bluuebunny/crossref_metadata_2025 huggingface dataset:
An Update on Wrong-Site Spine Surgery
Authors: DeVine John G. , Chutkan Norman , Gloystein David , Jackson Keith
Published: January 2020

Study Design:

Broad narrative review of current literature and adverse event databases.

Objective:

The aim of this review is to report the current state of wrong-site spine surgery (WSSS), whether the Universal Protocol has affected the rate, and the current trends regarding WSSS.

Methods:

An updated review of the current literature on WSSS, the Joint Commission sentinel event statistics database, and other state adverse event statistics database were performed.

Results:

WSSS is an adverse event that remains a potentially devastating problem, and although the incidence is difficult to determine, the rate is low. However, given the potential consequences for the patient as well as the surgeon, WSSS remains an event that continues to be reported alarmingly as often as before the implementation of the Universal Protocol.

Conclusions:

A systems-based approach like the Universal Protocol should be effective in preventing wrong-patient, wrong-procedure, and wrong-sided surgeries if the established protocol is implemented and followed consistently within a given institution. However, wrong-level surgery can still occur after successful completion of the Universal Protocol. The surgeon is the sole provider who can establish the correct vertebral level during the operation, and therefore, it is imperative that the surgeon design and implement a patient-specific protocol to ensure that the appropriate level is identified during the operation.
Anticoagulation and Spine Surgery
Authors: Porto Guilherme B. F. , Jeffrey Wessell DO , Alvarado Anthony , Arnold Paul M. , Buchholz Avery L.
Published: January 2020

Study Design:

Literature review.

Objective:

Preoperative management of therapeutic anticoagulation in spine surgery is critical to minimize risk of thromboembolic events yet prevent postsurgical complications. Limited research is available, and most guidelines are based on drug half-lives. We aim to clarify current guidelines and available evidence for safe practice of spine surgery in this patient population.

Methods:

A literature search in PubMed was done encompassing comprehensive search terms to locate published literature on anticoagulation and spine surgery. Predefined inclusion and exclusion criteria were applied and data extraction was performed.

Results:

A total of 17 articles met the final inclusion criteria. Of these, 12 articles were retrospective chart reviews, 3 were prospective observational studies, and 2 were systematic reviews. Current practice suggests holding warfarin until international normalized ratio <1.4, anti-Xa drugs for 48 to 72 hours, 12 to 24 hours for low-molecular-weight heparin, and 4 to 24 hours for heparin, before surgery. Antiplatelet agents can be stopped for 1 to 3 days prior to operation (81-500 mg) but must be stopped for 1 week for doses >1 g/d. For Plavix, 5 to 7 days of discontinuation advised to prevent complications.

Conclusions:

This review provides an overview of main anticoagulation agents seen in preoperative setting for spine patients. Although data is mixed and no true randomized control trials are available, there is growing evidence suggesting the aforementioned guidelines are needed to optimize anticoagulation in setting of spine surgery. Further studies are needed to elucidate risk of complications while operating under therapeutic levels of anticoagulation for a variety of comorbid conditions.
Minimizing Blood Loss in Spine Surgery
Authors: Mikhail Christopher , Pennington Zach , Arnold Paul M. , Brodke Darrel S. , Chapman Jens R. , Chutkan Norman , Daubs Michael D. , DeVine John G. , Fehlings Michael G. , Gelb Daniel E. , Ghobrial George M. , Harrop James S. , Hoelscher Christian , Jiang Fan , Knightly John J. , Kwon Brian K. , Mroz Thomas E. , Nassr Ahmad , Riew K. Daniel , Sekhon Lali H. , Smith Justin S. , Traynelis Vincent C. , Wang Jeffrey C. , Weber Michael H. , Wilson Jefferson R. , Witiw Christopher D. , Sciubba Daniel M. , Cho Samuel K.
Published: January 2020

Study Design:

Broad narrative review.

Objective:

To review and summarize the current literature on guidelines, outcomes, techniques and indications surrounding multiple modalities of minimizing blood loss in spine surgery.

Methods:

A thorough review of peer-reviewed literature was performed on the guidelines, outcomes, techniques, and indications for multiple modalities of minimizing blood loss in spine surgery.

Results:

There is a large body of literature that provides a consensus on guidelines regarding the appropriate timing of discontinuation of anticoagulation, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and herbal supplements prior to surgery. Additionally, there is a more heterogenous discussion the utility of preoperative autologous blood donation facilitated by erythropoietin and iron supplementation for healthy patients slated for procedures with high anticipated blood loss and for whom allogeneic transfusion is likely. Intraoperative maneuvers available to minimize blood loss include positioning and maintaining normothermia. Tranexamic acid (TXA), bipolar sealer electrocautery, and topical hemostatic agents, and hypotensive anesthesia (mean arterial pressure (MAP) <65 mm Hg) should be strongly considered in cases with larger exposures and higher anticipated blood loss. There is strong level 1 evidence for the use of TXA in spine surgery as it reduces the overall blood loss and transfusion requirements.

Conclusion:

As the volume and complexity of spinal procedures rise, intraoperative blood loss management has become a pivotal topic of research within the field. There are many tools for minimizing blood loss in patients undergoing spine surgery. The current literature supports combining techniques to use a cost- effective multimodal approach to minimize blood loss in the perioperative period.
Evaluating Communication Effectiveness Through Eye Tracking: Benefits, State of the Art, and Unresolved Questions
Authors: Casado-Aranda Luis-Alberto , Sánchez-Fernández Juan , Ibáñez-Zapata José-Ángel
Published: January 2020

Modern eye-tracking techniques have opened a new door of opportunities for evaluating communication effectiveness in a way that minimizes cognitive biases and provides moment-by-moment insights into communication’s attention processes. The increasing body of research applying eye-tracking methodologies, together with the reorientation of the landscape of communication, calls for a comprehensive overview of the scope of research concerning audience’s visual attention to advertising. This is the first study that applies a systematic literature review approach to face this research gap by analyzing 112 papers published between 1979 and 2019 in journals indexed by the ISI Web of Science database. Based on this review, the article examines current evidence determining the visual attention to ads and the relationship between eye-tracking measures and other facets of advertising effectiveness, namely cognitive, affective, and behavioral consumer response. Finally, this article discusses the implications for business communication and proposes directions for academics and professionals intending to explore advertising effectiveness through eye tracking.
Effect of 9 weeks continuous vs. interval aerobic training on plasma BDNF levels, aerobic fitness, cognitive capacity and quality of life among seniors with mild to moderate Alzheimer’s disease: a randomized controlled trial
Authors: Enette Lievyn , Vogel Thomas , Merle Sylvie , Valard-Guiguet Anna-Gaelle , Ozier-Lafontaine Nathalie , Neviere Remi , Leuly-Joncart Claudia , Fanon Jean Luc , Lang Pierre Olivier
Published: January 2020

Background

Evidence suggests that aerobic-type training confers physical benefits and appears to contribute positively to brain health. This study aims to compare the effect of 9-weeks continuous (CAT) to interval aerobic training (IAT) on brain derived neurotrophic factor (BDNF) plasma level, aerobic fitness, cognitive performance, and quality of life among senior with Alzheimer’s disease (AD).

Methods

52 participants were randomly allocated into three groups (CAT n = 14; IAT n = 17; and Controls n = 21). CAT and IAT consisted of 18 sessions of 30-min cycling, twice a week, over 9 weeks. During the same period, controls were engaged in interactive information sessions. Plasma BDNF level; aerobic fitness parameters (Metabolic equivalent task - METs; Maximal Tolerated Power – MTP); functional capacities (6-Minute Walk Test - 6MWT); cognitive performance (Mini Mental State Examination; Rey auditory verbal learning test; and digit span test) and quality of life (Quality Of Life of Alzheimer’s Disease scale - QoL-AD) were measured in all participants at baseline and 9 weeks later. A third plasma BDNF level was quantified following a 4 weeks detraining.

Results

No significant change was measured in terms of plasma BDNF level and cognitive performance after interventions, in all groups compared to baseline. After 9 weeks, CAT and IAT significantly improved aerobic fitness parameters compared to controls (METs: + 0.6 and + 1.0 vs. + 0.4; MTP: + 16 watts and + 20 watts vs. + 10 watts; and functional capacities (6MWT: + 22 m and + 31 m vs. -40 m). Compared to controls, QoL-AD after CAT was improved (+ 2 points; p = 0.02).

Conclusions

Neither aerobic exercise modalities significantly modified plasma BDNF levels and cognitive performances. CAT and IAT enhanced aerobic fitness and functional capacities in AD patients and CAT their QoL.

Trial registration

ClinicalTrials.gov website (NCT02968875); registration date: 7 September 2016. “Retrospectively registered”.
Development of Whole-Genome Agarose-Resolvable LInDel Markers in Rice
Authors: Hu Wei , Zhou Tianhao , Wang Pengfei , Wang Bo , Song Jiaming , Han Zhongmin , Chen Lingling , Liu Kede , Xing Yongzhong
Published: January 2020

The level of difficulty involved in separating marker genotypes greatly determines the utilization of such marker-aided selection (MAS) by breeders. Genotyping by use of agarose gel electrophoresis is easily accepted by breeders due to its simple requirements and easy operation in the lab. Here, we extracted 19,937 large fragment insertions/deletions (LInDels) that were 30–55 bp based on two indica rice and one japonica rice reference genome sequences. Thousands of primer pairs were designed by the Primer 3 program to amplify the corresponding LInDels, and 6582 LInDel markers with unique genome loci were reserved after being tested by e-PCR; 346 of these markers were validated in a panel of 22 cultivars by running on a 1.5% agarose gel. Most LInDel markers had a considerable number of polymorphisms. The LInDel markers have an equivalent efficiency to that of the SSR and SNP markers in identifying hybrids, estimating genetic distance and developing genetic linkage maps. The hybrid genotypes of the LInDel markers exhibited three bands, which were the result of heteroduplex formation between the insertion allele and the deletion allele. Fifty-five breeding markers, including 9 intragenic markers and 46 closely linked LInDel markers, were developed for 55 known genes that are related to yield, biotic and abiotic stress tolerance. These agarose-resolvable LInDel markers will be welcomed by breeders and will play an important role in MAS.
Living on the edge: comparative phylogeography and phylogenetics of Oreohelix land snails at their range edge in Western Canada
Authors: Dempsey Z. W. , Goater C. P. , Burg T. M.
Published: January 2020

Background

The biodiversity and distributions of terrestrial snails at local and regional scales are influenced by their low vagility and microhabitat specificity. The accessibility of large-bodied species and their characteristically high levels of genetic polymorphism make them excellent ecological and evolutionary models for studies on the phylogeography, phylogenetics, and conservation of organisms in fragmented populations. This study aims to elucidate the biodiversity, systematics, and distributions of genetic lineages within the genus Oreohelix at the northern and western periphery of their range.

Results

We found four mitochondrial clades, three of which are putative subspecies of Oreohelix subrudis. One clade was geographically widespread, occurring within numerous sites in Cypress Hills and in the Rocky Mountains, a second was geographically restricted to the Rocky Mountains in Alberta, and a third was restricted to the Cypress Hills region. A fourth clade was the small-bodied species, O. cooperi. ITS2 sequence and screening data revealed three genetic clusters, of which one was O. cooperi. Cluster 1 contained most individuals in COI clade X and some from clade B and cluster 2 was predominantly made up of individuals from COI clades B and B′ and a few from clade X. ITS2 alleles were shared in a narrow contact zone between two COI clades, suggestive of hybridization between the two.

Conclusions

A sky island known as Cypress Hills, in southeastern Alberta, Canada, is a biodiversity hotspot for terrestrial land snails in the genus Oreohelix. The observed phylogeographic patterns likely reflect reproductive isolation during the Last Glacial Maximum, followed by secondary contact due to passive, long-range dispersal resulting from low vagility, local adaptation, and complex glacial history.
Invasive pseudomembranous upper airway and tracheal Aspergillosis refractory to systemic antifungal therapy and serial surgical debridement in an Immunocompetent patient
Authors: Khan Shihan N. , Manur Rashmi , Brooks John S. , Husson Michael A. , Leahy Kevin , Grant Matthew
Published: January 2020

Background

The development of respiratory infections secondary toAspergillus spp.spores found ubiquitously in the ambient environment is uncommon in immunocompetent patients. Previous reports of invasive upper airway aspergillosis in immunocompetent patients have generally demonstrated the efficacy of treatment regimens utilizing antifungal agents in combination with periodic endoscopic debridement, with symptoms typically resolving within months of initiating therapy.

Case presentation

A 43-year-old previously healthy female presented with worsening respiratory symptoms after failing to respond to long-term antibiotic treatment of bacterial sinusitis. Biopsy of her nasopharynx and trachea revealed extensive fungal infiltration andAspergillus fumigatuswas isolated on tissue culture. Several months of oral voriconazole monotherapy failed to resolve her symptoms and she underwent mechanical debridement for symptom control. Following transient improvement, her symptoms subsequently returned and failed to fully resolve in spite of increased voriconazole dosing and multiple additional tissue debridements over the course of many years.

Conclusions

Invasive upper airway aspergillosis is exceedingly uncommon in immunocompetent patients. In the rare instances that such infections do occur, combinatorial voriconazole and endoscopic debridement is typically an efficacious treatment approach. However, some patients may continue to experience refractory symptoms. In such cases, continued aggressive treatment may potentially slow disease progression even if complete disease resolution cannot be achieved.
Loss of the SWI/SNF-ATPase subunit members SMARCF1 (ARID1A), SMARCA2 (BRM), SMARCA4 (BRG1) and SMARCB1 (INI1) in oesophageal adenocarcinoma
Authors: Schallenberg Simon , Bork Julian , Essakly Ahlem , Alakus Hakan , Buettner Reinhard , Hillmer Axel M. , Bruns Christiane , Schroeder Wolfgang , Zander Thomas , Loeser Heike , Gebauer Florian , Quaas Alexander
Published: January 2020

Background

The SWI/SNF complex is an important chromatin remodeler, commonly dysregulated in cancer, with an estimated mutation frequency of 20%. ARID1A is the most frequently mutated subunit gene. Almost nothing is known about the other familiar members of the SWI/SNF complexes, SMARCA2 (BRM), SMARCA4 (BRG1) and SMARCB1 (INI1), in oesophageal adenocarcinoma (EAC).

Methods

We analysed a large cohort of 685 patients with EAC. We used four different antibodies to detect a loss-of-protein of ARID1A BRM, BRG1 and INI1 by immunohistochemistry and correlated these findings with molecular and clinical data.

Results

Loss of ARID1A, BRG1, BRM and INI1 was observed in 10.4, 3.4, 9.9 and 2% of EAC. We found a co-existing protein loss of ARID1A and BRM in 9.9% and of ARID1A and BRG1 in 2.2%. Patients with loss of ARID1A and TP53 wildtype EACs showed a shortened overall survival compared with AIRDA1A-positive tumours [median overall survival was 60.1 months (95%CI 1.2–139.9 months)] in patients with ARIDA-1A expression and 26.2 months (95%CI 3.7–19.1 months) in cases of ARIDA-1A loss (p = 0.044). Tumours with loss or expression of ARID1A and TP53 loss were not associated with a difference in survival. Only one tumour revealed high microsatellite instability (MSI-H) with concomitant ARID1A loss. All other ARID1A loss-EACs were microsatellite-stable (MSS). No predictive relevance was seen for SWI/SNF-complex alterations and simultaneous amplification of different genes (PIK3CA, KRAS, c-MYC, MET, GATA6, ERBB2).

Conclusion

Our work describes, for the first time, loss of one of the SWI/SNF ATPase subunit proteins in a large number of adenocarcinomas of the oesophagus. Several papers discuss possible therapeutic interventions for tumours showing a loss of function of the SWI/SNF complex, such as PARP inhibitors or PI3K and AKT inhibitors. Future studies will be needed to show whether SWI/SNF complex-deficient EACs may benefit from personalized therapy.
Utilization of insecticide-treated bed nets and care-seeking for fever and its associated socio-demographic and geographical factors among under-five children in different regions: evidence from the Myanmar Demographic and Health Survey, 2015–2016
Authors: Min Kyi Thar , Maung Thae Maung , Oo Myo Minn , Oo Tin , Lin Zaw , Thi Aung , Tripathy Jaya Prasad
Published: January 2020

Background

Malaria is one of the top-five contributors to under-5 deaths in Myanmar. Use of insecticide-treated nets (ITN) and receiving early appropriate care in case of fever are the core interventions to prevent malaria and its complications and thereby deaths. This study aimed to assess among the under-five children, (a) utilization of ITNs and its associated factors, (b) care-seeking behaviour among their caregivers and its associated factors and uptake of malaria testing among those with fever in the last 2 weeks.

Methods

This was a cross sectional study using secondary analysis of Myanmar Demographic and Health Survey (MDHS) conducted in 2015–2016. Multivariable logistic regression was used to explore the factors associated with non-utilization of ITNs and not seeking care for fever. Effect sizes have been presented using odds ratios with 95% confidence intervals. Data analysis was done using svyset command in STATA to account for the multi-stage sampling design of the survey.

Results

Of 4597 alive under-five children, 80.5% did not sleep under an ITN last night. The factors significantly associated with non-utilization of ITNs were residing in malaria elimination regions (aOR = 2.0, 1.3–3.2), urban residence (aOR = 1.8, 1.2–2.9), staying in delta region (aOR = 8.7, 4.7–12.2), hilly region (aOR = 3.0, 2.0–4.6, and having highest wealth quintile (aOR = 1.8, 1.1–3.0). Around 16% had fever in the last 2 weeks, of whom 66.7% sought care for fever and 3% got tested for malaria. Nearly half (50.9%) of the caregivers sought care from a government health facility, followed by private hospital/doctor (27.8%), shop (8.0%), village health worker (4.4%) and pharmacy (3.1%). The factors associated with not seeking care for fever were residing in specific geographical locations (hilly, delta and central plains compared to coastal region) and having lowest wealth quintile (aOR = 2.3, 1.1–5.7).

Conclusions

This study highlighted that ownership and utilization of ITNs was very poor among under-5children. Care-seeking behaviour of the caregivers of under-5 children in case of fever was dismal with two-thirds not seeking care. The programme should seriously consider addressing these barriers if Myanmar is to achieve zero malaria deaths by 2030.
Ex vivo resection and temporary portocaval shunt of unresectable hepatocellular carcinoma followed by autotransplantation of liver: a case report
Authors: Eghlimi Hesameddin , Arasteh Peyman , Shamsaeefar Alireza , Nikopour Hamed , Sohrabi Sahar , Nikeghbalian Saman
Published: January 2020

Background

Ex situ liver resection and autotransplantation is among the most advanced techniques which has been introduced in recent years.

Case presentation

A 24-year-old male referred with chief complaints of abdominal pain, nausea, and vomiting from 1 month prior to admission. Computed tomography showed a large liver mass in the left lobe of the liver with involvement of retrohepatic inferior vena cava (IVC), in favor of hepatocellular carcinoma.

After hepatectomy, the common bile duct was completely removed. A 4-cm Dacron graft was anastomosed to the inferior and top of the IVC. A temporary portocaval shunt was placed, and ex situ resection of the left lobe of the liver was done. Remnant of the liver was implanted. Reconstruction of the bile duct was done using a Roux-en-Y technique, and autotransplantation of the liver was then completed. During a 4-year follow-up, the patient had no complaints and is in good conditions.

Conclusion

With appropriate consideration of patients, despite surgical complexities, ex situ resection of unresectable HCC can provide excellent prognosis.
Comprehensive profiling identifies a novel signature with robust predictive value and reveals the potential drug resistance mechanism in glioma
Authors: Zeng Fan , Wang Kuanyu , Liu Xiu , Zhao Zheng
Published: January 2020

Background

Gliomas are the most common and malignant brain tumors. The standard therapy is surgery combined with radiotherapy, chemotherapy, and/or other comprehensive methods. However, the emergence of chemoresistance is the main obstacle in treatment and its mechanism is still unclear.

Methods

We firstly developed a multi-gene signature by integrated analysis of cancer stem cell and drug resistance related genes. The Chinese Glioma Genome Atlas (CGGA, 325 samples) and The Cancer Genome Atlas (TCGA, 699 samples) datasets were then employed to verify the efficacy of the risk signature and investigate its significance in glioma prognosis. GraphPad Prism, SPSS and R language were used for statistical analysis and graphical work.

Results

This signature could distinguish the prognosis of patients, and patients with high risk score exhibited short survival time. The Cox regression and Nomogram model indicated the independent prognostic performance and high prognostic accuracy of the signature for survival. Combined with a well-known chemotherapy impact factor-MGMT promoter methylation status, this risk signature could further subdivide patients with distinct survival. Functional analysis of associated genes revealed signature-related biological process of cell proliferation, immune response and cell stemness. These mechanisms were confirmed in patient samples.

Conclusions

The signature was an independent and powerful prognostic biomarker in glioma, which would improve risk stratification and provide a more accurate assessment of personalized treatment.
Clinician awareness of brain computer interfaces: a Canadian national survey
Authors: Letourneau Sasha , Zewdie Ephrem Takele , Jadavji Zeanna , Andersen John , Burkholder Lee M. , Kirton Adam
Published: January 2020

Background

Individuals with severe neurological disabilities but preserved cognition, including children, are often precluded from connecting with their environments. Brain computer interfaces (BCI) are a potential solution where advancing technologies create new clinical opportunities. We evaluated clinician awareness as a modifiable barrier to progress and identified eligible populations.

Methods

We executed a national, population-based, cross-sectional survey of physician specialists caring for persons with severe disability. An evidence- and experience-based survey had three themes: clinician BCI knowledge, eligible populations, and potential impact. A BCI knowledge index was created and scored. Canadian adult and pediatric neurologists, physiatrists and a subset of developmental pediatricians were contacted. Secure, web-based software administered the survey via email with online data collection.

Results

Of 922 valid emails (664 neurologists, 253 physiatrists), 137 (15%) responded. One third estimated that ≥10% of their patients had severe neurological disability with cognitive capacity. BCI knowledge scores were low with > 40% identifying as less than “vaguely aware” and only 15% as “somewhat familiar” or better. Knowledge did not differ across specialties. Only 6 physicians (4%) had patients using BCI. Communication and wheelchair control rated highest for potentially improving quality of life. Most (81%) felt BCI had high potential to improve quality of life. Estimates suggested that > 13,000 Canadians (36 M population) might benefit from BCI technologies.

Conclusions

Despite high potential and thousands of patients who might benefit, BCI awareness among clinicians caring for disabled persons is poor. Further, functional priorities for BCI applications may differ between medical professionals and potential BCI users, perhaps reflecting that clinicians possess a less accurate understanding of the desires and needs of potential end-users. Improving knowledge and engaging both clinicians and patients could facilitate BCI program development to improve patient outcomes.
First report and genetic diversity of porcine bufavirus in China
Authors: Sun Yan-Kuo , Chen Yong-Jie , Cai Yu , Zhu Di-Hua , Pan Hao-Ming , Wei Ying-Fang , Han Xiao-Liang , Ji Chi-Hai , Lu Gang , Wang Heng , Ma Chun-Quan , Zhang Gui-Hong
Published: January 2020

Background

Bufavirus is a newly discovered zoonotic virus reported in numerous mammals and humans. However, the epidemiological and genetic characteristics of porcine bufaviruses (PBuVs) in China remain unclear.

Methods

To detect PBuVs in China, 384 samples (92 fecal and 292 serum specimens) were collected from 2017 to 2018, covering six provinces in China, and were evaluated by nested PCR. Further, the positive samples from different provinces were selected to obtain the complete genome of Chinese PBuVs.

Results

The prevalence rate of PBuV was 16.7% in Chinese domestic pigs in the Guangdong, Guangxi, Fujian, Jiangxi, Anhui, and Henan provinces. Additionally, the positive rate of fecal specimens was higher than that of the serum samples. Next, we sequenced nine near-complete genomes of Chinese field PBuV strains from different provinces. Homology and phylogenetic analyses indicated that Chinese PBuVs have high genetic variation (93.3–99.2%), showed higher nucleotide identity with an Austrian PBuV strain (KU867071.1), and developed into different branches within the same cluster.

Conclusion

To our knowledge, this is the first report on PBuV in China, expanding the geographic boundaries of PBuV circulation. Our data demonstrate that PBuVs are widely distributed in the six Chinese provinces. Moreover, these Chinese PBuVs exhibit genetic variation and continuous evolution characteristics. Taken together, our findings provide a foundation for future studies on bufaviruses.
Determinants of enrollment decision in the community-based health insurance, North West Ethiopia: a case-control study
Authors: Taddesse Getasew , Atnafu Desta Debalkie , Ketemaw Asmamaw , Alemu Yibeltal
Published: January 2020

Objective

To identify the determinants for enrollment decision in the community-based health insurance program among informal economic sector-engaged societies, North West Ethiopia.

Method

Unmatched case-control study was conducted on 148 cases (member-to-insurance) and 148 controls (not-member-to-insurance program) from September 1 to October 30,2016. To select the villages and households, stratified then simple random sampling method was employed respectively. The data were entered in to Epi-info version 7 and exported to SPSS version 20 for analysis. Descriptive statistics, bi-variable, and multi-variable logistic regression analyses were computed to describe the study objectives and identify the determinants of enrolment decision for the insurance program. Odds ratio at 95% CI was used to describe the association between the independent and outcome variables.

Results

A total of 296 respondents (148 cases and 148 controls) were employed. The mean age for both cases and controls were 42 ± 11.73 and 40 ± 11.37 years respectively. Majority of respondents were males (87.2% for cases and 79% for controls). Family size between 4 and 6 (AOR = 2.26; 95% CI: 1.04, 4.89), history of illness by household (AOR = 3.24; 95% CI: 1.68, 6.24), perceived amount of membership contribution was medium (AOR = 2.3; 95% CI: 1.23, 4.26), being married (AOR = 6; 95% CI:1.43, 10.18) and trust on program (AOR = 4.79; 95% CI: 2.40, 9.55) were independent determinants for increased enrollment decision in the community-based health insurance. While, being merchant (AOR = 0.07; 95% CI: 0.09, 0.6) decreased the enrollment decision.

Conclusion

Societies’ enrollment decision to community-based health insurance program was determined by demographic, social, economic and political factors. Households with large family sizes and farmers in the informal sector should be given maximal attention for intensifying enrollment decision in the insurance program.
RETRACTED ARTICLE: LncRNA miR503HG interacts with miR-31-5p through multiple ways to regulate cancer cell invasion and migration in ovarian cancer
Authors: Zhu Ding , Huang Xueshuang , Liang Fang , Zhao Lijing
Published: January 2020

The role of lncRNA miR503HG has been investigated in several types of cancer, but its functions in ovarian cancer (OC) is unclear. Analysis of TCGA dataset revealed a 50-fold lower expression level of miR503HG in OC tissues than that in non-tumor tissues, indicating the involvement of miR503HG in OC. Results in this study showed that miR503HG was downregulated in OC and predicted poor survival. Expression of miR503HG negatively correlated with the expression of miR-31-5p across OC and non-tumor tissues. RNA-RNA interaction analysis revealed that miR503HG can interact with miR-31-5p. Dual-luciferase assay showed that miR-31-5p and miR503HG may directly interact with each other. Methylation specific PCR (MSP) showed that overexpression of miR503HG led to increased methylation level of miR-31-5p gene. Transwell assay showed that overexpression of miR-31-5p resulted in increased invasion and migration rates of OC cells. Overexpression of MiR503HG played an opposite role and attenuated the effects of overexpressing miR-31-5p. Therefore, miR503HG may promote the methylation of miR-31-5p and serve as its sponge to inhibit OC cell invasion and migration.
A cluster randomized clinical trial to evaluate the effectiveness of the Implementation of Infant Pain Practice Change (ImPaC) Resource to improve pain practices in hospitalized infants: a study protocol
Authors: Bueno Mariana , Stevens Bonnie , Barwick Melanie A. , Riahi Shirine , Li Shelly-Anne , Lanese Alexa , Willan Andrew R. , Synnes Anne , Estabrooks Carole A. , Chambers Christine T. , Harrison Denise , Yamada Janet , Stinson Jennifer , Campbell-Yeo Marsha , Noel Melanie , Gibbins Sharyn , LeMay Sylvie , Isaranuwatchai Wanrudee
Published: January 2020

Background

Hospitalized infants undergo multiple painful procedures daily. Despite the significant evidence, procedural pain assessment and management continues to be suboptimal. Repetitive and untreated pain at this vital developmental juncture is associated with negative behavioral and neurodevelopmental consequences. To address this knowledge to practice gap, we developed the web-based Implementation of Infant Pain Practice Change (ImPaC) Resource to guide change in healthcare professionals’ pain practice behaviors. This protocol describes the evaluation of the intervention effectiveness and implementation of the Resource and how organizational context influences outcomes.

Methods

An effectiveness-implementation hybrid type 1 design, blending a cluster randomized clinical trial and a mixed-methods implementation study will be used. Eighteen Neonatal Intensive Care Units (NICUs) across Canada will be randomized to intervention (INT) or standard practice (SP) groups. NICUs in the INT group will receive the Resource for six months; those in the SP group will continue with practice as usual and will be offered the Resource after a six-month waiting period. Data analysts will be blinded to group allocation. To address the intervention effectiveness, the INT and SP groups will be compared on clinical outcomes including the proportion of infants who have procedural pain assessed and managed, and the frequency and nature of painful procedures. Data will be collected at baseline (before randomization) and at completion of the intervention (six months). Implementation outcomes (feasibility, fidelity, implementation cost, and reach) will be measured at completion of the intervention. Sustainability will be assessed at six and 12 months following the intervention. Organizational context will be assessed to examine its influence on intervention and implementation outcomes.

Discussion

This mixed-methods study aims to determine the effectiveness and the implementation of a multifaceted online strategy for changing healthcare professionals’ pain practices for hospitalized infants. Implementation strategies that are easily and effectively implemented are important for sustained change. The results will inform healthcare professionals and decision-makers on how to address the challenges of implementing the Resource within various organizational contexts.

Trial registration

ClinicalTrials.gov,NCT03825822. Registered 31 January 2019.
Treatment effects of Chinese medicine (Yi-Qi-Qing-Jie herbal compound) combined with immunosuppression therapies in IgA nephropathy patients with high-risk of end-stage renal disease (TCM-WINE): study protocol for a randomized controlled trial
Authors: Li Shen , Li Jin-pu
Published: January 2020

Background

IgA nephropathy (IgAN) is the most common glomerular disease worldwide. It has a high incidence in Asians and is more likely to progress to end-stage renal disease (ESRD). For high-risk IgAN, which is clinically characterized by massive proteinuria and renal dysfunction, however, there has been no international consensus on treatment options. Compared with other developed countries, IgAN patients in China are often found to have severe kidney function loss at initial diagnosis. Yi-Qi-Qing-Jie formula (YQF; a compound recipe of Chinese medicinal herbs) has shown potential renal protection in our previous clinical studies. To further confirm the efficacy and safety of YQF in the treatment of high-risk IgAN, we have designed a prospective double-blind randomized placebo-controlled trial.

Methods/design

The TCM-WINE study is a single-center, prospective, double-blind randomized placebo-controlled trial. We plan to randomize 60 participants with biopsy-proven IgAN to a YQF combined group (YQF compound combined with prednisolone, and cyclophosphamide if necessary) or an immunosuppression group (placebo-YQF combined with prednisolone, and cyclophosphamide if necessary). The two groups will enter a 48-week in-trial treatment phase and receive post-trial follow-up until study completion (3 years). All patients will receive optimal supportive care. The primary composite outcome is defined as the first occurrence of a 40% decrease in estimated glomerular filtration rate (eGFR) from the baseline lasting for 3 months, initiating continuous renal replacement treatment, or death due to chronic kidney disease (CKD) during the 3-year study phase. The secondary endpoint events are defined as the mean annual eGFR decline rate (eGFR slope, ml/min per 1.73 m2 per year), which is calculated by the eGFR regression curve for each eligible patient, and proteinuria remission (prescribed as proteinuria < 0.5 g/day) at weeks 24, 36, and 48 during the in-trial phase. The remission rate of symptoms and inflammation status will be evaluated at week 48. Safety monitoring and assessment will be undertaken during the study.

Discussion

The TCM-WINE study will evaluate the effects and safety of YQF combined therapy compared with immunosuppression monotherapy on the basis of the optimal supportive treatment in high-risk IgAN. The evidence from this study will provide a novel, effective, and safe Chinese characteristic therapy for high-risk IgAN patients.

Trial registration

ClinicalTrials.gov, NCT03418779. Registered on 18 June 2018.
TSC patient-derived isogenic neural progenitor cells reveal altered early neurodevelopmental phenotypes and rapamycin-induced MNK-eIF4E signaling
Authors: Martin Pauline , Wagh Vilas , Reis Surya A. , Erdin Serkan , Beauchamp Roberta L. , Shaikh Ghalib , Talkowski Michael , Thiele Elizabeth , Sheridan Steven D. , Haggarty Stephen J. , Ramesh Vijaya
Published: January 2020

Background

Tuberous sclerosis complex (TSC) is a neurodevelopmental disorder with frequent occurrence of epilepsy, autism spectrum disorder (ASD), intellectual disability (ID), and tumors in multiple organs. The aberrant activation of mTORC1 in TSC has led to treatment with mTORC1 inhibitor rapamycin as a lifelong therapy for tumors, but TSC-associated neurocognitive manifestations remain unaffected by rapamycin.

Methods

Here, we generated patient-specific, induced pluripotent stem cells (iPSCs) from a TSC patient with a heterozygous, germline, nonsense mutation in exon 15 of TSC1 and established an isogenic set of heterozygous (Het), null and corrected wildtype (Corr-WT) iPSCs using CRISPR/Cas9-mediated gene editing. We differentiated these iPSCs into neural progenitor cells (NPCs) and examined neurodevelopmental phenotypes, signaling and changes in gene expression by RNA-seq.

Results

Differentiated NPCs revealed enlarged cell size in TSC1-Het and Null NPCs, consistent with mTORC1 activation. TSC1-Het and Null NPCs also revealed enhanced proliferation and altered neurite outgrowth in a genotype-dependent manner, which was not reversed by rapamycin. Transcriptome analyses of TSC1-NPCs revealed differentially expressed genes that display a genotype-dependent linear response, i.e., genes upregulated/downregulated in Het were further increased/decreased in Null. In particular, genes linked to ASD, epilepsy, and ID were significantly upregulated or downregulated warranting further investigation. In TSC1-Het and Null NPCs, we also observed basal activation of ERK1/2, which was further activated upon rapamycin treatment. Rapamycin also increased MNK1/2-eIF4E signaling in TSC1-deficient NPCs.

Conclusion

MEK-ERK and MNK-eIF4E pathways regulate protein translation, and our results suggest that aberrant translation distinct in TSC1/2-deficient NPCs could play a role in neurodevelopmental defects. Our data showing upregulation of these signaling pathways by rapamycin support a strategy to combine a MEK or a MNK inhibitor with rapamycin that may be superior for TSC-associated CNS defects. Importantly, our generation of isogenic sets of NPCs from TSC patients provides a valuable platform for translatome and large-scale drug screening studies. Overall, our studies further support the notion that early developmental events such as NPC proliferation and initial process formation, such as neurite number and length that occur prior to neuronal differentiation, represent primary events in neurogenesis critical to disease pathogenesis of neurodevelopmental disorders such as ASD.
Enhanced efficiency in isolation and expansion of hAMSCs via dual enzyme digestion and micro-carrier
Authors: Gohi Bi Foua Claude Alain , Liu Xue-Ying , Zeng Hong-Yan , Xu Sheng , Ake Kouassi Marius Honore , Cao Xiao-Ju , Zou Kai-Min , Namulondo Sheila
Published: January 2020

A two-stage method of obtaining viable human amniotic stem cells (hAMSCs) in large-scale is described. First, human amniotic stem cells are isolated via dual enzyme (collagenase II and DNAase I) digestion. Next, relying on a culture of the cells from porous chitosan-based microspheres in vitro, high purity hAMSCs are obtained in large-scale. Dual enzymatic (collagenase II and DNase I) digestion provides a primary cell culture and first subculture with a lower contamination rate, higher purity and a larger number of isolated cells. The obtained hAMSCs were seeded onto chitosan microspheres (CM), gelatin–chitosan microspheres (GCM) and collagen–chitosan microspheres (CCM) to produce large numbers of hAMSCs for clinical trials. Growth activity measurement and differentiation essays of hAMSCs were realized. Within 2 weeks of culturing, GCMs achieved over 1.28 ± 0.06 × 107hAMSCs whereas CCMs and CMs achieved 7.86 ± 0.11 × 106and 1.98 ± 0.86 × 106respectively within this time. In conclusion, hAMSCs showed excellent attachment and viability on GCM-chitosan microspheres, matching the hAMSCs’ normal culture medium. Therefore, dual enzyme (collagenase II and DNAase I) digestion may be a more useful isolation process and culture of hAMSCs on porous GCM in vitro as an ideal environment for the large-scale expansion of highly functional hAMSCs for eventual use in stem cell-based therapy.
Effects of light availability on leaf attributes and seedling growth of four tree species in tropical dry forest
Authors: Tripathi Sachchidanand , Bhadouria Rahul , Srivastava Pratap , Devi Rajkumari S. , Chaturvedi Ravikant , Raghubanshi A. S.
Published: January 2020

Background

In tropical dry forests, variation in understory light availability due to season and canopy tree density could be a governing factor in establishment and growth of tree seedlings. Species with varying life history traits are expected to respond differentially to such heterogeneity. We investigated the response of seedlings of four tree species in a tropical day forest in relation to spatiotemporal variability of light. We attempt to explore the role of leaf attributes in explaining intra- and inter-specific variations in relative growth rate. Four study sites, each with three contrasting canopy conditions, were selected along a soil moisture gradient. Seedlings of four tree species (viz., Acacia catechu, Bridelia retusa, Lagerstroemia parviflora, and Shorea robusta), varying in life history traits, were monitored for seasonal variations in growth traits across canopy condition and sites for 2 years.

Results

We observed a larger variation in leaf attributes for pioneer species. A. catechu showed highest mean values for leaf dry matter content, leaf nitrogen concentration, leaf phosphorus concentration, net stomatal conductance, net photosynthetic rate, and relative growth rate in high light conditions. S. robusta and B. retusa demonstrated highest mean values for all the leaf attributes (except leaf dry matter content) in low light conditions. However, intermediate values for leaf attributes were observed in L. parviflora which preferred moderate light conditions.

Conclusions

Seasonal variations in light availability at the forest floor appear to play an important role in the establishment and growth of tree seedlings in seasonal dry forests. Leaf attributes can be used to explain intra- and inter-specific variation in response to light availability. Leaf attributes in combinations can be used to predict relative growth rate of tree species in tropical dry environment, which apart from soil moisture is also determined by light availability due to seasonal changes and canopy tree density.
The prognostic value of integration of pretreatment serum amyloid A (SAA)–EBV DNA (S‐D) grade in patients with nasopharyngeal carcinoma
Authors: Li Jianpei , Lai Changchun , Peng Songguo , Chen Hao , Zhou Lei , Chen Yufeng , Chen Shulin
Published: January 2020

Background

Serum amyloid A (SAA) has been associated with the development and prognosis of cancer. The purpose of this study was to evaluate the predictive value of integration of pretreatment SAA–EBV DNA (S‐D) grade and comparison with the TNM staging system in patients with nasopharyngeal carcinoma (NPC). The S‐D grade was calculated based on the cut‐off values of serum SAA and EBV DNA copy numbers which were determined by receiver operating characteristic (ROC) curves. We evaluated the prognostic value of pretreatment SAA, EBV DNA and S‐D grade on overall survival (OS) of NPC patients. We also evaluated the predictive power of S‐D grade with TNM staging system using 4 indices: concordance statistics (C‐index), time‐dependent ROC (ROCt) curve, net reclassification index (NRI) and integrated discrimination improvement (IDI).

Results

A total of 304 NPC patients were enrolled in this study. Multivariate analysis showed that TNM stage (P = 0.007), SAA (P = 0.013), and EBV DNA (P = 0.033) were independent prognostic factors in NPC. The S‐D grade was divided into S‐D grade 1, S‐D grade 2, and S‐D grade 3, which had more predictive accuracy for OS than TNM staging according to all 4 indices.

Conclusions

We found that the S‐D grade could be used as a new tool to predict the OS in NPC patients.
Systems biology approaches toward autosomal dominant polycystic kidney disease (ADPKD)
Authors: Rahimmanesh Ilnaz , Fatehi Razieh
Published: January 2020

Background

Autosomal dominant polycystic kidney disease (ADPKD), a common of monogenetic disorder caused by the polycystic kidney disease‐1 (PKD1) or PKD2 genes deficiency. In this study, we have re‐analyzed a microarray dataset to generate a holistic view of this disease.

Methodology

GSE7869, an expression profiling dataset was downloaded from the Gene Expression Omnibus (GEO) database. After quality control assessment, using GEO2R tool of GEO, genes with adjusted p‐value ≤ 0.05 were determined as differentially expressed (DE). The expression profiles from ADPKD samples in different sizes were compared. Using CluePedia plugin of Cytoscape software, the protein–protein interaction (PPI) networks were constructed and analyzed by Cytoscape NetworkAnalyzer tool and MCODE application. Pathway enrichment analysis of clustered genes by MCODE with the high centrality parameters in PPI networks was performed using Cytoscape ClueGO plugin. Moreover, by Enrichr database, microRNAs (miRNAs) and transcription factors (TFs) targeted DE genes were identified.

Results

In this study to explore the molecular pathogenesis of kidney in ADPKD, mRNA expression profiles of cysts from patients in different sizes were re‐analyzed. The comparisons were performed between normal with minimally cystic tissue (MCT) samples, MCTs with small cysts, and small cysts with large cysts. 512, 7024, and 655 DE genes were determined, respectively. The top central genes, e.g. END1, EGFR, and FOXO1 were identified with topology and clustering analysis. DE genes that were significantly enriched in PPI networks are critical genes and their roles in ADPKD remain to be assessed in future experimental studies beside miRNAs and TFs predicted. Furthermore, the functional analysis resulted in which most of them are expected to be associated with ADPKD pathogenesis, such as signal pathways that involved in cell growth, inflammation, and cell polarity.

Conclusion

We have here explored systematic approaches for molecular mechanisms assay of ADPKD as a monogenic disease, which may also be used for other monogenetic diseases beside complex diseases to provide suitable therapeutic targets.