bluuebunny/crossref_metadata_2025 huggingface dataset:
A Single-Cell Immune Atlas of Triple Negative Breast Cancer Reveals Novel Immune Cell Subsets
Authors: Qiu Si , Hong Ruoxi , Zhuang Zhenkun , Zhu Linnan , Li Yuan , Zhang Weimin , Lin Xinxin , Zheng Qiufan , Liu Shang , Zhang Kai , Huang Mengxian , Lee Kaping , Lu Qianyi , Xia Wen , Xu Fei , Hou Yong , Zhang Xiuqing , Wang Jian , Yang Huanming , Zhan Qimin , Li Bo , Wang Shusen
Published: September 2020

Background: Triple-negative breast cancer (TNBC) represents the most aggressive breast cancer subtype, which recently attracts great interest for immune therapeutic development. In this context, in-depth understanding of TNBC immune landscape is highly demanded.Results: Here we report full-length single-cell RNA sequencing results of 9683 tumor-infiltrated immune cells isolated from 14 treatment naïve TNBC tumors, where 22 immune cell subsets, including T cells, macrophages, B cells, and DCs have been characterized. We identify a new T cell subset, CD8+CXCL8+ T cell, which associates with poor survival, and a subset of “pre-exhaustion” T cell cluster, which is predictive of favorable prognosis. A novel immune cell subset comprised of TCR+ macrophages, is found to be widely distributed in TNBC tumors. Further analyses reveal an up-regulation of molecules associated with TCR signaling and cytotoxicity in these immune cells.Conclusions: Altogether, our study provides a valuable resource to understand the immune ecosystem of TNBC. The novel immune cell subsets reported herein might be functionally important in cancer immunity. These data will be helpful for the immunotherapeutic strategy design of this disease.
Productive Safety Net Program and Dietary Practice Among Pregnant Women in Kacha Birra District, Southwest Ethiopia: Comparative Cross-Sectional Study
Authors: BAFFA LEMLEM DANIEL , DERSO TEREFE , MUHAMMAD ESMAEL ALI
Published: September 2020

Background: Morbidity and mortality associated with poor dietary practice among pregnant women are a common public health burdens especially in low income countries like Ethiopia, for which, household food insecurity can be a determinant factor. Productive safety net program (PSNP) is implemented in Ethiopia to alleviate this problem with emphasis on pregnant and lactating mothers even though little is known about the dietary practice among pregnant women in the program user and non-user households. Therefore, this study is aimed to compare the proportion of good dietary practice and associated factors among pregnant women in productive safety net program user and non-user households in Kacha Birra District. Method: A Community based comparative cross sectional study was conducted in Kacha Birra District from March 12 to April 20, 2019. A total of 715 pregnant women were included by simple random sampling technique. A pretested and structured interviewer administered questionnaire was used to collect the data. Data was entered into EpiData version 3.1 and transferred to Stata version 14 for analysis. Binary logistic regression model was fitted to identify factors associated with dietary practice. Crude odds ratio and adjusted odds ratios with 95% confidence intervals were calculated to assess the strength of associations and significance of the identified factors with dietary practice. Result: The overall proportion of good dietary practice among pregnant women was 14.97% (95%CI: 12.3-17.6), while it was 11.17% (95%CI: 6.5-15.8) and 16.23% (95%CI: 13.09-19.36) among pregnant women in PSNP user and non PSNP user households respectively. Dietary knowledge (AOR=2.64, 95%CI:1.67-4.18), nutrition information (AOR=2.36, 95%CI:1.41-3.95) and husband occupation (AOR=3.51, 95%CI:1.02-12.08) were significantly associated with dietary practice of the pregnant women. Conclusion: The proportion of good dietary practice of the pregnant women in the study area was low with no significant difference among the comparative groups. Dietary knowledge, nutrition information and husband occupation were significantly associated with the dietary practice. So, giving due attention to the improvement of knowledge of the pregnant mothers about nutrition during pregnancy and enhancing their exposure to nutrition information is crucial. Also, strengthening the PSNP is important.
Carriage of antimicrobial-resistant bacteria in a high-density informal settlement in Kenya is associated with environmental risk-factors
Authors: Omulo Sylvia , Lofgren Eric T , Lockwood Svetlana , Mwangi Samuel T , Bigogo Godfrey , Ouma Alice , Juma Bonventure , Njenga Kariuki M , Kariuki Samuel , McElwain Terry F , Palmer Guy H , Call Douglas R
Published: September 2020

BackgroundThe relationship between antibiotic use and antimicrobial resistance varies with cultural, socio-economic, and environmental factors. We examined these relationships in Kibera, an informal settlement in Nairobi - Kenya, characterized by high population density, high burden of respiratory disease and diarrhea. Methods. Two-hundred households were enrolled in a 5-month longitudinal study. One adult (≥18 years) and one child (≤5 years) participated per household. Biweekly interviews (n=1,516) were conducted and 2,341 stool, 2,843 hand swabs and 1,490 water samples collected. Presumptive E. coli (n=34,042) were isolated and tested for susceptibility to nine antibiotics.ResultsEighty percent of E. coli were resistant to ≥3 antibiotic classes. Stool isolates were resistant to trimethoprim (mean: 81%), sulfamethoxazole (80%), ampicillin (68%), streptomycin (60%) and tetracycline (55%). Ninety-seven households reported using an antibiotic in at least one visit over the study period for a total of 144 episodes and 190 antibiotic doses. Enrolled children had five times the number of episodes reported by enrolled adults (96 vs. 19). Multivariable linear mixed-effects models associated children eating soil from the household yard and informal hand-washing stations with increased numbers of antimicrobial-resistant bacteria (counts increasing by 0·27-0·80 log10 and 0·22 to 0·51 log10 respectively, depending on the antibiotic tested). Rainy conditions were associated with reduced carriage of antimicrobial-resistant bacteria (1·19 to 3·26 log10 reduction depending on the antibiotic tested).ConclusionAntibiotic use provided little explanatory power for the prevalence of antimicrobial resistance. Transmission of resistant bacteria in this setting through unsanitary living conditions likely overwhelms incremental changes in antibiotic use. Under such circumstances, sanitation, hygiene, and disease transmission are the limiting factors for controlling the presence of resistant bacteria.
Seeking Research Questions from Implementers: Considerations for Leveraging Ground Actors Research Needs in the Fight against Malaria in West Africa.
Authors: Amouh Tete Sitou , Ekoye Saidou Malam , Ahanhanzo Césaire Damien , Guiguemdé Tinga Robert , Sombié Issiaka
Published: September 2020

Malaria, a parasitic infection, still a major public health threat and hence a heavy economic burden that hampers the development of countries especially in West Africa. Malaria and Neglected Tropical Diseases (NTD) altogether are now the third leading cause of death in ECOWAS region with 77% of deaths in children under 5 years due to malaria. Countries and partners set ambitious goals for reducing the burden and eliminating malaria by 2030. To achieve these goals, West African countries program managers and researchers are engaged in a series of activities to address practical bottlenecks. This article aims to evaluate the effectiveness of a collaboration between malaria program implementation and research needs in West African countries, related to malaria. It describes the crucial role and process managers and researchers can play in these countries, in assuring the identification of research related program implementation issues as well as solutions to those barriers in order to alleviate the burden. Identifying research questions pertaining to each program through an implementation science approach, integrating health delivery and innovative approach to bottlenecks, and decision support to promote joint optimization of activities for malaria elimination. Managers and researcher discussed together programs difficulties being encountered and highlighted key research questions to be addressed.
Ten-year trend of mortality among patients hospitalized with Malaria in Ghana,
Authors: Malm Keziah , Peprah Nana Yaw , Mohammed Wahjib , Baddoo Nyonuku A. , Abdulai Marijanatu , Alebachew Zeleke , Bonsu Frank Adae , Addo Stephen Ayisi , Saalfeld Mark , Lee Donna , Workneh Nibretie , Bart-Plange Constance , Shargie Estafanos
Published: September 2020

Background Multiple interventions have been implemented over the years to decrease malaria morbidity and mortality in Ghana. After years of rolling out these interventions, assessing its effect on the trends for decision making is key. The objective of this study was to understand the trends of malaria related deaths in the country from 2005 to 2014.Methods Between September 2016 and June 2017, abstraction of retrospective data covering January 1st 2005 to December 31st, 2014 was conducted in 93 sampled health facilities providing AIDs/HIV, Tuberculosis and Malaria (ATM) services in Ghana. This paper is written out of a bigger study which looked at the mortality of ATM in Ghana. Abstraction form was used to retrieve socio-demographic and admission outcome of patients from facility registers, death certificates and inpatients registers. Data was entered using EpiData 3.1 statistical software package then exported to STATA 11 version for analysis. Bivariate analysis with Chi-square test and multiple logistic regression were done to assess factors associated with malaria related mortality at a 5% level of significance.Results A total of 667,186 admissions records related to malaria were retrieved in 93 hospitals from 2005 to 2014 with majority of the admissions being females (53.9%) and children under 5 years (47.8%). A total of 10,433(1.6%) of the admitted malaria cases were reported to have died with males and children under five years accounting for 51.0% and 26.6% respectively. Malaria case fatality rate showed an increasing trend from 2.2% in 2005 to 3.0% in 2007 and decreased to 1.1% in 2014. Malaria mortality declined by approximately 59% over the ten-year period with an average annual decline of 7%. Year of admissions, age, sex, insurance status and ownership of facility was significantly associated with mortality (p < 0.001). Sub-regional level hospitals have a decreased likelihood of malaria related mortality. A non-insured client increases the likelihood of mortality by 2.4 times (Odds Ratio = 2.4 p < 0.001).Conclusion Malaria mortality declined over the ten-year period with an average annual decline of 7%. An increase in age and not having health insurance among malaria-related admissions increases the likelihood of mortality.
Culture-negative versus Culture-positive in pyogenic spondylitis and Analysis of risk factors for relapse
Authors: dai guohua , li shu zhong , yin chuqiang , sun yuanliang , wang qizun , hou jianwen , luan liangrui , wang zhichao , wang ting
Published: September 2020

Objectives
This study aims to compare and analyze the clinical features, diagnosis, treatment and prognosis of culture-negative and culture-positive primary pyogenic spondylitis.
Methods
A retrospective analysis of 202 cases of adult primary pyogenic spondylitis with complete clinical data in our hospital from January 2013 to January 2020 were divided into 2 groups according to the bacterial culture results: culture negative group (n = 126), culture Positive group (n = 76). Compare the clinical characteristics, diagnosis, treatment and prognosis of patients with different culture results.
Results
The culture positive rate was 37.62% (76/202). There were no significant differences in age, gender, affected segment, spinal abscess, diabetes mellitus, course of disease, surgery, recurrence, and follow-up time between the two groups (P > 0.05). Two groups of hospital admission erythrocyte sedimentation rate (erythrocyte sedimentation rate, ESR), admission C-reactive protein (C-reactive protein, CRP), admission white blood cell count (white blood cell, WBC), discharge ESR, discharge CRP, ESR decline rate, CRP There were statistically significant differences in the rate of decline, hospitalization days, and body temperature ≥ 38 °C (P < 0.05). Higher CRP levels on admission, antibiotic treatment time < 6 weeks, and body temperature ≥ 38 ℃ are independent risk factors for infection recurrence.
Conclusion
The culture-negative group's admission WBC, admission ESR, admission CRP, discharge ESR, discharge CRP, ESR decline rate, CRP decline rate, and hospital stay were lower than the culture positive group, the difference was statistically significant (P < 0.05). The independent risk factors for infection recurrence are higher CRP levels in hospital admission, antibiotic treatment time < 6 weeks, and body temperature ≥ 38 °C.
Association between antenatal care utilization pattern and timely initiation of postnatal care checkup: Analysis of 2016 Ethiopian Demographic and Health Survey
Authors: Wassie Gizachew Tadesse , Belete Minyichil Birhanu , Tesfu Azmeraw Arega , Bantie Simachew Animen , Ayenew Asterey Assmie , Endeshaw Belaynew Adugna , Agdie Semaw Minale , Kiros Mengistu Desalegn , Haile Zelalem T , Haider Mohammad Rifat , Ice Gillian H
Published: September 2020

Background: Despite significant public health intervention, maternal mortality remains high in low- and middle-income countries, including Ethiopia. Effective postnatal care is a critical service to reduce maternal mortality. In Ethiopia, only 17% of mothers received postnatal care service in 2016. This study examined the association between antenatal care and timely postnatal care checkup among reproductive age women in Ethiopia.Methods: The study used the 2016 Ethiopian Demographic and Health Survey data. The sample consisted of 4,081 women who give birth within the last two years prior to survey. Chi-square test and multivariable logistic regression were used to examine the association between antenatal care and timely initiation of postnatal care.Results: Postnatal care services within 2 days of delivery were received by 16.5% of women. Women who had at least four timely antenatal care visits had higher odds of timely postnatal checkup compared to women who had no antenatal care [adjusted Odds Ratio (aOR): 2.50; 95% Confidence Interval (95%CI) 1.42–4.42]. Women who had at least four antennal care visits without timely initiation also had higher odds of postnatal check-up than their counterparts (aOR: 2.46; 95%CI: 1.22–4.97). Other factors significantly associated with timely initiation of PNC were secondary and above education (aOR: 1.64; 95%CI: 1.03–2.60), perceived distance to the nearby health facility as significant barrier (aOR: 1.55; 95%CI: 1.15–2.09), primiparous (aOR: 0.34; 95%CI: 0.19–0.61) and institutional delivery (aOR: 14.55; 95%CI: 2.21–95.77).Conclusion: Timely initiation of postnatal care within two days of delivery in Ethiopia is very low. Women who received recommended antenatal care services had higher odds of timely initiation of postnatal care. Thus, strengthening the existing maternal and child health programs to adhere to the recommended ANC care guidelines may improve timely initiation of postnatal care.
Curiosity or underdiagnosed? Thoracolumbar spinal column injuries with concomitant trauma of the pancreas
Authors: Hax Jakob , Halvachizadeh Sascha , Jensen Kai Oliver , Berk Till , Teuber Henrik , Primio Teresa Di , Lefering Rolf , Pape Hans-Christoph , Sprengel Kai
Published: September 2020

Background: The pancreas is an organ which is at risk of damage as a consequence of thoracolumbar spine injury. However, to our knowledge, no studies have provided any prevalence data to support this assumption. Therefore, the coincidence of pancreatic trauma in patients with spine injury is still unknown. Data from the TraumaRegister DGU® (TR-DGU) was analysed to estimate the prevalence of this correlation and to determine its influence on clinical outcome.Methods: A retrospective investigation of cases documented in the TR-DGU between 2008 and 2017 was performed. We included data of patients admitted to participating European trauma centres who had thoracic or lumbar spine injuries and met the following criteria: i) Injury Severity Score (ISS) ≥ 9, ii) blunt trauma, and iii) no early transfer out of hospital. We investigated the coincidence of pancreas injury in patients with at least an Abbreviated Injury Scale (AIS) of 2 of the thoracic or lumbar spine. Therefore, we included all kind of relevant injuries of the thoracolumbar spine.Results: In the group with thoracolumbar injury with concomitant pancreatic injury, the mean age was 43.1 ± 18.6 years, and 68% of these patients were male. The most frequent mechanisms of trauma were car (38%) and motorbike (17%) accidents, as well as high falls (23.8%). The mean Injury Severity Score was 35.7 ± 16.0 points and the in-hospital mortality rate was 17.5%. The overall prevalence of pancreatic injury was 60.7 (0.61%; 95% confidence interval (CI), 0.58–0.65) per 10,000 patients. Patients with severe spinal injuries (AIS ≥ 2) were more likely to present with a concomitant pancreatic injury compared to patients with no or only minor spinal injury (AIS 0–1) (Odds ratio (OR) 1.78; 95%CI, 1.57–2.01).Conclusions: Concomitant pancreatic injury in patients with spinal injuries of the thoracolumbar spine is rare. However, patients with more severe spinal injuries were overall more likely (OR 1.78) to present with an accompanying pancreatic injury than those with minor thoracolumbar injuries. Therefore, trauma surgeons treating severely injured patients must be alert not to overlook this rare concomitant injury, because it does not clearly correlate with the severity of spinal injury.
Inflammatory M1-like macrophages polarized by NK-4 undergo enhanced phenotypic switching to an anti-inflammatory M2-like phenotype upon co-culture with apoptotic cells
Authors: Kohno Keizo , Koya-Miyata Satomi , Harashima Akira , Tsukuda Takahiko , Katakami Masataka , Ariyasu Toshio , Ushio Shimpei , Iwaki Kanso
Published: September 2020

Background: NK-4 has been used to promote wound healing since the early-1950s; however, the mechanism of action of NK-4 is unknown. In this study, we examined whether NK-4 exerts a regulatory effect on macrophages, which play multiple roles during wound healing from the initial inflammatory phase until the tissue regeneration phase. Results: NK-4 treatment of THP-1 macrophages induced morphological features characteristic of classically-activated M1 macrophages, an inflammatory cytokine profile, and increased expression of the M1 macrophage-associated molecules CD38 and CD86. Interestingly, NK-4 augmented TNF-a production by THP-1 macrophages in combination with LPS, Pam3CSK4, or poly(I:C). Furthermore, NK-4 treatment enhanced THP-1 macrophage phagocytosis. These results indicate that NK-4 drives macrophage polarization toward an inflammatory M1-like phenotype with increased phagocytic activity. Efferocytosis is a crucial event for resolution of the inflammatory phase in wound healing. NK-4-treated THP-1 macrophages co-cultured with apoptotic Jurkat E6.1 (Apo-J) cells switched from an M1-like phenotype to an M2-like phenotype, as seen in the inverted ratio of TNF-a to IL-10 produced in response to LPS. We identified two separate mechanisms that are involved in this phenotypic switch. First, recognition of phosphatidylserine molecules on Apo-J cells by THP-1 macrophages downregulates TNF-a production. Second, phagocytosis of Apo-J cells by THP-1 macrophages and activation of PI3K/Akt signaling pathway upregulates IL-10 production. Conclusion: It is postulated that the phenotypic switch from a proinflammatory M1-like phenotype to an anti-inflammatory M2-like phenotype is dysregulated due to impaired efferocytosis of apoptotic neutrophils at the wound site. Our results demonstrate that NK-4 improves efferocytosis, suggesting its potential as a therapeutic strategy to resolve sustained inflammation in chronic wounds.
Behçet's Disease: Successful Aortic Root Reconstruction in Severely Dilated Aortoventricular Junction After Aortic Valve Replacement With Novel Surgical Method - a Case Report
Authors: Pólos Miklós , Koppányi Ádám , Benke Kálmán , Daróczi László , Oláh Attila , Heltai Krisztina , Kiss Emese , Fintha Attila , Nagy Beáta , Hartyánszky István , Lakatos Bálint , Kovács Attila , Merkely Béla , Szabolcs Zoltán
Published: September 2020

Background: Behçet’s disease is an auto-inflammatory disorder categorized as a primer systemic vasculitis of unknown aetiology. Genetic factors, infectious agents and the irregularity of T-cell homeostasis are presumed to be responsible for the emergence of Behçet’s disease. Characteristic symptoms are multisystemic. Although cardiovascular involvement is rare, it should be noted due to the difficulty of surgical treatment options.Case Presentation: Our 44-year-old male patient underwent aortic valve replacement due to aortic regurgitation. At the 15-month follow-up, echocardiography showed detachment of the prosthetic valve and in the aortic root, multiple pseudo-aneurysms were identified. We performed an aortic root reconstruction with a Bentall procedure using a special „skirted” conduit to reduce strain in the suture line between the conduit and the extremely dilated left ventricular outflow tract. Conclusions: The surgical treatment of cardiovascular manifestations of Behçet’s disease remains challenging. This new technique may be beneficial in well-selected cases where the annulus of the aorta is extremely dilated or annular tissue disorder is present.
Effects of Tidal Volume on Physiology and Clinical Outcomes of Surgery Patients Undergoing One-lung Ventilation: A Meta-analysis of Randomized Controlled Trials
Authors: Xia Feiping , Lu Zhonghua , Tang Yuying , Qiu Haibo , Yang Yi , Guo Fengmei
Published: September 2020

Objective: It is unclear how tidal volume (Vt) impacts patients during one-lung ventilation (OLV). A meta-analysis was performed to assess the effect of Vt on physiology and clinical outcomes in OLV patients. Methods: PubMed, Cochrane library, and Web of Science were retrieved until February 2020. Randomized controlled trials comparing the application of low and high Vt ventilation in adults with OLV were included. Demographic variables, Vt, physiology, and clinical outcomes were retrieved. Summary odds ratios (ORs) with 95% confidence intervals (CIs) and mean difference with standard deviation were calculated using a random-effects model.Results: 12 studies involving a total of 876 participants met inclusion criteria. Significant difference in blood interleukin-6 (IL-6) was observed between low Vt ventilation and high Vt ventilation (MD -35.51 pg/ml, 95% CI [-66.47, -4.54 pg/ml], p = 0.02). Low Vt ventilation decreased driving pressure (ΔP) (MD -6.02 cmH2O, 95% CI [-8.32, -3.72 cmH2O], p < 0.0001), Peak pressure (Ppeak) (MD -2.88 cmH2O, 95% CI [-4.60, -1.16 cmH2O], p = 0.001), and improved PaO2/FiO2 (MD 32.27 mmHg, 95% CI [19.54, 45.01 mmHg], p <0.00001). Risk of atelectasis was the same between the two groups. Furthermore, the study suggested that low Vt ventilation was associated with decreases in the risk of acute lung injury (OR 0.05, 95% CI [0.28, 0.88], p = 0.02). Decreased hospital length of stay in the low Vt group occurred when Vt was set 4-5 ml/kg (MD -0.78 d, 95% CI [-1.45, -0.11 d], p = 0.02).Conclusions: In OLV patients, low Vt ventilation improved PaO2/FiO2, and it was also associated with decreased blood IL-6, ΔP, Ppeak, and risk of acute lung injury, when the low Vt was set 4-5 ml/kg hospital length of stay was decreased .
No Neurochemical Evidence of Neuronal Injury or Glial Activation in Children with Paediatric Acute-onset Neuropsychiatric Syndrome
Authors: Johnson Mats , Fernell Elisabeth , Gillberg Christopher , Fasth Anders , Blennow Kaj , Zetterberg Henrik
Published: September 2020

Background Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterized by an acute onset of obsessive compulsive disorder, combined with at least two other neuropsychiatric symptoms with similarly acute onset. Diagnostic criteria also require that no specific medical aetiology is identified. Although there are no verified aetiological biomarkers, PANS is assumed to be a neuroinflammatory disorder with a possible autoimmune aetiology. Neurochemical markers such as neurofilament light (NfL, a neuronal injury marker) and glial fibrillary acidic protein (GFAP, an astrocytic activation marker) have not been published for this patient group.Methods Blood samples from 17 children meeting diagnostic criteria for PANS, after assessment at the Child Neuropsychiatry Centre, Sahlgrenska University Hospital, Gothenburg, Sweden, were analysed for serum concentrations of NfL and GFAP. Ten age-matched children without any neurological or psychiatric disorder served as a comparison group. Results No difference was found in mean NfL and mean GFAP serum concentrations between children with PANS and controls. NfL and GFAP concentrations did not correlate with disease duration between PANS onset and time of blood tests. Conclusion Neuronal injury and astrocyte activation do not seem to be a major event in PANS. The study group was small, and even if findings may be reassuring for parents and patients, they should be interpreted with caution and verified in larger cohort and possibly with other markers in both serum and CSF.
Association Between Waist Circumference Change and Incident Chronic Obstructive Pulmonary Disease in Chinese Adults: An 18-year Cohort Study
Authors: Ma Yun-Lei , Zhao Han-Jun , Su Ying-Hao
Published: September 2020

Background The aim of our study was to investigate waist circumference (WC) change and the risk of incident chronic obstructive pulmonary disease (COPD) among Chinese adults.Methods A total of 8,164 participants aged 20-35 years were recruited who attended health examination with the repeat measurements of WC and lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)) from 2001 to 2019. The data of same measurements were collected at their age of 38-53 years. Participants were categorized by WC change as ≤-2.5%, -2.5% to 2.5%, 2.5% to 5% and ＞5% according to gender. The modified Poisson regression models were used to assess the association of WC gain and the risk of COPD.Results During 18-year follow-up, a total of 917 COPD cases were identified. From baseline to follow-up, the mean of FEV1 decreased from 3.20 L to 2.79 L among male participants and 2.28 L to 1.95 L among female participants. Comparing with participants who were not abdominal obesity at both baseline and follow-up, participants with abdominal obesity among both genders after the follow-up were associated to the greater risk of COPD regardless of abdominal obesity at baseline. The risk of incident COPD increased 19% among male participants (RR=1.19, 95%CI=1.04-1.48) and 14% among female participants (RR=1.14, 95%CI=1.01-1.40) when WC gain increased ＞5% during the 18-year follow-up. The COPD risk decreased 28% among male participants with WC change ≤-2.5% (RR=0.82, 95%CI=0.67-0.99).Conclusions The risk of incident COPD was positively associated with increasing WC for both genders among Chinese adults.
Spatial distribution of asymptomatic Plasmodium vivax and Plasmodium falciparum infections in low, moderate and high endemic settings in Ethiopia
Authors: Hailemeskel Elifaged , Tebeje Surafel K , Behaksra Sinknesh , Shumie Girma , Shitaye Getasew , Keffale Migbaru , Chali Wakweya , Gashaw Abrham , Ashine Temesgen , Drakeley Chris , Bousema Teun , Gadisa Endalamaw , Tadesse Fitsum Girma
Published: September 2020

Background: As countries move to malaria elimination, detecting and targeting asymptomatic malaria infections might be needed. Here, we investigated their spatial distribution and detectability in P. falciparum and P. vivax co-endemic settings in Ethiopia.Method: A total of 1093 dried blood spot (DBS) samples were collected from afebrile and apparently healthy individuals across ten study sites in Ethiopia from 2016 to 2020. Of these, 862 were from community and 231 from school based cross-sectional surveys. Malaria infection status was determined by microscopy, rapid diagnostics tests (RDT) and 18S rRNA nested PCR (nPCR). The annual parasite index (API) was used to classify endemicity as low (API>0 and<5), moderate (API ≥5 and <100) and high transmission (API≥100).Results: In community surveys, the overall prevalence of asymptomatic malaria infections by microscopy/RDT, nPCR and all methods combined was 12.2% (105/860), 21.6% (183/846) and 24.1% (208/862), respectively. The proportion of nPCR positive infections that was detectable by microscopy/RDT was 48.7(73/150) for P. falciparum and 4.6(2/44) for P. vivax. Compared to low transmission settings, the likelihood of detecting infections by microscopy/RDT was increased in moderate (AOR: 3.4; 95%CI:1.6-7.2, P=0.002) and high endemic settings (AOR=5.1; 95%CI=2.6-9.9, P<0.001). After adjustment for site and correlation between observations from the same survey, increasing age reduced the likelihood of detecting asymptomatic infections by microscopy/RDT (AOR per year increase = 0.95, 95%CI=0.9-1.0, P=0.013).Conclusion: Conventional diagnostics missed nearly half of the asymptomatic malaria reservoir detected by nPCR. The detectability of infections was particularly low in older age groups and low endemic settings. These findings highlight the need for sensitive diagnostic tools to detect the entire parasite reservoir and potential infection transmitters.
Nasal Carriage Rate, Antimicrobial Susceptibility Patterns and Associated Risk Factors of Methicillin-resistant Staphylococcus Aureus Among Prisoners in Dessie Town, Northeast Ethiopia
Authors: Mamo Getinet , Ferede Getachew , Eshete Teshome Belachew
Published: September 2020

Background: The prevalence of Methicillin-resistant S. aureus (MRSA) within the general public has caused outbreaks in groups of people in close quarters such as military barracks, gyms, day care centres and correctional facilities. Correctional facilities are of particular importance for spreading MRSA, as inmates are often in close proximity and have limited access to hygienic products and clean clothing. In Ethiopia, there is a limited number of studies about methicillin-resistant S. aureus in the prison setting. Therefore, this study aimed to determine nasal carriages rate, antimicrobial susceptibility patterns, and associated risk factors of MRSA among prisoners in Dessie town, Northeast Ethiopia.Methods: An institution-based cross-sectional study was conducted from January 1 to March 30/2020 on 329 prisoners. Nasal swabs were collected and processed on blood agar and Mannitol salt agar plates. The isolates were identified as S. aureus based on morphology, coagulase test, and mannitol salt agar fermentation. Disk diffusion antibiotic susceptibility tests were performed according to the guidelines of the Clinical and Laboratory Standards Institute. Methicillin-resistance by S. aureus was confirmed by using cefoxitin (30μg). Data entry and statistical analysis was done using SPSS Version 20. Results: Out of the 329 prisoners, 115(35%) carried S. aureus, of which 35/115 (30.4%) were MRSA. Therefore, 10.64% of all prison inmates were identified as MRSA carriers. MRSA carriage rate was highest among the age groups of 24-34 and 35-45, which was 12 (34.3). Penicillin showed the highest rate of resistance among MRSA and MSSA isolates (100%). The multi-drug resistance rate was very high (50.4%). Among 115 S. aureus isolates, about 2(7.4%) showed inducible Clindamycin resistance. Conclusion: The high rate of nasal MRSA carriage among prisoners found in this study is alarming and highlights the need for adjusted infection control measures to prevent MRSA transmission within inmates or to the community during their discharge.
Assessment of Knowledge, Attitude and Practice of mothers on early breast feeding initiation after delivery in Debre Tabor Referral Hospital, and South West Ethiopia 2019: Institution based crosses sectional Study.
Authors: Feleke Dejen Getaneh , Mesfin Endalkachew , Mekete Gashew
Published: September 2020

BackgroundThe global breastfeeding recommendation states that all infants should be put to the breast within one hour of birth, which is defined as timely initiation or early initiation of breastfeeding. Early initiation of breastfeeding is having the capability to reduced risk in infant illness and death. Understanding the determinants of delay in initiation of breastfeeding might spur health staff and policy makers to foster timely breastfeeding. Therefore, this study was intended to assess Knowledge, Attitude and Practice of mothers on the early initiation of breast feeding in the study area.ObjectiveTo assess knowledge, attitude and practice of mothers on the early breast feeding initiation after delivery in Debre Tabor Referral Hospital from December 1/2018-January 30/2019.MethodsInstitutional based cross sectional study design was done to assess knowledge, attitude and practice of mothers on the early breast feeding initiation after delivery in Debre Tabor Referral Hospital from December 1/2018-January 30/2019 with a total sample of 336. Simple random sampling technique was used and data was collected by using structured questionnaire. Data was entered into Epi info version 7.2.0.1, and exported to SPSS window version 20 for analysis and the result was presented in tables and graphs.ResultThe overall knowledge, attitude and practice of breast feeding mothers about early initiation of breast feeding were 79.23%, 59.6% and 62.5% respectively, and 31% of mothers discard first milk or colostrum.Conclusion and recommendationsThe overall knowledge score of the pregnant mothers about early initiation of breast feeding was satisfactory while compared with different researches in Ethiopia and African but attitude of breast feeding mothers toward early initiation of breast was lower when compared with knowledge and practice of mother for this study and to alleviate this problem the organization and the health care providers should integrated and mobilize, educate and counsel about early initiation of breast feeding.
Comparative Study of Surface Roughness of Tungsten and Alumina co-sputtered on Stainless Steel and Copper substrates
Authors: Ankegowda Naveen , Prakash G V Naveen , Ravi K , Imran Khalid , Vinay K B , S Nityananda B
Published: September 2020

A comparative study of the effect of co-sputtering specifically mag­netron sputtering process input factors on surface roughness of W and Al2O3 thin film developed on the SS304 and Copper(Cu) substrates in the argon atmosphere. The input parameters have been varied based on the Design of Experiments specifically Center Composite Design experimental plan. Atomic Force microscope has been used to determine the average surface roughness in nanometer of all the samples as per experimental combinations. By using ANOVA method, the effect of factors on roughness and regression model have been developed, which express degree to input parameter can effect on the surface roughness. Analysis of surface roughness of W and Al2O3 thin film developed above said different substrates have been presented.
Knockdown Of Udp-Glucose Dehydrogenase Facilitates Epirubicin-Resistance In MDA-MB-231 Breast Cancer Cells By Regulation Of Hyaluronan Synthesis.
Authors: Vitale Daiana L. , Caon Ilaria , Parnigoni Arianna , Sevic Ina , Spinelli Fiorella M. , Icardi Antonella , Passi Alberto , Vigetti Davide , Alaniz Laura Daniela
Published: September 2020

Background: The catalytic action of the UDP-glucose transferase dehydrogenase (UGDH) enzyme produces UDP-glucuronic acid (UDP-GlcUA). The main detoxifying pathway of Epirubicin (EPI) is via glucuronidation by the specific transferase UGT2B7 (UDP-Glucuronosyltransferase-2B7), adding UDP-GlcUA to generates 4´-O-b-D-glucuronyl-4´-epi-doxorubicin. UDP-GlcUA is also a precursor of several glycosaminoglycans (GAGs) like hyaluronan (HA). Therefore, the EPI detoxifying pathway might be associated with GAGs metabolism, related to drug deactivation and tumor resistance. This work aimed to evaluate the effect of knockdown on the UGDH gene on EPI response and HA metabolism in the aggressive breast cancer cells MDA-MB 231. Methods: MDA-MB-231 cells were transfected in vitro with UGDH-specific siRNA for UGDH knockdown and treated with EPI. Viability, apoptosis, and cytotoxicity effects were evaluated. EPI intracellular accumulation was analyzed by flow cytometry. Differences in extracellular matrix (ECM) were analyzed through a particle exclusion assay and the composition of HA using hyaluronidase. The soluble HA secreted was detected by an ELISA like assay. Besides, gene expression of HA synthase and hyaluronidase (HYAL) enzymes were analyzed by RT-qPCR. To analyze the effect of UGDH knockdown and EPI treatment on autophagy, we evaluated the expression of the autophagosome marker, LC3-II by RT-qPCR and western blot, and its subcellular localization by confocal microscopy. Results: EPI accumulation increased during UGDH knockdown, but it was observed a decrease in cell death. HA synthesis and HA coated around the cells increased. In turn, it was found up-regulation of the expression of HYALs. Within the mechanisms activated by tumor cells to avoid EPI activity, an increase in autophagy was detected. Conclusions: for the first time we show that an increase in the expression, deposition and catabolism of HA positively contributed to the development of a resistant phenotype in breast cancer cells by a mechanism associated to sugar metabolism, specifically of UDP-GlcUA .
Use of Anti-Inflammatory Drugs interventions for the treatment of Muscle Soreness: a Systematic Review and Meta-analysis.
Authors: Nahon Roberto Lohn , Neto Anibal Monteiro de Magalhães , Lopes Jaqueline Santos Silva , Machado Aloa de Souza , Cameron L. C.
Published: September 2020

Objective: To investigate the effects of pharmacological interventions in the treatment of Delayed Onset Muscle Soreness (DOMS). Design: Systematic review and meta-analysis of randomised controlled clinical trials (RCTs). Data sources: The PubMed / MEDLINE, EMBASE, SPORTDiscus, Scielo and CENTRAL (Cochrane Central Register of Controlled Trials) databases were searched from the oldest records to August 3, 2020. Eligibility criteria: 1) Tue used a RCTs design; 2) Evaluate the effects of Steroidal or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for treatment DOMS; and 3) Therapeutically used drugs, after exercise. Results: In total, 26 studies (patients = 934) were eligible for qualitative analysis on the treatment of DOMS. The results of the meta-analysis showed no superiority between the use or not of NSAIDs, in the improvement of late muscle pain, since statistically significant differences were not verified (21 studies, n= 955; SMD= 0.02; 95% CI -0.58, 0.63; p=0.94; I2=93%). The quality of the synthesized evidence was very low according to the criteria of Evaluation, Development and Evaluation of the Classification of Recommendations, associated with the significant heterogeneity among the included studies. Conclusion: The results demonstrate that the use of NSAIDs is not a superior treatment to the control / placebo on DOMS improvement. The variation between dose-response and exercise protocol used in the studies may have influenced the results. In addition, the high risk of identified bias characterizes limitation to be considered in profound interpretations.
Blind Image Quality Assessment Based on Classification Guidance and Feature Aggregation
Authors: Cai WeiPeng , Fan Cien , Zou Lian , Liu Yifeng , Ma Yang , Wu MinYuan
Published: September 2020

In this work, we present a convolutional neural network (CNN) named CGFA-CNN for blind image quality assessment (BIQA). A unique 2-stage strategy is utilized which fifirstly identififies the distortion type in an image using Sub-network I and then quantififies this distortion using Sub-network II. And difffferent from most deep neural networks, we extract hierarchical features as descriptors to enhance the image representation and design a feature aggregation layer in an end-to-end training manner applying Fisher encoding to visual vocabularies modeled by Gaussian mixture models (GMMs). Considering the authentic distortions and synthetic distortions, the hierarchical feature contains the characteristics of a CNN trained on the self-built dataset and a CNN trained on ImageNet. We evaluate our algorithm on the four publicly available databases, and results demonstrate that our CGFA-CNN has superior performance over other methods both on synthetic and authentic databases.
Impact of Post-diagnosis Weight Change on Survival Outcomes in a Multiethnic Cohort of Breast Cancer Patients
Authors: Shang Lihua , Hattori Masaya , Fleming Gini , Jaskowiak Nora , Hedeker Donald , Olopade Olufunmilayo I , Huo Dezheng
Published: September 2020

Purpose: To evaluate weight change patterns over time following the diagnosis of breast cancer, and to examine the association of post-diagnosis weight change and survival outcomes in Black and White patients.Methods: The study included 2,888 women diagnosed with non-metastatic breast cancer in 2000-2017 in Chicago. Longitudinal repeated measures of weight and height were collected, along with a questionnaire survey including questions on body size. Multilevel mixed-effects models were used to examine changes in body mass index (BMI). Delayed entry Cox proportional hazards models were used to investigate the impacts of changing slope of BMI on survival outcomes. Results: At diagnosis, most patients were overweight or obese with a mean BMI of 27.5 kg/m2 and 31.5 kg/m2 for Blacks and Whites, respectively. Notably, about 45% of the patients had cachexia before death and substantial weight loss started about 30 months before death. In multivariable-adjusted analyses, compared to stable weight, BMI loss (>0.5 kg/m2/year) showed greater than 2-fold increased risk in overall survival (hazard ratio [HR]=2.68, 95%CI 1.95-3.66), breast cancer specific survival (HR=2.93, 95%CI 1.86-4.62), and disease-free survival (HR=2.25, 95%CI 1.63-3.11). The associations were not modified by race, age at diagnosis, and pre-diagnostic weight. BMI gain (>0.5 kg/m2/year) was also related to worse survival, but the effect was weak (HR=1.53, 95%CI 1.06-2.22 for overall survival).Conclusion: BMI loss is a strong predictor of worse breast cancer outcomes. Growing prevalence of obesity may hide diagnosis of cancer cachexia, which can occur in a large proportion of breast cancer patients long before death.
The water-eluting component of Anemarrhena asphodeloides Bge. laxative effects on loperamide-induced constipation rats
Authors: li xiaomao , Liu Yan , Sun Yanping , Xia Yonggang , Yang Bingyou , Kuang Haixue
Published: September 2020

Background

Slow transit functional constipation (STC) is the most common type of chronic constipation,with seriously affecting people's survival and quality of life in the recent years. Based on the safety and small side effects of traditional Chinese medicine, it is urgent to research and develop new medicine for the treatment of constipation. As a traditional Chinese medicine, Anemarrhena asphodeloides Bge. has been reported treat constipation in a long time, and carbohydrate is its active ingredient.
Methods

ELISA used for detection of serum gastrointestinal hormones and neurotransmitters levels. HE stain was analyzed to evaluate the colon injury. Western blot and RT-PCR detected interstitial cells of Cajal markers (SCF/c-Kit) and aquaporins (AQPs).
Results

The mainly compositions of oligosaccharide and amino acid from AABW was determined by HPLC. Based on the laxative activities of AABW in the study, AABW obviously enhanced the contents of VIP, Gas, MTL, SP and 5-HT and decreased the levels of NO from loperamide-induced rats by Elisa kits. Additionally, AABW could up-regulate the expressions of SCF, c-Kit, AQP3, VIP and down-regulate AQP8 to repair the damage of colon.
Conclusion

These findings suggested that AABW, which could treat constipation through mediating intestinal motility and water metabolism, were laxative active constituents from Anemarrhena asphodeloides Bge..
The Prospects for Sustaining Evidence-based Responses to the US Opioid Epidemic State Leadership Perspectives
Authors: Caton Lauren , Yuan Mina , Louie Dexter , Gallo Carlos , Abram Karen , Palinkas Lawrence , Brown C Hendricks , McGovern Mark
Published: September 2020

Background: The US 21st Century Cures Act provided $7.5 billion in grant funding to states and territories for evidence-based responses to the opioid epidemic. Currently, little is known about optimal strategies for sustaining these programs beyond this start-up funding.Methods: Using an inductive, conventional content analysis, we conducted key informant interviews with former and current state leaders (n=16) about barriers/facilitators to sustainment and strategies for sustaining time-limited grants.Results: Financing and reimbursement, service integration, and workforce capacity were the most cited barriers to sustainment. Status in state government structure, public support, and spending flexibility were noted as key facilitators. Effective levers to increase chances for sustainment included strong partnerships with other state agencies, workforce and credentialing changes, and marshalling advocacy through public awareness campaigns. Conclusions: Understanding the strategies that leaders have successfully used to sustain programs in the past can inform how to continue future time-limited, grant-funded initiatives.
Evidence on Respectful Maternity Care For Adolescents: A Systematic Review Protocol
Authors: Habib Helen H , Mwaisaka Jefferson , Torpey Kwasi , Maya Ernest Tei , Ankomah Augustine
Published: September 2020

Background
Intrapartum mistreatment of women is a globally rising public health and human rights phenomenon. The issue reportedly has severe maternal and neonatal outcomes including mortality, and generally leads to a decreased satisfaction with maternity care. Intrapartum mistreatment, despite being ubiquitous, indicates higher incidence among adolescent parturients who are simultaneously at a higher risk of maternal morbidity and mortality. Studies have suggested that Respectful Maternity Care (RMC) interventions reduce intrapartum mistreatment and improve clinical outcomes for women and neonates in general. However, evidence on the effect of RMC on adolescents is unclear. Hence the specific aim of this study is to synthesise the available evidence relating to the provision of RMC for adolescents during childbirth.
Methods
The methodology of the proposed systematic review follows the procedural guideline depicted in the preferred reporting items for systematic review protocol. The review will include all observational and intervention studies conducted between January 1, 1990 and April 30, 2020. Electronic databases including MEDLINE, PubMed, ScienceDirect, Cochrane, CINAHL, PsycINFO, Scopus, Google Scholar, and Web of Science will be searched to retrieve available studies using the appropriate search strings. The search results will be appraised with Joanna Briggs Institute quality assessment tool. The selection of relevant studies, data extraction, and quality assessment of individual studies will be carried out by two independent authors.
Results
A systematic narrative synthesis of the resultant studies will be done, and the relevant themes extracted. Findings will also be summarised in tables.
Discussion
Respectful Maternity Care for adolescents holds great promise for improved maternal and neonatal care. However, there is a gap in knowledge on the interventions that work and the extent of their effectiveness. Findings from this study will be beneficial in improving Adolescents Sexual and Reproductive Health and Rights (ASRHR) and reducing maternal mortality, especially for adolescents.
Systematic review registration:
PROSPERO (Submitted 21 August 2020)