bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness and safety assessment of drospirenone/ethinyl estradiol tablet in treatment of PCOS patients: a single center, prospective, observational study
Authors: Li Li , Zhang Ruiqin , Zeng Jing , Ke Hu , Peng Xiuhong , Huang Liying , Zhang Hongmei , Chen Zhijing , Li Tian Tian , Tan Qiuxiao , Yang Ying , Li Xiaofang , Li Xin
Published: February 2020

Background

To investigate the effectiveness and safety of 3 mg drospirenone and 20 μg ethinyl estradiol tablet (3 mg DRSP/20 μg EE) in the treatment of polycystic ovary syndrome (PCOS).

Methods

This single center, prospective observational study was conducted in 140 patients with PCOS. They were prescribed 3 mg DRSP/20 μg EE in a 24/4/ regimen for 3 months. Patients were instructed to take oral DRSP/EE tablets (once daily) on the 2nd day of menstruation, for 28 consecutive days for 1 cycle. After 3 months of treatment, anthropometric assessments along with variations in sex hormones related index, glucolipid metabolic index, changes in bilateral ovarian volume, as well as adverse effect of the combination were evaluated.

Results

When compared to baseline, body mass index (BMI, 22.07 ± 4.09 vs. 21.35 ± 3.22,p < 0.001) and waist hip ratio (WHR, 0.86 ± 0.07 vs. 0.854 ± 0.06,p = 0.026) decreased significantly after treatment. Sex-hormones such as luteinizing hormone (LH) (10.88 vs. 5.81 U/L), testosterone (T) (1.85 vs. 1.51 nmol/L) and free androgen index (FAI) (5.37 vs. 1.50) decreased significantly after treatment (p < 0.001). Follicular stimulating hormone (FSH) increased significantly at 3 months as compared to before treatment (5.13 vs. 5.42 U/L,p = 0.009). Plasma insulin (11.03 vs. 11.10 pmol/L), fasting (4.97 vs. 4.93 mmol/L) and 2 h-blood glucose levels (7.18 vs. 7.04 mmol/L) did not change when compared to baseline. Plasma triglycerides (TG, 1.32 vs. 1.65 mmol/L) significantly increased 3 months after treatment when compared to before treatment (p < 0.001). However, high density lipoprotein-cholesterol (HDL-C) levels increased significantly after treatment (1.41 vs. 1.57 mmol/L,p < 0.001). It was seen that, when compared to baseline, bilateral ovarian volume (left and right) was significantly lower after treatment (p < 0.05). It was seen that 81 patients reported no adverse reactions. Of the common discomforts reported, breast swelling and pain, gastrointestinal disorder and dizziness and headache were most frequent.

Conclusions

Treatment of PCOS patients with3 mg DRSP/20 μg EE has shown beneficial hormonal and lipid profile along with considerable safety profile.

Trial registration

Chinese Clinical Trial RegistryChiCTR1900022001, March 2019, retrospectively registered.
MHealth and perceived quality of care delivery: a conceptual model and validation
Authors: O’Connor Yvonne , Andreev Pavel , O’Reilly Philip
Published: February 2020

Background

The objective of this research is to examine, conceptualize, and empirically validate a model of mobile health (mHealth) impacts on physicians’ perceived quality of care delivery (PQoC).

Methods

Observational quasi-experimental one group posttest-only design was implemented through the empirical testing of the conceptual model with nine hypotheses related to the association of task and technology characteristics, self-efficacy, m-health utilization, task-technology fit (TTF), and their relationships with PQoC. Primary data was collected over a four-month period from acute care physicians in The Ottawa Hospital, Ontario, Canada. The self-reported data was collected by employing a survey and distributed through the internal hospital channels to physicians who adopted iPads for their daily activities.

Results

Physicians’ PQoC was found to be positively affected by the level of mHealth utilization and TTF, while the magnitude of the TTF direct effect was two times stronger than utilization. Additionally, self-efficacy has the highest direct and total effect on mHealth utilization; in the formation of TTF, technological characteristics dominate followed by task characteristics.

Conclusion

To date, the impact of utilized mHealth on PQoC has neither been richly theorized nor explored in depth. We address this gap in existing literature. Realizing how an organization can improve TTF will lead to better PQoC.
Perceptions of resuscitation care among in-hospital cardiac arrest responders: a qualitative analysis
Authors: Mullangi Samyukta , Bhandari Rohan , Thanaporn Porama , Christensen Mary , Kronick Steven , Nallamothu Brahmajee K.
Published: February 2020

Background

In-hospital cardiac arrests (IHCA) occur commonly and are associated with poor survival and variable outcomes. This study aimed to directly survey IHCA responders to understand their perceptions of resuscitation care.

Methods

As part of a quality improvement initiative, we surveyed participating providers of IHCAs at our institution from Jan 2014 to May 2016. The survey included unstructured free text feedback, which was the focus of this study. We systematically coded the free text and organized identifiable latent themes using thematic analysis.

We used the natural timeline of an IHCA – pre-arrest, arrest, and post-arrest – for organization of the identifiable latent themes, and created a separate category for holistic remarks that arched across the timeline.

Results

We identified 172 IHCAs with a mean of 1.7 responses per arrest (range: 1–8 responses). The mean age of this patient population was 59 years at the time of arrest, and 107 (62%) were men.

We identified several themes - [1] issues around code activation and code status characterized the pre-arrest period [2] ,team interactions and issues around supplies/equipment dominated the intra-arrest period, and [3] code cessation and transitions of care typified the post-arrest period. Holistic remarks focused on attentiveness paid by the arrest team to patient comfort and family. Some comments reflected positive experiences but most focused on areas of improvement consistent with the initiative’s purpose. In certain cases, we identified a tension between the need to balance established resuscitation protocols with flexibility required by real-life circumstances.

Conclusions

Directly surveying those who participated in IHCAs led to novel insights about their experiences. Our findings suggest that parsing through such qualitative feedback can help hospitals identify areas of improvement, modulate expectations, temper emotions, and refine protocols.
Using point-of-care C-reactive protein to guide antibiotic prescribing for lower respiratory tract infections in elderly nursing home residents (UPCARE): study design of a cluster randomized controlled trial
Authors: Boere Tjarda M. , van Buul Laura W. , Hopstaken Rogier M. , Veenhuizen Ruth B. , van Tulder Maurits W. , Cals Jochen W. L. , Verheij Theo J. M. , Hertogh Cees M. P. M.
Published: February 2020

Background

Antibiotics are over-prescribed for lower respiratory tract infections (LRTI) in nursing home residents due to diagnostic uncertainty. Inappropriate antibiotic use is undesirable both on patient level, considering their exposure to side effects and drug interactions, and on societal level, given the development of antibiotic resistance. C-reactive protein (CRP) point-of-care testing (POCT) may be a promising diagnostic tool to reduce antibiotic prescribing for LRTI in nursing homes. The UPCARE study will evaluate whether the use of CRP POCT for suspected LRTI is (cost-) effective in reducing antibiotic prescribing in the nursing home setting.

Methods/design

A cluster randomized controlled trial will be conducted in eleven nursing homes in the Netherlands, with the nursing home as the unit of randomization. Residents with suspected LRTI who reside at a psychogeriatric, somatic, or geriatric rehabilitation ward are eligible for study participation. Nursing homes in the intervention group will provide care as usual with the possibility to use CRP POCT, and the control group will provide care as usual without CRP POCT for residents with (suspected) LRTI. Data will be collected from September 2018 for approximately 1.5 year, using case report forms that are integrated in the electronic patient record system. The primary study outcome is antibiotic prescribing for suspected LRTI at index consultation (yes/no).

Discussion

This is the first randomised trial to evaluate the effect of nursing home access to and training in the use of CRP POCT on antibiotic prescribing for LRTI, yielding high-level evidence and contributing to antibiotic stewardship in the nursing home setting. The relatively broad inclusion criteria and the pragmatic study design add to the applicability and generalizability of the study results.

Trial registration

Netherlands Trial Register, TrialNL5054. Registered 29 August 2018.
Estimating the burden of iron deficiency among African children
Authors: Muriuki John Muthii , Mentzer Alexander J. , Webb Emily L. , Morovat Alireza , Kimita Wandia , Ndungu Francis M. , Macharia Alex W. , Crane Rosie J. , Berkley James A. , Lule Swaib A. , Cutland Clare , Sirima Sodiomon B. , Diarra Amidou , Tiono Alfred B. , Bejon Philip , Madhi Shabir A. , Hill Adrian V. S. , Prentice Andrew M. , Suchdev Parminder S. , Elliott Alison M. , Williams Thomas N. , Atkinson Sarah H.
Published: February 2020

Background

Iron deficiency (ID) is a major public health burden in African children and accurate prevalence estimates are important for effective nutritional interventions. However, ID may be incorrectly estimated in Africa because most measures of iron status are altered by inflammation and infections such as malaria. Through the current study, we have assessed different approaches to the prediction of iron status and estimated the burden of ID in African children.

Methods

We assayed iron and inflammatory biomarkers in 4853 children aged 0–8 years from Kenya, Uganda, Burkina Faso, South Africa, and The Gambia. We described iron status and its relationship with age, sex, inflammation, and malaria parasitemia. We defined ID using the WHO guideline (ferritin < 12 μg/L or < 30 μg/L in the presence of inflammation in children < 5 years old or < 15 μg/L in children ≥ 5 years old). We compared this with a recently proposed gold standard, which uses regression-correction for ferritin levels based on the relationship between ferritin levels, inflammatory markers, and malaria. We further investigated the utility of other iron biomarkers in predicting ID using the inflammation and malaria regression-corrected estimate as a gold standard.

Results

The prevalence of ID was highest at 1 year of age and in male infants. Inflammation and malaria parasitemia were associated with all iron biomarkers, although transferrin saturation was least affected. Overall prevalence of WHO-defined ID was 34% compared to 52% using the inflammation and malaria regression-corrected estimate. This unidentified burden of ID increased with age and was highest in countries with high prevalence of inflammation and malaria, where up to a quarter of iron-deficient children were misclassified as iron replete. Transferrin saturation < 11% most closely predicted the prevalence of ID according to the regression-correction gold standard.

Conclusions

The prevalence of ID is underestimated in African children when defined using the WHO guidelines, especially in malaria-endemic populations, and the use of transferrin saturation may provide a more accurate approach. Further research is needed to identify the most accurate measures for determining the prevalence of ID in sub-Saharan Africa.
The role of SOCS3 in the hypothalamic paraventricular nucleus in rat model of inflammatory pain
Authors: Meng Na , Ji Ning-Ning , Zhou Ziming , Qian Yicheng , Tang Yu , Yang Kangbo , Chen Binbin , Zhang Yong-Mei
Published: February 2020

Background

Inflammatory molecular signals are modulated by a variety of intracellular transduction pathways, the activation of which may induce and amplify the spread of inflammatory response. Suppresser of cytokine signaling 3 (SOCS3) is an established negative feedback regulation transcription factor associated with tumor, diabetes mellitus, inflammation and anaphylaxis. Herein, we investigated whether SOCS3 in the paraventricular nucleus (PVN) can attenuate pro-inflammatory responses, and thereby relieve the inflammatory pain.

Methods

Adeno-associated virus (AAV) overexpressing SOCS3 was pre-injected into the PVN. Three weeks later, rat model of chronic inflammatory pain was established via subcutaneous injection of complete Freund’s adjuvant (CFA) into the plantar center of hind paws. The therapeutic effect of SOCS3 was tested by the measurement of thermal and mechanical allodynia. In mechanistic study, the protein level of SOCS3 was evaluated by Western blotting, and the expression of c-fos and Iba-1 were assessed by immunofluorescent staining.

Results

Inflammatory pain was associated with upregulated interleukin 6 (IL-6) and SOCS3 in PVN in the acute phase. Thermal hyperalgesia can be relieved by intra-PVN injection of IL-6 neutralizing antibody (NA). Meanwhile, the upregulated c-fos and microglial activation was reversed. Furthermore, SOCS3 expression in PVN was downregulated in the chronic phase. Intra-PVN injection of AAV overexpressing SOCS3 suppressed the activation of neurons and attenuated thermal hyperalgesia and mechanical allodynia.

Conclusion

Inhibition of IL-6 signaling attenuated inflammatory hyperalgesia in the acute phase. SOCS3 overexpression in the PVN attenuated inflammatory pain in the chronic phase via suppression of neuronal activation.
Effects of a ketogenic diet in overweight women with polycystic ovary syndrome
Authors: Paoli Antonio , Mancin Laura , Giacona Maria Cristina , Bianco Antonino , Caprio Massimiliano
Published: February 2020

Background

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during reproductive age. It is characterised clinically by oligo-ovulation or anovulation, hyper-androgenism, and the presence of polycystic ovaries. It is associated with an increased prevalence of metabolic syndrome, cardiovascular disease and type 2 diabetes. The onset of PCOS has been associated to several hereditary and environmental factors, but insulin resistance plays a key pathogenetic role. We sought to investigate the effects of a ketogenic diet (KD) on women of childbearing age with a diagnosis of PCOS.

Methods

Fourteen overweight women with diagnosis of PCOS underwent to a ketogenic Mediterranean diet with phyoextracts (KEMEPHY) for 12 week. Changes in body weight, body mass index (BMI), fat body mass (FBM), lean body mass (LBM), visceral adipose tissue (VAT), insulin, glucose, HOMA-IR, total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TGs), total and free testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH); dehydroepiandrosterone sulfate (DHEAs), estradiol, progesterone, sex hormone binding globulin (SHBG) and Ferriman Gallwey score were evaluated.

Results

After 12 weeks, anthropometric and body composition measurements revealed a significant reduction of body weight (− 9.43 kg), BMI (− 3.35), FBM (8.29 kg) and VAT. There was a significant, slightly decrease of LBM. A significant decrease in glucose and insulin blood levels were observed, together with a significant improvement of HOMA-IR. A significant decrease of triglycerides, total cholesterol and LDL were observed along with a rise in HDL levels. The LH/FSH ratio, LH total and free testosterone, and DHEAS blood levels were also significantly reduced. Estradiol, progesterone and SHBG increased. The Ferriman Gallwey Score was slightly, although not significantly, reduced.

Conclusions

Our results suggest that a KD may be considered as a valuable non pharmacological treatment for PCOS. Longer treatment periods should be tested to verify the effect of a KD on the dermatological aspects of PCOS.

Trial registration Clinicaltrial.gov, NCT04163120, registrered 10 November 2019, retrospectively registered, https://clinicaltrials.gov.
Naringin provides neuroprotection in CCL2-induced cognition impairment by attenuating neuronal apoptosis in the hippocampus
Authors: Long Jiang-yi , Chen Jian-min , Liao Yuan-jun , Zhou Yi-jun , Liang Bing-yu , Zhou Yan
Published: February 2020

Background

Chemokine C–C motif ligand 2 (CCL2) is one of the most widely recognised proinflammatory chemokines in cognitive disorders. Currently, CCL2-targeting drugs are extremely limited. Thus, this study aimed to explore the neuroprotection afforded by naringin in CCL2-induced cognitive impairment in rats.

Methods

Before the CCL2 intra-hippocampal injection, rats were treated with naringin for 3 consecutive days via intraperitoneal injection. Two days post-surgery, the Morris water maze (MWM) and novel object recognition (NORT) tests were performed to detect spatial learning and memory and object cognition, respectively. Nissl staining and dUTP nick-end labelling (TUNEL) staining were performed to assess histopathological changes in the hippocampus. Commercial kits were used to measure the activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and the content of malondialdehyde (MDA). Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to examine the relative mRNA expression of interleukin 1β, (IL-1β), interleukin 6 (IL-6), glutamate/aspartate transporter (GLAST), glutamate transporter-1 (GLT-1), phosphate-activated glutaminase (PAG), cysteine aspartic acid-specific protease 8 (caspase-8), cysteine aspartic acid-specific protease 3 (caspase-3), cell lymphoma/leukaemia-2 (Bcl-2), and Bcl-2 associated X protein (Bax).

Results

In the MWM, the average escape latency and average swimming distance were significantly reduced and the crossing times were increased in the naringin-treated groups, compared with the CCL2 group. The NORT results revealed that, compared with the CCL2 rats, the discrimination index in the naringin-treated rats increased significantly. Nissl and TUNEL staining revealed that naringin protected the structure and survival of the neurons in the CA1 zone of the hippocampus. In the naringin-treated groups, the SOD and GSH-Px activities were increased, whereas the MDA levels were decreased. Furthermore, in the naringin-treated groups, the relative mRNA expression of IL-1β and IL-6 was significantly decreased; GLAST and GLT-1 mRNA expression levels were increased, whereas PAG was decreased. In the naringin-treated groups, the relative mRNA expression levels of caspase-8, caspase-3, and Bax were decreased, whereas that of Bcl-2 was increased.

Conclusion

Collectively, these data indicated that naringin alleviated the CCL2-induced cognitive impairment. The underlying mechanisms could be associated with the inhibition of neuroinflammation, oxidative stress, apoptosis, and the regulation of glutamate metabolism.
IGFBP5 increases cell invasion and inhibits cell proliferation by EMT and Akt signaling pathway in Glioblastoma multiforme cells
Authors: Dong Chengyuan , Zhang Junwen , Fang Sheng , Liu Fusheng
Published: February 2020

Background

Recurrence of Glioblastoma multiforme (GBM) seems to be the rule despite combination therapies. Cell invasion and cell proliferation are major reasons for recurrence of GBM. And insulin-like growth factor binding protein 5 (IGFBP5) is the most conserved of the IGFBPs and is frequently dysregulated in cancers and metastatic tissues.

Results

By studying the human glioma tissues, we find that IGFBP5 expression associate to the histopathological classification and highly expressed in GBM. Using IGFBP5 mutants we demonstrate that knockdown of IGFBP5 inhibited cell invasion, whereas promoting cell proliferation in GBM cells. Mechanistically, we observed that promoting GBM cell proliferation by inhibiting IGFBP5 was associated with stimulating Akt (Protein kinase B) phosphorylation. However, IGFBP5 promote GBM cell invasion was related to the epithelial-to-mesenchymal transition (EMT). Furthermore, the Chinese Glioma Genome Altas (CGGA) database show that IGFBP5 is significantly increased in recurrent glioma and it predicted worse survival.

Conclusions

The obtained results indicate that IGFBP5 has two sides in GBM—inhibiting cell proliferation but promoting cell invasion.
Dosimetric consequences of image guidance techniques on robust optimized intensity-modulated proton therapy for treatment of breast Cancer
Authors: Liang Xiaoying , Mailhot Vega Raymond B. , Li Zuofeng , Zheng Dandan , Mendenhall Nancy , Bradley Julie A.
Published: February 2020

Purpose

To investigate the consequences of residual setup error on target dose distribution using various image registration strategies for breast cancer treated with intensity-modulated proton therapy (IMPT).

Materials and methods

Among 11 post-lumpectomy patients who received IMPT, 44 dose distributions were computed. For each patient, the original plan (Plan-O) and three verification plans were calculated using different alignments: bony anatomy (VPlan-B), breast tissue (VPlan-T), and skin (VPlan-S). The target coverage were evaluated for each alignment technique. Additionally, 2 subvolumes—BreastNearSkin (1-cm rim of anterior CTV) and BreastNearCW (1-cm rim of posterior CTV)—were created to help localize CTV underdosing. Furthermore, we divided the setup error into the posture error and breast error. Patients with a large posture error and those with good posture setup but a large breast error were identified to evaluate the effect of posture error and breast error.

Results

For Plan-O, VPlan-B, VPlan-T, and VPlan-S, respectively, the median (interquartile range) breast CTV D95 was 95.7%(94.7–96.3%), 95.1% (93.9–95.7%), 95.2% (94.8–95.6%), and 95.2% (94.9–95.7%); BreastNearCW D95 was 96.9% (95.6–97.3%), 94.8% (93.5–97.0%), 95.6% (94.8–97.0%), 95.6% (94.8–97.1%); and BreastNearSkin D95 was 94.1% (92.7–94.4%), 93.6% (92.2–94.5%), 93.5% (92.4–94.5%), and 94.4% (92.2–94.5%) of the prescription dose. 4/11 patients had ≥1% decrease in breast CTV D95, 1 of whom developed breast edema while the other 3 all had a > 2o posture error. The CTV D95 variation was within 1% for the patients with good posture setup but >2o breast error.

Conclusion

Acceptable target coverage was achieved with all three alignment strategies. Breast tissue and skin alignment maintained the breast target coverage marginally better than bony alignment, with which the posterior CTV along the chest wall is the predominant area affected by under-dosing. For target dose distribution, posture error appears more influential than breast error.
Pericardial effusion after definitive concurrent chemotherapy and intensity modulated radiotherapy for esophageal cancer
Authors: Pao Tzu-Hui , Chang Wei-Lun , Chiang Nai-Jung , Lin Chia-Ying , Lai Wu-Wei , Tseng Yau-Lin , Lin Forn-Chia
Published: February 2020

Background

The literature regarding pericardial effusion after definitive concurrent chemotherapy and intensity modulated radiotherapy (IMRT) for esophageal cancer was lacking. This study aimed to investigate the risk factors of pericardial effusion in esophageal cancer patients undergoing definitive concurrent chemotherapy and IMRT.

Methods

A total of 126 consecutive esophageal cancer patients treated with definitive concurrent chemotherapy and IMRT between 2008 and 2018 were reviewed. The pericardial effusion was determined on computed tomography scan of the chest and graded by the Common Terminology Criteria for Adverse Events, version 4.0. The cumulative incidence of pericardial effusion was estimated by the Kaplan–Meier method and compared between groups by the log-rank test. The risk factors of pericardial effusion were determined with multivariate Cox proportional hazards regression analysis.

Results

The median follow-up time was 14.0 months. Thirty-seven (29.4%) patients had pericardial effusion after a median interval of 6.6 months since the end of IMRT. The cumulative incidence of pericardial effusion of any grade was higher in patients with mean heart dose > 23.45 Gy (p = 0.00018), heart V30 > 33.55% (p = 0.00015), mean pericardium dose > 20.33 Gy (p = 0.00027), and pericardium V20 > 42.55% (p = 0.00018). Furthermore, eight (6.3%) patients had symptoms related to pericardial effusion and were considered as cases with pericardial effusion ≥ grade 3. The cumulative incidence of pericardial effusion ≥ grade 3 was higher in patients with pericardium V30 > 65.80% (p = 0.00028), V40 > 55.35% (p < 0.0001), and V60 > 24.70% (p = 0.0021). Multivariate analyses showed the above dose-volume parameters predicted the risk of pericardial effusion in esophageal cancer.

Conclusions

Dose-volume parameters predicting the risk of pericardial effusion were identified in esophageal cancer treated with definitive concurrent chemotherapy and IMRT. They could be applied as constraints of IMRT for esophageal cancer.
The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis
Authors: Wang Ning , Chen Yungang , Ji Jindou , Chang Jinlei , Yu Shengwen , Yu Bo
Published: February 2020

Background

The incidence of osteoporotic fractures has increased rapidly, and because of the poor prognosis and high mortality associated with osteoporotic fractures, they remain a prospective research area globally. One way to reduce their incidence is to investigate their intervention risk factors in the elderly. Hence, this study explores the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and osteoporotic fractures in elderly patients through a meta-analysis.

Methods

We conducted our literature search mainly in PubMed and Embase for identifying studies that investigated the relationship between serum 25(OH)D levels and the risk for osteoporotic fractures. We performed categorical analysis, heterogeneity checks, publication bias analysis, and subgroup analyses.

Results

In total, 20 studies were included, of which 4 were case-cohort studies and 16 were cohort studies. A total of 41,738 patients from 20 studies were included in the meta-analysis, of which 5916 had fractures, including 3237 hip fractures. By combining the lowest and highest categories of relative risks (RRs) and 95% confidence intervals (CIs), it was suggested that lower serum 25-hydroxyvitamin D levels may be a risk factor for fractures. RR (95% CI) for total and hip fractures were 1.11 (0.99, 1.24) and 0.89 (0.80, 0.98) after adjustments.

Conclusions

Our study showed that compared to low serum 25(OH)D levels, high serum 25(OH)D levels reduce the risk of hip fractures in the patients aged 60 years or older. In contrast, serum 25(OH)D has no significant relationship with total fracture risk.
Is lobe specific lymph node dissection adequate for cN0–1 non-small cell lung cancer?
Authors: Fang Likui , Xu Jinming , Ye Bo , Yu Guocan , Chen Gang , Yang Jun
Published: February 2020

Purpose

This study aims to explore whether lobe specific lymph node dissection (LND) is adequate for cN0–1 non-small cell lung cancer (NSCLC) or not.

Methods

Among 5613 cN0–1 NSCLC patients, 394 cases (7.0%) with pN2 were enrolled and the distribution of mediastinal lymph node metastasis was analyzed. The included patients were divided into the non-lobe specific lymph node metastasis (NLSLNM) group and the lobe specific lymph node metastasis (LSLNM) group. The clinicopathological characteristics were compared between two groups and multivariable analysis was performed to find independent factors predicting NLSLNM.

Results

The incidence of pN2 cases deserved serious attention. The proportion of upper zone lymph node metastases was not rare in right (55.0%) and left (35.7%) lower lobe tumors. The proportion of subcarinal zone lymph node involvement was also high in right (21.8%) and left (25.8%) upper lobe tumors. Multivariable analysis showed that elevated carcinoembryonic antigen (CEA) level (P = 0.034), right lower lobe (RLL) tumors (P = 0.022) and station 11 involvement (P = 0.030) were independent risk factors for NLSLNM.

Conclusion

Systematic LND seems to be superior to lobe specific LND in the assessment of lymph node status and high CEA level, RLL tumors and station 11 involvement are predictors for NLSLNM.
Lower plasma cholesterol, LDL-cholesterol and LDL-lipoprotein subclasses in adult phenylketonuria (PKU) patients compared to healthy controls: results of NMR metabolomics investigation
Authors: Cannet Claire , Pilotto Andrea , Rocha Júlio César , Schäfer Hartmut , Spraul Manfred , Berg Daniela , Nawroth Peter , Kasperk Christian , Gramer Gwendolyn , Haas Dorothea , Piel David , Kölker Stefan , Hoffmann Georg , Freisinger Peter , Trefz Friedrich
Published: February 2020

Background

Phenylketonuria (PKU; OMIM#261600) is a rare metabolic disorder caused by mutations in the phenylalanine hydroxylase (PAH) gene resulting in high phenylalanine (Phe) in blood and brain. If not treated early this results in intellectual disability, behavioral and psychiatric problems, microcephaly, motor deficits, eczematous rash, autism, seizures, and developmental problems. There is a controversial discussion of whether patients with PKU have an additional risk for atherosclerosis due to interference of Phe with cholesterol synthesis and LDL-cholesterol regulation. Since cholesterol also plays a role in membrane structure and myelination, better insight into the clinical significance of the impact of Phe on lipoprotein metabolism is desirable. In 22 treated PKU patients (mean age 38.7 years) and 14 healthy controls (mean age 35.2 years), we investigated plasma with NMR spectroscopy and quantified 105 lipoprotein parameters (including lipoprotein subclasses) and 24 low molecular weight parameters. Analysis was performed on a 600 MHz Bruker AVANCE IVDr spectrometer as previously described.

Results

Concurrent plasma Phe in PKU patients showed a wide range with a mean of 899 μmol/L (50–1318 μmol/L). Total cholesterol and LDL-cholesterol were significantly lower in PKU patients versus controls: 179.4 versus 200.9 mg/dL (p < 0.02) and 79.5 versus 104.1 mg/dL (p < 0.0038), respectively. PKU patients also had lower levels of 22 LDL subclasses with the greatest differences in LDL2 Apo-B, LDL2 Particle Number, LDL2-phospholipids, and LDL2-cholesterol (p < 0.0001). There was a slight negative correlation of total cholesterol and LDL-cholesterol with concurrent Phe level. VLDL5-free cholesterol, VLDL5-cholesterol, VLDL5-phospholipids, and VLDL4-free cholesterol showed a significant (p < 0.05) negative correlation with concurrent Phe level. There was no difference in HDL and their subclasses between PKU patients and controls. Tyrosine, glutamine, and creatinine were significantly lower in PKU patients compared to controls, while citric and glutamic acids were significantly higher.

Conclusions

Using NMR spectroscopy, a unique lipoprotein profile in PKU patients can be demonstrated which mimics a non-atherogenic profile as seen in patients treated by statins.
Implementing an mhGAP-based training and supervision package to improve healthcare workers’ competencies and access to mental health care in Malawi
Authors: Ahrens Jen , Kokota Demoubly , Mafuta Chitsanzo , Konyani Mary , Chasweka Dennis , Mwale Owen , Stewart Robert C. , Osborn Madeline , Chikasema Blessings , Mcheka Mondie , Blackwood Douglas , Gilfillan Sheila
Published: February 2020

Background

It is now well established that the integration of mental health care into primary care is one of the most effective ways of reducing the substantial treatment gap for mental disorders which exists in most low- and middle-income countries. This study set out to determine whether a Mental Health Gap Action Programme (mhGAP) training and supervision package could be contextualised and implemented within the existing health care system in five districts in Southern Malawi. In addition, the study assessed the feasibility of holding community awareness events and establishing peer support groups in each district to further improve the access of the population to evidence-based mental health care.

Methods

A lead training team of experienced Malawian mental health professionals was appointed and mhGAP training materials were contextualised for use in Malawi. The lead team delivered a 4-day training package to district mental health teams in five districts covering three core conditions: psychosis, moderate-severe depression, and alcohol and substance use disorders. District mental health teams then delivered a 2-day training package and provided monthly supervision for 3 months to 500 non-specialist healthcare workers. Paired sample t-tests were used to compare knowledge, confidence and attitude scores before and immediately after training, and after 6 months in two districts. Case detection rates measured pre- and post-training in the pilot district were compared using Wilcoxon Rank Sum Test. Community awareness events were held and peer support groups were established in each of the five districts. The acceptability of the package was assessed through focus group discussions involving specialist and non-specialist healthcare workers, users and carers.

Results

Non-specialist healthcare workers’ knowledge and confidence scores significantly increased immediately after training in comparison to pre-training. These scores were maintained at 6 months. However, no statistically significant change in attitude scores was detected. Case detection rates increased immediately after the training in comparison to pre-training. Responses from focus group discussion participants illustrated the programme’s acceptability.

Conclusions

This study demonstrated that, with minimal additional funding and working within existing structures, an mhGAP based training at primary and secondary health care levels is feasible in Southern Malawi.
Publisher Correction: Host-associated microbiomes are predicted by immune system complexity and climate
Authors: Woodhams Douglas C. , Bletz Molly C. , Becker C. Guilherme , Bender Hayden A. , Buitrago-Rosas Daniel , Diebboll Hannah , Huynh Roger , Kearns Patrick J. , Kueneman Jordan , Kurosawa Emmi , LaBumbard Brandon C. , Lyons Casandra , McNally Kerry , Schliep Klaus , Shankar Nachiket , Tokash-Peters Amanda G. , Vences Miguel , Whetstone Ross
Published: February 2020

Following publication of the original paper [1], it was reported that an error in the processing of Fig. 8 occurred. In the online HTML version of the article, Fig. 8 was presented as a duplication of Fig. 7. The original article [1] has been corrected.
Author Correction: Interaction between the microbiome and TP53 in human lung cancer
Authors: Greathouse K. Leigh , White James R. , Vargas Ashely J. , Bliskovsky Valery V. , Beck Jessica A. , von Muhlinen Natalia , Polley Eric C. , Bowman Elise D. , Khan Mohammed A. , Robles Ana I. , Cooks Tomer , Ryan Bríd M. , Padgett Noah , Dzutsev Amiran H. , Trinchieri Giorgio , Pineda Marbin A. , Bilke Sven , Meltzer Paul S. , Hokenstad Alexis N. , Stickrod Tricia M. , Walther-Antonio Marina R. , Earl Joshua P. , Mell Joshua C. , Krol Jaroslaw E. , Balashov Sergey V. , Bhat Archana S. , Ehrlich Garth D. , Valm Alex , Deming Clayton , Conlan Sean , Oh Julia , Segre Julie A. , Harris Curtis C.
Published: February 2020

Following publication of the original paper [1], the authors submitted a new Additional file 5 to replace the one containing formatting issues. The updated Additional file 5 is published in this correction.
Identification and evaluation of UL36 protein from Dermacentor silvarum salivary gland and its interaction with Anaplasma ovis VirB10
Authors: Mukhtar Muhammad Uzair , Iqbal Naveed , Yang Jifei , Niu Qingli , Zhao Shuaiyang , Li Zhi , Zhao Yaru , Rashid Muhammad , Chen Ze , Guan Guiquan , Liu Zhijie , Yin Hong
Published: February 2020

Background

Anaplasma ovis is a gram-negative, tick-borne obligate intraerythrocytic pathogen, which causes ovine anaplasmosis in small ruminants worldwide. VirB10 of A. ovis is an integral component of the Type IV Secretion System (T4SS). The T4SS is used by bacteria to transfer DNA and/or proteins undeviatingly into the host cell to increase their virulence. To more thoroughly understand the interaction between A. ovis and Dermacentor silvarum, a vector containing the virb10 gene of A. ovis was used as a bait plasmid to screen interacting proteins from the cDNA library of the D. silvarum salivary gland using the yeast two-hybrid system.

Methods

The cDNA of the D. silvarum salivary gland was cloned into the pGADT7-SmaI vector (prey plasmid) to construct the yeast two-hybrid cDNA library. The virb10 gene was cloned into the pGBKT7 vector to generate a bait plasmid. Any gene auto-activation or toxicity effects in the yeast strain Y2HGold were excluded. The screening was performed by combining the bait and prey plasmids in yeast strains to identify positive preys. The positive preys were then sequenced, and the obtained sequences were subjected to further analyses using Gene Ontology, UniProt, SMART, and STRING. Additionally, the interaction between the bait and the prey was evaluated using the glutathione S-transferase (GST) pull-down assay.

Results

A total of two clones were obtained from the cDNA library using the yeast two-hybrid system, and the sequence analysis showed that both clones encoded the same large tegument protein, UL36. Furthermore, the proteins GST-UL36 and His-VirB10 were successfully expressed in vitro and the interaction between the two proteins was successfully demonstrated by the GST pull-down assay.

Conclusions

To our knowledge, this study is the first to screen for D. silvarum salivary gland proteins that interact with A. ovis VirB10. The resulting candidate, UL36, is a multi-functional protein. Further investigations into the functionality of UL36 should be carried out, which might help in identifying novel prevention and treatment strategies for A. ovis infection. The present study provides a base for exploring and further understanding the interactions between A. ovis and D. silvarum.
Mosquito-borne viral diseases in the Democratic Republic of the Congo: a review
Authors: Mbanzulu Kennedy M. , Mboera Leonard E. G. , Luzolo Flory K. , Wumba Roger , Misinzo Gerald , Kimera Sharadhuli I.
Published: February 2020

Background

Mosquito-borne viral infections have in recent years, become a public health threat globally. This review aimed to provide an overview of the ecological and epidemiological profiles of mosquito-borne viral infections in the Democratic Republic of the Congo (DRC).

Methods

A search of literature was conducted using Google Scholar, PubMed and the WHO website using the following keywords: “Democratic Republic of the Congo”, “Zaire”, “Belgian Congo” and either of the following: “mosquito-borne virus”, “arbovirus”, “yellow fever”, “dengue”, “chikungunya”, “West Nile”, “Rift Valley fever”, “O’nyong’nyong”, “Zika”, “epidemiology”, “ecology”, “morbidity”, “mortality”. Published articles in English or French covering a period between 1912 and October 2018 were reviewed.

Results

A total of 37 articles were included in the review. The findings indicate that the burden of mosquito-borne viral infections in DRC is increasing over time and space. The north-western, north-eastern, western and central regions have the highest burden of mosquito-borne viral infections compared to south and eastern highland regions. Yellow fever, chikungunya, dengue, Zika, Rift Valley fever, West Nile and O’nyong’nyong have been reported in the country. These mosquito-borne viruses were found circulating in human, wildlife and domestic animals. Yellow fever and chikungunya outbreaks have been frequently reported. Aedes aegypti and Ae. simpsoni were documented as the main vectors of most of the mosquito-borne viral infections. Heavy rains, human movements, forest encroachment and deforestation were identified as drivers of mosquito-borne viruses occurrence in DRC.

Conclusions

Mosquito-borne viral infections are becoming common and a serious public health problem in DRC. In the current context of climate change, there is urgent need to improve understanding on ecological and epidemiology of the diseases and strengthen surveillance systems for prompt response to epidemics in DRC.
On estimating the number of people with known HIV positive status
Authors: Nguefack-Tsague Georges , Billong Serge Clotaire , Tiemtore Ousseni W. , Zeh Meka Albert Frank , Diallo Ismael , Bongwong Brian , Ngoufack Marie Nicole , Mvilongo Ernest , Ndowa Yemurai , Diallo Houssey , Clary Bruno , Takpa Koubagnine , Guiard-Schmid Jean-Baptiste , Bonono Leonard , Elat-Nfetam Jean-Bosco , Zhao Jinkou
Published: February 2020

Objective

In 2014, the Joint United Nations Program on HIV and AIDS (UNAIDS) and partners set the ‘90-90-90 targets’. Many countries are facing the challenge of estimating the first 90. Our objective was to propose an alternative modelling procedure, and to discuss its usefulness for taking into account duplication.

Results

For deduplication, we identified two important ingredients: the probability for an HIV+ person of being re-tested during the period and average number of HIV+ tests. Other adjusted factors included: the false positive probability; the death and emigration probabilities. The uncertainty of the adjusted estimate was assessed using the plausibility bounds and sensitivity analysis. The proposed method was applied to Cameroon for the period 1987–2016. Of the 560,000 people living with HIV estimated from UNAIDS in 2016; 504,000 out to know their status. The model estimates that 380,464 [379,257, 381,674] know their status (75.5%); thus 179,536 who do not know their status should be sought through the intensification of testing. These results were subsequently used for constructing the full 2016 Cameroon HIV cascade for identifying programmatic gap, prioritizing the resources, and guiding the strategies of the 2018–2022 National Strategy Plan and funding request.
A comparison of erythrocyte sedimentation rates of bloods anticoagulated with trisodium citrate and EDTA among TB presumptive patients at the University of Gondar comprehensive specialized hospital, northwest Ethiopia
Authors: Getaneh Zegeye , Ayelgn Fekadu , Asemahegn Geletaw , Geleta Habtamu , Yalew Aregawi , Melak Tadele
Published: February 2020

Objective

The purpose of this study was comparing the erythrocyte sedimentation rate (ESR) results of trisodium citrate (TSC) and ethylene diamine tetra-acetic acid (EDTA) anticoagulants. A comparative cross-sectional study was conducted at the University of Gondar specialized referral hospital, northwest Ethiopia. A total of 70 TB presumptive participants were recruited. From each of the 70 participants of the study, 3 and 1.6 ml of blood was collected in EDTA tubes and 0.4 ml of trisodium Citrate anticoagulant containing test tubes, respectively.

Results

The mean ± SD values of ESR were 57.9 ± 41.45 mm/h in EDTA and 50.99 ± 43.5 mm/h in TSC anticoagulated blood. The mean difference of ESR values between EDTA and TSC blood (6.91 ± 13.66 mm/h) was statistically significant. The Mean ± SD of ESR values using EDTA and TSC in males were 59.57 ± 42.31 and 53.57 ± 44.61 mm/h while for females it was 54.71 ± 40.44 and 46.04 ± 41.82 mm/h, respectively. The study indicated that there was a significant difference between ESR values with EDTA and TSC anticoagulants.
A candidate probiotic strain of Enterococcus faecium from the intestine of the crucian carp Carassius auratus
Authors: Mao Qing , Sun Xueliang , Sun Jingfeng , Zhang Feng , Lv Aijun , Hu Xiucai , Guo Yongjun
Published: February 2020

In the present study, a Gram-positive bacterium was isolated from the intestine of healthy crucian carp Carassius auratus and named strain R8. It was initially identified as Enterococcus faecium according to its morphological, physiological and biochemical characteristics. Further identification by using 16S rRNA gene sequence analysis confirmed the R8 strain (Genbank accession no. MF928076) as E. faecium. Challenge and hemolysis experiments showed that the E. faecium R8 strain had no toxicity to the crucian carp. Bacteriostatic experiment showed that this isolate obviously inhibited the growth of Aeromonas veronii and Staphylococcus haemolyticus. The proliferation of E. faecium R8 strain occurred after exposure to various growth conditions such as at pH values from 2.0 to 4.0 for 8 h, bile concentrations from 0.2 to 1.2% and high temperature of 80 °C. This bacterial strain grew best under the condition of 37 °C, pH 7.0 and salinity 30 ppt, and its growth curve exhibited four distinct phases. These results showed that the E. faecium R8 strain had potential probiotic characteristics and could be used as a candidate strain for aquatic probiotics.
Insights into superoxide dismutase 3 in regulating biological and functional properties of mesenchymal stem cells
Authors: Sah Shyam Kishor , Agrahari Gaurav , Kim Tae-Yoon
Published: February 2020

Mesenchymal stem cells (MSCs) have been extensively studied and implicated for the cell-based therapy in several diseases due to theirs immunomodulatory properties. Embryonic stem cells and induced-pluripotent stem cells have either ethical issues or concerns regarding the formation of teratomas, introduction of mutations into genome during prolonged culture, respectively which limit their uses in clinical settings. On the other hand, MSCs also encounter certain limitation of circumscribed survival and reduced immunomodulatory potential during transplantation. Plethora of research is undergoing to improve the efficacy of MSCs during therapy. Several compounds and novel techniques have been employed to increase the therapeutic potency of MSCs. MSCs secreted superoxide dismutase 3 (SOD3) may be the mechanism for exhibiting direct antioxidant activities by MSCs. SOD3 is a well known antioxidant enzyme and recently known to possess immunomodulatory properties. Along with superoxide scavenging property, SOD3 also displays anti-angiogenic, anti-chemotactic and anti-inflammatory functions in both enzymatic and non-enzymatic manners. In this review, we summarize the emerging role of SOD3 secreted from MSCs and SOD3’s effects during cell-based therapy.
Leveraging lessons learned to prevent future disasters—insights from the 2013 Colombia-US binational exchange
Authors: Driedger Carolyn , Calvache Marta , Cortés Gloria Patricia , Ewert John , Montoya Jacqueline , Lockhart Andy , Allen Robert , Banks Daniel , Beason Scott , Bocanegra Harold Trujillo , Burkhart Frances , Bustad Kyle , Gallego Jaime Andres , Gibson Zane , Giraldo Felix Ricardo , Gutierrez Cesar , Quintero Jorge Ivan , Rodríguez Eduardo , Schelling John , Scott Marci
Published: February 2020

In 2013, scientists implemented a binational exchange for emergency planners and responders in communities near Nevado del Ruiz in Colombia and volcanoes of the Cascade Range of the United States (US). This program was designed to promote understanding of volcanic disasters and effective mitigation options, motivate participants to strengthen emergency planning efforts, and promote trust-building among participants. The 2013 Binational Exchange was funded by the Volcano Disaster Assistance Program (VDAP), a joint U.S. Geological Survey (USGS)—U.S. Agency for International Development (USAID) program.

During a week-long visit to Colombian emergency response agencies, Nevado del Ruiz, and lahar-destroyed ruins of the city of Armero and the region of Viejo Rio Claro, US participants became familiar with Colombian counterparts who have had recent and frequent experiences addressing volcanic crises. Aging survivors and authorities of the Nevado del Ruiz catastrophe of 1985 gave participants first-hand accounts, and ideas for improved preparedness and response. While in the US, Colombian participants observed emergency response capabilities and facilities, and received training in systems of incident command. Colombians made presentations to the US public and officials about the similarities of lahar risks in both nations.

This article describes the 2013 Binational Exchange as an experiential learning event and uses results of post-exchange discussions and interviews as evidence of steps achieved within the learning process. Six years hence, this article provides examples of progress with volcano hazards mitigation in both nations. The article offers the binational exchange model as an effective tool that employs both experiential learning and socialization of participants to create a highly motivating and effective learning environment.