bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of gravidity, symptomatology and timing of infection on placental malaria
Authors: Tran Erin E , Cheeks Morgan , Kakuru Abel , Muhindo Mary K , Natureeba Paul , Nakalembe Miriam , Ategeka John , Nayebare Patience , Kamya Moses , Havlir Diane , Feeney Margaret E , Dorsey Grant , Gaw Stephanie L
Published: June 2020

Background Placental malaria is associated with increased risk of adverse perinatal outcomes. While primigravidity has been reported as a risk factor for placental malaria, little is known regarding the relationship between gravidity, symptomatology and timing of Plasmodium falciparum infection and the development of placental malaria. Methods The aim of this study was to investigate the relationship between the development of placental malaria and gravidity, timing of infection, and presence of symptoms. This is a secondary analysis of data from a double-blind randomized control trial of intermittent preventive therapy during pregnancy in Uganda. Women were enrolled from 12 to 20 weeks gestation and followed through delivery. Exposure to malaria parasites was defined as symptomatic (fever with positive blood smear) or asymptomatic (based on molecular detection of parasitemia done routinely every 4 weeks). The primary outcome was placental malaria diagnosed by histopathology, placental blood smear, and/or placental blood loop-mediated isothermal amplification. Multivariate analyses were performed using logistic regression models. Subgroup analysis was performed based on the presence of symptomatic malaria, gravidity, and timing of infection. Results Of the 228 patients with documented maternal infection with malaria parasites during pregnancy, 101 (44.3%) had placental malaria. Primigravidity was strongly associated with placental malaria (aOR 8.90, 95% CI 4.34-18.2, p<0.001), and each episode of malaria was associated with over a 2-fold increase in placental malaria (aOR 2.35, 95% CI 1.69-3.26, p<0.001). Among multigravid women, the odds of placental malaria increased by 14% with each advancing week of gestation at first documented infection (aOR 1.14, 95% CI 1.02-1.27, p=0.02). When stratified by the presence of symptoms, primigravidity was only associated with placental malaria in asymptomatic women, who had a 12-fold increase in the odds of placental malaria (aOR 12.19, 95% CI 5.23-28.43, p<0.001). Conclusions Total number of Plasmodium falciparum infections in pregnancy is a significant predictor of placental malaria. The importance of timing of infection on the development of placental malaria varies based on gravidity. In primigravidas, earlier asymptomatic infections were more frequently identified in those with placental malaria, whereas in multigravidas, parasitemias detected later in gestation were associated with placental malaria. Earlier initiation of an effective intermittent preventive therapy may help to prevent placental malaria and improve birth outcomes, particularly in primigravid women.
Can posterior stand-alone expandable cages safely restore lumbar lordosis? A minimum 5-year follow-up study
Authors: Kim Seung-Kook , Elbashier Ogeil Mubarak , Lee Su-chan , Choi Woo-jin
Published: June 2020

Background: Lumbar lordosis (LL) can be restored and screw-related complications may be avoided with the stand-alone expandable cage method. However, the long-term spinopelvic profile changes and safety remain unknown. We aimed to elucidate the long-term radiologic outcomes and safety of this technique. Methods: Data from a total of 69 patients who underwent multi-level stand-alone expandable cage fusion and 80 patients who underwent screw-assisted fusion between February 2007 and December 2012, with at least 5 years of follow-up, were retrospectively analyzed. Segmental angle and translation, short and whole LL, pelvic incidence, pelvic tilt, sacral slope (SS), sagittal vertical balance, thoracic kyphosis, and presence of subsidence, pseudoarthrosis, retropulsion, cage breakage, proximal junctional kyphosis (PJK), and screw malposition were assessed. The relationship between local and spinopelvic effects was investigated. The implant failure rate was considered a measure of procedure effectiveness and safety. Results: The stand-alone expandable cage fusion group showed shorter operative times, a lower rate of PJK, and better improvements in segmental angles than the control group, and there was a positive correlation with LL. However, the whole LL was not restored; the SS significantly increased; and subsidence, pseudoarthrosis, and retropulsion rates were significantly higher than those in the control group. Conclusions: Stand-alone expandable cage fusion can restore local lordosis, however, global sagittal balance was not restored. Furthermore, implant safety still has not been proven.
Procedural sedation for direct current cardioversion: a feasibility study between two management strategies in the emergency department.
Authors: Stronati Giulia , Capucci Alessandro , Russo Antonio Dello , Adrario Erica , Carsetti Andrea , Casella Michela , Donati Abele , Guerra Federico
Published: June 2020

BackgroundA cardiologist-only approach to procedural sedation with midazolam in the setting of elective cardioversion (DCC) for AF has already been proven as safe as sedation with propofol and anaesthesiologist assistance. No data exist regarding the safety of such a strategy during emergency procedures. The aim of this study is to compare the feasibility of sedation with midazolam, administered by a cardiologist, to an anaesthesiologist-assisted protocol with propofol in emergency DCC.MethodsSingle centre, prospective, open blinded, randomized study including all consecutive patients admitted to the Emergency Department requiring urgent or emergency DCC. Patients were randomized in a 1:1 fashion to either propofol or midazolam treatment arm. Patients in the midazolam group were managed by the cardiologist only, while patients treated with propofol group underwent DCC with anaesthesiologist assistance.ResultsSixty-nine patients were enrolled and split into two groups. Eighteen patients (26.1%) experienced peri-procedural adverse events (bradycardia, severe hypotension and severe hypoxia), which were similar between the two groups and all successfully managed by the cardiologist. No deaths, stroke or need for invasive ventilation were registered. Patients treated with propofol experienced a greater decrease in systolic and diastolic blood pressure when compared with those treated with midazolam.ConclusionsProcedural sedation with midazolam given by the cardiologist alone was safe, well-tolerated and cost-effective in emergency DCC.
COVID-19 Infection Manifesting as a Severe Gastroparesis Flare: A Case Report
Authors: Song Jun , Bhuta Rajiv , Baig Kamal , Parkman Henry P. , Malik Zubair
Published: June 2020

Background: Coronavirus Disease 2019 (COVID-19) is a disease caused by infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which commonly presents with symptoms including fever, cough, and dyspnea. More recently, however, some patients have tested positive for COVID-19 after developing gastrointestinal (GI) symptoms either solely or in conjunction with respiratory symptoms. This may be due to SARS-CoV-2 infection of the GI tract. In patients with chronic GI illnesses, COVID-19 may initially present as a flare of their underlying GI conditions as viruses have historically been implicated in exacerbations of GI disorders, including gastroparesis. Case presentation: We report a case of a 37 year-old female with a history of diabetic gastroparesis who presented to the Emergency Department (ED) in a gastroparesis flare. Her symptoms in the ED failed to improve with fluids and anti-emetic medications. After developing a fever, she was tested and found to be positive for COVID-19.Conclusion: To our knowledge, at the present time, this is the first report of a patient with COVID-19 presenting with signs and symptoms of a gastroparesis flare. This case illustrates that patients with underlying GI disorders, such as gastroparesis, may have SARS-CoV-2 infections that present as an exacerbation of their underlying disorder. Initial presentation of these patients manifesting as a flare of their chronic GI disease, more severe than usual, should prompt an index of suspicion for COVID-19.
Perioperative change in neutrophil count predicts worse survival in esophageal squamous cell carcinoma
Authors: Song Qian , Wu Jun-zhou , Wang Sheng , Xu Song-xiao
Published: June 2020

Background
Numerous studies reported the prognostic significance of neutrophil count (or preferably NLR) in patients with esophageal squamous cell carcinoma (ESCC), while the relationship between perioperative change in neutrophil count and survival of patients with ESCC after surgery has not been assessed.
Methods
A total of 603 patients with newly diagnosed ESCC after the operation were enrolled in the study. Neutrophil change (Nc) (Nc = Post-Neutrophil–Pre-Neutrophil) was counted according to data within one week before surgery and two week after surgery. The median of Nc was selected to be the cut off value to evaluate the relationship between Nc and Overall survival (OS).
Results
105 (17.4%) patients had pathological stage 1a-1b, 205 (34.0%) patients had pathological stage 2a-2b, and 293 (48.6%) patients had pathological stage 3a-3c.There were 180 (29.9%) patients who had vessel invasive, and 423 (70.1%) patients without vessel invasive. There were 215(35.7%) patients who had nerve infiltration, and 388 (64.3%) without nerve infiltration. In univariate analysis, six parameters including neutrophil change(Nc)(≥ 2.60 vs.<2.60) (P = 0.010, HR = 0.694, 95% CI 0.526–0.915) significantly correlated to worse OS. Multivariate analysis revealed that neutrophil change(Nc)(≥ 2.60 vs.<2.60) was an independent prognostic marker for OS (P = 0.022, HR = 0.720, 95% CI 0.544–0.954). Kaplan-Meier curves shown that Nc < 2.60 was significantly associated with worse OS (P = 0.016).
Conclusions
Perioperative change in neutrophil count predicts worse survival in patients with ESCC after the operation.
rhCygb reverses bleomycin-induced established pulmonary fibrosis in rats
Authors: Zhen Li , Zhongshun Lin , Ping Wang , Dong Wenqi
Published: June 2020

PurposeRecombinant human cytoglobin (rhCygb) has been demonstrated to anti-inflammation, anti-oxidation, anti-fibrosis in liver and kidney in animal disease models. However, the effect of rhCygb on the progression of pulmonary fibrosis is still unclear. The aim of this study was to investigate the therapeutic effect of rhCygb in the bleomycin (BLM)-induced pulmonary fibrosis rats.MethodsWe tested whether rhCygb would reverse lung fibrosis (at day 28 and 56) in Sprague-Dawley rats treated with bleomycin. Bleomycin (5mg/kg) resulted in fibrosis by CT and serum measurement at day 7. Effects of rhCygb treatment on morphological and CT imaging of the lung, as well as serial serum levels of biomarkers with progressive lung fibrosis were tested at day 28 and 56.ResultsIn BLM-treated rats (7 days), the well-established lung fibrosis was evidence by changes in rat lungs with CT images and serum levels of hyaluronic acid (HA), laminin (LN), procollagen III N-terminal peptide (PIIINP) and type IV collagen (IVC).After treatment with rhCygb for 49 days, we found significantly decreasing in HA, LN, PIIINP and IVC levels almost to controls. Hydroxyproline (HYP) , CT mean lung density（MLD）and Masson collage volume fraction (CVF) were also significantly reduced. Furthermore, CT MLD positively correlated with serum levels of HA, LN, PIIINP, IVC, and HYP, and especially with CVF.ConclusionrhCygb may be a new potential medicine for reversing lung fibrosis in the future.
LncRNA LINC00240 suppresses invasion and migration in non-small cell lung cancer by sponging miR-7-5p
Authors: Ku gwan woo , Kang Yujin , Yu Seong-Lan , Park Joonghoon , Park Sejin , Jeong In Beom , Kang Min Woong , Son Ji Woong , Kang Jaeku
Published: June 2020

Background
lncRNAs have important roles in regulating cancer biology. Accumulating evidence has established a link between the dysregulation of lncRNAs and microRNA in cancer progression. In previous studies, miR-7-5p has been found to be significantly down-regulated in mesenchymal-like lung cancer cell lines and directly regulated EGFR. In this work, we investigated the lncRNA partner of miR-7-5p in the progression of lung cancer.
Methods
We investigated the expression of miR-7-5p and the lncRNA after transfection with an miR-7-5p mimics using a microarray. The microarray results were validated using quantitative real time-polymerase Chain Reaction (qRT-PCR). The regulatory effects of lncRNA on miR-7-5p and its target were evaluated by changes in the expression of miR-7-5p after transfection with siRNAs for lncRNA and the synthesis of full-length lncRNA. The effect of miR-7-5p on lncRNA and the miRNA target was evaluated after transfection with miRNA mimic and inhibitor. The role of lncRNA in cancer progression was determined using invasion and migration assays. The level of lncRNA in lung cancer and normal lung tissue was analyzed using TCGA data.
Results
We found that LINC00240 was downregulated in lung cancer cell line after miR-7-5p trandfection with an miR-7-5p mimic. Further investigations reveal ed that the knockdown of LINC00240 induced the overexpression of miR-7-5p. The overexpression of miR-7-5p diminished cancer invasion and migration. The EGFR expression was down regulated after siRNA treatment for LINC00240. Silencing LINC00240 suppressed the invasion and migration of lung cancer cells, whereas LINC00240 overexpression exerted the opposite effect. The lower expression of LINC00240 in squamous lung cancer was analyzed using TCGA data.
Conclusions
Taken together, LINC00240 acted as a sponge for miR-7-5p and induced the overexpression of EGFR. LINC00240 may represent a potential target for the treatment of lung cancer.
Feasibility of circulating tumor cells (CTCs) combined with medical imaging examinations to screen for cancer and improve diagnosis in non-metastatic invasive breast cancer patients: a cohort study
Authors: Shao Xuan , Jin Xiao Yan , Chen Zhi Gang , Zhang Zhi Gang , Wang Ke , Yu Xiu Yan , Chen Wu Zhen , Jiang Jing Xin , Wang Zhen , Cui Ying , Fan Wan Hung , Huang Jian
Published: June 2020

Background

Previous study has reported that circulating tumor cells (CTCs) could serve as a diagnostic biomarker in breast cancer (BC) screening. However, the differential efficacy of routine examination including ultrasound (US), mammogram (MG), magnetic resonance imaging (MR), and breast-specific gamma imaging (BSGI) and CTCs is unknown. This study aimed to combine CTCs with other BC screening imaging modalities to screen for cancer and enhance diagnostic potency in non-metastatic BC patients.
Methods

102 treatment-naive non-metastatic BC patients were enrolled in this study between December 2017 and November 2018. All these patients received CTC detection and at least one medical imaging examination. Correlations of CTC enumeration with patients’ clinicopathological characteristics and medical imaging examinations were evaluated.
Results

CTC detection rates (average CTC counts) in stage I-III BC patients were 92.9% (2.1), 87.2% (2.4) and 100% (4.2), respectively. CTCs counts were positively associated with cancer stage (p = 0.0084) and tumor size (p = 0.0301). CTCs counts were more correlated with US than MR, and showed least correlation with MG. CTCs counts were not associated with molecular subtypes of BC nor breast-specific gamma imaging (BSGI) results, indicating that CTC enumeration cannot be used to reflect molecular signatures of BC. When both cut-off values for CTCs and Breast Imaging-Reporting and Data System (BI-RADS) were used, false negative rates (FNR) of CTCs, US, MG and MR in BC detection in this study were 22.5%, 15.8%, 30.6% and 12.8%, respectively. Combination of CTC with US, MG or MR decreased FNR of BC detection to 7.9%, 8.3% and 5.8%, respectively. False negatives are more common in early stage patients, and in patients with smaller tumors.
Conclusion

CTCs counts can be used as a diagnostic aid in BC screening and early diagnosis. CTCs counts were more relevant to US than MR or MG. Conjugation of CTCs counts would improve the diagnostic potency of medical imaging examinations for BC detection, especially for MG in Chinese women.
Distribution of Medical Institutions in Cold Regions of China Based on Public Health Emergencies
Authors: Wu Yue , He Jun , Zhang Shanshan
Published: June 2020

Background: Recently, investments in the construction of medical resources have been increasing annually China, and consequently, the allocation of these resources has improved. However, the outbreak of covid-19 in 2020 highlights the problems in the distribution of medical institutions. After the occurrence of public health emergencies, the joint action of different levels of medical and health institutions can bring the role of urban medical and health system into full play. Therefore, after a global public health emergency, the study of medical institution distribution needs to be reconsidered.Methods: With the continuous application and development of GIS, the application of GIS in civil planning is relatively mature, and research investigating distribution has been conducted in depth. Based on this foundation, this paper analyzes the factors impacting distribution, such as the transportation system, land use characteristics and personal factors, by a weighted spatial separation model of a representative city in a cold region in China.Results: A weighted spatial separation model was built and applied to comprehensively consider several factors affecting accessibility, including the spatial coverage separation, the service areas separation, the road network separation, the population separation and the weather separation. To calculate the accessibility of medical institutions using a weighted spatial separation model, Harbin was chosen as a case study. The accessibility of medical institutions was analyzed.Conclusions: The accessibility of medical institutions in this representative cold city in China was comparatively analyzed in this paper through theoretical research, software computations/simulations and model analysis based on the GIS paradigm. This study will help optimize the layout of medical institutions and improve medical equality.Trial registration: An ethics review and approval for this study was not required according to the local legislation and institutional requirements.
The Impacts of Family Physician Plan and Health Transformation Plan on Hospitalization Rates in Iran: An Interrupted Time Series
Authors: Rouhani Samad , Esmaeili Reza , YazdaniCharati Jamshid , Khandehroo Masoud
Published: June 2020

Background : Low and middle income countries has recently implemented various reforms toward Universal Health Coverage (UHC). This study aims to assess the impact of Family Physician Plan (FPP) and Health Transformation Plan (HTP) on hospitalization rate in Iran.Methods: We conducted an Interrupted Time Series (ITS) design. The data was monthly hospitalization of Mazandaran province over a period of 7 years. Segmented regression analysis was applied in R version 3.6.1.Results: A decreasing trend by -0.056 for every month was found after implementation of Family Physician Plan, but this was not significant. Significant level change was appeared at the beginning of Health Transformation Plan and average of hospitalization rate increased by 1.04 (P<0.001). Also hospitalization trend increased significantly nearly 0.09 every month in period after Health Transformation Plan (P<0.001).Conclusions: Family physician created a decreasing trend for hospitalization. Development of FPP to urban area of Iran will lead to health system efficiency. HTP with lower user fee in public hospitals and clinics as well as fee-for-service mechanisms, stimulated both level and trend changes in hospital admissions. Some integrated health policy is required to optimize the implementation of diverse simultaneous reforms in low and middle-income countries.
Epidemic Trend of Corona Virus Disease 2019 (COVID-19) and Public Health Response in Senegal
Authors: Diop Boly , Faye Adama , Ndiaye El Hadj Mamadou , Ndiaye Mamadou , Diallo Jean Pierre , Diongue Fatou Bintou
Published: June 2020

Background: The first case of Covid-19 was notified in Senegal on March 2, 2020. One month after, this study aims to analyze the trend and the main measures that have been taken.Methods: Data sources are from the Department of Disease Prevention in Senegal and some administrative documents. The epidemic trend has been described through epidemic curves according to the characteristics of infected people.Results: Of the 195 patients tested positive for COVID-19, a proportion of 53.8% is female. Six out of 14 regions were affected by the epidemic on April 1, 2020. The mean age is 37.9 years with a standard deviation of 18.6 years. The proportion of imported cases is 39.5%. The major strategy in Senegal is based on the isolation of cases for treatment and tracking of contacts. Decisions have been made to limit spread of the virus through social distancing. Airlines have been closed and border control strengthened.Conclusions: The preparation and the measures taken made it possible to contain the pandemic during the first month. However, there is a need to strengthen the surveillance following the appearance of community-based cases and readjust strategies to hope to contain the pandemic during the second month.
Willingness to Pay for a for a Potential Vaccine Against SARS-CoV-2 / COVID-19 Among Adult Persons
Authors: Berghea Florian , Berghea Camelia Elena , Abobului Mihai , Vlad Violeta Maria
Published: June 2020

Background: This study aims to investigate willingness to pay for a potential vaccine against SARS-CoV-2 / COVID-19 among adult persons in Romania. The study was conducted during the peak period of the pandemic curve in Europe and Romania, too.Methods: An online survey was developed and delivered to Romanian general population by using two of the largest social networking web services (Facebook and LinkedIn). The questionnaire included demographic data, description of the responder’s financial situation and their willingness to pay for a hypothetical anti COVID-19 vaccine. The study was based on the Van Westendorp Price Sensitivity Meter method.Results: A total of 203 adult subjects participated in the survey; 42.4% male and 55,2% members of a family with at least one child. Mean participants’ age was 44.12 ± 8.9 (mean ± SD). The acceptable price range for a vaccine against SARS-CoV-2 / COVID-19 was situated between 20 and 200 EUR. Subgroup analyses revealed similar price range in all groups with the notable exception of those with excellent financial situation who selected a 50 to 400 EUR interval. These results match the existing optional various vaccination schemes offered in the private health care sector: 43.2 ± 32.1 EUR. Conclusions: Despite substantial social impact of SARS-CoV-2, potential patients would pay for a perfect vaccination scheme against COVID-19 a price in the same range with the prices of existing vaccination schemes. Our findings could impact the way a vaccination policy will be developed in this context both in terms of general acceptance of vaccine and personal and social costs.
Wearable Sensors Technology as a Tool for Discriminating Frailty Levels During Instrumented Gait Analysis
Authors: Apsega Andrius , Petrauskas Liudvikas , Alekna Vidmantas , Daunoraviciene Kristina , Sevcenko Viktorija , Mastaviciute Asta , Vitkus Dovydas , Tamulaitiene Marija , Griskevicius Julius
Published: June 2020

Background: One of the greatest challenges facing the healthcare of the aging population is frailty. There is growing scientific evidence that gait assessment using wearable sensors could be used for prefrailty and frailty screening. The purpose of this study was to examine the ability of a wearable sensor-based assessment of gait to discriminate between frailty levels (robust, prefrail, and frail).Methods: 133 participants (≥ 60 years) were recruited and frailty was assessed using the Fried criteria. Gait was assessed using wireless inertial sensors attached by straps on the thighs, shins, and feet. Between-group differences in frailty were assessed using analysis of variance. Associations between frailty and gait parameters was assessed using multinomial logistic models with frailty as the dependent variable. We used receiver operating characteristic (ROC) curves to calculate the area under the curve (AUC) to estimate the predictive validity of each parameter. The cut-off values were calculated based on the Youden index.Results: Frailty was identified in 37 (28%) participants, prefrailty in 66 (50%), and no Fried criteria were found in 30 (23%) participants. Gait speed, stance phase time, swing phase time, stride time, double support time, and cadence were able to discriminate frailty from robust, and prefrail from robust. Stride time (AUC = 0.915), stance phase (AUC = 0.923), and cadence (AUC = 0.930) were the most sensitive parameters to separate frail or prefrail from robust. Other gait parameters, such as double support, had poor sensitivity. We determined the value of stride time (1.19s), stance phase time (0.68s), and cadence (101 steps/min) to identify individuals with prefrailty or frailty with sufficient sensitivity and specificity.Conclusions: The results of our study show that gait analysis using wearable sensors could discriminate between frailty levels. We were able to identify several gait indicators apart from gait speed that distinguish frail or prefrail from robust with sufficient sensitivity and specificity. If improved and adapted for everyday use, gait assessment technologies could contribute to frailty screening and monitoring.
Meta-analysis of Genome-wide Association Study Identifies FBN2 as a Novel Locus Associated With Systemic Lupus Erythematosus in Thai Population
Authors: Tangtanatakul Pattarin , Thumarat Chisanu , Satproedprai Nusara , Kunhapan Punna , Chaiyasung Tassamonwan , Klinchanhom Siriwan , Wang Yong-Fei , Wei Wei , Wongshinsri Jeerapat , Chiewchengchol Direkrit , Rodsaward Pongsawat , Ngamjanyaporn Pintip , Suangtamai Thanitta , Mahasirimongkol Surakameth , Pisitkun Prapaporn , Hirankarn Nattiya
Published: June 2020

Background: Differences in the expression of variants across ethnic groups in the Systemic Lupus Erythematosus (SLE) patients have been well documented. However, the genetic architecture in the Thai population has not been thoroughly examined. In this study, we carried out genome-wide association study (GWAS) in Thai population.Methods: Two GWAS cohorts were independently collected and genotyped: discovery dataset (487 SLE cases and 1,606 healthy controls) and replication dataset (405 SLE cases and 1,590 unrelated-disease controls). Data were imputed to the density of the 1,000 Genomes Project Phase 3. Association studies were performed based on different genetic models, and pathway enrichment analysis was further examined. In addition, the performance of disease risk estimation for individuals in Thai GWAS was assessed based on the polygenic risk score (PRS) model trained by other Asian populations.Results: Previous findings on SLE susceptible alleles were well replicated in the two GWAS. The SNPs on HLA-class II (rs9270970, A>G, OR=1.82, p-value = 3.61E-26), STAT4 (rs7582694, C>G, OR=1.57, p-value = 8.21E-16), GTF2I (rs73366469, A>G, OR=1.73, p-value = 2.42E-11) and FAM167A-BLK allele (rs13277113, A>G, OR=0.68, p-value = 1.58E-09) were also significantly associated with SLE in Thai population. Meta-analysis of the two GWAS identified a novel locus at the FBN2 that was specifically associated with SLE in the Thai population (rs74989671, A>G, OR=1.54, p-value = 1.61E-08). Functional analysis showed that rs74989671 resided in a peak of H3K36me3 derived from CD14+ monocytes and H3K4me1 from T-lymphocytes. In addition, we showed that the PRS model trained from the Chinese population could be applied in individuals of Thai ancestry, with the area under the receiver-operator curve (AUC) achieving 0.76 for this predictor.Conclusions: We demonstrated the genetic architecture of SLE in the Thai population and identified a novel locus associated with SLE. Also, our study suggested a potential use of the PRS model from Chinese population to estimate the disease risk for individuals of Thai ancestry.
Comparing Two Treatment Approaches for Patients with Type 1 Diabetes During Aerobic Exercise: A Randomised, Crossover Study
Authors: Vartak Varun , Chepulis Lynne , Driller Matthew , Paul Ryan G.
Published: June 2020

In a randomised, counterbalanced, crossover design, eight men with type 1 diabetes (T1D; mean ± SD age: 27.6 ± 11.4 years) reduced insulin (INS) or consumed carbohydrates without the usual insulin bolus (CARBS) over two sessions, held a week apart. Each session included standardised meals, a 45-minute treadmill-walk at 7.24 km.h-1 and a six-minute walk test (6MWT). Rate of perceived exertion (RPE), blood glucose, blood ketone and blood lactate measures were taken before, during and immediately after the aerobic exercise. The distance covered and the predicted VO2 max were also calculated for the 6MWT. Participants completing the INS intervention spent more time in normoglycaemia (P < 0.01) and less time in hyperglycaemia (P = 0.01) as compared to the CARBS intervention. Mild hypoglycaemia occurred in two participants during INS and no participants during CARBS. Furthermore, there was no significant difference for blood lactate, ketone, RPE, distance covered and predicted VO2 max between interventions. Six of the eight participants felt that their performance was better during INS, with all six (including the two participants that experienced mild hypoglycaemia) indicating that they would prefer to use this strategy for management of glycaemic during exercise in the future. Based on this pilot study, INS intervention appears to be the best approach for maintaining blood glucose levels in those with T1D during aerobic exercise, though this does need evaluating in other groups, including women, children and those with sub-optimal glycaemic control.Trial registration: ACTRN12619001397101p. Registered 09 September 2019, http://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378264
Anaemia and Associated Factors Among Pregnant Women Attending Antenatal Care Follow-Up at Yabello General Hospital Living in Pastoralist Borena Zone, Oromia, Ethiopia From From July to August, 2019
Authors: Arero Godana , Asssefa Kinde
Published: June 2020

Objective: The purpose of the study is to assess magnitude of anemia and associated factors among pregnant women attending antennal care follow-up at Yabello General Hospital in Pastoralist Borena Zone from July-August, 2019.Method: A hospital based cross-sectional study design was employed among 265 pregnant women attending antenatal care at Yabello General Hospital from June 17-August 16 2019. A systematic random sampling technique was used to select two hundreds sixty five study subjects. The first study subject was chosen randomly by simple random sampling method blindly picking one of two using pieces of papers named for the first two visitors. The sampling interval (K) calculated to be 2, and then, every second pregnant woman who attending antenatal care was recruited.Socio-demographic, maternal nutrition, information and obstetric and medical characteristics were assessed. Hemoglobin value, stool examination, HIV and syphilis test results were collected from their regular laboratory tests. Blood film was conducted for pregnant women who had signs and symptoms and whose hemoglobin value less than the established cut of values and data were analyzed using SPSS version 20.0 softwareResults: Magnitude of anemia with median hemoglobin value were (11.10g/dl ± 1.66); majority 46(63.9%) had mildly anemia, 24(33.3%) moderate and 2(2.8%) were severe anemia. Urban dwellers women (AOR, 95% CI: .18(.05-.64)), for those who had abortion before current pregnancy (AOR, 95% CI: 3.08(1.17-8.13)); coffee/tea drinking immediately after meal (AOR, 95% CI: 4.39(1.82-10.59), & who had excessive menstrual bleeding before current pregnancy were (AOR, 95% CI: 3.39(1.47-7.84)) & mid-upper arm circumference less than 23cm (AOR, 95% CI: 6.27(1.15-14.30)) were found to be independent predictors of anemia among pregnant women.Conclusion: Anemia in study area among pregnant women in Ethiopia was higher as compare with similar study elsewhere. Malnutrition, abortion, excessive bleeding & nutrition interaction with other inhibitors like coca cola, tea and coffee immediately after meals were independent predictors for anemia.
Risk Factors for Technical Difficulty of Endoscopic Submucosal Dissection in Colorectal Tumors: A Case Series and Meta-Analysis
Authors: Gao Yan , Jiang Wei , Zhai Hui-Hong , Xu Jianing , Wu Shanshan , Zhang Shutian
Published: June 2020

Background and Aims: Endoscopic submucosal dissection has become widely accepted as an efficient and well-established option for colorectal neoplastic lesions (CRNs). However, there are still some barriers for endoscopists that hinder the successful ESD. The current study was to evaluate risk factors for the failure of en-bloc resection in the colorectal endoscopic submucosal dissection (ESD).Methods: A retrospective chart review was performed from patients who underwent ESD for colorectal neoplasms (CRNs) between January 2015 and April 2017. The demographics and colonoscopic reports were analyzed. A meta-analysis was conducted for the risk factors for the failure of en-bloc or R0 resection. Results: 253 ESD cases were completed in en-bloc resection. Ulcerative colitis, previous abdominal surgeries, lesions on the Bauhin’s valve/ dentate line, non-lifting sign and submucosal fibrosis were associated with the failure of en-bloc resection (P<0.05). Meta-analysis showed that laterally spreading tumors, tumor larger than 40mm, Bauhin’s valve/dentate line, flexure, non-lifting sign, and submucosal fibrosis were the factors for the failure of en bloc or R0 resection. The rates of perforation were obviously higher in N-EBR groups compared to EBR groups. No significant results can be observed on the local recurrence based on these studies. Conclusions: Preoperative factors such as laterally spreading tumors, tumor larger than 40mm, Bauhin’s valve/dentate line, flexure and intraoperative factors such as non-lifting sign, submucosal fibrosis should be put more focus to reach better outcomes in CRNs patients.
Computer-aided three-dimensional assessment of periodontal healing distal to the mandibular second molar after coronectomy of the mandibular third molar: a prospective study
Authors: Yan Ziyu , Tan Yao , Xie Xiaoyan , He Wei , Guo Chuanbin , Cui Nianhui
Published: June 2020

Background
The periodontal healing distal to the mandibular second molar (M2M) after coronectomy of the M3M was controversary. This study aimed to combine a digital method with cone-beam computed tomography (CBCT) and estimate periodontal healing of M2M after M3M coronectomy. An accurate and stable indicator in three dimensions was also tentatively explored.
Methods
Patients with a M3M in contact with the inferior alveolar canal were included. CBCT was applied immediately after coronectomy (baseline) and 6-months later. Data were investigated with digital software for registration. Previously reported and coronectomy-related factors were included for univariate and multivariate analyses.
Results
A total of 181 patients (213 M3Ms) completed 6-month follow-up. Significant reduction in the distal intra-bony defect (DBD) depth of the M2M was shown (1.28 ± 1.24 mm, P < 0.001). DBD depth of the M2M at baseline was the most influential factor (r = 0.59), followed by preoperative M3M condition, age, rotation and eruption of the root complex. Remaining enamel (OR = 6.93) and small retromolar space (0.67) contributed to re-contact of the root complex and M2M. Bone volume regenerated in the distal 2 mm was associated significantly with DBD-depth reduction (r = 0.74, P < 0.001).
Conclusions
Bone volume regenerated in the distal 2 mm of the M2M denoted stability of distal periodontal healing of the M2M. DBD depth at baseline was the most influential factor for healing of a DBD of the M2M after M3M coronectomy. The remaining enamel and a small retromolar space could contribute to re-contact of the root complex and the M2M.
Trial registration:
China Clinical Trial Center, ChiCTR1800014862. Registered 10 February 2018, http://www.chictr.org.cn/showproj.aspx?proj=24216
Knowledge Among the Rural Parents About the Vaccinations and Vaccination Coverage of Children in the First Year of Life in Papua New Guinea – Analysis of Data Provided by Christian Health Services
Authors: Gowin Ewelina , Kuzma Jerzy , Januszkiewicz-Lewandowska Danuta
Published: June 2020

Knowledge among the rural parents about the vaccinations and vaccination coverage of children in the first year of life in Papua New Guinea – analysis of data provided by Christian Health Services.BackgroundThe aim of this analysis was to establish knowledge among the rural parents about the vaccinationsvaccination coverage of children in the first year of life in Papua New Guinea (PNG).Methods56 parents including 52 mothers and 4 fathers from 2 areas Simbu Province (Kervagi district) and Morobe Province (Finschhafen district). We analysed knowledge among the rural parents about the diseases prevented by vaccinations. data on vaccination coverage from 2016 to 2018 from all Catholic health facilities. Analysed vaccinations were the pentavalent vaccine (DTaP-HiB-HepB) and measles vaccine given in the first year of life.ResultsDuring the analysed period a total of 25,502 doses of measles vaccine was given, 31,428 children were vaccinated with the pentavalent vaccine. In 2016, the coverage rate for the measles vaccine was 26.6% and 33.4% for the pentavalent vaccine. In 2017, the coverage rate for measles and pentavalent vaccines was 12.5% and 16.6%, respectively. There were big differences in immunization coverage between provinces. In 2016, greater than 80% coverage was noted in one province for measles vaccine and in four provinces for pentavalent vaccine. In 2017, in none of the provinces, the coverage rate, neither for pentavalent nor for measles vaccine, was higher than 80%. A decreasing trend in the number of administered vaccinations was observed.ConclusionThe results of this analysis demonstrate that in PNG, the majority of children are not fully immunised. There are big differences in the vaccination coverage between provinces. As protection from diseases is low, there is a very high risk of an outbreak of the vaccine-preventable disease in the community.Delivery of vaccinations in PNG encounters many barriers from access to healthcare services to natural disasters and inter-tribial conflicts.Trial registration NA
The Effects of Management of Infection Source of Echinococcosis in Linzhi, Tibet Autonomous Region of China
Authors: Wang Ying , Ma Bing-Cheng , Wang Li-Ying , Quzhen Gongsang , Pang Hua-Sheng
Published: June 2020

BackgroundEchinococcosis is highly endemic in western and northern China，Tibet Autonomous Region （TAR）is one of the most serious prevalent area with the prevalence of echinococcosis in humans was 1.66% and in dog was 7.30% in 2016. Linzhi is located in southeastern part of TAR with the prevalence of echinococcosis in humans was 1.55% and in dog was 7.28% in 2016.，Dogs are the main infection source for the transmission of echinococcosis to humans. A control and prevention campaignbased on dog management has been undertaken in the past three years. This study is toevaluate the effects of dog management on prevalence of echinococcosis in dogs.MethodsData of dog population, registration and de-worming of 7 counties/district in Linzhi from 2017 to 2019 were collected. Domestic dog fecal samples were collected from each endemic town of7 counties/district in Linzhi in 2019 to determine infection of dog using coproantigen ELISA. Data analysis was processed using SPSS statistics to compare dog infection rate between 2016 and 2019 by chi-square test, and maps were mapped using ArcGIS.ResultsIn Linzhi, domestic dog population with 17407, 16512, 12663 decreased and the registration rate with 5.92%, 95.48%, 98.64% increased each year from 2017 to 2019. Similarly, stray dog population with 14336, 13067, 11837 decreased while sheltered rate with 84.63%, 92.32% 96.63% increased year by year. Dog de-worming frequency increased from 4 times per annum in 2017 to 12 times in 2019, almost every dog was dewormed monthly. A total of 2715 dog fecal samples were collected for coproantigen ELISA assay. The dog infection rate was 2.84% (77/2715) in 2019, which significantly lower than 2016 with 7.28% (45/618) (P＜0.05).ConclusionIncreased dog registration, decreased dog population and increased dog de-worming frequency contributed to significantly decreased dog infection rate in Linzhi, TAR. Control and prevention campaign based on dog management can significantly decrease dog infection with Echinococcus spp in echinococcosis endemic areas but needs strictly implementation.
High immune efficacy against different avian influenza H5N1 viruses by oral administration of a Saccharomyces cerevisiae-based vaccine in chickens
Authors: Lei Han , Cen Qianhong , Gao Tong , Ren Yi , Lu Xin
Published: June 2020

BackgroundA safe and effective vaccine is the best way to control large-scale highly pathogenic avian influenza virus (HPAI) A (H5N1) outbreaks. Saccharomyces cerevisiae (S. cerevisiae) is an ideal mucosal delivery vector for vaccine development, and we have previously shown that conventional injection administration with a S. cerevisiae-based vaccine (EBY100/pYD1-HA) was protective against homologous H5N1 virus in a mouse model. Due to the diameter of S. cerevisiae is around 10 μm which results in a severe inflammation by injection route, therefore, oral administration is a more suitable approach for EBY100/pYD1-HA conferring cross-protection in poultry. ResultsWe extended our work by evaluating the immunogenicity and cross-protective efficacy of oral vaccination with EBY100/pYD1-HA in the chicken model. Oral immunization with EBY100/pYD1-HA could induce robust serum IgG, mucosal IgA and cellular immune responses. Importantly, EBY100/pYD1-HA provided complete cross-protection against different H5N1 viruses challenge. ConclusionsThese findings suggest EBY100/pYD1-HA, a promising H5N1 oral vaccine candidate, can avoid potential reassortment of other avian influenza viruses in oral administration of live virus vaccines and overcome the drawbacks of conventional injection route. Importantly, this platform will be able to provide opportunities for broader applications in poultry during HPAI A (H5N1) outbreaks.
Quality Evaluation in Delivering Care of Acute Myocardial Infarction in Sancti-spirítus, Cuba
Authors: Rodriguez-Ramos Miguel Alejandro , Cairo-Saez Gilberto , Prohias-Martinez Juan Antonio
Published: June 2020

Background: Prevalence of cardiac conditions is increasing worldwide. Low and middle-income scenario (LMISs), especially in Latin America, don’t scape from this phenomenon. To give a high-quality cardiovascular disease care may be economic challenging for these countries, in every level of attention.Methods: Observational and retrospective study of quality of care evaluation using the European Society of Cardiology (ESC 2017) Quality of Care Working Group’s consensus on quality document, of admitted Acute Myocardial Infarction in a General Hospital in Sancti-Spiritus, Cuba.Results: Between 2017 and 2019, 660 patients with AMI were admitted, most of them (72%), presented with features of ST-elevation myocardial infarction. Thrombolytics were administered to 268 (72.4%) patients, 43 (16%) of them in less than 30 minutes after diagnosis. Double antiplatelet treatment was administered to 98.1% of patients at admission. However, only 163 (34.8%) were enrolled in secondary prevention programs. No information regarding Patient Experience, nor 30-day adjusted mortality, was collected. Secondary prevention was fulfilled around 90%Conclusion: Determination of the quality metrics brought some improvement for the perception of the actual quality of care in this low/middle income scenario. Pre-hospital quality markers need to be improved, before trying to introduce a higher level of treatment.
Mesenchymal Stem Cells Desensitize Castration-resistant Prostate Cancer to Docetaxel Chemotherapy via Inducing TGF-β1-mediated Cell Autophagy
Authors: Yu Yang , Zhang Wen-tao , Yang Fu-han , Guo Ya-dong , Ye Lin , Yao Xu-dong
Published: June 2020

Background: Mesenchymal stem cells (MSCs) have been proved to accelerate prostate cancer (PCa) castration resistance progression. The purpose of this study is to investigate the contribution of MSCs to the development of docetaxel resistance in castration-resistant prostate cancer (CRPC) cells and its potential mechanisms.Methods: The effect of MSCs on CRPC cells resistance to docetaxel was determined using in-vivo and in-vitro approaches. CCK8 and PI/Annexin V-FITC assay were used to examined the cell viability and apoptosis. The concentration of transforming growth factor-β1 was measured by enzyme-linked immunosorbent assay and small interfering RNA was used for functional analyses.Results: MSCs significantly reduced the sensitivity of CRPC cells to docetaxel-induced proliferation inhibition and apoptosis promotion in vivo and in vitro. CRPC cells cocultured with MSCs under docetaxel administration have an increased autophagy activation, while autophagy inhibitor could effectively reversed MSCs-induced resistance to docetaxel. Additionally, MSCs-induced CRPC cell autophagy increase under docetaxel administration depends on MSCs secreting TGF-β1 and inhibition of TGF-β1 secretion in MSCs could consequently increase the sensitivity of CRPC cells to docetaxel.Conclusions: These results suggest that docetaxel administrated CRPC cells may elicit MSCs secreting TGF-β1 increase, which desensitizes CRPC to docetaxel chemotherapy accelerating chemoresistance occurrence via inducing cell autophagy.
Preoperative Internal Medicine Evaluation Reduces 30-Day Postoperative Mortality Risk in Patients with Cancer
Authors: Soones Tacara , Guo Anna , Foreman Jessica T. , Leung Cheuk Hong , Lin Heather Y. , Popovich Shannon , Sahai Sunil K. , Hwang Jessica P.
Published: June 2020

Background

The effect of preoperative internal medicine evaluations on cancer patients undergoing surgery is uncertain.
Methods

We conducted a retrospective cohort study of cancer patients who had been included in the National Surgery Quality Improvement Program from 2011–2014 to determine the effect of an Internal Medicine Perioperative Assessment Center (IMPAC) evaluation on the risk of 30-day mortality compared to that of patients who proceeded directly to surgery.
Results

Of the 11,577 participants, 3589 underwent an IMPAC evaluation. Among the propensity score-matched cohorts, the odds ratio (OR) of 30-day mortality was .39 (95% CI = .18-.84).
Conclusions

Our findings demonstrate that a preoperative internal medicine evaluation was associated with lower 30-day mortality.
Changes in the use of Otorhinolaryngology Emergency Department during the COVID-19 pandemic: report from Lombardy, Italy
Authors: Elli Fabrizia , Zanoni Mario Turri , Arosio Alberto Daniele , Karligkiotis Apostolos , Battaglia Paolo , Castelnuovo Paolo
Published: June 2020

Purpose. This paper aims to report the impact of COVID-19 outbreak on Emergency Ear nose and Throat (ENT) activity, in Lombardy (Italy), during COVID-19 pandemic.Methods. The number of accesses to Emergency Department requiring ENT consultations between February 21st and May 7th, 2020, was retrospectively collected, along with the conditions treated. Data were stratified in one-week time spans, in order to evaluate the evolving trends during the on-going epidemic and a comparison with the two previous years was performed. Results. A significant reduction in the number of consultations performed during the pandemic was observed, as high as - 91% compared to the same period of 2018. Conclusion. Multiple reasons can explain such a reduction of Emergency ENT consultations, not least the fear of potentially being infected by SARS-Cov-2 by while accessing the hospital. The analysis performed might be useful as a starting point for a future reorganization of first aid consultations once the epidemic will be resolved.