bluuebunny/crossref_metadata_2025 huggingface dataset:
Relevance between Helicobacter pylori infection and nonalcoholic fatty liver disease in Bai minority region, Southwestern China
Authors: Yan Ping , Yu Bocheng , Li Min , Zhao Weidong
Published: November 2020

Objective

The association between Helicobacter pylori (H. pylori) infection and nonalcoholic fatty liver disease (NAFLD) remains a matter of debate. We conducted this study to evaluate whether H. pylori infection is a major risk factor for NAFLD.
Methods

A total of 1185 individuals who received health check-ups from January 2017 to June 2019 were studied. Data of each subject who underwent 13C-urea breath, abdominal ultrasound, neck vascular color doppler ultrasound, and had a complete set of serum biochemical results was collected from the hospital information system. Participants were allocated to NAFLD group and non-NAFLD group based on abdominal color ultrasound for NAFLD. The baseline characteristics and serum biochemical results were compared. Logistic regression analyses were utilized to identify risk factors for NAFLD. Logistic regression models adjusted for confounding factors was performed to investigate the association between H. pylori infection and NAFLD.
Results

Compared to subjects without NAFLD(n = 656), those with NAFLD (n = 529) were more likely to be older, with higher weight, SBP, DBP, higher levels of TC, TG, LDL-C, FPG, AST and ALT, but with lower levels of HDL-C (all P values < 0.05). The levels of ALT, AST, BMI, FPG, TG, and DBP were independent risk factors for NAFLD (all P values < 0.05). Additionally, H. pylori was also an independent risk factor for NAFLD (OR = 1.35, 95%CI 1.02–1.79, P = 0.036). TC and LDL-C levels were significantly higher in H. pylori-positive group (n = 464) than that of in H. pylori-negative group (n = 721) (all P values < 0.05).
Conclusions

H. pylori infection is a key risk factor for NAFLD, and serum lipid metabolic dysfunction can be observed in the subjects with H. pylori, suggesting the potential role of H. pylori infection in the progression of NAFLD.
Identification of Autism Risk Genes in a Chinese Cohort via Whole-Exome Sequencing with the Joint Calling Analysis
Authors: Yuan Bo , Cheng Peipei , Zhang Ran , Du Yasong , Qiu Zilong
Published: November 2020

Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental disorder characterized by deficits in social interactions and repetitive behaviors. Although hundreds of ASD risk genes, implicated in synaptic formation, transcriptional regulation, and chromatin remodeling, have been identified, the genetic analysis on east Asian ASD cohorts in the whole-geome or whole-exome level is still limited(1-5). Here we performed whole-exome sequencing on 168 ASD probands with their unaffected parents of Chinese origin. We applied a joint calling analytical pipeline based on GATK best practices and identified numerous de novo variants including single nucleotide variants (SNVs) and insertion or deletions (INDELs). By querying the Simons foundation autism research initiative (SFARI) gene database, we found that there were potential novel ASD risk genes in East Asian cohorts, which did not exist in European American populations. Furthermore, our analysis pipeline identified de novo copy number variations (CNVs) of known ASD-related gene based on a sufficiently large sample size, validated by quantitative PCR. Our work indicated that there may be differences in potential ASD genetic components existing across different geographical populations, suggesting that genomic analysis over large cohorts are required for each population in order to precisely identify ASD risk genes.
Ethnic Disparities in Presentation, Management and Outcome of Testicular Cancer
Authors: Low Li Sian , Nair Shiva , Holmes Michael
Published: November 2020

Background: The incidence rate of testicular cancer in New Zealand (NZ) is one of the highest in the world. Compared to other ethnic groups in NZ, Maori have been reported as having the highest incidence and cancer specific mortality. We aim to investigate whether disparities in presentation and management of the disease exist between European and Maori males within a large tertiary referral centre in NZ. Methods: A retrospective cohort study was performed from January 2009 to July 2019. Ethnicity was self-defined. Tumour characteristics and mortality data were recorded. Time from onset of symptoms to surgical treatment was measured. Exclusion criteria were paratesticular tumour and non-Maori and non-European ethnicity.Results: 113 patients underwent radical orchidectomy within the time period. Maori had a significantly higher risk of developing testicular cancer compared to Europeans (RR 2.19, 95% CI 1.47 – 3.24, p =0.01). There were no significant differences in cancer specific or overall survival. The mean time duration between symptom onset and first specialist assessment (FSA) was 189 days for Maori and 128 days for European (p=0.12). Once FSA is done, there was no difference in time to operating theatre. However, Maori were less likely to attend follow up appointments (87% vs 98%, p =0.02). Conclusion: Maori males are more likely to develop testicular cancer in this study. Although no difference in cancer specific survival was seen, there was a large difference in time from symptom onset to referral to specialist review and the probability of attending follow up appointments.
The First Case of Reactive Arthritis Associated with SARS-CoV-2-Infection in A 4-Year Old Child
Authors: Werner Stephanie Gabriele , Langer Hans-Eckhard
Published: November 2020

Background: The novel coronavirus SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2) and its associated disease COVID‐19 (Corona Virus Disease 19) has become a worldwide pandemic since its first cases in December 2019 in Wuhan Province in China. In Germany the pandemic started in February 2020.Case presentation: A 4 year old boy was presented and suffered from pain in the right hip. Arthrosonography demonstrated a significant effusion in the involved joint. The extended history revealed a slight but long lasting cold before. Serological findings were inconspicuous except for positive ELISA (Enzyme-linked Immuno Sorbent Assay) - test for SARS-CoV-2. Conclusion: In conclusion we believe that we can report the first case of reactive arthritis associated with SARS-CoV-2 in children.
A Novel Method for Screening the Effective Compatibility Fractions of Naomaitong for the Treatment of Cerebral Ischemic Stroke Using Support Vector Machine Model
Authors: Yu Huanzheng , Liu Qiu , Zheng Huiting , Xian Minghua , Liang Shengwang , Wang Shumei
Published: November 2020

Background: Screening the fractions of traditional Chinese medicine (TCM) medications effective against a disease without affecting their compatibility is a major challenge. Therefore, the goal of the present study was to establish a novel methodology for screening the bioactive fractions of Naomaitong (NMT) utilizing the Support Vector Machine (SVM) model. Methods: The extract of NMT was separated into 21 fractions using macroporous resin. The different combinations of elution fractions were selected using the Plackett-Burman method and used as an input value for SVM. Infarct size in the rat model of cerebral ischemia-reperfusion injury and the content of selected compounds measured by HPLC were used as output vectors of the SVM training set. Based on the SVM target model, the optimal combination of elution fractions was predicted and verified in the rat model of ischemia-reperfusion injury. Results: The effective compatibility of NMT was screened by SVM simulation: all elution fractions of rhubarb, 30%, 60%, and 95% ethanol elution fractions of ginseng, and 30% and 60% ethanol elution fractions of puerarin and chuanxiong. The optimization of compatibility fractions of NMT was found to have the same protective efficacy in cerebral ischemia-reperfusion injury in rats. Conclusions: The performed analysis established a novel SVM-based method for screening the compatibility fractions of NMT effective against cerebral ischemic stroke injury. The results provide a new methodology for the optimization of the compatibility of TCM compounds and the discovery of effective components.
Association Between Diabetic Retinopathy, Dietary Inflammatory Index and Metabolic Syndrome in Azar Cohort Study
Authors: Somi Mohammad hossein , Nikniaz Zeinab , Jafarabadi Mohammad Asghari , Eftekharsadat Amir Taher , Mirzaei Mohammad , Holmskov Uffe , Grauslund Jakob , Shivappa Nitin , Hébert James R. , Faramarzi Elnaz , Ostadrahimi Alireza
Published: November 2020

Background : The aim of present study was to evaluate the association between diabetic retinopathy (DR), dietary inflammatory index (DII), and metabolic syndrome (MetS) in patients with type 2 diabetes in a cohort study in Iran. Methods: This cross-sectional study was a part of the large Azar eye cohort study that included 1378 patients with type 2 diabetes. To diagnose DR, two mydriatric fundus photographs were captured using a digital fundus camera. The DR severity was classified as non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR). MetS was determined on the basis of the ATPIII criteria. DII was calculated according to Shivappa et al. method. Results: Of 1378 diabetic patients, 185 (13.4%) had NPDR and 142 (10.3%) had PDR. The risk of NPDR and PDR increased by 2.65-fold and 2.01-fold, respectively, in patients having blood glucose levels that fell outside the recommended range. There was no statistically significant relationship between Mets, Mets components, and DII in NPDR and PDR. Conclusion: The results suggest that intensive glycemic control, rather than conventional control, may help reduce the progression of DR. It seems that longitudinal studies and clinical trials for evaluating role of DII in DR are necessary.
Physiological Reactions and Performance Parameters in Single-Player and Competitive Arm Rehabilitation Game: A Pilot Study
Authors: Catalán José M , Blanco Andrea , Díez Jorge A , García José V , Martínez David , Bertomeu-Motos Arturo , García-Aracil Nicolás
Published: November 2020

BackgroundInterpersonal rehabilitation games, compared to single-player games, enhance motivation and intensity level. Usually, it is very difficult to limit the use of the system to pairs of impaired patients who have a similar skill level. Thus, such games must be dynamically adapted so that two players with different abilities can play together. Current algorithms are based only on game performance parameters (e.g., score). In addition, these studies do not include active robotic devices, so the parameters related to the level of robot assistance are not usually included in these studies. This means that the adaptation methods are entirely based on modifying aspects of the game. The aim of this article, is to study the effect that game modality and robot parameters that can be affected by the level of robot assistance (e.g., velocity, reaction time) have on the stress level of the subjects.MethodsThe pilot study has involved 10 unimpaired participants (5 pairs). Each subject sat in front of a robotic rehabilitation platform and grasped the end-effector of the robot with their dominant hand and played two kinds of therapy games: i) a single-player game in 3 difficulty modes; and ii) a competitive game. Robot and game parameters and subject's physiological responses were recording during the therapy games.ResultsThe intensity level in the most difficult single-player game mode, is almost equal to the one of the competitive mode (p=1.0). The stress perceived subjectively by participants increases with intensity. They indicate that the stress level in competitive mode is equal or somewhat greater than in high difficulty mode. On the other hand, physiological data suggest that it is somewhat lower in the competitive mode. Therefore, in this mode participants think they experience a higher stress level than they are actually experiencing. In addition, physiological responses show differences between intensity levels, and they also have a good correlation with the measured robot parameters.ConclusionResults show that, comparing competitive game with the single-player high-difficulty game, a similar intensity level is remarkable. However, the competitive game increase the stress level to a lesser extent. In addition, feedback from participants suggests that it is necessary to keep a certain stress level to make the activity more challenging, and therefore be more engaging and rewarding.
Patient-important Outcomes Reported in Clinical Studies of Pharmacologic Treatments for COVID-19: A Protocol of a Meta-epidemiological Study
Authors: Jimenez-Mora Mario A , Varela Andrea Ramírez , Meneses-Echavez Jose F , Bidonde Julia , Angarita-Fonseca Adriana , Siemieniuk Reed AC , Zeraatkar Dena , Bartoszko Jessica , Brignardello-Petersen Romina , Honarmand Kimia , Rochwerg Bram , Guyatt Gordon , Yepes-Nuñez Juan José
Published: November 2020

Background: The coronavirus disease 19 (covid-19) pandemic has underscored the need to expedite clinical research, which may lead investigators to shift away from measuring patient-important outcomes (PIOs), limiting research applicability. We aim to describe the extent to which randomized controlled trials (RCTs) of covid-19 therapies will determine PIOs. Methods: We will perform a meta-epidemiological study of RCTs that included people at risk for, or with suspected, probable, or confirmed covid-19, examining any pharmacological treatment or blood product aimed at prophylaxis or treatment. We will obtain data from all RCTs identified in a recent published network metanalysis (NMA). To categorize the outcomes according to their importance to patients, we will adapt a previously defined hierarchy: a) mortality, b) quality of life/ functional status/symptoms, c) morbidity, and d) surrogate outcomes. Outcomes within the category a) and b) will be considered critically important to patients, and outcomes within the category c) will be regarded as important. We will use descriptive statistics to assess the proportion of studies that report each category of outcomes. We will perform univariable and multivariable analysis to explore associations between trial characteristics and the likelihood of reporting PIOs. Discussion: The findings from this meta-epidemiological study will help health care professionals and researchers understand if the current covid-19 trials are effectively assessing and reporting the outcomes that are important to patients. If a deficiency in capturing PIOs is identified, this information may help inform the development of future RCTs in covid-19.Systematic Review registrations: Open Science Framework registration: osf.io/6xgjz
Empowering Large Chemical Knowledge Bases for Exposomics: Pubchemlite Meets Metfrag
Authors: Schymanski Emma Louise , Kondic Todor , Neumann Steffen , Thiessen Paul , Zhang Jian , Bolton Evan
Published: November 2020

Compound (or chemical) databases are an invaluable resource for many scientific disciplines. Exposomics researchers need to find and identify relevant chemicals that cover the entirety of potential (chemical and other) exposures over entire lifetimes. This daunting task, with over 100 million chemicals in the largest chemical databases, coupled with broadly acknowledged knowledge gaps in these resources, leaves researchers faced with too much – yet not enough – information at the same time to perform comprehensive exposomics research. Furthermore, the improvements in analytical technologies and computational mass spectrometry workflows coupled with the rapid growth in databases and increasing demand for high throughput “big data” services from the research community present significant challenges for both data hosts and workflow developers. This article explores how to reduce candidate search spaces in non-target small molecule identification workflows, while increasing content usability in the context of environmental and exposomics analyses, so as to profit from the increasing size and information content of large compound databases, while increasing efficiency at the same time. In this article, these methods are explored using PubChem, the NORMAN Network Suspect List Exchange and the in silico fragmentation approach MetFrag. A subset of the PubChem database relevant for exposomics, PubChemLite, is presented as a database resource that can be (and has been) integrated into current workflows for high resolution mass spectrometry. Benchmarking datasets from earlier publications are used to show how experimental knowledge and existing datasets can be used to detect and fill gaps in compound databases to progressively improve large resources such as PubChem, and topic-specific subsets such as PubChemLite. PubChemLite is a living collection, updating as annotation content in PubChem is updated, and exported to allow direct integration into existing workflows such as MetFrag. The source code and files necessary to recreate or adjust this are jointly hosted between the research parties (see data availability statement). This effort shows that enhancing the FAIRness (Findability, Accessibility, Interoperability and Reusability) of open resources can mutually enhance several resources for whole community benefit. The authors explicitly welcome additional community input on ideas for future developments.
Effectiveness of plasma with low concentration of platelets combined with hyaluronic acid compared with platelet rich plasma in the conservative treatment of knee osteoarthritis. A retrospective study
Authors: Palco Michelangelo , Fenga Domenico , Rizzo Paolo , Cavalieri Bruno , Milardi Demetrio , Leonetti Danilo , Bruschetta Antongiulio , Alito Angelo , Basile Giorgio , Traina Francesco
Published: November 2020

Background: Knee osteoarthritis (KO) is one of the most common joint diseases, often determining knee pain and reduction of mobility with impact on the overall quality of life of the patients. Intra-articular injections of different formulations of platelet rich plasma (PRP) are an increasingly common non-surgical treatment for KO. Recently, in order to combine the antinflammatory effect of platelet rich plasma and the viscosupplementation effect of hyaluronic acid, a formulation of plasma with relatively low concentration of platelets and very few leukocytes combined with hyaluronic acid (PRP+HA) has been proposed. The purpose of this study is to retrospectively compare the effectiveness of plasma with high concentration of platelets and leukocytes (L-PRP) with PRP+HA in patients with mild to moderate (Kellegren-Lawrence scale II-III grade) KO.Materials and Methods: Among the 51 patients included, 28 have been treated with L-PRP, while 23 with PRP+HA. A retrospective evaluation at baseline (T0), after 3 months (T1) and 1 year (T2) has been performed. The outcome analyzed are the Knee Society Score(KSS), the Visuo Analogic Scale (VAS) (at T0,T1 and T2) and the Knee injury and Osteoarthritis Outcome Score(KOOS) (T0 and T2).We evaluated change in mean scores within group among different time points using repeated measures ANOVA or paired t-test. Comparison between different groups of treatment has been performed using mixed ANOVA.Results: The main finding is that, although the two treatments have been both effective, PRP+HA determined significantly better functional status, pain and mobility, measured with KSS.Discussion: We observed a significant effect of the two formulations in exam in all the outcomes in analysis: both treatments were effective in improving pain, knee functional status and symptoms, and the benefits persisted after 3 and 12 months from the infiltrative therapy. Nevertheless, patients who received PRP+HA injections presented higher knee mobility and better function (measured by KSS score) after one year.Conclusions: This work compares clinical outcomes of L-PRP and PRP+HA treatment in patients with KO. Our results encourage the use of one of the two treatments in patients with mild to moderate KO. When possible, we suggest to the use of PRP+HA formulation, because it may determine better results in improving knee function and mobility.
Vesselplasty for the treatment of osteoporotic vertebral compression fractures with peripheral wall damage: A retrospective study
Authors: Xu Chongqing , Yin Mengchen , Mo Wen
Published: November 2020

Background

The clinical efficacy of vertebroplasty and kyphoplasty treating osteoporotic vertebral compression fractures (OVCF) has been widely recognized in recent years. However, there are also disadvantages of bone cement leakage (BCL), limited correction of kyphosis and recovery of vertebral height. Nowadays, in view of these shortcomings, vesselplasty has been widely used in clinical practice. The objective of this study is to assess its clinical effect and application value for the treatment of OVCF with peripheral wall damage.
Methods/Design:

All 62 patients (70 vertebrae) treated for OVCF with peripheral wall damage using vesselplasty were involved and retrospectively analyzed. The data collection included operation time, volume of bone cement, relevant surgical complications, visual analog scale (VAS), Oswestry disability index (ODI), vertebral body height and kyphosis Cobb angle.
Results

The time of operation was 20–65 (34.5 ± 10.5) minutes. The volume of bone cement was 3–8 (5.3 ± 1.3) ml. VAS and ODI at different time points after operation were decreased compared with before operation (all P < 0.05). There were no statistical differences between VAS or ODI at different postoperative time points (P > 0.05). Vertebral body height and Cobb angle at different time points after operation were improved compared with before operation (all P < 0.05). There were no statistical differences between vertebral body height or Cobb angle at different postoperative time points (all P > 0.05).
Conclusion

Vesselplasty can reduce the risk of BCL and better control the dispersion of bone cement in the treatment of OVCF. It has a definite effect in relieving pain, restoring the vertebral body height and correcting the kyphosis caused by injured vertebrae, especially in OVCF with peripheral wall damage. Therefore, vesselplasty is safe and worthy of clinical application.
Validation of the arthro-MAP Nomogram to Predict Major Complications after Hip and Knee Arthroplasty in Chinese Population
Authors: tan xiujuan , Ge Fengmin , Mo Guixi , Li Zhiyi , Gu Xiaoxia , Zhang Liangqing
Published: November 2020

Background

A nomogram(arthro-MAP) predict major complications after Hip and Knee Arthroplasty has been establish by England people. The goal of this study is to externally validate the nomogram whether suitable for Chinese people or not.
Methods

A total of 414 elderly patients with Hip and Knee Arthroplasty underwent surgical treatment in the Affiliated Hospital of Guangdong Medical University from March 1, 2017 to August 31, 2019 were included into this study. Variables assessed were lowest intraoperative HR, EBL, preoperative BUN, procedure type, race, ASA score, comorbidities, presence of fracture. Receiver-operator characteristics (ROC) curve analysis, calibration (HL) and DCA were used to evaluate predictive properties of the nomogram.
Results

A total of 414 patients were consecutively enrolled. 47 patients (11.35%) presented a major complications after Hip and Knee Arthroplasty. The arthro-MAP nomogram presented an AUC of 0.816; 95%CI: 0.757–0.875 to predict major complications. At the calibration plot x2 = 17.13, P > 0.05, means the arthro-MAP nomogram appears to be well-calibrated in Chinese population, with predicted outcome rates closely reflecting the observed rates.
Conclusions

Although further studies are needed to confirm our results, the arthro-MAP nomogram was, in our experience, an excellent tool to predict major complications after Hip and Knee Arthroplasty, can be perform well in the Chinese population.
Mildly decreased preoperative bilirubin levels are considered as risk factors for periprosthetic joint infection after total hip and knee arthroplasty
Authors: Fu Jun , Chen Xiyue , Xu Chi , Ni Ming , Li Xiang , Hao Libo , Zhou Yonggang , Chai Wei , Chen Jiying
Published: November 2020

Background and Purpose

Many blood biomarkers are routinely assessed before joint arthroplasty, but only few are commonly used to guide surgeons in determining patients most at risk of periprosthetic joint infection (PJI). The objective of this study was to investigate the correlation between preoperative bilirubin level and PJI after hip and knee arthroplasty.
Methods

A retrospective analysis was performed on patients undergoing revision hip and knee arthroplasty at our hospital from January 2016 to December 2019. Laboratory biomarkers were collected before the primary arthroplasty, as well as general patient information. The correlation between the above blood biomarkers and postoperative PJI was analyzed.
Results

A total of 72 patients (30 hips/42 knees) were analyzed, including 39 patients with PJI and 33 patients without PJI. Except for total bilirubin (TB) and direct bilirubin (DB), there was no significant difference between the remaining laboratory biomarkers. The preoperative TB and DB in the PJI group were 10.84 ± 0.61 µmol/L and 3.07 ± 0.19 µmol/L, respectively, which were lower than those in the non-PJI group (14.68 ± 0.75 µmol/L and 4.70 ± 0.39 µmol/L, p = 0.0001 and 0.0002). The AUC of preoperative TB to predict PJI was 0.7552 (p = 0.0002, cutoff = 11.55 µmol/L, sensitivity = 66.67%, specificity = 75.76%, PPV = 76.47%, NPV = 65.79%). Meanwhile, the AUC of preoperative DB was 0.7603 (p = 0.0001, cutoff = 4.00 µmol/L, sensitivity = 84.62%, specificity = 54.45%, PPV = 68.75%, NPV = 75%).
Conclusions

The serum levels of TB and DB before the primary arthroplasty of PJI patients were lower than those non-PJI patients, and the preoperative values lower than 11.55 µmol/L and 4.00 µmol/L could be considered as risk factors for postoperative PJI.
Employment Changes among Chinese Family Caregivers of Long-Term Cancer Survivors
Authors: Liu Siqi , Su Mingzhu , Yao Nengliang , Zhang Nan , Wang Jialin , Anderson Roger. T. , Sun Xiaojie
Published: November 2020

Background: Family caregivers (FCGs) play a key role in the plan of care provision for long-term cancer survivors, yet few studies have been conducted on the impact of long-term caregiving on FCGs and their employment patterns. This study aims to further our understanding of the effect that caregiving role has on FCGs by identifying what cancer-related characteristics influence reduction of employment hours among FCGs in the post-treatment phase in China. Methods: A total of 1155 cancer survivors participated in this study. Patients reported changes in the employment patterns of their FCGs. Descriptive analysis looked at demographic and cancer-related characteristics of cancer survivors and types of FCGs’ employment changes in both primary- and post-treatment phases. Chi-square test was used to statistically test the association between survivors’ characteristics and changes in FCGs’ hours of labor force work in post-treatment phase. Separate multivariable logistic regression models were used to examine the relationship between cancer-related characteristics of participants and employment reduction patterns among FCGs in post-treatment phase while controlling for demographic factors. Results: In the primary-treatment phase, 45.6% of all FCGs reduced their working hours and 17.4% stopped working altogether. In the post-treatment phase, 25.2% of FCGs worked fewer hours and 6.6% left the workforce completely. The results show that a higher probability of change in employment hours among FCGs is associated with the following patient characteristics: having comorbidities, receiving chemotherapy treatment, limited ability to perform physical tasks, limited ability to perform mental tasks, and diagnosis of stage II of cancer. Conclusions: Care for cancer patients in both primary- and post- treatment phases may have substantial impacts on hours of formal employment of Chinese FCGs. Interventions helping FCGs balance caregiving duties with labor force work are warranted.
Quality of life of patients living with psoriasis: a qualitative study
Authors: Godoy Natalia , Meneguin Silmara , Pollo Camila Fernandes , Miot Helio Amante , Oliveira Cesar Messias
Published: November 2020

Background: Psoriasis is a multifactorial inflammatory disease prevalent in dermatology. We aimed to understand the perceptions of patients living with psoriasis in relation to their quality of life and to identify aspects to improve it.Methods: This is qualitative research carried out in a dermatology outpatient clinic of the São Paulo State University (UNESP) medical school, Botucatu, Brazil, with 81 psoriasis patients. The interviews were transcribed and analysed using the Discourse of the Collective Subject method (DCS).Results: Quality of life was linked to well-being, happiness, leisure, good food and financial stability. However, disease symptoms, social and clothing restrictions, impairment of professional activities and the absence of a cure, negatively influenced their perceptions. Suggestions for improvements included an increase of public awareness, stress reduction, disease acceptance and multidisciplinary care.Conclusion: The meanings of quality of life revealed by the participants are subjective, multidimensional, linked to moments experienced by them and to the health-disease process. Public health policies promoting reduction in social stigma and stress as well as multidisciplinary approaches towards care can contribute to improvements of QoL in psoriasis.
Transplanted embryonic retinal stem cells have the potential to repair the injured retina in mice
Authors: Feng Xia , Chen Peng , Zhao Xin , Wang Jing , Wang Hong
Published: November 2020

Background: Stem cell transplantation has been reported as one of the promising strategies to treat retinal degenerative diseases. But, the application and the role of retina stem cells (RSCs) in the treatment of patients with retinal degenerative diseases have not been fully revealed. This study aimed to investigate the potential role of transplantation of the embryo-derived RSCs into the vitreous cavity in repairing the damaged retina in mice. Methods: RSCs were isolated from Kunming mice E17 embryonic retina and ciliary body tissues, and labeled with 5-bromo-2’-deoxyuridin (BrdU). Retinal injury was induced in left eyes in male Kunming mice by ring clamping the optic nerve. The 6th-generation of BrdU-labeled RSCs were transplanted into the damaged retina by the intravitreal injection, and saline injected eyes were used as the control. Hematoxylin and eosin histological staining, and BrdU, Nestin and Pax6 immunostaining were performed. Electroretinogram (ERG) was used for assessing the electrical activity of the retina. Results: Embryo-derived RSCs were identified by the positive stains of Pax6 and Nestin. BrdU incorporation was detected in the majority of RSCs. The damaged retina showed cellular nuclear disintegration and fragmentation in the retinal tissue which progressed over the periods of clamping time, and decreased amplitudes of a and b waves in ERG. In the damaged retina with RSCs transplantation, the positive staining for BrdU, Pax6 and Nestin were revealed on the retinal surface. Notably, a small amount of RSCs migrated into the retinal ganglion cell layer and inner nuclear. Transplanted RSCs significantly elevated the amplitudes of a waves in retina injured eyes. Conclusions: Embryonic RSCs have similar characteristics to neural stem cells. Transplantation of RSCs by intravitreal injection would be able to repair the damaged retina.
Accessing the syndemic of COVID-19 and malaria intervention in Africa
Authors: Shi Benyun , Zheng Jinxin , Xia Shang , Lin Shan , Wang Xinyi , Liu Yang , Zhou Xiao-Nong , Liu Jiming
Published: November 2020

Background: The pandemic of the coronavirus disease 2019 (COVID-19) has caused substantial disruptions to health services in the low and middle-income countries with a high burden of other diseases, such as malaria in sub-Saharan Africa. The aim of this study is to assess the impact of COVID-19 pandemic on malaria transmission potential in malaria-endemic countries in Africa. Methods: We present a data-driven method to quantify the extent to which the COVID-19 pandemic, as well as various non-pharmaceutical interventions (NPIs), could lead to the change of malaria transmission potential in 2020. First, we adopt a particle Markov Chain Monte Carlo method to estimate epidemiological parameters in each country by fitting the time series of the cumulative number of reported COVID-19 cases. Then, we simulate the epidemic dynamics of COVID-19 under two groups of NPIs: (i) contact restriction and social distancing, and (ii) early identification and isolation of cases. Based on the simulated epidemic curves, we quantify the impact of COVID-19 epidemic and NPIs on the distribution of insecticide-treated nets (ITNs). Finally, by treating the total number of ITNs available in each country in 2020, we evaluate the negative effects of COVID-19 pandemic on malaria transmission potential based on the notion of vectorial capacity. Results: In this paper, we conduct case studies in four malaria-endemic countries, Ethiopia, Nigeria, Tanzania, and Zambia, in Africa. The epidemiological parameters (i.e., the basic reproduction number R_0 and the duration of infection D_I) of COVID-19 in each country are estimated as follows: Ethiopia (R_0=1.57, D_I=5.32), Nigeria (R_0=2.18, D_I=6.58), Tanzania (R_0=2.47, D_I=6.01), and Zambia (R_0=2.12, D_I=6.96). Based on the estimated epidemiological parameters, the epidemic curves simulated under various NPIs indicated that the earlier the interventions are implemented, the better the epidemic is controlled. Moreover, the effect of combined NPIs is better than contact restriction and social distancing only. By treating the total number of ITNs available in each country in 2020 as a baseline, our results show that even with stringent NPIs, malaria transmission potential will remain higher than expected in the second half of 2020. Conclusions: By quantifying the impact of various NPI response to the COVID-19 pandemic on malaria transmission potential, this study provides a way to jointly address the syndemic between COVID-19 and malaria in malaria-endemic countries in Africa. The results suggest that the early intervention of COVID-19 can effectively reduce the scale of the epidemic and mitigate its impact on malaria transmission potential. Keywords : COVID-19 pandemic; Non-pharmaceutical interventions; Particle Markov chain Monte Carlo; Insecticide-treated nets; Vectorial capacity; Malaria transmission potential
Assessing the routine-practice gap for home blood pressure monitoring among Chinese adults with hypertension
Authors: Zuo Hui-Juan , Ma Ji-Xiang , Wang Jin-Wen , Chen Xiao-Rong
Published: November 2020

Background: Home blood pressure monitoring (HBPM) is recommended for diagnosis, treatment adjustment and management of most hypertension cases in hypertension guidelines from multiple countries. This study aimed to evaluate HBPM behaviour and explore the routine-practice gap in HBPM among Chinese adults with hypertension. Methods: Data were collected from 20 communities across three cities and six townships in three provinces (Beijing, Shandong and Jiangsu) in China between October 2014 and November 2014. In total, 2,272 patients with hypertension aged ≥35 years that were registered with a primary health station in their local communities were selected by simple random sampling. Results: Among the 2,272 participants, 45.3% owned a home blood pressure (BP) monitor. In addition, 27.5% (625/2,272) engaged in HBPM weekly or more frequently. Healthcare providers’ advice was the strongest factor contributing to home BP monitor ownership and weekly HBPM behaviour, with odds ratios of 13.50 and 8.97, respectively. Approximately 4.4% of participants had achieved optimal HBPM regimens (duplicate measurements in the morning and evening for 7 days). Patients with uncontrolled office-measured BP were more likely to conduct HBPM regularly in the morning and evening, measure their BP two or three times in each session and maintain 7 consecutive days of HBPM than patients with controlled office BP (8.8% vs. 5.8%, P=0.042; 14.3% vs. 8.1%, P=0.002; and 19.9% vs. 12.4%, P=0.005, respectively). Only 16.0% (165/1,030) of participants actively reported their HBPM readings to doctors. Conclusion: The HBPM strategies specified in hypertension guidelines are seldom achieved in actual practice in China. Only a small proportion of patients actively participate in using HBPM to enhance their hypertension care. HBPM may be improved by healthcare providers offering specific advice and training.
A new candidate vaccine for human brucellosis based on influenza viral vectors: development of immunization schedule in guinea pig model
Authors: Bugybayeva Dina , Kydyrbayev Zhailaubay , Zinina Nadezhda , Assanzhanova Nurika , Yespembetov Bolat , Kozhamkulov Yerken , Zakarya Kunsulu , Ryskeldinova Sholpan , Tabynov Kaissar
Published: November 2020

Background: A new candidate vector vaccine against human brucellosis based on recombinant influenza viral vectors (rIVV) subtypes H5N1 expressing Brucella Omp16, L7/L12, Omp19 or Cu-Zn SOD proteins has been developed. This paper presents the results of the study of protection of the vaccine with various options of administering, dosing and frequency of use on guinea pigs.Methods: General states of guinea pigs was assessed based on , behavior and dynamics of a guinea pig weight-gain test. The effectiveness of the new anti-brucellosis vector vaccine was determined by studying its protective effect after conjunctival, intranasal and sublingual administration in doses 105 EID50, 106 EID50 and 107 EID50 during prime and boost vaccinations of animals, followed by challenge with a virulent strain of B. mellitensis 16M infection. For sake of comparison, the commercial B. melitensis Rev.1 vaccine was used as a control. The protective properties of vaccines were assessed by quantitation of Brucella colonization in organs and tissues of infected animals and compared to the control groups.Results: It was observed a gradual increase in body weight of guinea pigs after prime and booster immunization with the vaccine using conjunctival, intranasal and sublingual routes of administration, as well as after using various doses of vaccine. . The most optimal way of using the vaccine has been established: double intranasal immunization of guinea pigs at a dose of 106 EID50, which provides 80% protection of guinea pigs from B. melitensis 16M infection (P < 0.05), which is comparable to the results of the effectiveness of the commercial B. melitensis Rev.1 vaccine.Conclusions: We developed effective vaccine candidate against brucellosis and developed its immunization protocol in guinea pig model. We believe that this study is a substantial step for using the vaccine for future pre-clinical and clinical trials in human.
Aerobic and Resistance Exercise Improves Reynolds Risk Score in Overweight or Obese Breast Cancer Survivors
Authors: Lee Kyuwan , Sami Nathalie , Tripathy Debu , Demark-Wahnefried Wendy , Norris Mary K. , Courneya Kerry S. , Dieli-Conwright Christina
Published: November 2020

Background: Breast cancer survivors have double the risk of mortality from cardiovascular disease than age-matched women without a cancer history. Reynolds risk score (RRS) is a validated algorithm for the assessment of cardiovascular disease risk. This secondary analysis sought to examine the effects of a 16-week aerobic and resistance exercise intervention on RRS in overweight or obese breast cancer survivors. Methods and Results: One hundred overweight or obese (BMI>25kg/m2) breast cancer survivors were randomized to exercise or usual care. The exercise group underwent aerobic and resistance exercise sessions for 16 weeks. RRS was calculated using a validated equation. Group differences in mean change for RRS were evaluated using repeated-measures analyses of variance. Post-intervention, RRS was significantly reduced (7.9±0.9% to 1.0±0.5%, p<0.001) in the exercise group compared to a significant increase (9.0±0.8% to 11.6±1.2%; p=0.002%) in the usual care group (P<0.01). RRS was significantly reduced in exercise vs usual care (between group difference, -10.6; 95% CI, -16.3 to -7.4; p<0.001). Conclusion: A 16-week aerobic and resistance exercise intervention is an effective approach to reduce the risk of cardiovascular disease in breast cancer survivors. Exercise during cancer survivorship should be considered to reduce the risk for cardiovascular disease risk in overweight women breast cancer survivors.Trial registration: ClinicalTrials.gov: NCT01140282. Registered 9 June 2010, https://clinicaltrials.gov/ct2/show/NCT01140282?term=NCT01140282&draw=2&rank=1
Long-term body mass index changes in obese adults and the risk of heart failure, cardiovascular disease and mortality: a longitudinal study of 260,000 adults
Authors: Iyen Barbara , Weng Stephen , Vinogradova Yana , Akyea Ralph , Qureshi Nadeem , Kai Joe
Published: November 2020

Background: Although obesity is a well-recognised risk factor for cardiovascular disease (CVD), the impact of long-term body mass index (BMI) changes in overweight or obese adults, on the risk of heart failure, CVD and mortality has not been quantified. Methods: This population-based cohort study used routine UK primary care electronic health data linked to secondary care and death-registry records. We identified adults who were overweight or obese, free from CVD and who had repeated BMI measures. Using group-based trajectory modelling, we examined the BMI trajectories of these individuals and then determined incidence rates of CVD, heart failure and mortality associated with the different trajectories. Cox-proportional hazards regression determined hazards ratios for incident outcomes. Results: 264,230 individuals (mean age 49.5 years (SD 12.7) and mean BMI 33.8kg/m 2 (SD 6.1)) were followed-up for a median duration of 10.9 years. Four BMI trajectories were identified, corresponding at baseline, with World Health Organisation BMI classifications for overweight, class-1, class-2 and class-3 obesity respectively. In all four groups, there was a small, stable upwards trajectory in BMI (mean BMI increase of 1.06kg/m 2 (± 3.8)). Compared with overweight individuals, class-3 obese individuals had a 3.3-fold increased risk of heart failure (HR 3.26 (95% CI 2.98-3.57)), 2.7-fold increased risk of all-cause mortality (HR 2.72 (2.58-2.87)) and 3.3-fold increased risk of CVD-related mortality (HR 3.31 (2.84-3.86)) after adjusting for baseline demographic and cardiovascular risk factors. Conclusion: The majority of adults who are overweight or obese retain their degree of overweight or obesity over the long term. Individuals with stable severe obesity experience the worst heart failure, CVD and mortality outcomes. These findings highlight the high cardiovascular toll exacted by continuing failure to tackle obesity.
Physician-led prehospital management is associated with reduced mortality in severe blunt trauma patients: A retrospective analysis of the Japanese nationwide trauma registry
Authors: Endo Akira , Kojima Mitsuaki , Uchiyama Saya , Shiraishi Atsushi , Otomo Yasuhiro
Published: November 2020

Background: Although the results of previous studies suggested the effectiveness of physician-led prehospital trauma management, it has been uncertain because of the limited number of high-quality studies. Furthermore, the advantage of physician-led prehospital management might have been overestimated due to the shortened prehospital time by helicopter transportation in some studies. The present study aimed to evaluate the effect of physician-led prehospital management independent of prehospital time. Also, subgroup analysis was performed to explore the subpopulation that especially benefit from physician-led prehospital management. Methods: This retrospective cohort study analyzed the data of Japan’s nationwide trauma registry. Severe blunt trauma patients, defined by Injury Severity Score (ISS) ≥16, who were transported directly to a hospital between April 2009 and March 2019 were evaluated. In-hospital mortality was compared between groups dichotomized by the occupation of primary prehospital healthcare provider (i.e., physician or paramedic), using 1:4 propensity score-matched analysis. The propensity score was calculated using potential confounders including patient demographics, mechanism of injury, vital signs at the scene of injury, ISS, and total time from injury to hospital arrival. Subpopulations that especially benefit from physician-led prehospital management were explored by assessing interaction effects between physician-led prehospital management and patient characteristics. Results: A total of 30,551 patients (physician-led: 2,976, paramedic-led: 27,575) were eligible for analysis, of whom 2,690 propensity score-matched pairs (physician-led: 2,690, paramedic-led: 10,760) were generated and compared. Physician-led group showed significantly decreased in-hospital mortality than paramedic-led group (in-hospital mortality: 387 [14.4%] and 1,718 [16.0%]; odds ratio [95% confidence interval] = 0.88 [0.78–1.00], p = 0.044). Patients with age <65 years, ISS ≥25, Abbreviated Injury Scale in pelvis and lower extremities ≥3, and total prehospital time <60 min were likely to benefit from physician-led prehospital management. Conclusions: Physician-led prehospital trauma management was significantly associated with reduced in-hospital mortality independent of prehospital time. The findings of exploratory subgroup analysis would be useful for the future research to establish efficient dispatch system of physician team.
A SARS-CoV-2 neutralizing antibody with exceptional spike binding coverage and optimized therapeutic potentials
Authors: Guo Yu , Huang Lisu , Zhang Guangshun , Yao Yanfeng , Zhou He , Shen Shu , Shen Bingqing , Li Bo , Li Xin , Chen Mingjie , Chen Da , Wu Jia , Fu Dan , Zeng Xinxin , Feng Mingfang , Pi Chunjiang , Wang Yuan , Zhou Xingdong , Lu Minmin , Fang Yaohui , Lu Yun-Yueh , Hu Xue , Wang Shanshan , Zhang Wanju , Zhang Qian , Gao Ge , Adrian Francisco , Wang Qisheng , Yu Feng , Peng Yun , Gabibov Alexander , Min Juan , Wang Yuhui , Huang Heyu , Stepanov Alexey , Zhang Wei , Cai Yan , Liu Junwei , Yuan Zhi-Ming , Zhang Chen , Lou Zhiyong , Deng Fei , Zhang Hongkai , Shan Chao , Schweizer Liang , Sun Kun , Rao Zihe
Published: November 2020

The Coronavirus Disease of 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) threatens global public health and economy. Therapeutic options such as monoclonal antibodies (mAbs) against SARS-CoV-2 are in urgent need. We have identified potent monoclonal antibodies binding to SARS-CoV-2 Spike protein from COVID-19 convalescent patients and one of these antibodies, P4A1, interacts directly and covers the majority of the Receptor Binding Motif (RBM) of Spike receptor-binding domain (RBD), shown by high-resolution complex structure analysis. We further demonstrated P4A1 binding and neutralizing activities against wild type and mutant spike proteins. P4A1 was subsequently engineered to reduce the potential risk for antibody-dependent enhancement (ADE) of infection and to extend its half-life. The engineered mAb exhibits optimized pharmacokinetic and safety profile, and results in complete viral clearance in a rhesus monkey model of COVID-19 following a single injection.