bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of MUC1 5640G>A and PSCA 5057C>T polymorphisms with the Risk of Gastric Cancer in Northern Iran
Authors: Alikhani Reza , Taravati Ali , Hashemi-Soteh Mohammad Bagher
Published: June 2020

Background: Gastric cancer is the fourth most common cancer worldwide and the second leading cause of cancer-related death. Genome-Wide Association Studies (GWAS) have shown that genetic diversities MUC1 (Mucin 1) and PSCA (Prostate Stem Cell Antigen) genes are involved in gastric cancer. The aim of this study was to determine the association between rs4072037G>A polymorphism in MUC1 and rs2294008 C>T in PSCA gene with gastric cancer in northern Iran. Methods: DNA was extracted from 99 formalin fixed paraffin-embedded (FFPE) tissue samples of gastric cancer and 96 blood samples from healthy individuals (sex matched) as controls. DNA was extracted followed by PCR using specific primers. Two desired polymorphisms, 5640G>A and 5057C>T for MUC1 and PSCA genes were genotyped using PCR-RFLP method.Results: The G allele at rs4072037 of MUC1 gene was associated with a significant decreased gastric cancer risk (OR = 0.507, 95% CI: 0.322–0.799, p = 0.003). A significant decreased risk of gastric cancer was observed in people with either AG vs. AA, AG+AA vs. GG and AA+GG vs. AG genotypes of MUC1 polymorphism (OR = 4.296, 95% CI: 1.190–15.517, p = 0.026), (OR = 3.726, 95% CI: 2.033–6.830, p = 0.0001) and (OR = 0.223, 95% CI: 0.120-0.413, p = 0.0001) respectively. Overall, no significant association was observed between the PSCA 5057C>T polymorphism and risk of gastric cancer in all genetic models. Conclusion: Results indicated that the MUC1 5640G>A polymorphism may have protective effect for gastric cancer and could be considered a potential molecular marker in gastric cancer in the Northern Iran population.
Maternal Multimorbidity During Pregnancy and After Childbirth in Women in Low- and Middle-Income Countries: A Systematic Literature Review
Authors: McCauley Mary , Zafar Shamsa , Broek Nynke van den
Published: June 2020

Background For every maternal death, 20 to 30 women are estimated to have morbidity related to pregnancy or childbirth. Much of this burden of disease is in women in low- and middle-income countries. Maternal multimorbidity can include physical, psychological, and social ill-health. Limited data exist about the associations between these morbidities. In order to address all health needs that women may have when attending maternity care, it is important to be able to identify all types of morbidities and understand how each morbidity influences other aspects of women’s health and wellbeing during pregnancy and after childbirth.Methods We systematically reviewed published literature, in English, describing measurement of two or more types of maternal morbidity, and/or associations between morbidities, during pregnancy or after childbirth for women in low- and middle-income countries. CINAHL plus, Global Health, Medline and Web of Science databases were searched from 2007-2018. Outcomes were descriptions, occurrence of all maternal morbidities, and associations between these morbidities. Narrative analysis was conducted. Results 38 papers reporting about 36 studies were included (71,229 women; 60,911 during and 10,318 after pregnancy from 17 countries). Most studies (26/36) were cross-sectional surveys. Self-reported physical ill-health was documented in 26 studies, but no standardised data collection tools were used. In total, physical morbidity was included in 28 studies; psychological morbidity in 32 studies and social morbidity in 27 studies; with three studies assessing associations between all three types of morbidity and 30 studies assessing associations between two types of morbidity. In four studies, clinical examination and/or basic laboratory investigations were also conducted. Associations between physical and psychological morbidity were reported in four studies and between psychological and social morbidity in six. Domestic violence increased risks of physical ill-health in two studies. Conclusions Lack of standardised, comprehensive and routine measurements and tools exist to assess the burden of maternal multimorbidity in women during pregnancy and after childbirth. Emerging data suggest significant associations between the different types of morbidity.
Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city
Authors: Santalahti Maija , Sumit Kumar , Perkiö Mikko
Published: June 2020

Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.
Effect of preoperative jaundice on long-term prognosis of gallbladder carcinoma with radical resection
Authors: yang xinwei , Jun-yi Chen , Zhi-jian Wen , Yu-long Li , Fei-yu Wang , Liang Li , Jue Yang , Ping-hua Yang , zhang baohua , shen feng
Published: June 2020

Purposes: This study was designed to evaluate the long-term prognostic value of preoperative jaundice and explore which clinicopathological factor significantly influencing the long-term prognosis of gallbladder carcinoma (GBC) after radical resection (R0). Methods: A total of 267 GBC patients who underwent R0 resection between January 2004 and December 2014 were enrolled, including 54 patients with preoperative jaundice and 213 patients without jaundice. The clinicopathological parameters between the two groups were compared, and the correlation between preoperative jaundice and the long-term prognosis was furtherly analyzed. Results: Unilateral and multivariate analyses of 267 GBC patients showed that the depth of tumor invasion (pT stage), lymphatic metastasis, and hepatic invasion were independent prognostic factors. In terms of the 54 GBC patients with preoperative jaundice, univariate and multivariate analysis showed that only pT stage was an independent factor for prognosis. Furthermore, the intraoperative blood transfusion and pT stage were significant different between long-term survival (survival for more than 3 years) and those who died within 3 years (P<0.05). Conclusion: Preoperative jaundice was not the independent factor affecting the poor long-term prognosis of gallbladder carcinoma after R0 resection. The pT stage was the only long-term prognostic factor in all GBC patients with and without preoperative jaundice.
Risk factors for malaria infection prevalence and household vector density between mass distribution campaigns of long-lasting insecticidal nets in Northern Tanzania
Authors: Mosha Jacklin Franklin , Lukole Eliud , Charlwood J Derek , Wright Alexandra , Bullock Olivia , Manjurano Alphaxard , Kisinza William , Mosha Franklin W , Kleinschmidt Immo , Rowland Mark , Protopopoff Natacha
Published: June 2020

Background Long Lasting Insecticidal nets (LLINs) are the most widely deployed vector control intervention in Sub-Saharan Africa to prevent malaria. Recent reports indicate selection of pyrethroid insecticide resistance is widespread in mosquito vectors. This paper explores net coverage indicators and other risk factors associated with malaria infection prevalence and vector density three years after a mass distribution campaigns of LLINs in Northwest Tanzania. Methods A cross sectional malaria survey of 3,456 children was undertaken in 2014 in Muleba district in the Lake Zone. Vector density was assessed using indoor light traps and outdoor tent traps. Anophelines were identified to species using PCR and tested for falciparum circumsporozoite protein. Logistic regression was used to identify household and environmental factors associated with malaria infection and vector density. Results LLINs use was 27.7%. Only 16.9% of households had sufficient nets to cover all sleeping places. Malaria infection was independently associated with access to LLINs (OR: 0.57; 95%CI 0.34 – 0.98). LLINs less than 2 years old were more protective than older LLINs (53% vs 65% prevalence of infection); however, there was no evidence that LLINs in good condition (hole index <65) were more protective than LLINs which were more holed. Other risk factors for malaria infection were age group, altitude and house construction quality. Independent risk factors for vector density were consistent with malaria outcomes and included altitude, wind, livestock, house quality, open eaves and LLINs usage. Indoor collections comprised 4.6% Anopheles funestus and 95.4% An. gambiae of which 4.5% were An. arabiensis and 93.5% were An. gambiae s.s.Conclusion Three years after the mass distribution campaign and despite top-ups, LLINs usage had declined considerably. While children living in households with access to LLINs were at lower risk of malaria, infection prevalence remained high even among users of LLINs in good condition. While effort should be made to maintain high coverage between campaigns, distribution of standard pyrethroid-only LLINs appears insufficient to prevent malaria transmission in this area of intense pyrethroid resistance.
Correlation of Resting Heart Rate with Anthropometric factors and serum biomarkers in a population-based study: Fasa PERSIAN Cohort study
Authors: Goorakani Yashar , Rahimabadi Massih Sedigh , Dehghan Azizallah , Kazemi Maryam , Chijan Mahsa Rostami , Asl Mostafa Bizhani , Shahraki Hadi Raeisi , Davoodi Ali , Farjam Mojtaba , Homayounfar Reza
Published: June 2020

Background There is a positive association between raised resting heart rate (RHR), and all causes of mortality and shorter life expectancy. Several serum biomarkers and some anthropometric factors can affect the resting heart rate. This study aimed to investigate the determinants of resting heart rate in a large random sample of the Iranian population. Material and Methods It is a standardized, retrospective study and the subjects were chosen from the baseline survey of the Prospective Epidemiological Research Study in IrAN (PERSIAN) Fasa non-communicable disease cohort study. It was conducted from winter 2014 to summer 2019 and after obtaining informed consent from a random sample, all the eligible subjects were enrolled. All anthropometric factors and biologic laboratory factors were collected and analyzed by implement smoothly clipped absolute deviation (SCAD) linear regression and SCAD quantile regression. The comparisons between males and females were done via independent T-test. Results & Conclusion A total number of 9975 persons were included. The overall median resting heart rate was 74 (interquartile range:66-80). Mean age has no important difference between males and females (P=0.79) but, resting heart rate was significantly higher in females (76.6 versus 71.4, P<0.001). All anthropometric factors except wrist circumference were higher in females (P<0.05). Age has an adverse effect on resting heart rate and also, there was direct association between resting heart rate and systolic blood pressure and blood glucose. Alpha-blockers (coefficient=5.2) and Beta1-blockers (coefficient=-2.2) were the most effective drugs with positive and negative effects on resting heart rate respectively. Lower hemoglobin, obesity and more body mass index, and more low-density lipoprotein were associated with more resting heart rate. Continuing the monitoring of this sample via our cohort study and put to action multinational prospective researches with large sample sizes and long follow-ups can lead to more precise results and better scientific judgments.
Clinicopathological and Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) in Gastric Cancer: An Updated Meta-Analysis
Authors: Zhang Xunlei , Zhao Wenjing , Yu Yang , Qi Xue , Song Li , Zhang Chenfei , Li Guoxing , Yang Lei
Published: June 2020

Background: Pretreatment PLR (platelet-lymphocyte ratio), was reported to be associated with the prognosis in gastric cancer (GC), but the results remain inconclusive. This meta-analysis aimed to investigate the prognostic potential of the pre-treatment PLR in gastric cancer.Methods: We performed a systematic literature search in PubMed, Embase and the Cochrane Library to identify eligible publications. The hazard ratio (HR) /Odds Ratio (OR) and its 95% confidence (CI) of survival outcomes and clinicopathological parameters were calculated.Results: A total of 49 studies (51 cohorts), collectting data from 28,929 GC patients, were included in the final analysis. The pooled results demonstrated that the elevated pre-treatment PLR was significantly associated with poor overall survival (OS) (HR: 1.37, 95% CI: 1.26-1.49, p < 0.001; I2= 79.90%, Ph < 0.001) and disease-free survival (DFS) (HR 1.52, 95%CI 1.22–1.90, P< 0.001, I2= 88.6%, Ph< 0.001). Furthermore, the patients with the elevated PLR had a higher risk of lymph node metastasis (OR = 1.17, 95% CI: 1.02–1.33, p=0.023), serosal invasion (T3 +T4) (OR = 1.34, 95% CI: 1.10–1.64, p=0.003) and increased advanced stage (III+IV) (OR = 1.20, 95% CI: 1.06–1.37, p=0.004).Conclusions: An elevated pre-treatment PLR was a prognostic factor for poor OS and DFS, and associated with poor clinicopathological parameters in GC patients .
Nutritional support for lactating women with or without Azithromycin for infants compared to breast-feeding counselling alone, to improve six-month growth outcomes among infants of peri-urban slums of Karachi, Pakistan – a protocol of multi-arm assessor blinded randomized controlled trial (Mumta LW trial)
Authors: Muhammad Ameer , Shafiq Yasir , Nisar M Imran , Baloch Benazir , Yazdani Amna Tanweer , Yazdani Nida , Jehan Fyezah
Published: June 2020

BackgroundGlobally, 45% of under-five deaths are, directly or indirectly, attributable to malnutrition, most of these deaths are in low- and middle-income countries (LMICs). Children in the first 6 months of life are particularly vulnerable. An estimated 4.7 million infants under the age of 6 months are moderately wasted whereas 3.8 million are severely wasted. Despite the increased risk to a child of a mother with nutritional decompensation, there are discrepancies in guidance in this area. MethodsThis is a community-based, open-label factorial randomized controlled trial, using parallel assignment with 1:1:1 allocation ratio, in low-income squatter settlements of urban Karachi, Pakistan. In the control group (Arm A), women are randomized to standard counseling only; whereas in the first intervention group (Arm B), lactating women receive two sachets of balanced energy-protein (BEP) supplementation per day from enrollment till the infant reaches six months of age, in the second intervention group (Arm C), lactating women receive same BEP as in intervention Arm B while their babies also receive a single stat dose (20mg/kg orally) of azithromycin at 42 days. The primary outcome is relative length velocity from 0 to 6 months by the limb of allocation. The primary analysis will be Intention-to-treat analysisTrial registrationRegistration of the trial is done at ClinicalTrials.gov. NCT03564652, registered on June 21, 2018. Trial registration data is available through https://clinicaltrials.gov/ct2/show/NCT03564652
The role of periodontal disease in preterm labor: A prospective cohort study (A path analysis)
Authors: Farshad Mohammad MAHDI , Khorsand Afshin , kheirkhah Masoomeh , Shamshiri Ahmad Reza
Published: June 2020

Background: Periodontal infections are the most common oral diseases in pregnancy. This condition can cause complications during pregnancy. Therefore, this study was designed to determine the factors affecting preterm birth and their relationship with periodontal diseases. Methods: This was a prospective cohort study and the population, consisted of women 18-45 years attending prenatal care centers in their second trimester of pregnancy. After obtaining informed and free consent from the female parent, a periodontal examination was performed and her medical information was recorded. Examination of Rumford’s teeth was performed to assess the severity of gingivitis, plaque, calculus, and attachment loss, and AMOS software was used to investigate the association between preterm labor and delivery and to provide a conceptual model. Results: The consequences showed a direct association between preterm labor and factors, such as attachment loss, calculus , bleeding on probing (BOP), age, current diabetes, gestational diabetes, gestational hypertension, lack of Calcium, Folic acid, and Fe supplementation, mothers’ depression, polyhy dramnios, smoking severity and history of premature rupture of the membrane. The results also indicated an indirect relationship between an irregular tooth brushing and preterm birth. Conclusion: Attachment loss, calculus, bleeding on probing are directly related to premature labor and irregular tooth brushing is indirectly associated with early birth. Due to the direct relationship between periodontal diseases and preterm delivery, regular brushing, oral hygiene, oral examinations during pregnancy and follow-up treatment of periodontal disease during pregnancy are recommended. Keywords: Periodontal disease, Preterm labor, Cohort study, Path analysis, Pregnancy
A Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) for first-time families: study protocol of a three-arm randomised controlled trial
Authors: Loy See Ling , - Thilagamangai , Teo Joyce , Chan Sze Wern , Razak Nurul Khairani Abdul , Chay Oh Moh , Ng Kee Chong
Published: June 2020

Background: Enhanced parenting self-efficacy (PSE) contributes to positive parenting and future parental-child health. First-time parents, in particular, are in need of support since the pregnancy until post-delivery to strengthen their early PSE. However, there is a lack of effective and sustainable relevant programmes in the community. The Community-enabled Readiness for first 1000 Days Learning Ecosystem (CRADLE) aims to develop a self-learning eco-community throughout the pregnancy and early childhood to promote PSE among first-time parents. We apply choice architecture strategy using behavioural nudges and midwife-led continuity care during the first 1000 days, and test their effects on PSE and mother-child health for first-time families in Singapore. Methods: This three-arm randomised controlled trial will recruit up to 750 pregnant women from the KK Women’s and Children’s Hospital, Singapore. Participants will be randomly assigned to receive: (1) standard routine care; (2) behavioural nudges (text messages) along with the use of a social media platform; or (3) midwife-led continuity care involving home visits, during pregnancy and post-delivery. Using web-based questionnaires, participants will be assessed for baseline socio-demography and health status in the first trimester, with follow-up assessments in the third trimester, at birth, 6-week (primary end-point), 6-, 12-, 18- and 24-month post-delivery. The primary outcome is PSE. Secondary outcomes include health and birth experience, mental wellness, feeding practice, maternal and child nutritional status. Intention-to-treat and per-protocol analyses will be performed using linear regression mixed models to test the effects of interventions across time-point. Recruitment is projected to begin in June 2020 and end in May 2021.Discussion: This study may identify a sustainable effective strategy in the community by helping first-time parents to have a positive experience during the pregnancy, childbirth and parenthood, leading to an enhanced PSE and health outcomes for both mother and child. Findings from this study will provide insight into the implementation of early parenting and mother-child care programmes. Trial registration: ClinicalTrials.gov, NCT 04275765. Registered on 19 February 2020, https://clinicaltrials.gov/ct2/show/NCT04275765?term=NCT+04275765&draw=2&rank=1.
Clinical Trial Protocol to Evaluate the Efficacy of Cefixime in the Treatment of Early Syphilis
Authors: Mehta Shivani N. , Stafylis Chrysovalantis , Tellalian David M. , Burian Pamela L. , Okada Cliff M. , Millner Carl E. , Mejia Christopher M. , Klausner Jeffrey D.
Published: June 2020

Background: Syphilis rates have been increasing both in the US and internationally with incidence higher among men-who-have-sex-with-men and people living with human immunodeficiency virus (HIV) infection. Currently, benzathine penicillin is the recommended treatment for syphilis in all patients. Global shortages and cost increases in benzathine penicillin call for alternative treatment options. This study evaluates the efficacy of oral cefixime for the treatment of early syphilis. Methods: We are conducting a randomized, multisite, open-label, non-comparative clinical trial in Los Angeles and Oakland, California. Eligible participants are ≥18 years old, with primary, secondary or early latent syphilis (Rapid Plasma Reagin [RPR] titer ≥1:8). Patients with HIV infection must have a viral load ≤200 copies/mL and CD4+ T cell count ≥350 cells/μl during the past 6 months. Participants are randomized to receive either 2.4M IU benzathine penicillin G intramuscularly once or cefixime 400mg orally twice a day for 10 days. Participants return at 3, 6, and 12 months post-treatment for follow-up RPR serological testing. The primary outcome is the proportion of participants who achieve ≥4-fold RPR titer decrease at 3- or 6-months post-treatment.Discussion: Clinical trials evaluating the efficacy of alternative antibiotics to penicillin are urgently needed. Trial Registration: Clinicaltrials.gov, NCT03660488. Registered September 4, 2018, https://clinicaltrials.gov/ct2/show/NCT03660488
Patterns of Fish and Whale Consumption in Relation to Methylmercury in Hair among Residents of Western Canadian Arctic Communities
Authors: Walker Emily Victoria , Yuan Yuan , Girgis Safwat , Goodman Karen J.
Published: June 2020

Background: Methylmercury contamination of the environment represents a substantial environmental health concern. Human exposure to methylmercury occurs primarily through consumption of fish and marine mammals. Heavily exposed subgroups include sport or subsistence fishers residing in Arctic communities. We aimed to estimate the association of fish/whale consumption patterns of Canadian Arctic subsistence fishers with the internal dose of methylmercury as measured in hair. Methods: This research was conducted within ongoing community projects led by the CAN Help Working Group in Aklavik and Fort McPherson, Northwest Territories and Old Crow, Yukon. We interviewed each participant using a fish-focused food-frequency questionnaire during September-November 2016 and collected hair samples concurrently. Methylmercury was measured in the full-length of each hair sample using gas chromatography inductively-coupled plasma-mass spectrometry. Multivariable linear regression estimated beta-coefficients and 95% confidence intervals (CIs) for the effect of fish/whale consumption on hair-methylmercury concentrations. Results: Among 101 participants who provided hair samples and diet data, the mean number of fish/whale species eaten was 3.5 (SD:1.9). The mean hair-methylmercury concentration was 0.60μg/g (SD:0.47). Fish/whale consumption was positively associated with hair-methylmercury concentration, after adjusting for sex, hair length and use of permanent hair treatments. Hair-methylmercury concentrations among participants who consumed the most fish/whale in each season ranged from 0.30- 0.50μg/g higher than those who consumed <1 meal/week. Conclusions: In this population of Canadian Arctic subsistence fishers, hair-methylmercury concentration increased with fish/whale consumption, but the maximum concentrations were below Health Canada’s 6.0μg/g threshold for safe exposure.
Factors Influencing Adoption of Improved Structural Soil and Water Conservation Measures in Eastern Ethiopia
Authors: Wordofa Muluken Gezahegn , Okoyo Eric N. , Erkalo Eliso
Published: June 2020

Background: Agriculture remains to be the leading sector that contributes enormously to economic development in Ethiopia. Despite its significant contribution to livelihoods, the sector faces persistent challenges due to depletion of natural resources and soil erosion that resulted in diminishing crop and livestock productivity. In order to curb the effects of land degradation, the Government of Ethiopia has been taking serious measures to expand Soil and Water Conservation (SWC) practices throughout the country. Despite the efforts made, the adoption of new practices by farmers have been generally low. This study was aimed at assessing factors influencing smallholder farmers’ decision on the use of improved structural SWC practices in Haramaya district, eastern Ethiopia. A multi-stage sampling technique was used to select 120 farm households and 248 plots. A structured interview schedule was used to collect primary data. Descriptive and inferential statistics and Multinomial Logit (MNL) regression model were used to analyze the data. Results: The key findings showed that a host of socio-demographic, economic and institutional factors significantly affected smallholders’ decision to adopt improved structural SWC. In this study, we found that education, farming experience, plot area, distance of the plot from dwelling unit, number of economically active household members, and extension contact were the significant predictors of using improved SWC structures. Conclusions: Based on our findings, we concluded that improved SWC measures should be scaled up through a concerted effort of extension workers, local administration and other relevant non-state actors. In particular, the extension system should encourage rural communities on sustainable management and use of natural resources. Moreover, the need to create learning opportunities through facilitating appropriate educational and training programs for farmers and focusing on proper management of available economically active household members should be emphasized.
The Effectiveness of Battlefield Acupuncture in Addition to Standard Physical Therapy Treatment after Shoulder Surgery: A Protocol for a Randomized Clinical Trial
Authors: Crowell Michael S , Brindle Richard A , Mason John S , Pitt William J , Miller Erin M , Posner Matthew A , Cameron Kenneth L , Goss Donald L.
Published: June 2020

Introduction: There is a large incidence of shoulder instability among active young athletes and military personnel. Shoulder stabilization surgery is the commonly employed intervention for treating individuals with instability. Following surgery, a substantial proportion of individuals experience acute post-operative pain, which is usually managed with opioid pain medications. Unfortunately, the extended use of opioid medications can have adverse effects that impair function and reduce military operational readiness, but there are currently few alternatives. However, Battlefield Acupuncture (BFA) is a minimally invasive therapy demonstrating promise as a non-pharmaceutical intervention for managing acute post-operative pain.Methods: This is a single-blind randomized clinical trial featuring a 2x5 mixed-model factorial design. The two independent variables are intervention (2 levels; standard physical therapy and standard physical therapy plus Battlefield Acupuncture) and time (5 levels; 24-hours, 48-hours, 72-hours, 1-week, and 4-weeks post shoulder stabilization surgery). The primary dependent variable is worst and average pain as measured on the Visual Analog Scale. Secondary outcomes include medication usage, Profile of Mood States, and Global Rating of Change.Discussion: The magnitude of the effect of BFA is uncertain; current studies report confidence intervals of between group differences that include MCIDs between intervention and control groups. The results of this study may help determine if BFA is an effective adjunct to physical therapy in reducing pain and opioid usage in acute pain conditions. Trial registration: ClinicalTrials.gov, NCT04094246. Registered 16 September 2019, http://clinicaltrials.gov/NCT04094246.
Elevated serum levels of checkpoint molecules in patients with adult Still’s disease
Authors: Fujita Yuya , Asano Tomoyuki , Matsumoto Haruki , Matsuoka Naoki , Temmoku Jumpei , Sato Shuzo , Furuya Makiko Yashiro , Suzuki Eiji , Watanabe Hiroshi , Koga Tomohiro , Kawakami Atsushi , Migita Kiyoshi
Published: June 2020

Background: The interaction between galectin-9 (Gal-9) and its ligand, T cell immunoglobulin and mucin-containing-molecule-3 (TIM-3), one of the coinhibitory receptors, transduce the inhibitory signaling to regulate immune responses. The dysregulated expression of checkpoint molecules has been reported under various inflammatory or autoimmune conditions. The aim of this study is to investigate the levels of these checkpoint molecules and their associations between proinflammatory markers in patients with adult Still’s disease (ASD).

Methods: Serum samples were collected from 47 patients with active ASD, 116 patients with rheumatoid arthritis (RA), and 37 healthy controls (HCs). Serum levels of Gal-9, soluble TIM-3 (sTIM-3), and IL-18 were determined using enzyme-linked immunosorbent assay (ELISA). Results were compared with clinical features of ASD.

Results: Serum Gal-9 levels in patients with ASD (median: 21.57 ng/ml, interquartile range IQR [11.41–39.72]) were significantly higher compared to those in patients with RA (7.58 ng/ml, IQR [5.57–10.20] p < 0.001) as well as those in HCs (4.51 ng/ml, [IQR; 3.58–5.45], p < 0.001). Similarly, serum sTIM-3 levels in patients with ASD were significantly higher than those in patients with RA and HCs. Serum levels of Gal-9 or sTIM-3 showed positive correlations with IL-18 levels (Gal-9; r = 0.90, p< 0.001, sTIM-3; r = 0.78, p< 0.001) in patients with ASD. Serum levels of Gal-9 or sTIM-3 correlated with serum ferritin (Gal-9; r = 0.77, p< 0.001, sTIM-3; r = 0.71, p< 0.001) and ASD disease activity score (Pouchot’s score, Gal-9; r = 0.66, p< 0.001, sTIM-3; r = 0.59, p< 0.001). Whereas there was no significant correlation between serum Gal-9 or sTIM-3 and CRP. ASD patients with chronic arthritis phenotype had a significantly higher Gal-9/ferritin and sTIM-3/ferritin ratio than those without this phenotype. After immunosuppressive treatment, Gal-9 and sTIM-3 levels showed a significant decline in parallel to the disease activity scores.

Conclusions: Serum levels of the coinhibitory checkpoint molecules were elevated and correlated with disease activity in patients with ASD. These coinhibitory checkpoint molecule may be implicated in the autoinflammatory process seen in ASD.
Impact of Coronavirus Disease 2019 on Pulmonary Function in Early Convalescence Phase
Authors: Huang Yiying , Tan Cui yan , Wu Jian , Chen Mei zhu , Wang Zhen guo , Luo Li yun , Zhou Xiao rong , Liu Xin ran , Huang Xiao ling , Yuan Chi can , Chen Chao lin , Gao Fen , Huang Jin , Shan Hong , Liu Jing
Published: June 2020

Objective: This study investigated the influence of Coronavirus Disease 2019 (COVID-19) on lung function in early convalescence phase.Methods: A prospective retrospective study of COVID-19 patients at the Fifth Affiliated Hospital of Sun Yat-sen University were conducted, with serial assessments including lung volumes (TLC), spirometry (FVC, FEV1), lung diffusing capacity for carbon monoxide (DLCO),respiratory muscle strength, 6-minute walking distance (6MWD) and high resolution CT being collected at 30 days after discharged.Results: 57 patients completed the serial assessments. There were 40 non-severe cases and 17 severe cases. Thirty-one patients (54.3%) had abnormal CT findings. Abnormalities were detected in the pulmonary function tests in 43 (75.4%) of the patients. Six (10.5%), 5(8.7%), 25(43.8%) 7(12.3%), and 30 (52.6%) patients had FVC, FEV1, FEV1/FVC ratio, TLC, and DLCO values less than 80% of predicted values, respectively. 28 (49.1%) and 13 (22.8%) patients had PImax and PEmax values less than 80% of the corresponding predicted values. Compared with non-severe cases, severe patients showed higher incidence of DLCO impairment (75.6%vs42.5%, p=0.019), higher lung total severity score（TSS）and R20, and significantly lower percentage of predicted TLC and 6MWD. No significant correlation between TSS and pulmonary function parameters was found during follow-up visit.Conclusion: Impaired diffusing-capacityDeclining DLCO, lower respiratory muscle strength, and lung imaging abnormalities were detected in more than half of the COVID-19 patients in early convalescence phase. Compared with non-severe cases, severe patients had a higher incidence of DLCO impairment and encountered more TLC decrease and 6MWD decline.
An outbreak of intestinal schistosomiasis, alongside increasing urogenital schistosomiasis prevalence, in primary school children on the shoreline of Lake Malawi, Mangochi District, Malawi
Authors: Kayuni Sekeleghe , O’Ferrall Angus M. , Baxter Hamish , Hesketh Josie , Mainga Bright , Lally David , Al-Harbi Mohammad H. , LaCourse E. James , Juziwelo Lazarus , Musaya Janelisa , Makaula Peter , Stothard John Russell
Published: June 2020

Background: Intestinal schistosomiasis was not considered endemic in Lake Malawi until November 2017 when populations of Biomphalaria pfeifferi were first reported; in May 2018, emergence of intestinal schistosomiasis was confirmed. This emergence was in spite of ongoing control of urogenital schistosomiasis by preventive chemotherapy. Our current study sought to ascertain whether intestinal schistosomiasis is transitioning from emergence to outbreak, to judge if stepped-up control interventions are needed.Methods: During late-May 2019, three cross-sectional surveys of primary school children for schistosomiasis were conducted using a combination of rapid diagnostic tests, parasitological examinations and applied morbidity-markers; 1) schistosomiasis dynamics were assessed at Samama (n=80) and Mchoka (n=80) schools, where Schistosoma mansoni was first reported, 2) occurrence of S. mansoni was investigated at two non-sampled schools, MOET (Mangochi Orphan Education and Training) (n=60) and Koche (n=60) schools, where B. pfeifferi was nearby, and 3) rapid mapping of schistosomiasis, and B. pfeifferi, conducted across a further 8 shoreline schools (n=240). Results: In total, 520 children from 12 lakeshore primary schools were examined, mean prevalence of S. mansoni by ‘positive’ urine CCA-dipsticks was 31.5% [95% CI 27.5 – 35.5]. Upon comparisons of infection prevalence in May 2018, significant increases at Samama (RR=1.7 [95% CI 1.4 – 2.2]) and Mchoka (RR= 2.7 [95% CI 1.7 – 4.3]) schools were observed. Intestinal schistosomiasis was confirmed at MOET (18.3%) and Koche (35.0%) schools, and in all rapid mapping schools, ranging from 10.0% to 56.7%. Several populations of B. pfeifferi were confirmed, with two new eastern shoreline locations noted. Mean prevalence of urogenital schistosomiasis was 24.0% [95% CI 20.3 – 27.7]. Conclusions: We notify that intestinal schistosomiasis, once considered non-endemic in Lake Malawi, is now transitioning from emergence to outbreak. Once control interventions can resume after COVID-19, we recommend stepped-up preventive chemotherapy, with increased community-access to treatments, alongside renewed efforts in appropriate environmental control.
Proton versus photon radiotherapy for primary hepatocellular carcinoma: A propensity-matched analysis
Authors: Cheng Jen-Yu , Liu Chieh-Min , Wang Yu-Ming , Hsu Hsuan-Chih , Huang Eng-Yen , Huang Tzu-Ting , Lee Ching-Hsin , Hung Sheng-Ping , Huang Bing-Shen
Published: June 2020

Background Proton radiotherapy has a dosimetric advantage over photon radiotherapy. Many retrospective studies have shown promising results with proton radiotherapy in treating hepatocellular carcinoma (HCC). However, clinical evidence demonstrating the benefit of protons over photons is still limited. We therefore compared the clinical outcomes of the two modalities using medical research databases from our medical foundation.Methods We conducted a propensity score-matched cohort study based on our multi-institution medical organization research database. From January 2007 to January 2018, a total of 413 patients (photon: 349; proton: 64) who were diagnosed with HCC and primarily treated with radiotherapy with curative intent were enrolled. Overall survival (OS) and radiation-induced liver disease (RILD) were assessed. Stratified analysis was also performed to evaluate the heterogeneous effects of the two arms.Results A total of 110 patients (photon: 55; proton: 55) were analyzed in the propensity-matched series. The matched groups were balanced for baseline tumor risk factors. Cox regression analysis revealed a significant survival benefit in the proton group (p=0.032, HR 0.56, 95% CI 0.33-0.96). The median overall survival in the proton group was not reached and that in the photon group was 17.4 months. The biological equivalent dose of radiotherapy was significantly higher in the proton group than in the photon group (median, 96.56 Gray [relative biological effectiveness] vs. 62.5 Gray, p<0.001). The risk of RILD was significantly lower in the proton group (11.8% vs. 36%, p=0.004).Conclusions Proton radiotherapy could deliver a higher radiation dose than photon radiotherapy without increasing the risk of RILD and result in a better overall survival rate for those diagnosed with HCC and treated with radiotherapy with curative intent.
Metalloproteins and apolipoprotein C: candidate plasma biomarkers of T2DM screened by comparative proteomics and lipidomics in ZDF rats
Authors: Wang Shuai , Lu Zhiyuan , Wang Yuxin , Zhang Tianran , He Xiaodong
Published: June 2020

Background
Early diagnosis of type 2 diabetes mellitus (T2DM) is still difficult. Screening of plasma biomarkers has great significance of optimizing diagnosis and predicting the complications of T2DM.
Methods
We used a special diet, Purina #5C08, to induce diabetes in Zucker leptin receptor gene-deficient rats (fa/fa) to establish Zucker diabetic fatty (ZDF) rats, simulating the early stage of T2DM. The differentially expressed proteins (DEP) and lipids (DEL), as potential biomarkers, were screened to compare the plasma expression levels in ZDF rats and their basic diet-fed wild-type controls (fa/+) by Tandem Mass Tags (TMT) and liquid chromatography-tandem mass spectrometry.
Results
These two groups had different plasma proteins and lipids profiles consisting of 84 DEPs and, 179 DELs identified in the positive ion mode and 178 DELs in the negative ion mode, respectively. Enrichment analysis of these different indicators showed that oxidative stress, insulin resistance and metabolic disorders of glycan and lipid played an important role in generating the difference. Some markers can be used as candidate biomarkers, such as ceruloplasmin, apolipoprotein C-I, apolipoprotein C-II, apolipoprotein C-IV, etc., in prediction and treatments of T2DM.
Conclusion
These plasma differences help to optimize the diagnosis and predict the complications of T2DM, although this remains to be verified in the crowd. Trace elements related-metalloproteins, such as ceruloplasmin, and lipid metabolism and transport-related apolipoprotein C are expected to be candidate biomarkers of T2DM and should be given more attention.
Optimal H2O2 preconditioning to improve BMSCs’ engraftment in wounds healing
Authors: Guo Ling , Zhang Ya , Du Juan , Yuan Dan Feng , Zhang Shu , Zhang Hua Cai , Mi Jun Wei , Ning Ya Lei , Chen Min Jia , Wen Da Lin , Sun Jian Hui , Liu Di , Zeng Ling , Zhang An Qiang , Jiang Jian Xin , Huang Hong
Published: June 2020

Background.

The transplantation of bone marrow mesenchymal stem cells (BMSCs) is a promising therapeutic strategy for wound healing. However, the poor migration capacity and low survival rate of transplanted BMSCs in wounds weaken their potential application.
Objective.

The optimal protocol for BMSCs preconditioned with H2O2 was investigated, and the therapeutic efficacy of preconditioned BMSCs in wounds was evaluated.
Methods.

Mouse BMSCs were exposed to various concentrations of H2O2, and their functions were assessed; The H2O2-preconditioned BMSCs were transplanted into mice with full-thickness excisional wounds. Wound analysis was performed to assess the transplantation efficacy.
Results.

Treatment BMSCs with 50 µM H2O2 for 12 h could enhance their proliferation, migration and survival by maximizing up-regulation the cyclin D1, SDF-1 and its receptors CXCR4/7 expressions, and activating the PI3K/Akt/mTOR pathway, but inhibiting the expression of p16 and GSK-3β. Meanwhile, oxidative stress-induced-BMSCs apoptosis was significantly attenuated by an obviously decreased ratio of Bax/Bcl-2 and cleaved caspase-9/3 expression. After transplantation of BMSCs, the migration of H2O2 preconditioned-BMSCs into the wounds was dramatically increased compared to un-preconditioned-BMSCs, and had an increased microvessel density and wound closure speed.
Conclusions.

The findings suggested that 50 µM H2O2 pretreated for 12 h is the optimal precondition for the transplantation of BMSC, which gives a considerable insight that this protocol may be served as a promising candidate for improving the therapeutic potential of BMSCs for wound healing.
Vascular function and cardiovascular risk in a HIV infected and HIV free cohort of African ancestry: Baseline Profile, Rationale and Methods of the Longitudinal EndoAfrica-NWU Study
Authors: Fourie Carla Maria Theresia , Roux Shani Botha-Le , Smith Wayne , Schutte Aletta E , Breet Yolandi , Mels Carina MC , Gafane-Matemane Lebo F , Lammertyn Leandi , Uys Lisa , Burger Adele , Joseph Jitcy S , Goswami Nandu , De Boever Patrick , Strijdom Hans
Published: June 2020

Background: People living with the Human Immunodeficiency Virus (PLHIV) have an increased susceptibility to develop non-communicable diseases such as cardiovascular disease (CVD). Infection with HIV contributes to the development of CVD independent of traditional risk factors, with endothelial dysfunction being the central physiological mechanism. While HIV-related mortality is declining due to antiretroviral treatment (ART), the number of deaths due to CVD is rising in South Africa - the country with the highest number of PLHIV and the world’s largest ART programme.The EndoAfrica study was developed to determine whether HIV infection and ART are associated with cardiovascular risk markers and changes in vascular structure and function over 18 months in adults from different provinces of South Africa. This paper describes the rationale, methodology and baseline cohort profile of the EndoAfrica study conducted in the North West Province, South Africa. Methods: In this case-control study, conducted between August 2017 and June 2018, 382 volunteers of African descent (276 women; 106 men), comprising of 278 HIV infected and 104 HIV free individuals were included. We measured health behaviours, a detailed cardiovascular profile, and performed biomarker analyses. We compared baseline characteristics, blood pressure, vascular function and biochemical markers between those infected and HIV free. Results: At baseline, the HIV infected participants were older (43 vs 39 years), less were employed (21% vs 40%), less had a tertiary education (7% vs 16%) and their body mass index was lower (26 vs 29 kg/m2) than that of the HIV free participants. While the cardiovascular profile, flow-mediated dilation and pulse wave velocity did not differ, glycated haemoglobin was lower (p=0.017) and total cholesterol, high density lipoprotein cholesterol, triglycerides, gamma-glutamyltransferase and tobacco use were higher (all p<0.047) in PLHIV. Conclusion: Despite PLHIV being older, preliminary cross-sectional analysis suggests that PLHIV being treated with ART do not have poorer endothelial or vascular function compared to the HIV free participants. More detailed analyses on the baseline and follow-up data will provide further clarity regarding the cardiovascular profile of South Africans living with HIV.
Meta-analysis of the effects of dexmedetomidine vs esmolol for used controlled hypotension during surgery
Authors: Li Jiuyi , Huang Lingkun , Zhang Zhiming , Zeng Bin , Deng Huiyin
Published: June 2020

Background: At present ,the anesthetist usally use Controlled hypotension tecnical reduced blood loss and improved surgical field. Dexmedetomidine and esmolol have been proved effective for controlled hypotension. This meta-analysis aimed to evaluate the effects of dexmedetomidine versus esmolol on the controlled hypotension during surgery.Methods: All articles were retrieved from PubMed, Embase, Cochrane Library up to January 2020. JL and HD independently screened, extracted and evaluated the literature that meet the inclusion and exclusion criteria, and used RevMan 5.3 for statistic analysis.Results: Eight randomised trials, including 418 patients were selected in this meta-anaysis. And it’s results showed:1) The dexmedetomidine group was more favorable in reducing blood loss (MD 49.48 with 95% CI [-5.44,104.40], P =0.08）;2）Compared with the esmolol group，HR （MD 3.30 with 95% CI [2.11,4.50], P <0.00001）,requiring of fentany(SMD 5.96 with 95% CI [3.43,8.48], P <0.00001）were considerably lower in the dexmedetomidine group，while emergence time （MD -6.69 with 95% CI [-9.61,-3.76], P <0.0001)was more longer in the dexmedetomidine group . 3）Compared with the esmolol group，duration of surgery（MD -0.12 with 95% CI [-6.24,6.01], P = 0.97），MAP（ MD 2.29 with 95% CI [-2.02,6.60],P =0.30），the recovery period（MD -0.52 with 95% CI [-3.07,2.04], P = 0.69）were not statistically significant differences in the dexmedetomidine group.Conclusion: Two drugs were effective for controlled hypotension, but compared with esmolol, dexmedetomidine is more better in reducing blood loss ,and less requiring of fentanyl.But attention should be paid to the long emegence time and bradycardia.