients, 14.7%). Nine of the 11 patients who experienced SSI after AE had undergone nBIIAE. The positive predictive value of contrast extravasation (CE) during computed tomography (CT) was 29.6%, with a negative predictive value of 91.3%. Relative to patients with identifiable CE, patients without identifiable CE during CT had a higher mortality rate (30.0% vs. 11.0%, p = 0.03). Conclusion : Performing AE for pelvic fracture-related hemorrhage may not be the best practice for patients with no CE detected during CT or for unstable patients who do not respond to resuscitation after excluding other sources of hemorrhage. Given the high incidence of SSI following nBIIAE, this procedure should be carefully selected. Other hemostasis procedures, such as preperitoneal pelvic packing, might be appropriate for patients without CE during imaging, based on their high mortality rate.
TNF-α inhibitor therapy can improve the immune imbalance of CD4+ T cells and negative regulatory cells but not CD8+ T cells in ankylosing spondylitis
Authors: Yang Mingcan , Lv Qing , Wei Qiujing , Jiang Yutong , Qi Jun , Xiao Min , Fang Linkai , Xie Ya , Cao Shuangyan , Lin Zhiming , Zhang Yanli , Tu Liudan , Zhao Minjing , Pan Yunfeng , Jin Ou , Gu Jieruo
Published: April 2020

Background: Studies into ankylosing spondylitis (AS) and its relationship with immune function are controversial, and the correlation between the efficacy of TNF-α inhibitor and changes in immune function is unclear.Methods: A total of 40 immune cells were tested with flow cytometry, and the results of 105 HC (healthy control) subjects, 177 active-stage AS patients, and 23 AS cases before and after 12 weeks of TNF-α inhibitor therapy (Anbainuo) were analyzed.Results: Compared with the HC group, the proportion of immune cells, such as naïve and central memory CD4+T cells, in AS increased (p<0.0001), but effector memory and terminally differentiated CD4+T cells were decreased (p<0.01 and 0.0001, respectively). Naïve, central memory, and effector memory CD8+T cells were increased (p<0.0001, 0.001, and 0.01, respectively), but terminally differentiated CD8+T cells were decreased (p<0.0001). Th1 cells (helper T cells-1), Tfh1 cells (follicular helper T cells-1), Tc1 cells (cytotoxic T cells-1), and Tregs (regulatory T cells) were lower (p<0.01, 0.05, 0.0001, and 0.001, respectively), but Th17 cells, Tfh17 cells, and Tc cells were higher (p<0.001, 0.0001 and 0.001, respectively). The proportions of total B cells and class-switched B cells were increased (p<0.05), but non-switched B cells, plasma cells, memory B cells, and immature Bregs (regulatory B cells) were lower (p<0.01, 0.0001, 0.0001, and 0.0001, respectively). After Anbainuo therapy, the percentage of naïve CD4+ T cells had decreased (p<0.05) but Tregs and B10 cells (IL-10-producing regulatory B cells) had increased (p<0.01and 0.05, respectively), and the increase in Tregs was positively correlated with the decrease in CRP (C-reactive protein) (r= 0.489, p=0.018). Conclusions: We found that active-stage AS patients have an immunity imbalance involving multiple types of immune cells, including CD4+T cells, CD8+T cells, Th cells, Tfh cells, Tc cells, Tregs, Bregs, and B cells. TNF-α inhibitor Anbainuo can not only help to inhibit disease activity but can also improve the immune imbalance of CD4+ T cells and negative regulatory cells. But CD8 + T cells have not been rescued.
Prevalence and phylogeny of Chlamydiae and hemotropic mycoplasma species in captive and free-living bats
Authors: Fritschi Janine , Marti Hanna , Seth-Smith Helena M.B. , Aeby Sébastien , Greub Gilbert , Meli Marina L. , Hofmann-Lehmann Regina , Mühldorfer Kristin , Stokar-Regenscheit Nadine , Wiederkehr Danja , Pilo Paola , Broek Peggy Van Den , Borel Nicole
Published: April 2020

Background: Bats are hosts for a variety of microorganisms, however, little is known about the presence of Chlamydiales and hemotropic mycoplasmas. This study investigated 475 captive and free-living bats from Switzerland, Germany and Costa Rica for Chlamydiales and hemotropic mycoplasmas by PCR to determine the prevalence and phylogeny of these organisms.Results: Screening for Chlamydiales resulted in a total prevalence of 31.4%. Positive samples originated from captive and free-living bats from all three countries. Sequencing of 15 samples allowed the detection of two phylogenetically distinct groups. These groups share sequence identities to Chlamydiaceae, and to Chlamydia-like organisms including Rhabdochlamydiaceae and unclassified Chlamydiales from environmental samples, respectively.PCR analysis for the presence of hemotropic mycoplasmas resulted in a total prevalence of 0.7%, comprising free-living bats from Germany and Costa Rica. Sequencing and phylogenetic analysis revealed three sequences related to other unidentified mycoplasmas found in vampire bats and Chilean bats.Conclusions: Bats can harbor Chlamydiales and hemotropic mycoplasmas and the newly described sequences in this study indicate that the diversity of these bacteria in bats is much larger than previously thought. Both, Chlamydiales and hemotropic mycoplasmas are not restricted to certain bat species or countries and captive and free-living bats can be colonized. In conclusion, bats represent another potential host or vector for novel, previously unidentified, Chlamydiales and hemotropic mycoplasmas.
Implementation of a Quality Improvement Strategy to Increase Outpatient Kidney Transplant Referrals
Authors: Farouk Samira , Atallah Sarah , Campbell Kirk N , Vassalotti Joseph A , Uribarri Jaime
Published: April 2020

Background: Kidney transplantation remains the optimal therapy for patients with end stage kidney disease (ESKD), though a small fraction of patients on dialysis are on organ waitlists. An important barrier to preemptive kidney transplantation and successful waitlisting is timely referral to a kidney transplant center. We implemented a quality improvement strategy to improve outpatient kidney transplant referrals in a single center academic outpatient nephrology clinic. Methods: Over a 3 month period (July 1 - September 30, 2016), we assessed the baseline kidney transplantation referral rate at our outpatient nephrology clinic for patients 18 - 75 years old with an estimated glomerular filtration rate (eGFR) of less than 20 mL/min/1.73m 2 (2 values over 90 days apart). Charts were manually reviewed by two reviewers to look for kidney transplant referrals and documentation of discussions about kidney transplantation. We then performed a root cause analysis to explore potential barriers to kidney transplantation. Our intervention began on July 1, 2017 and included the implementation of a column in the electronic medical record (EMR) which displayed the patient's last eGFR as part of the clinic schedule. Physicians were given a document listing their patients to be seen that day with an eGFR of < 20 mL/min/1.73m 2 . Results: 54 unique patients with eGFR ≤ 20 ml/min/1.73 m 2 were identified who were seen in the Clinic between July 1, 2016 and September 30, 2016. 29.6% (16) eligible patients were referred for kidney transplantation evaluation. 69.5% (37) of these patients were not referred for kidney transplant evaluation. 46.3% (25) did not have documentation regarding kidney transplant in the EMR. Following the intervention, 66 unique patients met criteria for eligibility for kidney transplant evaluation. Kidney transplant referrals increased to 60.6% (p < 0.001). Conclusions: Our pilot implementation study of a strategy to improve outpatient kidney transplant referrals showed that a free, simple, scalable intervention can significantly improve kidney transplant referrals in the outpatient setting Next steps include further study of the impact of early referral to kidney transplant centers on preemptive and living donor kidney transplantation as well as successful waitlisting.
The impact of body mass index on adaptive immune cells in the human bone marrow
Authors: Pangrazzi Luca , Naismith Erin , Miggitsch Carina , Arana Jose’ Antonio Carmona , Keller Michael , Grubeck-Loebenstein Beatrix , Weinberger Birgit
Published: April 2020

Background. Obesity has been associated with chronic inflammation and oxidative stress. Both conditions play a determinant role in the pathogenesis of age-related diseases, such as immunosenescence. Adipose tissue can modulate the function of the immune system with the secretion of molecules influencing the phenotype of immune cells. The importance of the bone marrow (BM) in the maintenance of antigen-experienced adaptive immune cells has been documented in mice. Recently, some groups have investigated the survival of effector/memory T cells in the human BM. Despite this, whether high body mass index (BMI) may affect immune cells in the BM and the production of molecules supporting the maintenance of these cells it is unknown.Methods. Using flow cytometry, the frequency and the phenotype of immune cell populations were measured in paired BM and PB samples obtained from persons with different BMI. Furthermore, the expression of BM cytokines was assessed. The influence of cytomegalovirus (CMV) on T cell subsets was additionally considered, dividing the donors into the CMV- and CMV+ groups.Results. Our study suggests that increased BMI may affect both the maintenance and the phenotype of adaptive immune cells in the BM. While the BM levels of IL-15 and IL-6, supporting the survival of highly differentiated T cells, and oxygen radicals increased in overweight persons, the production of IFNγ and TNF by CD8+ T cells was reduced. In addition, the frequency of B cells and CD4+ T cells positively correlated with BMI in the BM of CMV- persons. Finally, the frequency of several T cell subsets, and the expression of senescence/exhaustion markers within these subpopulations, were affected by BMI. In particular, the levels of bona fide memory T cells may be reduced in overweight persons.Conclusion. Our work suggests that, in addition to aging and CMV, obesity may represent an additional risk factor for immunosenescence in adaptive immune cells. Metabolic interventions may help in improving the fitness of the immune system in the elderly.
Measuring Antibody Avidity to Plasmodium Falciparum Merozoite Antigens Using a Multiplex Immunoassay Approach
Authors: Taylor Diane Wallace , Bobbili Naveen , Kayatani Alexander K , Tassi-Yunga Samuel , Kidima Winifrida , Leke Rose FG
Published: April 2020

Background: Antibodies (Ab) play a significant role in immunity to Plasmodium falciparum malaria. Usually, following repeated exposure to pathogens, affinity maturation and clonal selection take place, resulting in increased antibody avidity. However, some studies suggest affinity maturation may not occur to malaria antigens in endemic areas. Information on development of antibody avidity is confusing and conflicting, in part, because different techniques have been used to measure avidity. Today, bead-based multiplex immunoassays (MIA) are routinely used to simultaneously quantitate antibody levels to multiple antigens. This study evaluated the feasibility of developing an avidity MIA with 5 merozoite antigens (AMA1, EBA-175, MSP1-42, MSP2, MSP3) that uses a single chaotropic concentration.Methods: The most common ELISA protocols that used the chaotropic reagents guanidine HCl (GdHCl), urea, and ammonium thiocyanate (NH4SCN) were adapted to a multiplex MIA format. Then, different concentrations of chaotropes and incubation times were compared and results were expressed as an Avidity Index (AI), i.e., percentage of antibody remaining bound in the presence of chaotrope. Experiments were conducted to i) identify the assay with the widest range of AI (discriminatory power), ii) determine the amount of chaotrope needed to release 50% of bound Ab using plasma from adults and infants, and iii) evaluate assay repeatability. Results: Overall, 4M GdHCl and 8M urea were weaker chaotropes than 3M NH4SCN. For example, they failed to release significant amounts of Ab bound to MSP1-42 in adult plasma samples; whereas, a range of AI values was obtained with NH4SCN. Titration of NH4SCN revealed that 2M NH4SCN gave the widest range of AI for the 5 antigens. Binding studies using plasma from 40 adults and 57 one-year old infants in Cameroon showed that 2.1M ± 0.32 (mean ± SD) NH4SCN (adults) and 1.8M ± 0.23M (infants) released 50% of bound Ab from the merozoite antigens. Conclusions. An avidity MIA is feasible for the 5 merozoite antigens that uses a single concentration (2M) of NH4SCN. The assay provides a simple method to quickly obtain information about Ab quantity and quality in the acquisition of immunity to malaria in endemic populations.
Identification of blast resistance QTLs based on two ad vanced backcross populations in rice
Authors: Jiang Haichao , Feng Yutao , Qiu Lei , Gao Guanjun , Zhang Qinglu , He Yuqing
Published: April 2020

Background: Rice blast is an economically important and mutable disease of rice. Using host resistance gene to breed resistant varieties has been proven to be the most effective and economical method to control rice blast and new resistance genes or quantitative trait loci (QTLs) are then needed.Results: In this study, we constructed two advanced backcross population to mapping blast resistance QTLs. CR071 and QingGuAi were as the donor parent to establish two BC3F1 and derived BC3F2 backcross population in the Jin23B background. By challenging the two populations with natural infection in 2011 and 2012, 16 and 13 blast resistance QTLs were identified in Jin23B/CR071 and Jin23B/QingGuAi population, respectively. Among Jin23B/CR071 population, 3 major and 13 minor QTLs have explained the phenotypic variation from 3.50% to 34.08% during six observation times. And, among Jin23B/QingGuAi population, 2 major and 11 minor QTLs have explained the phenotypic variation from 2.42% to 28.95% during six observation times.Conclusions: Sixteen and thirteen blast resistance QTLs were identified in Jin23B/CR071 and Jin23B/QingGuAi population, respectively. QTL effect analyses suggested that major and minor QTLs interaction is the genetic basis for durable blast resistance in rice variety CR071 and QingGuAi.
Evaluation of a cell-based osteogenic formulation compliant with good manufacturing practice for use in tissue engineering
Authors: Vivas Daniel , Grau-Vorster Marta , Oliver-Vila Irene , García-López Joan , Vives Joaquim
Published: April 2020

Background: Proper bony tissue regeneration requires mechanical stabilization, an osteogenic biological activity and appropriate scaffolds. The latter two elements can be combined in a hydrogel format for effective delivery, so it can readily adapt to the architecture of the defect. Results: We evaluated a Good Manufacturing Practice-compliant formulation composed of bone marrow-derived mesenchymal stromal cells in combination with bone particles (Ø = 0.25 to 1 µm) and fibrin, which can be readily translated into the clinical setting for the treatment of bone defects, as an alternative to bone tissue autografts. Remarkably, cells survived with unaltered phenotype (CD73+, CD90+, CD105+, CD31-, CD45-) and retained their osteogenic capacity up to 48 h after being combined with hydrogel and bone particles, thus demonstrating the stability of their identity and potency. Moreover, in a subchronic toxicity in vivo study, no toxicity was observed upon subcutaneous administration in athymic mice and signs of osteogenesis and vascularization were detected two months after administration.Conclusions: The preclinical data gathered in the present work, in compliance with current quality and regulatory requirements, demonstrated the feasibility of formulating an osteogenic cell-based tissue engineering product with a defined profile including identity, purity and potency (in vitro and in vivo), and the stability of these attributes, which complements the preclinical package required prior to move towards its use of prior to its clinical use.
Improving the energy conversion efficiency of a laser-driven flyer by an in-situ fabricated nano-absorption layer
Authors: Wang Liang , Yan Yichao , Ji Xiangbo , Zhang Wanli , Jiang Hongchuan , Qin Wenzhi , Wang Yao , Tang Duo
Published: April 2020

Three kinds of Al flyer plates with different nanostructured absorption layers were in-situ prepared by a direct laser writing technology to improve the energy conversion efficiency in a laser-driven flyer assembly. Microstructures, light absorption, flyer velocity in the acceleration chamber were investigated. The reflectance for the flyers at 1064 nm wavelength can be reduced from 81.3% to 9.8% by the nanostructured absorption layer. The terminal velocity of a 50 μm thick Al flyer irradiated by a 60mJ laser pulse is 831 m/s, while the velocity of the flyer with an in-situ fabricated nano-absorption layer reaches up to 1113 m/s at the same condition. Resultantly, the energy conversion efficiency of the flyer with nanostructure absorption layer can reach as high as 1.99 times that of the Al flyer. Therefore, the nanostructured absorption layer in-situ prepared on the surface of a flyer provides a new method to significantly improve the energy conversion efficiency of a laser-driven flyer.
Association between social capital and mental health among older people living with HIV: The Sichuan Older HIV-Infected Cohort Study (SOHICS)
Authors: Han Jiayu , Jia Peng , Huang Yuling , Gao Bo , Yu Bin , Yang Shifan , Yu Jun , Xiong Jun , Liu Chang , Xie Tian , Dong Peijie , Yang Chao , Wang Zixin , Yang Shujuan
Published: April 2020

Background: Mental health problems are common among older people living with HIV and associated with poorer health outcomes. Social capital is an important determinant of mental health problems but under-studied in this population. This study investigated the association between social capital and mental health problems among older people living with HIV in China.
Methods: The study was based on the baseline data of a cohort study investigating mental health among older people living with HIV in Sichuan, China during November 2018 to February 2019. Participants were people living with HIV aged ≥50 years living in Sichuan province. Stratified multi-stage cluster sampling was used to recruit participants from 30 communities/towns; 529 out of 556 participants being approached completed the face-to-face interview. Social capital was measured by two validated health-related social capital scales: the Individual and Family scale and the Community and Society scale. Presence of probable depression (CES-D-10 score ≥10) and probable anxiety (GAD-7 score ≥5) were used as dependent variables. Two-level logistic regression models were applied to examine the association between social capital and probable depression/anxiety.
Results: The prevalence of probable depression and probable anxiety was 25.9% (137/529) and 36.3% (192/529) , respectively. After adjusting for significant covariates, the individual/family level of social capital was inversely associated with both probable depression (odds ratios (OR): 0.89, 95%CI: 0.84-0.93, p <0.001) and probable anxiety (OR: 0.90, 95%CI: 0.86-0.95, p <0.001). The community/society level social capital was associated with probable depression (OR: 0.91, 95%CI: 0.84-0.99, p <0.001) but not probable anxiety ( p >0.05).
Conclusions: Interventions building up social capital should be considered to improve mental health of older people living with HIV. Some useful strategies include cognitive processing therapy, improving community networking and engagement, and promoting social bonding with neighborhood.
Impact of guideline awareness in public pharmacies on counseling of patients with acute or chronic constipation in a survey of pharmacy personnel
Authors: Eberlin Marion , Landes Sabine , Biber-Feiter Doerthe , Michel Martin C.
Published: April 2020

Background: Constipation is often self-managed by patients and guidelines are available to aid healthcare professionals in the counseling of patients for self-management. Therefore, we have explored the knowledge and attitude of pharmacy personnel towards guidelines for the management of acute and functional chronic constipation and how they affects their recommendations.Methods: An online survey was conducted among 201 pharmacists and pharmacy technicians from an existing panel. They were presented with two typical cases, a 62-year old woman with functional chronic constipation and a 42-year old woman with travel plans. For each case, they were asked about their treatment recommendations and the underlying rationale. Thereafter, they were provided with contents from an applicable national guideline and asked again about their recommendations and the underlying rationale. In line with the exploratory nature, data were analyzed in a descriptive manner only. Results: Before exposure to guideline content, the most frequent recommendations for chronic constipation were macrogol, fiber and lactulose and for acute constipation sodium picosulfate, bisacodyl and enemas. Following guideline exposure, the most frequent recommendations for chronic constipation were macrogol, bisacodyl and sodium picosulfate and for acute constipation bisacodyl, sodium picosulfate and macrogol (all three equally recommended by the guideline for the management of acute and chronic constipation). Correspondingly, the rationale behind the recommendations shifted with guideline conformity becoming a leading reason.Conclusions: Awareness of the content of an applicable guideline on the management of constipation was poor among pharmacy personnel. Accordingly, recommendations in many cases were not in line with the guideline. Greater awareness of guideline content is desirable to enable more evidence-based recommendations in the management of constipation.
Maternal health services for pregnant adolescent girls in Uganda: Barriers and Opportunities
Authors: Namuli Vivian , Chinkonono Gorgeous Sarah , Atuhaire Catherine , Christensen Betty Nyawira , Pemunta Vitalis , Cumber Samuel Nambile
Published: April 2020

Background: Globally, adolescent pregnancy is one of the major areas of concern. Over 16 million girls aged between 15-19 years give birth, while over 1 million become pregnant before 15 years, most of who are in Sub-Saharan Africa. Yet, very few adolescents access maternal health services. This study explored the available maternal health services, barriers in accessing them and possible strategies for improving accessibility to these services among pregnant adolescents, specifically in Uganda.Methods: The study was carried out at Naguru teenage information and health Centre (NTIHC), Nakawa division, Kampala district using a qualitative research approach. Data was obtained using in-depth face to face interviews from 31 independent pregnant adolescents and four health care providers. These participants were selected using convenient sampling technique. Data was manually analyzed and themes were extracted and used in the interpretation of results.Results: The study found out that adolescents use only antenatal health care services while the uptake of postpartum health services was side-lined much as they were found available in the health facilities. The dominant antenatal care services among adolescents include; testing and managing of STIs, measuring pressure, tetanus vaccine, measuring weight, counselling and guidance, peer education, and providing drugs. Adolescents also encountered challenges such as long distances, financial constraints, stigmatization, negative attitude of health workers and community expressed bias when accessing these services. It further revealed that through government intervention, community and health workers, accessibility to maternal health services would be improved. Specifically, increasing remuneration for health workers; sensitizing communities about adolescent pregnancy and rights; construction of labour suites; and health workers’ competence were highly emphasized.Conclusion: Advertising and promotion of maternal health services; sensitization of community members; and government involvement will be the key parameters for enhancing maternal health care among adolescent mothers.