bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic value of pretreatment platelet counts in lung cancer: a systematic review and meta-analysis
Authors: Yuan Yuan , Zhong Hai , Ye Liang , Li Qian , Fang rong su , Gu Wei , Qian Ying ying
Published: April 2020

Background : The prognostic value of elevated pretreatment platelet counts remains controversial in lung cancer patients. We performed the present meta-analysis to determine its precise role in these patients. Methods: We employed a multiple search strategy in the PubMed, EMBASE and Cochrane Library databases to identify eligible studies. Disease-free survival (DFS)/progression-free survival (PFS)/time to progression (TTP) and overall survival (OS) were used as outcomes with hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity among the studies and publication bias were also evaluated. Results : A total of 40 studies including 16696 lung cancer patients were eligible for the analysis. Overall, the pooled analysis showed that compared with normal platelet counts, elevated pretreatment platelet counts were associated with poorer OS (HR= 1.54, 95% CI: 1.37-1.72, P<0.001) and poorer DFS/PFS/TTP (HR=1.62, 95% CI: 1.33-1.98, P<0.001) in patients with lung cancer. In subgroup analyses, elevated pretreatment platelet counts were also associated with poorer OS and DFS/PFS/TTP in most subgroups. There was no evidence of publication bias. Conclusions : This meta-analysis revealed that elevated pretreatment platelet counts were an independent predictor of OS and DFS/PFS/TTP in lung cancer patients. Large-scale prospective studies and a validation study are warranted.
Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India – A time series analysis over 10 years
Authors: Damlin Anna , Sharma Megha , Marrone Gaetano , Lundborg Cecilia Stålsby
Published: April 2020

Background Antibiotic resistance is an emerging problem caused due to antibiotic use. In countries with high rates of infectious diseases, antibiotic resistance is a frequent cause of mortality. The aim was to analyse antibiotic prescribing practices between 2008 and 2017 in a teaching (TH) and a non-teaching (NTH) hospital, as typical hospitals of low- and middle-income countries, and to compare antibiotic prescribing for severe infectious indications for which empiric antibiotic treatment is recommended. Methods Data from adult patients registered at two Indian private-sector hospitals with one of the following indications: epiglottitis, pneumonia, peritonitis, pyelonephritis, cellulitis, erysipelas, septic arthritis, endocarditis, meningitis or sepsis; were included and analysed. Antibiotic prescription data was analyzed using the World Health Organization’s (WHO) Anatomical Therapeutic Chemical classification system and the Defined Daily Doses. Chi-square and linear regression were used to compare the data between groups. Time series analyses were conducted using linear regression. P-values <0.05 were considered significant. Results In total, 3,766 patients were included, 2,504 inpatients in the NTH and 1,262 in the TH, of which 92% and 89% patients, respectively, were prescribed antibiotics. Sixty-one percent of total prescriptions in the TH and 40% in the NTH comprised the access category of antibiotics (i.e. the first-choice of treatment according to the WHO). The WHO’s second-choice of treatment, the watch category, comprised 29% and 40% of total prescriptions in the TH and NTH, respectively. Prescribing of fixed-dose combinations (FDCs) of antibiotics was significantly higher in the NTH (18%) than in the TH (8%, P <0.05). Prescribing of watch antibiotics and FDCs increased significantly in both hospitals between 2008 and 2017 among patients with pneumonia, cellulitis and peritonitis (P <0.05). Conclusions Prescribing of watch antibiotics and FDCs of antibiotics increased over time at both hospitals, indicating under prescribing of access antibiotics and more prescribing of second-choice antibiotics. The results can be used to highlight the areas of improvement in similar settings. Implementing diagnostic routines and local prescribing guidelines could improve the prescribing practices.
Bromide impairs the circadian clock and glycolytic homeostasis via disruption of autophagy in rat H9C2 cardiomyocytes
Authors: Jiang Yicheng , Gu Yang , Xu Hai , Tian Xiaoyi , Zhang Xuefeng , Xu Xiaojin , Yan Wenting , Zhang Xiwen
Published: April 2020

Background: Trace elements function as essential cofactors that are involved in various biochemical processes in mammals. Autophagy is vital for nutrient supplement, which is an important Zeitegber for the circadian homeostasis in heart. Here, we considered the possibility that autophagy, as well as the cardiomyocyte clock and glycolysis are interlinked. Detrimental effects were observed when cardiac system is exposed to bromine containing drugs. This study investigated the effects and mechanisms of bromide on the circadian clock and glycolytic metabolism of H9C2 cardiomyocytes. Methods: H9C2 cardiomyocytes were incubated with sodium bromide at indicated doses for 24 hours, cell viability, mRNA expression of clock genes, glycolytic genes and autophagic genes were examined using various cellular and molecular approaches. Also, circadian oscillation rhythm of these genes was determined by serum shock with sodium bromide or equal amounts of sodium chloride. Results: Bromide does not affect cell viability and apoptosis of H9C2 cardiomyocytes. Bromide dampens the clock and glycolytic ( Hk2 and Pkm2 ) gene expression rhythmicity in a dose-dependent manner. Additionally, bromide inhibits autophagic process in H9C2 cardiomyocytes. In contrast, rapamycin (an autophagy inducer) dramatically restores the inhibitory effect of NaBr on the mRNA expression levels of clock genes ( Bmal1 , Cry1 and Rorα ) and glycolytic genes ( Hk2 and Pkm2 ).Conclusions: Our results reveal that bromide represses the clock and glycolytic gene expression patterns, partially through inhibition of autophagy.
The effect of improved housing on indoor mosquito density and exposure to malaria in the rural community of Minkoameyos, Centre Region of Cameroon.
Authors: Nguela Rachel Laure , Bigoga Jude D. , Armel Tedjou N. , Esther Tallah Tayie Ngobiyo , Dongmo Line Lekou , Boris Njeambosay A. , Frederic Tchouine , Kazi Riksum , Williams Peter , Mbacham Wilfred F. , Leke Rose G. F.
Published: April 2020

Background This study evaluated the effectiveness of improved housing on indoor residual mosquito density and exposure to infected Anophelines in Minkoameyos, a rural community in southern forested Cameroon. Methods Following the identification of housing factors affecting malaria prevalence in 2013, 218 houses were improved by screening the doors and windows, installing plywood ceilings on open eaves and closing holes on walls and doors. Monthly entomological surveys were conducted in a sample of 21 improved and 21 non-improved houses from November 2014 to October 2015. Mosquitoes sampled from night collections on human volunteers were identified morphologically and their parity status determined. Mosquito infectivity was verified through Plasmodium falciparum CSP ELISA and the average entomological inoculation rates determined. A Reduction Factor (RF), defined as the ratio of the values for mosquitoes collected outdoor to those collected indoor was calculated in improved houses (RFI) and non-improved houses (RFN). An Intervention Effect (IE=RFI/RFN) measured the true effect of the intervention. Chi-square test was used to determine variable significance. The threshold for statistical significance was set at P < 0.05.Results A total of 1113 mosquitoes were collected comprising Anopheles sp (58.6%), Culex sp (36.4%), Aedes sp (2.5%), Mansonia sp (2.4%) and Coquillettidia sp (0.2%). Amongst the Anophelines were Anopheles gambiae sensu lato (s.l.) (95.2%), Anopheles funestus (2.9%), Anopheles ziemanni (0.2%), Anopheles brohieri (1.2%) and Anopheles paludis (0.5%). Anopheles gambiae sensu stricto (s.s.) was the only An. gambiae sibling species found. The intervention reduced the indoor Anopheles density by 1.8-fold (RFI=3.99; RFN=2.21; P=0.001). The indoor density of parous Anopheles was reduced by 1.7-fold (RFI=3.99; RFN=2.21; P=0.04) and that of infected Anopheles by 1.8-fold (RFI=3.26; RFN=1.78; P=0.04). Indoor peak biting rates were observed between 02am to 04am in non-improved houses and from 02am to 06am in improved houses.Conclusion Housing improvement contributed to reducing indoor residual anopheline density and malaria transmission. This highlights the need for policy specialists to further evaluate and promote aspects of house design as a complementary control tool that could reduce indoor human–vector contact and malaria transmission in similar epidemiological settings.
De novo transcriptome sequencing of Rhododendron molle and identification of genes involved in the biosynthesis of secondary metabolites
Authors: Zhou Guolin , Zhu Ping
Published: April 2020

Background: Rhododendron molle (Ericaceae) is a traditional Chinese medicinal plant, its flower and root have been widely used to treat rheumatism and relieve pain for thousands of years in China. Chemical studies have revealed that R. molle contains abundant secondary metabolites such as terpenoinds, flavonoids and lignans, some of which have exhibited various bioactivities including antioxidant, hypotension and analgesic activity. In spite of immense pharmaceutical importance, the mechanism underlying the biosynthesis of secondary metabolites remains unknown and the genomic information is unavailable. Results: To gain molecular insight into this plant, especially on the pharmaceutically important secondary metabolic information, we conducted deep transcriptome sequencing for R. molle flower and root using the Illumina Hiseq platform. In total, 100,603 unigenes were generated through de novo assembly with mean length of 778 bp, 57.1% of these unigenes were annotated in public databases and 17,906 of those unigenes showed significant match in the KEGG database. Unigenes involved in the biosynthesis of secondary metabolites were annotated, including the TPSs and CYPs that were potentially responsible for the biosynthesis of grayanoids. Moreover, 3,376 transcription factors and 10,828 simple sequence repeats (SSRs) were also identified. Additionally, we further performed differential gene expression (DEG) analysis of the flower and root transcriptome libraries and identified numerous genes that were specifically expressed or up-regulated in flower.Conclusions: To the best of our knowledge, this is the first time to generate and thoroughly analyze the transcriptome data of both R. molle flower and root. This study provided an important genetic resource which will shed light on elucidating various secondary metabolite biosynthetic pathways in R. molle, especially for those with medicinal value and allow for drug development in this plant.
Fasciotomy through Multiple Small Skin Incisions for the treatment of early acute osteofascial compartment syndrome in children
Authors: Yuan Xiaowei , Wu Jun , Qu Xiangyang , Li Ming , Jiang Linjun , Liu Xing
Published: April 2020

Background The purpose of the present study is to investigate the therapeutic effect of fasciotomy through multiple small skin incisions for the treatment of early osteofascial compartment syndrome in children.Methods From January 2009 to May 2017, 56 pediatric patients with early osteofascial compartment syndrome in their limbs were admitted into our department and treated with multiple small skin incisions for decompression at the early stage. The skin incisions, function and sensation of the limbs were followed up.Results The osteofascial compartment syndrome was diagnosed at 7.4±2.1 hours after injury, and then fasciotomy was performed at 1.4±0.4 hours later. The average procedure time of fasciotomy was 12.7±4.8 minutes. No postoperative incision infections or neurovascular injuries were observed in all the patients. The incisions completely healed in 7-10 days with an average healing time of 8 days without secondary suture. The patients were followed up for an average of 5.1 years. No Volkmann’s contractures in the injured climbs were found. The appearance, electromyography and nerve conduction velocity of the affected limbs were not significantly different from that of the contralateral limbs. All the patients were free of symptoms, were full recovery of sensation and function, being an “excellent” outcome at the latest follow-up. Conclusion Fasciotomy through multiple small skin incisions, which can be useful to decompress the compartment pressure with fewer complications, is a simple and effective strategy for the treatment of early osteofascial compartment syndrome in children.
Improving the diagnosis of common parotid tumors via the combination of CT image biomarkers and clinical parameters
Authors: Zhang Dan , Li Xiaojiao , Lv Liang , Yu Jiayi , Yang Chao , Xiong Hua , Liao Ruikun , Zhou Bi , Huang Xianlong , Liu Xiaoshuang , Tang Zhuoyue
Published: April 2020

Background : Our study aims to develop and validate diagnostic models of the common parotid tumors based on whole-volume CT textural image biomarkers (IBMs) in combination with clinical parameters at a single institution. Methods: The study cohort was composed of 51 pleomorphic adenoma (PA) patients and 42 Warthin tumor (WT) patients. Clinical parameters and conventional image features were scored retrospectively and textural IBMs were extracted from CT images of arterial phase. Independent-samples t test or Chi-square test was used for evaluating the significance of the difference among clinical parameters, conventional CT image features, and textural IBMs. The diagnostic performance of univariate model and multivariate model was evaluated via receiver operating characteristic (ROC) curve and area under ROC curve (AUC). Results: Significant differences were found in clinical parameters (age, gender, disease duration, smoking), conventional image features (site, maximum diameter, time-density curve, peripheral vessels sign) and textural IBMs (mean, uniformity, energy, entropy) between PA group and WT group (P＜0.05). ROC analysis showed that clinical parameter (age) and quantitative textural IBMs (mean, energy, entropy) were able to categorize the patients into PA group and WT group, with the AUC of 0.784, 0.902, 0.910, 0.805, respectively. When IBMs were added in clinical model, the multivariate models including age-mean and age-energy performed significantly better than the univariate models with the improved AUC of 0.940, 0.944, respectively (P＜0.001). Conclusions: Both clinical parameter and CT textural IBMs can be used for the preoperative, noninvasive diagnosis of parotid PA and WT. The diagnostic performance of textural IBM model was obviously better than that of clinical model and conventional image model in this study. While the multivariate model consisted of clinical parameter and textural IBM had the optimal diagnostic performance, which would contribute to the better selection of individualized surgery program.
Hospitalization and Definitive Radiotherapy in Lung Cancer: Incidence, Risk Factors and Survival Impact
Authors: Hazell Sarah Z. , Mai Nicholas , Fu Wei , Hu Chen , Friedes Cole , Negron Alex , Voong Khinh Ranh , Feliciano Josephine L. , Han Peijin , Myers Samantha , McNutt Todd R. , Hales Russell K.
Published: April 2020

Background: Unplanned hospitalization during cancer treatment is costly, can disrupt treatment, and affect patient quality of life. However, incidence and risks factors for hospitalization during lung cancer radiotherapy are not well characterized. Methods: Patients treated with definitive intent radiation (≥45 Gy) for lung cancer between 2008 and 2018 at a tertiary academic institution were identified. In addition to patient, tumor, and treatment related characteristics, specific baseline frailty markers (Charlson comorbidity index, ECOG, patient reported weight loss, BMI, hemoglobin, creatinine, albumin) were recorded. All cancer-related hospitalizations during or within 30 days of completing radiation were identified. Associations between baseline variables and any hospitalization, number of hospitalizations, and overall survival were identified using multivariable linear regression and multivariable Cox proportional-hazards models, respectively. Results: Of 270 patients included: median age was 66.6 years (31-88), 50.4% of patients were male (n=136), 62% were Caucasian (n=168). Cancer-related hospitalization incidence was 17% (n=47), of which 21% of patients hospitalized (n=10/47) had >1 hospitalization. On multivariable analysis, each 1 g/dL baseline drop in albumin was associated with a 2.4 times higher risk of any hospitalization (95% confidence interval (CI) 1.2-5.0, P=0.01), and baseline hemoglobin ≤10 was associated with, on average, 2.7 more hospitalizations than having pre-treatment hemoglobin >10 (95% CI 1.3-5.4, P=0.01). After controlling for baseline variables, cancer-related hospitalization was associated with 1.8 times increased risk of all-cause death (95% CI: 1.02-3.1, P=0.04).Conclusions: Our data show baseline factors can predict those who may be at increased risk for hospitalization, which was independently associated with increased mortality. Taken together, these data support the need for developing further studies aimed at early and aggressive interventions to decrease hospitalizations during treatment.
Pre-operative denosumab is associated with higher risk of local recurrence in giant cell tumor of bone: a systematic review and meta-analysis
Authors: Chen Xi , Li Hairui , Zhu Shibai , Wang Yiou , Qian Wenwei
Published: April 2020

Background In 2013, denosumab was introduced as peri-operative adjuvant treatment for giant cell tumor (GCT) of bone as it inhibits osteoclast activity. It is suggested that denosumab relives pain, facilitate curettage in lesions requiring resection initially. However, controversy remains whether denosumab increases the risk of local recurrence after surgery. Methods Medline, Embase and the Cochrane Library were comprehensively searched in June 2019 to identify studies investigating the clinical outcome of GCT of bone with and without peri-operative denosumab after surgery. Data were gathered and a meta-analysis was conducted. Result Ten studies with 1082 cases (169 in denosumab group, 913 in control group) were included. Overall, denosumab was associated with significantly higher risk of recurrence(P<0.02) and inferior 5 year recurrence free survival(P=0.000). Denosumab and curettage has a relatively higher risk of recurrence comparing to curettage alone(P=0.07). The risk of recurrence is not significantly increased if denosumab was administered both preoperatively and postoperatively(P=0.24). Conclusion Administration of denosumab is associated with increased risk of recurrence due to a variety of reasons, though it is proven effective in relieving pain, enabling curettage and improved functional outcome. Post-operative denosumab is recommended as it continuously suppress/eliminate residue tumor cells.
Uptake and acceptability of human papillomavirus self-sampling in rural and remote Aboriginal communities: Evaluation of a nurse-led community engagement model
Authors: Dutton Tegan , Marjoram Jo , Burgess Shellie , Campbell Laurinne , Vail Anne , Callan Nichole , Jacob Sunil , Hawkes David , Saville Marion , Bailey Jannine
Published: April 2020

Background: Aboriginal women experience disproportionately higher rates of cervical cancer mortality yet are less likely to participate in screening for early detection. This study sought to determine whether a community-based HPV self-sampling service model can effectively recruit never-screened and under-screened Aboriginal women to participate in cervical cancer screening; assess the clinical outcomes; and explore the acceptability of the model from the perspective of the participants.Methods: Aboriginal women aged 25-69 years of age were recruited from eight rural and remote communities in New South Wales, Australia to participate in HPV self-sampling via a community-based service model. Outcome measures were: number of women screened by HPV self-sampling, their prior cervical screening status (under-screened or never-screened), clinical outcomes and participation in follow-up pathways of care, and satisfaction with the service model.Results: In total, 215 women conducted a HPV self-sampling test and 200 evaluation surveys were completed. One-fifth of participants (n=46) were never-screened and one-third (n=69) were under-screened. Many were unsure of their screening status. Nine women were HPV 16/18 positive and eight had completed all follow up by the conclusion of the study. A further 30 women tested positive for a high risk type other than HPV 16/18 (HPV other), of which 14 had completed follow up at the conclusion of the study. Satisfaction with the HPV self-sampling kit, the process of self-sampling and the service model was high (>92% satisfied on all items). Many women had difficulty understanding their official HPV results and placed high importance on the nurse explaining it to them.Conclusions: A community-based service model that respects Aboriginal Women’s Business can effectively recruit under-screened and never-screened Aboriginal women to complete cervical cancer screening. Furthermore, this service model supports them to complete recommended follow-up care and engage with their local existing health services.
Energy-dense nutrient-poor snacks and risk of non-alcoholic fatty liver disease: a case-control study in Iran
Authors: Yari Zahra , Cheraghpour Makan , Aghamohammadi Vahideh , Alipour Meysam , Ghanei Nila , Hekmatdoost Azita
Published: April 2020

Objective: The purpose of the present study was to determine the association between energy-dense nutrient-poor snacks intake and the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. For this purpose, a total of 143 cases with a newly confirmed diagnosis of NAFLD and 471 controls free of the disease were studied. Dietary intake was assessed using a food frequency questionnaire. Results: The percentage of calories from total energy-dense nutrient-poor snacks was 6.08% and 5.04%, in patients and controls, respectively (p=0.036). Compared with subjects in the lowest quartile of total energy-dense nutrient-poor snacks intake, the risk of NAFLD for those in the top quartile of consumption increased by about two times, in both crude (OR:1.94; 95% CIs: 1.16-3.26; P for trend=0.015) and adjusted (OR:2.27; 95%CIs: 1.19-4.31; P for trend=0.001) models. The relative odds of NAFLD increased significantly in the fourth quartile of dietary cake and biscuit (OR: 1.21, P for trend=0.037) and soft drinks (OR: 1.64, P for trend=0.005) intake compared with the lowest corresponding quartiles, after adjustment for age, sex, body mass index, physical activity, alcohol, energy intake. Our results indicate that there might be a moderate positive association between energy-dense nutrient-poor snacks intake and risk of NAFLD.
Reimagining the role of the nursing workforce in Uganda after more than a decade of ART scale-up
Authors: Zakumumpa Henry
Published: April 2020

Background The expanding roles and increasing importance of the nursing workforce in health services delivery in resource-limited settings is not adequately documented and sufficiently recognized in the current literature. Drawing upon the theme of 2020 as the international year of the Nurse and Midwife, we set out to describe how the role of nurses expanded tremendously in health facilities in Uganda during the era of anti-retroviral therapy (ART) scale-up that commenced in June 2004.Methods We employed a mixed-methods sequential explanatory research design. Phase One entailed a cross-sectional health facility survey (n=195) to assess the extent to which human resource management strategies (such as task shifting) were common. Phase Two entailed a qualitative multiple case-study of 16 (of the 195) health facilities for an in-depth understanding of the strategies adopted (e.g. nurse-centred HIV care). Descriptive analyses were performed in STATA (v 13) while qualitative data were analyzed by thematic approach.Results We found that nurses were the most represented cadre of health workers involved in the overall leadership of HIV clinics across Uganda. Most nurse-led HIV clinics were based in rural settings however this trend was fairly even across setting (rural/urban/peri-urban). While 181(93%) health facilities allowed non-physician cadre to prescribe ART, a number of health facilities (n=36) or 18% deliberately adopted nurse-led HIV care models. Nurses were empowered to be multi-skilled with a wide range of competencies across the HIV care continuum right from HIV testing to mainstream clinical HIV disease management. In several facilities, nursing cadre were the backbone of ART service delivery. A select number of facilities devised differentiated models of task shifting from physicians to nurses in which the latter handled patients who were stable on ART. Conclusion Overall, our study reveals a wide expansion in the scope-of-practice of nurses during ART scale-up in Uganda. Nurses were thrust in roles of HIV disease management that were traditionally the preserve of physicians. Our study underscores the importance of reforming regulatory frameworks governing nursing workforce scope-of-practice such as the need for developing a policy on task shifting which is currently lacking in Uganda.
The role of routine flexible sigmoidoscopy in patients presenting with fistula-in-ano: an observational study
Authors: Waidyasekera Ruvindu H , Jayarajah Umesh , Samarasekera Dharmabandhu Nandadeva
Published: April 2020

Objective: Flexible sigmoidoscopy is useful to look for an underlying aetiology in fistula-in-ano. This study was aimed to assess the yield of routine flexible sigmoidoscopy in patients presenting with fistula-in-ano. A retrospective analysis of 159 consecutive patients with fistula-in-ano who underwent routine flexible sigmoidoscopy was performed. Sigmoidoscopy findings were recorded on a standard uniform format using a computer database. Those with a known aetiology were excluded. Results: The median age was 39(range:14-74) years and the majority were males(n=128,80.5%). Forty-nine patients(30.8%) presented with a recurrent fistula-in-ano. On flexible sigmoidoscopy, internal opening was seen in only 23 patients (14.4%). Furthermore, incidental findings of haemorrhoids (n=5, 3.1%) and polyps (n=7, 4.4%) were found. One patient(0.6%) had a healed anal fissure, 5 patients(3.1%) had inflamed mucosa and 2 patients(1.3%) had ulcers. Only two patients with inflamed mucosa were diagnosed to have Crohn’s disease on histology. Therefore, flexible sigmoidoscopy was not helpful in the majority to locate the internal opening. Only two patients had evidence of an underlying aetiology, which was Crohn’s disease. However, they had recurrent complex fistulae and other associated symptoms. Therefore, flexible sigmoidoscopy may be reserved for selected group of patients with symptoms of an underlying aetiology.
Pharmacological prophylaxis versus none- pharmacological prophylaxis in prevention of clinical venous thromboembolic complications in morbid obese patients following bariatric surgery: a retrospective observational case-control study
Authors: Amini Masoud , Moein-vaziri Nader , Hosseini Babak , Vafa Leila , Haghighat Neda
Published: April 2020

Background: Venous thromboembolism (VTE) is a serious complication that may occur after bariatric surgery. This study aims to report the rate of clinically evident VTE using pharmacologic versus non-pharmacologic prophylaxis among morbid obese patients undergoing laparoscopic bariatric surgery who were at low risk for VTE.Methods: The laparoscopic research center database from 2017 to 2018 was queried to identify patients undergoing laparoscopic bariatric surgery. Retrospectively, each patient who met the inclusion and exclusion criteria was clinically evaluated for the presence of symptomatic VTE (DVT and PTE) during the postoperative period. VTE prophylaxis regimens were pharmacological prophylaxis or non-pharmacological prophylaxis. Results: We identified 794 patients who underwent bariatric surgery.110 patients excluded from the study based on the VTE risk factor. 371 (54.4%) patients had non-pharmacological, 313 (45.9%) patients had pharmacological prophylaxis. In the non-pharmacological group, the overall rates of DVT, and PTE were 1 (0.26%) and 1 (0.26%), respectively. In the pharmacological group, the overall rates of PTE and DVT were 2 (0.63%) and 0, respectively. Patients without pharmacological prophylaxis had no significant difference in DVT and PTE rate compared to the group which received pharmacological prophylaxis (P>0.5). Conclusions: Adequate VTE prophylaxis is achieved without pharmacological thromboprophylactic agents for lower-risk patients. Thus, an individualized prophylaxis regimen that balances efficacy and safety is suggested for each patient, based on various risk factors.
Emergence of high multidrug-resistant Escherichia coli isolates from neonates with infection
Authors: Wu Dan , Ding Yijun , Zhang Jinjing , Yao Kaihu , Gao Wei , Liu Ying , Wang Xiaojiao , Wang Yajuan
Published: April 2020

Background Escherichia coli (E.coli) rank one of the most common pathogens that can cause neonatal infections. The emergence of antibiotic-resistant bacteria is a major cause of treatment failure in newborn with infection. The purpose of this study was to describe the antibiotic resistance and multidrug-resistance of E.coli isolated from neonates with infection.Methods The antimicrobial susceptibility testing of the E. coli strains to selected antibiotics was assessed with the E-test technique on the Mueller-Hinton agar. The antimicrobials tests were included ceftazidime, cefuroxime, cefatriaxone, amoxicillin, amoxicillin-clavulanic acid, cefoperazone - sulbactam, meropenem, gentamicin, ciprofloxacin and sulfonamides. The minimal inhibitory concerntration (MIC) values of the antimicrobial agents selected for this study was determined by an agar dilution technique on Mueller-Hinton agar according to the Clinical and Laboratory Standards Institute recommendations. Results A total of 100 E. coli strains was isolated from phlegm (n = 78), blood (n = 10), cerebrospinal fluid (n = 5), and umbilical discharge (n = 7) of neonates hospitalized at Beijing Children’s Hospital. The highest resistance rate of E.coli was found in amoxicillin at 85%, followed by cefuroxime 65%, and cefatriaxone 60%, respectively. 6% and 5% of all isolates were resistant to amoxicillin/clavulanic acid and cefoperazone -sulbactam merely. The resistance rates to ceftazidime, gentamicin, ciprofloxacin and sulfonamides were 31%, 20%, 33%, 47%, respectively. All the isolates were susceptible to meropenem. Multidrug resistance was defined in E.coli as resistance to at least three antibiotic families. About 26% (26/100) of all the E.coli isolates were multidrug-resistant. The detection rate of ESBL-Producing E. coli was 55%. The rate in E. coli isolates from phlegm was higher than aseptic humoral. The difference was statistically significant (P < 0.05). It is worth noting that the majority of the isolates were also resistant to non-β-lactam antimicrobial agents, but the resistant rates were significantly lower than extended-spectrum β-lactamases.Conclusions: Multi-drug-resistant E.coli has become a thorny problem in clinical treatment. It is necessary to monitor E. coli resistance.
Efficiency of 123I-ioflupane SPECT as a marker of basal ganglia damage in acute methanol poisoning: a six-year prospective study
Authors: Kotikova Katerina , Zogala David , Ptacnik Vaclav , Trnka Jiri , Kupka Karel , Vaneckova Manuela , Seidl Zdenek , Diblik Pavel , Heissigerova Jarmila , Zak Ivan , Navratil Tomas , Komarc Martin , Zakharov Sergey
Published: April 2020

PurposeInvestigate whether 123I-ioflupane SPECT (DaT SPECT) has the potential as a marker of basal ganglia damage in acute methanol poisoning.MethodsProspective, single-centre, cohort study of patients with confirmed methanol poisoning was conducted. DaT SPECT was performed twice with semi-quantification using DaTQUANTTM and MRI-based volumetry was calculated. Specific binding ratios (SBR) of striatum, caudate nucleus, and putamen were correlated with laboratory parameters of outcome, volumetric data, and retinal nerve fibres layer (RNFL) thickness measurements.ResultsForty-two patients (mean age 46.3±4.2 y; 8 females), including 15 with putamen lesions (Group I) and 27 patients with intact putamen (Group II), underwent DaT SPECT. Volumetry was calculated in 35 of the patients assessed. SBR values for the left putamen correlated with putamen volume (r=0.665; p<0.001). Decreased bilateral SBR values were determined for the striatum and the putamen, but not for the nucleus caudate, in Group I (p<0.05). A strong correlation was observed between the SBR of the posterior putamen and arterial blood pH (r=0.574; p<0.001) and other toxicological parameters of severity of poisoning/outcome including serum lactate, glucose, and creatinine concentrations (p<0.05). The SBR of the posterior putamen positively correlated with the global RNFL thickness (p<0.05). ROC analysis demonstrated a significant discriminatory ability of SBR of the posterior putamen with AUC=0.753 (95%CI 0.604–0.902; p=0.007). The multivariate regression model demonstrated that arterial blood pH, age, and gender were the most significant factors associated with SBR of the posterior putamen.ConclusionDaT SPECT demonstrates significant potential for the diagnosis of methanol-induced basal ganglia damage.
Medicinal Plants Used for Treating Human and Livestock Ailments in Tiyo District, Arsi Zone of Oromia, Ethiopia
Authors: Aman Misbahu , Asfaw Zemede , Dalle Gemedo
Published: April 2020

Background Systematic documentation and promotion of indigenous knowledge associated with medicinal plants are limited. The aim of this study was to undertake ethnobotanical investigation on medicinal plants used for the treatment of human and livestock ailments and document indigenous knowledge of local communities on the preparation and administration of herbal remedies in the study area. Methods The study involved 153 informants from nine kebeles, comprising traditional healers, knowledgeable elders and local user communities. Various ethnobotanical techniques were used to collect and analyze data: semi- structured interview, guided field walk, group discussion, preference ranking, and fidelity level index. Data was analyzed using descriptive statistical analysis. Results Local communities had rich and diverse indigenous knowledge on medicinal plants, types of ailments, methods of remedy preparations and routes of applications. There were differences in this indigenous knowledge across age and sex. A total of 83 medicinal plants were documented during this study. Fifty two (62.65%) plants were used for treating human ailments, 20 species (24.10%) for treating health problems of livestock and the remaining 11 (13.25%) for treating both human and livestock ailments. The highest informant consensus was documented for the plants Allium sativum , Asparagus africanus and Azadirachta indica. Leaves were the most commonly used parts of medicinal plants accounting for 51.81% of the total followed by roots (20.48%) and barks (2.41%). Oral administration of the herbal medicine was the dominant route 66.3%, followed by dermal (22.7%) which included washing, holding on, rubbing and brushing. Smoking (8.5%) was also important. It was documented that 27 species (32.5%) were used in fresh, 13 species (15.7%) dried and 43 species (51.8%) either in dry or fresh state. Conclusion Owing to their access, curing ability, manageable charges, existence of deep indigenous knowledge and other associated cultural values, medicinal plants continued to play a significant role in meeting healthcare needs of the community in the study area. Conservation and sustainable use of the diverse medicinal plants need to be promoted. Systemic documentation and protection of the rich knowledge of local communities and further research on selected potential species was recommended as a result of this study.
Post-developmental extracellular proteoglycan maintenance in attractin-deficient mice
Authors: Azouz Abdallah , Duke-Cohan Jonathan
Published: April 2020

Objective: Neurodegeneration and hair pigmentation alterations in mice occur consequent to aberrations at the Atrn locus coding for the transmembrane form of attractin. Earlier results pointed to a possible involvement in intracellular trafficking/export of secretory vesicles containing proteoglycan. Here we examined kidney and liver, both heavily dependent upon proteoglycan, of attractin-deficient mice to determine whether abnormalities were observed in these tissues.Results: Histological and histochemical analysis to detect glycosylated protein identified a severe loss in attractin-deficient mice of extracellular proteoglycan between kidney tubules in addition to a loss of glycosylated material within the intratubular brush border. In the liver, extracellular matrix material was significantly depleted between hepatocytes together with swollen sinuses and aberrations in the proteoglycan-dependent space of Disse. These results are consistent with a generalized defect in extracellular proteoglycan deposition in Atrn -mutant mice and support previous reports suggesting a role for attractin in the secretory vesicle pathway.
DSG2 expression is correlated with poor prognosis and promotes early-stage cervical cancer
Authors: Qin Shuhang , Liao Yuandong , Du Qiqiao , Wang Wei , Huang Jiaming , Liu Pan , Shang Chunliang , Liu Tianyu , Xia Meng , Yao Shuzhong
Published: April 2020

Background: The pathogenesis and developmental mechanism of early-stage (FIGO 2009 IA2-IIA2) cervical cancer (CC) remain unclear. Seeking novel molecular biomarkers based on The Cancer Genome Atlas (TCGA) will facilitate the understanding of CC pathogenesis and help evaluate early-stage CC prognosis.Methods: To identify prognosis-related genes in early-stage CC, we analyzed TCGA mRNA-seq data and clinical data by univariate Cox and Kaplan-Meier plotter analyses. Differential expression analysis identified upregulated genes in early-stage CC. Combined with the genes correlated with unfavorable prognosis, we selected DSG2 for further investigation. To detect DSG2 expression in early-stage CC, we used immunohistochemistry (IHC), quantitative real-time PCR (qRT-PCR) and western blotting. The relationship between the expression of DSG2 and clinical features was analyzed by the chi-square test. Cox analysis was applied to assess the relationship between CC overall survival (OS) and risk factors. The correlations between DSG2 expression and CC cell line proliferation and migration were investigated with Cell Counting Kit-8 (CCK-8) and migration assays.Results: There were 416 prognosis-related genes in early-stage CC. DSG2, MMP1, CA9, HOXA1, and SERPINB3 were upregulated in early-stage CC compared with adjacent noncancerous tissue (ANT) and correlated with unfavorable prognosis. Among them, DSG2 was most significantly correlated with patient survival. Coexpression analysis indicated that DSG2 was probably involved in cell division, positive regulation of transferase activity, positive regulation of cell migration, EGFR upregulation pathway and regulation of lymphangiogenesis. IHC, qRT-PCR and western blotting showed that DSG2 expression was higher in CC than in normal tissue. Significant correlations were identified between DSG2 expression and several aggressive clinical features, including pelvic lymph node metastasis (PLNM). Multivariate Cox analysis showed that DSG2 and PLNM were independent prognostic factors for OS. DSG2 knockdown inhibited CC cell proliferation and migration.Conclusions: DSG2 is a new biomarker that promotes tumor proliferation and metastasis and is correlated with poor prognosis in early-stage CC.
Frailty prevalence and screening for frailty among elderly community-dwelling, first-time seekers of formal assistance in Norway.
Authors: Laukli Ingerid , Ormstad Heidi Kristin , Sandvik Leiv
Published: April 2020

Background Detection of frailty may be essential to prevent or delay disability in home-dwelling elderly who seek formal assistance for the first time. The prevalence of frailty among elderly, first-time seekers of formal assistance in Norway, is unknown. Simple tests like Short Physical Performance Battery (SPPB) or assessment of gait speed (GS) may identify frailty. The aim of this study was to investigate the prevalence of frailty in this population, and to investigate the test accuracy of GS and SPPB to detect frailty.Methods We conducted a cross-sectional study of 116 home dwelling elderly > 65 years seeking formal assistance for the first time. Frailty was assessed by an adapted version of Fried Frailty Phenotype (FFP), GS was measured over 4 meters, and physical function was assessed by the Norwegian version of SPPB. The test accuracy for frailty (FFP) of GS < 0.8 m/s, SPPB < 10 and SPPB < 10 were assessed.Results 62.1%, 29.3% and 8.6% of the participants were frail, prefrail and non-frail, respectively. No association was found between age and degree of frailty. Both GS and SPPB-scores were significantly lower in the frail group than in the prefrail group, as well as significantly lower in the prefrail group than in the non-frail group (both p < 0.001). Numbers of criteria in FFP were significantly and inversely associated with GS (p < 0.001). GS ≤ 0.8 m/s showed the best test accuracy for frailty, with a sensitivity of 0.99, specificity of 0.37, positive predictive value of 0.76 and negative predictive value of 0.93.Conclusions The present study assessed that over 90% of elderly seeking formal assistance for the first time were either frail or prefrail. This indicates that screening for frailty should be considered for this population in order to enable action to prevent or delay disability. Further, our results indicate that GS with a cut-off at ≤ 0.8 m/s may represent a feasible and easy-to-use screening tool for detecting frailty in this population.
Demographic and cardiovascular risk factors associated with drug use in truck drivers
Authors: Pereira Mariana Moura , Mansur Antonio Padua , Takada Julio Yoshio , Leyton Vilma
Published: April 2020

Background: The irregular routine of truck drivers favors the development of chronic noncommunicable diseases (NCDs), especially cardiovascular diseases (CVDs), which can be exacerbated by the use of illicit drugs.Methods: A cross-sectional study was carried out with data from 2,071 truck drivers who traveled through the state of São Paulo between 2010 and 2016. Socioeconomic and occupational variables and risk factors for CVD were associated with drug use. Clinical and toxicological tests were also carried out.Results: The average age of the truck drivers was 42.27 ± 11.07 years, and the use of illicit drugs, at least once while working, was reported or detected in 388 (18.7%) drivers. Compared to non-users, drug users were younger (37.25 ± 9.45 vs. 43.43 ± 11.1 years; p <0.001) and single (43.3% vs. 28.4%; p <0.001). The independent variables age [OR = 0.93 (95% CI: 0.91 - 0.95; p<0.001)], smoking [OR = 2.18 (95% CI: 1.39 - 3.44; p = 0.001)], alcohol consumption [OR = 1.626 (95% CI: 1.06 - 2.49; p = 0.026)] and hours of driving per day [OR = 1.08 (95% CI: 1.01 - 1.15; p = 0.012)] were also associated with the use of illicit drugs.Conclusion: The use of illicit drugs was higher in young and single drivers and was associated with a higher prevalence of smoking, alcohol consumption and more driving hours, which are risk factors for NCDs, CVD and traffic accidents.
The design optimization of Chinese medicinal compound for the treatment of co-infection of Mycoplasma gallisepticum and Escherichia Coli
Authors: Wu Zhiyong , Fan Qianqian , Bao Jiaxin , Li Rui , Ishfaq Muhammad , Li Jichang
Published: April 2020

Background: A new Chinese medicinal compound including Isatdis Radix, Forsythiae Fructus, Mori Cortex, Ginkgo Folium, Licorice and Radix Salviae was pre-screened through the method of network pharmacology for the treatment of co-infection of Mycoplasma gallisepticum and Escherichia Coli. While, the optimal combination of Chinese medicine is still an obstacle to the development of the Chinese medicinal compound.Results: A multi-indicators evaluation method was used in this study to establish a comprehensive assessment system based on the minimal inhibitory concentration of Mycoplasma gallisepticum and Escherichia Coli in vitro, air sac and tracheal lesion scores in vivo. We used the min-max normalization method to normalize the scores of the four metrics and gave them the same proportion of weights to calculate the total score. Then, according to the method of uniform test, the six-factor ten-level experiment (U*10(106) was designed, with the total score as the index. The multi-nonlinear regression equation was established by data processing system according to the comprehensive index. The results showed that the ratio of Isatdis Radix, Forsythiae Fructus, Ginkgo Folium, Mori Cortex, Licorice and Radix Salviae were 14:7:11:12:5:3, which showed effective treatment. Conclusions: It turned out that uniform design can be effectively used to solve dose optimization for combined use of multiple compounds. In addition, this study also proposes a new method to comprehensively evaluate medicinal compounds for respiratory diseases such as Mycoplasma gallisepticum and Escherichia Coli infection.
WITHDRAWN: Differences in the soil bacterial community under organic farming and conventional farming modes revealed by 16S rDNA sequencing
Authors: Yang Yazhen , Fang Mingke , Wu Meiyan , Zhang Huaisheng , Li Huizhen , Zhu Jianqiang
Published: April 2020

Background The bacterial communities is complex and different in various agricultural ecosystem. In this study, high-throughput Illumina MiSeq sequencing was conducted to assess the differences in soil bacterial communities between organic farming and conventional farming modes. Results A total of 3, 919 operational taxonomic units were identified and classified as 26 phyla, 42 classes, 78 orders, 120 families, 281 genera. The dominant genera were Lysobacter , Pseudomonas , Massilia , Pseudarthrobacter , Ferruginibacter , Flavobacterium , Flavisolibacter , Brevundimonas , Haliangium and Sphingomonas . Analysis of soil bacterial diversity showed that the soil under the organic farming had a greater bacterial diversity than that under the conventional farming. Linear discriminant analysis effect size analysis showed that the major bacterial groups identified in the soil sample CK1 (2015.4) and CK6 (2017.10) under conventional farming mode were largely different from those in the soil sample O6 (2017.10) under organic farming mode. Redundancy analysis demonstrated that available nitrogen was the most important factor regulating bacterial composition under the organic farming mode, followed by soil rapidly available phosphorous and potassium. Massilia , Pseudomonas , Lysobacter and Pseudarthrobacter abundances showed a strong positive correlation with the content of available nitrogen. Conclusions Organic farming could improve soil organic matter, available nitrogen, rapidly available phosphorus and retard soil acidification. This modification of soil can directly or indirectly relate to the bacterial communities in soil. The shifts of bacterial communities were complicated and dynamic with respect to all sorts of the measures of cultivation and management under organic farming mode.