bluuebunny/crossref_metadata_2025 huggingface dataset:
Why is tobacco control progress in Indonesia stalled? - A qualitative analysis of interviews with tobacco control experts
Authors: Astuti Putu Ayu Swandewi , Assunta Mary , Freeman Becky
Published: February 2020

Introduction Indonesia shoulders a significant tobacco burden, with almost two million cases of tobacco-related illnesses and more than two hundred thousand tobacco-related deaths annually. Indonesian tobacco control is progressing but lags behind other countries. Our study evaluates factors that contribute to the slow progress of tobacco policy change in Indonesia from the perspective of tobacco control experts (TCEs). Method We conducted qualitative interviews with four international and ten national TCEs, who have been active in tobacco control for at least 5 years. Our interview guideline included questions on the current tobacco control situation in Indonesia and explored reasons why tobacco control is progressing so slowly. The interviews were conducted either in English or Bahasa Indonesia, recorded and then transcribed verbatim. We conducted a thematic analysis based on five core causal factors for policy adoption: institutions, networks, socio-economic factors, agendas and ideas. Results and Discussion The multistage delay of tobacco policy adoption is principally due to political structures and policy hierarchy, complex bureaucracy, unclear roles and responsibilities, and a high degree of corruption. The low bargaining position and lack of respect for the Ministry of Health also contributes. There are contrasting frames of tobacco as a strategic economic asset and tobacco control as a sovereignty threat. There is an imbalance of power and influence between well entrenched and resourced tobacco industry networks compared to relatively young and less established tobacco control networks. The policy agenda is likely influenced by the privileged position of tobacco in Indonesia as a socially acceptable product with high consumption. There are constraints on transferring ideas and evidence to successful policy adoption. Conclusion Tobacco companies have substantially influenced both policy decisions and public perceptions, signifying a power imbalance within the government system and broader networks. Acceding to and enforcing the World Health Organization-Framework Convention on Tobacco Control (WHO-FCTC) would enable the Indonesian government to shift the power imbalance towards public health stakeholders. Tobacco control advocates must enhance their network cohesion and embrace other community groups to improve engagement and communication with policymakers.
Semi-supervised Method for Image Texture Classification of Pituitary Tumors via CycleGAN and Optimized Feature Extraction
Authors: ZHU Hong , FANG Qianhao , HUANG Yihe , XU Kai
Published: February 2020

Background: Accurately determining the softness level of pituitary tumors preoperatively by using their image textures can provide a basis for surgical options and prognosis. Existing methods for this problem require manual intervention, which could hinder the efficiency and accuracy considerably. Methods: we present an automatic method for diagnosing the texture of pituitary tumors using unbalanced sequence image data. Firstly, for the small sample problem in our pituitary tumor MRI image dataset where T1 and T2 sequence data are unbalanced (due to data missing) and under-sampled, our method uses a CycleGAN model for domain conversion to obtain fully sampled MRI spatial sequence. Then, it uses a DenseNet-ResNet based Autoencoder framework to optimize the feature extraction process for pituitary tumor image data. Finally, to take advantage of sequence data, it uses a CRNN model to classify pituitary tumors based on their predicted softness levels. Results: Experiments show that our method is the best in terms of efficiency and accuracy(91.78%) compared to other methods. Conclusions: We propose a semi-supervised method for grading pituitary tumor texture. This method can accurately determine the softness level of pituitary tumors, which provides convenience for surgical selection and prognosis, and improves the diagnostic efficiency of pituitary tumors.
Transcriptomic and metabolomic analysis provides insights into anthocyanin and pyocyanin accumulation in pear
Authors: Zhang Zhen , Tian Changping , Zhang Ya , Li Chenzhiyu , Li Xi , Yu Qiang , Wang Shuo , Wang Xinyu , Chen Xuesen , Feng Shouqian
Published: February 2020

Background Pear is one of the most important fruit crops worldwide. Anthocyanins and procyanidins (PAs) are important secondary metabolites that affect the appearance and nutritive quality of pear. However, few studies have focused on the molecular mechanism underlying anthocyanin and PA accumulation in pear . Results We conducted metabolome and transcriptome analyses to identify candidate genes involved in anthocyanin and PA accumulation in young fruits of the pear cultivar ‘Clapp Favorite’ (CF) and its red mutation cultivar ‘Red Clapp Favorite’ ( RCF ). Gene–metabolite correlation analyses revealed a ‘core set’ of 20 genes that were strongly correlated with 10 anthocyanin and seven PA metabolites. Of these, PcGSTF12 was confirmed to be involved in anthocyanin and PA accumulation by complementation of the tt19-7 Arabidopsis mutant. Interestingly, PcGSTF12 was found to be responsible for the accumulation of procyanidin A3, but not petunidin 3, 5-diglucoside, opposite to the function of AtGSTs in Arabidopsis . Transformation with PcGSTF12 greatly promoted or repressed genes involved in anthocyanin and PA biosynthesis, regulation, and transport. Electrophoretic mobility shift and luciferase reporter assays confirmed positive regulation of PcGSTF12 by PcMYB114 . Conclusion These findings identify a core set of genes for anthocyanin and PA accumulation in pear. Of these, PcGSTF12 , was confirmed to be involved in anthocyanin and PA accumulation. Our results also identified an important anthocyanin and PA regulation node comprising two core genes, PcGSTF12 and PcMYB114 . These results provide novel insights into anthocyanin and PA accumulation in pear and represent a valuable data set to guide future functional studies and pear breeding.
Transcriptome co-expression network analysis identifies key genes and regulators of ripening kiwifruit ester biosynthesis
Authors: Zhang Aidi , Zhang Qiuyun , Li Jianzhao , Gong Hansheng , Fan Xinguang , Yang Yanqing , Liu Xiaofen , Yin Xueren
Published: February 2020

Background: Aroma is an important organoleptic quality for fruit and has a large influence on consumer preference. Kiwifruit esters undergo rapid and substantial changes contributing to the flavor during fruit ripening. Part of enzymes and their coding genes have been indicated potential candidates for flavor-related esters synthesis. However, there still exist obvious gaps in the biosynthetic pathways of esters and the mechanisms regulating ester biosynthesis in kiwifruit remain unknown. Results: Using gas chromatography-mass spectrometry (GC-MS), volatile compounds of kiwifruit were quantified in response to ethylene (ETH, 100 µl/l, 24 h, 20 °C) and 1-methylcyclopropene (1-MCP, 1 µl/l, 24 h, 20 °C). The results indicated that esters showed the most substantial changes enhanced by ethylene and were inhibited by 1-MCP. Correlations between RNA-seq results and concentrations of esters, constructed using Weighted Gene Co-Expression Network Analysis (WGCNA) indicated that three structural genes (fatty acid desaturase, AdFAD1 ; aldehyde dehydrogenase, AdALDH2 ; alcohol acyltransferase, AdAT17 ) had similar expression patterns that paralled the changes in total ester content, and AdFAD1 transcripts exhibited the highest correlation. In order to search for potential regulators for ester biosynthesis, 14 previously reported ethylene-responsive transcription factors (TFs) were included in the correlation analysis with esters and their biosynthetic genes. Using dual-luciferase assay, the in vivo regulatory activities of TFs on ester biosynthetic gene promoters were investigated and the results indicated that AdNAC5 and AdDof4 (DNA binding with one finger) trans-activated and trans-suppressed the AdFAD1 promoter. Conclusions: The present study advanced the molecular basis of ripening-related ester biosynthesis in kiwifruit by identifying three biosynthetic related genes AdFAD1 , AdALDH2 and AdAT17 by transcriptome analysis, and highlighted the function of two TFs by transactivation studies.
Associations of leptin and adiponectin with incident type 2 diabetes and interactions among African Americans: the Jackson Heart Study
Authors: Bidulescu Aurelian , Dinh Paul C. , Sarwary Shabir , Forsyth Emily , Luetke Maya C. , King David B. , Liu Jiankang , Davis Sharon K. , Correa Adolfo
Published: February 2020

Background:
Growing evidence suggests that leptin is critical for glycemic control. Impaired leptin signaling may also contribute to low adiponectin expression in obese individuals. We assessed the association of leptin and adiponectin with incident type 2 diabetes (T2D), their interactions with sex and obesity status, and mediation by insulin resistance.
Methods:
We included study participants from the Jackson Heart Study, a prospective cohort of adult African Americans in Jackson, Mississippi, that were free of T2D at the baseline Exam 1. Incident T2D was defined as new cases at Exam 2 or Exam 3. We created separate Cox regression models (hazard ratios per log-transformed ng/mL of leptin and adiponectin) with and without insulin resistance, HOMA-IR. Mediation by insulin resistance was analyzed. Several interactions were assessed, including by sex, HbA1c, and obesity.
Results:
Among our 3,363 participants (mean age 53 years, 63% women), 584 developed incident T2D. Leptin was directly associated with incident T2D when modeled without HOMA-IR (HR=1.29, 95% CI=1.05-1.58). This direct association between leptin and T2D was significant among men (HR=1.33, 95% CI=1.05-1.69), but nonsignificant among women (HR=1.24, 95% CI=0.94-1.64); statistical interaction with sex was nonsignificant (p=0.65). The associations in all participants and in men were nullified by HOMA-IR (HR=0.99, 95% CI=0.80-1.22; HR=1.00, 95% CI=0.78-1.28, respectively), indicating mediation through insulin resistance (proportion mediated: 1.04), and were not observed in abdominally obese participants. Adiponectin was inversely associated with T2D even after adjustment for HOMA-IR in women (HR=0.68, 95% CI=0.55-0.84), but not in men (HR=0.80, 95% CI=0.62-1.04). The inverse association was present only among abdominally obese participants, and persisted after adjustment for HOMA-IR.
Conclusions:
Among African Americans in the Jackson Heart Study the association of leptin with incident type 2 diabetes was explained by HOMA-IR. The association of leptin and incident T2D was mediated by insulin resistance and present only among abdominally non-obese. Differences by sex appeared: men showed a significant association mediated by insulin resistance. Among abdominally obese participants, adiponectin was inversely associated with incident T2D even after adjustment for HOMA-IR.
Concentrations of 137Cs radiocaesium in the organs and tissues of low-dose-exposed wild Japanese monkeys
Authors: Omi Toshinori , Nakiri Sachie , Nakanishi Setsuko , Ishii Naomi , Uno Taiki , Konno Fumiharu , Inagaki Takeshi , Sakamoto Atsushi , Shito Masayuki , Udagawa Chihiro , Tada Naomi , Ochiai Kazuhiko , Kato Takuya , Kawamoto Yoshi , Tsuchida Shuichi , Hayama Shin-ichi
Published: February 2020

Objectives
Following the massive earthquake that struck eastern Japan on March 11, 2011, a large amount of radioactive material was released into the environment from the damaged reactor of the Fukushima Daiichi Nuclear Power Plant (FDNPP). After the FDNPP accident, radiocaesium was first detected in muscle samples from wild Japanese monkeys exposed to radioactive materials, and haematologic effects, changes in head size, and delayed body weight gain were also reported, but little is known about the distribution of 137 Cs in the organs and tissues of wild Japanese monkeys.
Results
We detected the 137 Cs in various organ and tissue samples of 10 wild Japanese monkeys inhabiting the forested areas of Fukushima City that were captured between July and August 2012.Among muscle, brain, heart, kidney, liver, lung, and spleen, muscle exhibited the highest and the brain the lowest 137 Cs concentration. The concentration (mean±SD) of 137 Cs in muscle, brain, heart, kidney, liver, lung, and spleen was 77 ± 66, 26 ± 22, 41 ± 35, 49 ± 41, 41 ± 38, 53 ± 41, and 53 ± 51 Bq/kg, respectively.These results can help us understand the biological effects of long-term internal radiation exposure in non-human primates.
Genetic testing for the diagnosis and classification of joint hypermobility: a case report of 15 patients
Authors: Zeng Lanlan , Zhang Li , Linpeng Siyuan , Li Zhuo , Liang Desheng , Wu lingqian
Published: February 2020

The authors have withdrawn this preprint from Research Square.
Physiological evidence that three known mutations in the para-sodium channel gene confer cypermethrin knockdown resistance in Rhipicephalus microplus
Authors: Cossío-Bayúgar Raquel , Miranda-Miranda Estefan , Ibañez Francisco Martínez , Padilla Verónica Narváez , Reynaud Enrique
Published: February 2020

Background: Acaricide resistance is a central problem for the control of the cattle tick Rhipicephalus microplus. Genetic changes that confer resistance get fixed in the population, however, the physiological effects and phenotypes of these mutations are not always well understood or characterized. SNPs in the para-sodium channel gene that confer cypermethrin knockdown resistance (kdr) were identified in several arthropods, and homologous mutations have been reported in R. microplus populations. To our knowledge, R. microplus populations that have these homologous SNPs have been associated and correlated with pyrethroid resistance but there is no direct physiological evidence that their presence does confer kdr in this organism. Methods: Resistance profiles from resistant and susceptible strains used in this work were obtained using the larval packet discriminating dose assay. The relevant genomic regions of the para-sodium channel of these strains were amplified using standard PCR; SNPs were detected by sequencing the corresponding amplicons. Ovary response to cypermethrin was evaluated using videometrical analysis.Results: In this work we present historical evidence that the pyrethroid resistance trait is stable in a resistant reference strain after many years without selection, thus suggesting that the primary resistance mechanism is caused by mutations fixed in the population. In our experimental system, ovary contraction resistance to pyrethroids is likely to be mediated by a change in the structure of the presynaptic para-sodium channel. We found that the resistant strain has the G184C, the C190A and the T2134A mutations in the para-sodium channel gene. SNPs G184C and T2134A have been reported to be genetically linked in resistant populations and are always found together. These mutations were confirmed to be absent in the susceptible strain used as control. Finally, using videometric analysis, we demonstrate that cypermethrin blocks ovary contraction from cypermethrin-susceptible ticks. We also show that ovaries from populations that carry the kdr associated SNPs still contract at cypermethrin concentrations that completely block susceptible ovary contraction. The configuration of the experimental system excludes a xenobiotic detoxification mechanism. Conclusions: This is the first report that presents physiological evidence that the G184C, the C190A, and the T2134A mutations in the para-sodium channel have a phenotype in R. microplus. These results confirm that these SNPs confer cypermethrin resistance in this organism by avoiding presynaptic blockage that in turn cause flaccid muscle paralysis that is characteristic of this acaricide. This work also demonstrates that the videometric assay that we previously validated can be used to rapidly detect kdr-like cypermethrin resistant tick strains.
Effects of toner-handling work on respiratory function, chest X-ray findings, and biomarkers of inflammation, allergy, and oxidative stress: a prospective Japanese cohort study from 2003 to 2013
Authors: Terunuma Niina , Ikegami Kazunori , Kitamura Hiroko , Ando Hajime , Kurosaki Shizuka , Masuda Masashi , Kochi Takeshi , Yanagi Nobuaki , Fujino Yoshihisa , Ogami Akira , Higashi Toshiaki
Published: February 2020

Background: Exposure to toner, a substance used in photocopiers and printers, has been associated with siderosilicosis and other adverse effects. However, these findings are limited, and there is insufficient evidence on the long-term effects of toner exposure. Using longitudinal analysis, this study aimed to examine the effects of work involving toner exposure on the respiratory system over time.Methods: We conducted a prospective cohort study in a Japanese toner and copier manufacturing enterprise between 2003 and 2013. The cohort included a total of 1468 workers, which comprised 887 toner-handling workers and 581 non-toner-handling workers. We subdivided the toner-handling workers into two groups according to the toner exposure concentration, based on the baseline survey in 2003. We compared the chest X-ray results, respiratory function indicators, and serum and urinary biomarkers of inflammation, allergy, and oxidative stress among three groups: high-concentration toner exposure group, low-concentration toner exposure group, and non-toner-handling group. To consider the effects of individual differences on longitudinal data, we used a linear mixed model.Results: The chest X-ray results and most of the biomarkers and respiratory function indicators were similar for the non-toner-handling and toner-handling groups. There were no significant yearly changes in the percentage of vital capacity (%VC) and peak expiratory flow rate (PEFR) in the high-concentration toner exposure group, while there was a significant yearly increase in %VC and PEFR in the low-concentration toner exposure group and non-toner-handling group. Regarding interleukin-8, we did not observe a significant yearly change in the toner-handling group but observed a significant yearly increase of 0.1 pg/ml in the non-toner-handling group.Conclusions: Toner-handling work was not associated with the deterioration of respiratory function and an increase in biomarker values for inflammation, allergy, and oxidative stress. This finding suggests that toner-handling work is irrelevant to the onset of respiratory disease and has minimal adverse effects on the respiratory system under the well-managed work environment.
Clinical Features and Prognosis of Gas-forming and Non-gas-forming Pyogenic Liver Abscess: A Comparative Study
Authors: Zhang Jia , Gao Yi , Du Zhaoqing , Ren Yifan , Bi Jianbin , Wu Zheng , Lv Yi , Wu Rongqian
Published: February 2020

Background

Gas-forming pyogenic liver abscess (GFPLA) accounts for up to 30% of all pyogenic liver abscess (PLA) cases. However, little is known of the differences in clinical features and prognosis between GFPLA and non-GFPLA.

Aim

This retrospective study compared the clinical features and prognosis of GFPLA and non-GFPLA.

Methods

Data of 392 patients with PLA treated from 1 January 2007 to 31 December 2016 were reviewed. GFPLA was defined as gas in the abscess. Liver abscesses were considered non- GFPLA (n = 326) or GFPLA (n = 66). The clinical features and outcomes of patients with GFPLA were compared relative to that of patients without GFPLA.

Results

The groups were similar in gender ratio, age, smoking, drinking, and coexistences. Klebsiella pneumoniae was the most common pathogenic bacteria, but the negative rate of bacterial culture of the non-GFPLA group was significantly higher than that of the GFPLA, and the GFPLA group had a significantly higher rate of previous abdominal surgery, especially hepatobiliary surgery. Compared with the non-GFPLA group, the percentage of the GFPLA group with antibiotics combined with percutaneous drainage was significantly higher, while the percentages given antibiotics alone and antibiotics combined with surgical drainage were significantly lower. GFPLA patients had significantly higher rates of sepsis and pleural effusion, and longer hospital stays than did non-GFPLA patients. No patient died during hospitalization.

Conclusions

GFPLA is associated with past abdominal surgery, especially hepatobiliary surgery. Patients with a history of abdominal surgery should be monitored more closely in the early stage of the PLA. GFPLA has high rates of sepsis and long hospitalization. It needs to be recognized as a distinct clinical entity.
Physical Work and Exercise Reduce the Risk of Cognitive Impairment in Rural Older Adults: A Population-based Longitudinal Study
Authors: He Fan , Lin Junfen , Li Fudong , Zhai Yujia , Zhang Tao , Gu Xue , Zhao Genming
Published: February 2020

Background: The effect of physical work on the risk of cognitive impairment in Chinese older adults living in rural areas remains to be elucidated. We investigated whether physical work and exercise can reduce the risk of cognitive impairment. Methods: We collected data from 7,000 individuals without cognitive impairment (age ≥60 years) over a follow-up period of 2 years. The Chinese version of the Mini-Mental State Examination was used to assess cognitive function, and the multivariable Cox regression model was used to identify associations between physical work/exercise and cognitive impairment. Results: Over a median follow-up period of 1.93 years, 1,224 (17.5%) of 7,000 participants developed cognitive impairment, with a total incidence of 97.69 per 1,000 person-years. Participation in physical work (hazard ratio [HR]: 0.66; 95% confidence interval [CI], 0.55-0.78) or exercise (HR: 0.76; 95% CI, 0.62-0.93) was associated with a reduced risk of cognitive impairment. Agricultural work (HR: 0.60; 95% CI, 0.49-0.73) and walking/tai chi (HR: 0.75; 95% CI, 0.60-0.93) exerted significant protective effects against cognitive impairment. Conclusions: Physical work and exercise can reduce the risk of cognitive impairment in older adults. Reasonable types and appropriate intensities of physical activity are recommended to prevent or delay the progression of cognitive impairment.
Suicidality Among Young Adolescents in Secondary Schools in Hong Kong
Authors: Cheung Teris , Fong Daniel Y. T. , Fan Susan , Fong Tommy K.H. , Yip Paul
Published: February 2020

Background:Despite concerted effort in suicide research and prevention across countries, youth suicide remains a significant public health concern in Hong Kong and nationwide. This study examined the prevalence and correlates of suicidality among secondary school students in Hong Kong. Methods:Data were derived from the 2016 Youth Sexuality Survey initiated by the Family Planning Association of Hong Kong using a stratified random sample of 3,672 secondary school students aged 12 to 18 years in Hong Kong. Suicidality was measured in four progressive levels (suicidal ideation, suicidal plan, suicidal attempts and suicidal attempts requiring medical attention). Multivariable cumulative logit model analysis was used to identify significant risk factors of suicidality.Results:Female students reported more suicidality than their male counterparts (28.0% versus 17.0%, respectively). Multivariable cumulative logit model analysis showed that female gender, age, unhappy school life, disharmony with classmates, unhappy family life, living with mother, acceptance of mothers’ discipline, not sleeping for more than 9 hours on weekdays, alcohol consumption, non-suicidal self-injury, and dissatisfaction with life were significantly associated with suicidality. Limitations:Due to cross-sectional design, causality between suicidality, individual psychosocial and psychological characteristics cannot be established.Conclusions:Suicidal behaviour among Chinese young adolescents remains prevalent in Hong Kong. Family disintegration, school-related problems, and life satisfaction are significant predictors of suicidal behaviour in this study. There is a pressing need to restore optimal mental health among youth adolescents via interdisciplinary collaboration among schools, healthcare providers, stakeholders and mental health experts. The involvement of stakeholders in the community in suicide research and prevention is pivotal in mental health promotion for young adolescents.
The Healthy Eating Plate advice for Migraine prevention: an interventional study
Authors: Altamura Claudia , Cecchi Gianluca , Bravo Maria , Laudisio Alice , Caprio Paola Di , Brunelli Nicoletta , Botti Giorgia , Paolucci Matteo , Khazrai Yeganeh Manon , Vernieri Fabrizio
Published: February 2020

Background: migraine is a chronic neurological disorder with a high social impact. Several diets have been proposed to help managing migraine, with different outcomes. We aimed at evaluating the effect of education on the Healthy Eating Plate on migraine frequency and disability.Methods: 240 consecutive people with migraine (18 – 72-year old, 84.5% female) were screened for participation in this interventional study. Migraine was diagnosed according to the International Classification of Headache Disorders. At three times of observation (screening = T-12, 12 weeks before the intervention; baseline = T0, time of educational intervention; and follow-up = T12, after 12 weeks from baseline) the enrolled people affected by migraine underwent anthropometric measurement, dietary patterns assessment, and migraine frequency and related disability evaluation (MIDAS, MIDAS A, MIDAS B). At T0 all enrolled people were educated about the Healthy Eating Plate by a nutritionist. The Healthy Eating Plate score was created to assess adherence to the dietary advice.Results; 204 people with migraine were enrolled in the study, of these 119 people were still eligible at T0 while 97 people completed the evaluations at T12. From T0 to T12 we observed a reduction in body mass index and in monthly migraine days in the three months before the last evaluation (MIDAS A). People presenting a reduction of at least 30% in monthly migraine days were classified as responders. Responders significantly presented a reduction in red and processed meats and carb intake compared with non-responders. In addition, the Healthy Eating Plate scores were significantly higher in responders compared to non-responders, while no difference was observed for body mass index. The modification in carb consumption was also related to the variation in perceived disability (MIDAS score, ρ = 0.372 with p <0.0001) and in headache pain intensity (MIDAS B, ρ = 0.220, p=0.033). Binary logistic regression confirmed the main effect of the Healthy Eating Plate score increase and total carb decrease on the responder state.Conclusions This longitudinal study showed that adherence to the healthy eating plate advice, particularly the indication to reduce carb and red and processed meat consumption, is useful in migraine management, reducing monthly migraine days and disability.Trial registration: ISRCTN, ISRCTN14092914. Registered 14 February 2020 - Retrospectively registered, http://www.isrctn.com/ISRCTN14092914
Breadth of concomitant immune responses underpinning viral clearance and patient recovery in a non-severe case of COVID-19
Authors: Thevarajan Irani , Nguyen Thi HO , Koutsakos Marios , Druce Julian , Caly Leon , de Sandt Carolien E van , Jia Xiaoxiao , Nicholson Suellen , Catton Mike , Cowie Benjamin , Tong Steven YC , Lewin Sharon R , Kedzierska Katherine
Published: February 2020

We report the kinetics of the immune response in relation to clinical and virological features of a patient with mild-to-moderate coronavirus disease-19 (COVID-19) requiring hospitalisation. Increased antibody-secreting cells, follicular T-helper cells, activated CD4+ and CD8+ T-cells and IgM/IgG SARS-CoV-2-binding antibodies were detected in blood, prior to symptomatic recovery. These immunological changes persisted for at least 7 days following full resolution of symptoms, indicating substantial anti-viral immunity in this non-severe COVID-19.Authors Irani Thevarajan and Thi HO Nguyen contributed equally to this work.
Next generation sequencing of RB1gene for the molecular diagnosis of ethnic minority with retinoblastoma in Yunnan
Authors: Gu Huaiyu , Zhang Zhen , Xiao Yi-shuang , Shen Ru , Jiang Hong-chao , Tang Li , Li Ren-qu , Yang Xiao-hong , Gu Huai-yu , He Wen-Ji , Ma Jing
Published: February 2020

Background: Retinoblastoma is a rare intraocular malignancy and typically initiated by inactivating biallelic mutations of RB1 gene. Each year, ~8,000 children worldwide are diagnosed for retinoblastoma. In high-income countries, patient survival is over 95% while low-income countries is ~30%.If disease is diagnosed early and treated in centers specializing in retinoblastoma, the survival might exceed 95% and many eyes could be safely treated and support a lifetime of good vision. In China, approximate 1,100 newly diagnosed cases are expected annually and 28 hospitals covering 25 provinces established centers classified by expertise and resources for better treatment options and follow-up. Comparing with other province of eastern China, Yunnan province is remote geographically. This might result that healthcare staff have low awareness of the role of genetic testing in management and screening in families.Methods: The patients with retinoblastoma were selected in Yunnan. DNA from blood was used for targeted gene sequencing. Then, an in-house bioinformatics pipeline was done to detect both single nucleotide variants and small insertions/deletions. The pathogenic mutations were identified and further confirmed by conventional methods and cosegregation in families.Results: Using our approach, targeted next generation sequencing was used to detect the mutation of these 12 probands. Bioinformatic predictions showed that nine mutations were found in our study and four were novel pathogenic variants in these nine mutations.Conclusions: It’s the first report to describe RB1 mutations in Yunnan children with retinoblastoma. This study would improve role of genetic testing for management and family screening.
Respiratory, birth and health economic measures for use with Indigenous Australian infants in a research trial: A modified Delphi with an Indigenous panel
Authors: Perkes Sarah Jane , Bonevski Billie , Mattes Joerg , Hall Kerry , Gould Gillian
Published: February 2020

Background: There is significant disparity between the respiratory health of Indigenous and non-Indigenous Australian infants. There is no culturally accepted measure to collect respiratory health outcomes in Indigenous infants. The aim of this study was to gain end user and expert consensus on the most relevant and acceptable respiratory and birth measures for Indigenous infants at birth, between birth and 6 months, and at 6 months of age follow-up for use in a research trial. Methods: A three round modified Delphi process was conducted from February 2018 to April 2019. Eight Indigenous panel members, and 18 Indigenous women participated. Items reached consensus if 7/8 (≥80 %) panel members indicated the item was ‘very essential’. Qualitative responses by Indigenous women and the panel were used to modify the 6 months of age surveys. Results: In total, 15 items for birth, 48 items from 1 to 6 months, and five potential questionnaires for use at 6 months of age were considered. Of those, 15 measures for birth were accepted, i.e., gestational age, birth weight, Neonatal Intensive Care Unit (NICU) admissions, length, head circumference, sex, Apgar score, substance use, cord blood gas values, labour, birth type, health of the mother, number people living in the home, education of mother and place of residence. Seventeen measures from 1-to 6 months of age were accepted, i.e., acute respiratory symptoms (7), general health items (2), health care utilisation (6), exposure to tobacco smoke (1) and breastfeeding status (1). Three questionnaires for use at 6 months of age were accepted, i.e., a shortened 33-item respiratory questionnaire, a clinical history survey and a developmental questionnaire. Conclusions: In a modified Delphi process with an Indigenous panel, measures and items were proposed for use to assess respiratory, birth and health economic outcomes in Indigenous Australian infants between birth and 6 months of age. This initial step can be used to develop a set of relevant and acceptable measures to report respiratory illness and birth outcomes in community based Indigenous infants.
Acute pain management in patients with opiate maintenance treatment in primary care: a qualitative study
Authors: landreat morgane guillou , Baillot Melia , Delphine Le Goff , Yves Le Reste Jean
Published: February 2020

Background: Opiate use disorders are a worldwide disease. In the last 30 years, opiate maintenance treatment prescription changed patients’ and also changed physicians’ practice. General practitioners (GPs) have to deal with patients on OMT who are in acute pain. Both clinically and pharmacologically, the treatment of acute pain in patients with an opiate use disorder and an OMT(opiate maintenance treatment) differs from that given to patients with other conditions. As this situation is complex, it was important to explore whether GPs recognised this problem and whether they managed it effectively.Objective: To investigate how GPs identify and manage situations of acute pain in patients with opiate use disorders and OMT. Methods: semi-structured interviews were used as a data collection technique with a purposive sample of practising GPs. Data collection continued until saturation was reached. Analysis was undertaken using a thematic analysis method. Two independent researchers, working blind and pooling data, carried out the analysis. Results: The maximal variation of the sample and saturation of data were reached with 11 GPs. The thematic analysis resulted in 4 main themes: (1) the importance and difficulties of professional links , (2) the specific clinical reasoning , (3) the importance of the doctor-patient relationship and (4) the particular characteristics of OMT patients. Conclusion: The complexity of pain and opioid dependence represents significant challenges for GPs. It is hard to achieve a balance between pain relief and opiate use disorder treatment. These questions are particularly important in general practice, where the practitioner may feel insufficiently trained, and isolated. Existing protocols do not seem to be in line with general practice. The number of patients on OMT has increased since it was first marketed; GPs will increasingly have to deal with these situations and will have to issue their own recommendations.
Patient’s travel distance to specialised cancer diagnostics and the association with the general practitioner’s diagnostic strategy and satisfaction with the access to diagnostic procedures: an observational study in Denmark
Authors: Virgilsen Line Flytkjær , Hvidberg Line , Vedsted Peter
Published: February 2020

Background: Patients with cancer often consult their general practitioner (GP) prior to the diagnosis. Thus, actions taken by the GP are crucial for optimisation of cancer care. This study aimed to investigate the association between cancer patient’s travel distance to the first specialised diagnostic investigation and the GP’s diagnostic strategy and satisfaction with the waiting time and the availability of diagnostic investigations.Method: This combined questionnaire- and registry-based study included incident cancer patients diagnosed in the last six months of 2016 where the GP had been involved in the diagnostic process of the patients prior to their diagnosis of cancer (n=3,455). The patient’s travel distance to the first specialised diagnostic investigation was calculated by ArcGIS Network Analyst. The diagnostic strategy of the GP and the GP’s satisfaction with the waiting times and the available investigations were assessed from GP questionnaires. Results: The patient’s travel distance to the first specialised diagnostic investigation was not associated with the diagnostic strategy of the GP. However, when the GP did not suspect cancer or serious illness, a tendency was seen that longer travel distance to the first specialised diagnostic investigation increased the likelihood of the GP using ’wait-and-see’ approach and ’medical treatment’ as diagnostic strategies. The GPs of patients with travel distance longer than 49 kilometres to the first specialised diagnostic investigation were more likely to report dissatisfaction with the waiting time for requested diagnostic investigations (PRR: 1.98, 95% CI: 1.20-3.28).Conclusion: A tendency to use ‘wait-and-see’ and ‘medical treatment’ were more likely in GPs of patients with long travel distance to the first diagnostic investigation when the GP did not suspect cancer or serious illness. Long distance was associated with higher probability of GP dissatisfaction with the waiting time for diagnostic investigations.
Developing an E-Platform for Monitoring Wellbeing in Schools: Involving Young People in Setting the Research Agenda.
Authors: Grant Claire Ellen , Widnall Emily , Cross Lauren , Simonoff Emily , Downs Johnny
Published: February 2020

Background : The use of new technologies and methodologies in young people’s mental health research is needed to allow more frequent and reliable sampling. Mobile applications and e-platforms create exciting potential for the collection of large-scale cohort data, however there are various feasibility and ethical issues to consider. Consultation with young people is needed to inform the research agenda, and ensure these technologies are engaging, useful and safe. This article describes the process of Public and Patient Involvement (PPI) with a sample of young people in London, with the aim of i) informing the development of a mood-monitoring e-platform, and ii) providing feedback and advice for researchers developing web-based technologies in the mental health field. Methods : A total of 26 young people were consulted across four advisory group sessions. All young people were students enrolled at one of the participating London based sixth form colleges, and voluntarily attended a workshop session. Audio recordings of the sessions were analysed using a theory driven thematic analysis framework. Results: Young people were generally receptive to e-health technologies and valued the opportunity to collaborate throughout the development process. The advisory groups identified key considerations for future web-development work to encourage engagement and prolonged use, including, the promotion of trust and transparency, consideration of accessibility, provision of support, production of engaging and functional design, and acknowledgment of specific contextual influences surrounding young people’s wellbeing. Conclusions : Involving young people in the development process of e-health technologies contributes to optimising the successful adoption and prolonged usage of new methodologies. The thematic map outlines can be used to inform researchers interested in developing web-based technologies in the mental health field and will be directly applicable to the development of a mood-monitoring e-platform.
Understanding the impact of a new Pharmacy Sore throat Test and Treat service on patient experience: A quantitative study
Authors: Mantzourani Efi , Cannings-John Rebecca , Evans Andrew , Ahmed Haroon , Meudell Alan , Hill Ian , Williams Emma , Way Cheryl , Hood Kerenza , Legay Benjamin , Houldcroft Laura , Deslandes Rhian
Published: February 2020

Background : A pilot of the first NHS funded Sore Throat Test and Treat (STTT) service in the United Kingdom began in selected community pharmacies in Wales in November 2018. The aim of this research was to explore whether a pharmacist delivering consultation for sore throat that included clinical scoring and point-of-care testing was acceptable to patients, and how this might influence future health-seeking behaviour for subsequent sore-throats. Methods : Quantitative research was employed, with a non-experimental design using a survey research tool including a mix of closed and open questions, developed in collaboration with members of the public. The patient experience survey was distributed to all patients who had completed a consultation between November 2018 and May 2019. Data from completed surveys were entered in Jisc Online Surveys® and exported to Excel® for descriptive statistics. Free-text comments were analysed using content and inductive thematic analysis. Results : A total of 510 surveys were received from 2,839 sore throat consultations (response rate 18%). Overall, 501 patients (98%) were satisfied with the service. Patients’ confidence in managing their condition and service satisfaction was not dependent on having been supplied antibiotics. A total of 343 patients (67%) requested a GP appointment but were offered to a consultation in the pharmacy. After the service, 504 patients (99%) stated that they would return to the pharmacy for subsequent sore throat symptoms. Inductive analysis of free-text comments (n=242) revealed 3 themes: convenience and accessibility; professionalism of pharmacy team; and perceived value of the service. Conclusions : Results confirmed high levels of patient satisfaction with the new service, the way it was delivered and the increased choice of options for sore throat symptom management it offered. Whilst this research can only discuss patients’ reported future behaviour, the patient-reported stated intentions signify a potential shift in health-seeking behaviour towards a pharmacist-led service. This has important implications in supporting the long term plan of the governments in Wales and England to redirect management of uncomplicated conditions from GPs to pharmacies.
Supplementation of c-type natriuretic peptide during the whole in vitro growth period benefits the development of murine secondary follicles
Authors: Li Ang , Cao Haixia , Li Hongxia , Li Ruijiao , Wang Huaixiu , Guo Xingping
Published: February 2020

Background: Supplementation of c-type natriuretic peptide (CNP) in the culture medium shortly before in vitro maturation (IVM) has been reported to be effective in delaying meiotic resumption of murine oocyte. The present study investigated the effect of CNP supplementation during the whole period of in vitro growth (IVG) on the development of murine secondary ovarian follicles.Methods: Late secondary ovarian follicles isolated from ovaries of Kunming mice were cultured in vitro with and without supplementation of CNP. In experiment 1, CNP was supplemented at the early stage and the follicle development was evaluated. In experiment 2 and 3, CNP was supplemented during the whole period of IVG. In experiment 2, follicle development and oocyte maturity were evaluated. In group 3, follicle development and rate of cleaved embryos after in vitro fertilization (IVF) was assessed.Results: In control group in all 3 experiments, granulosa cells migrated from within follicle and adhered to the plate at different degrees. The follicles flattened and could not reach antral stage. About 39.8% (39/98) of the oocytes ovulated nakedly. As no antral follicle was obtained, IVF was not performed in control group in experiment 3. In experiment group in all 3 experiments, no migration of guanulosa cells was observed and the follicles grew three-dimensionally. Ovulation of naked oocyte decreased substantially. The rate of antral stage follicle were 45% (18/40) in experiment 1. This parameter was 75.9% (44/58) in experiment 2 and 3 combined. In experiment 2, in preovulatory follicles without ovulation induction, oocytes at germinal vesicle (GV) stage and germinal vesicle breakdown (GVBD) stage were 87.5% (14/16) and 12.5% (2/16), respectively. In preovulatory follicles with ovulation induction, no GV stage oocyte was retrieved, oocytes at GVBD and metaphase II (MII) stage were 50% (8/16), respectively. In experiment 3, among 18 follicles cultured, 12 cumulus-oocyte complexes (COC) ovulated automatically after ovulation induction. Eleven oocytes were fertilized and cleaved. Compared with control groups, the follicle development assessed by naked oocyte ovulation and follicle stage (preantral follicle and antral follicle) in experiment groups were significantly superior (p<0.0001). CNP effectively maintained oocytes’ meiotic arrest and enhanced fertilization competency.Conclusions: The supplementation of CNP in culture system of murine late secondary follicle during the whole period of IVG could sustain the 3-dimensional structure of follicle, increase the antral formation rate. As a result, the oocyte’s competency to be fertilized was greatly improved.
LIF level is a predictive marker for clinical pregnancy following IVF-ET of patients with fallopian tube obstruction
Authors: Li Zewu , Li Ruimei , Dai Huiying , Li Xiaoyun , Han Xiao , Wang xuenan , Yang Aijun
Published: February 2020

Background: Leukemia inhibitory factor (LIF) has played a vital role in a series of reproductive events, including follicle growth, embryo growth and differentiation. However, it is unclear whether the level of LIF in embryo culture medium can be used as a marker for clinical pregnancy. In this study, we aimed to investigate whether LIF level in embryo culture medium can act as a predictive marker for pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET) in infertile patients due to tubal problems.Methods: A total of 104 infertile patients due to tubal problems underwent IVF-ET treatment. The patients were divided into two groups according to whether they were clinically pregnant. The level of LIF in the embryo culture medium was measured, and the correlation between LIF level and embryo quality and clinical pregnancy outcome was analyzed. The embryo culture medium was collected on the day of blastocyst transplantation.Results: Compared to non-pregnant group, LIF level in the embryo culture medium on the day of blastocyst transplantation was significantly higher in the pregnant group.Conclusions: LIF level in the embryo culture medium may be used as a non-invasive auxiliary biomarker for predictive clinical pregnancy in infertile patients with tubal problems that using single blastocyst transfer method.