bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional economic development, household income, gender and hypertension: evidence from half a million Chinese
Authors: Tang Kun , Zhang Yu , Wang Hanyu , Tan Shi Hui , Bai Lin , Liu Yuning
Published: June 2020

Background

Hypertension may be influenced by multiple factors, including social and individual determinants. Regional and individual economic disparity in China is closely associated with such factors that may give rise to diverse health outcomes. This study examines the relationship between regional economic development, household income, gender and hypertension prevalence in China.

Methods

This study utilized data from the China Kadoorie Biobank (CKB), a population-based study on half a million Chinese adults from 10 geographically distinct regions. Hypertension was identified by a measured systolic blood pressure/diastolic blood pressure ≥ 140/90 mmHg or receiving treatment. Regional economic development was inferred from GDP per capita at the time of the study. A logistic regression based method was used in calculating the prevalence of hypertension in different household income, regional economic development, and gender groups, adjusting for demographic, social-economic and lifestyle factors.

Results

The prevalence of hypertension was the lowest in the medium GDP per capita areas in both male (31.62, 95% CI: 31.26–31.98%) and female (22.85, 95% CI: 22.50–23.19%) as compared to that in the low GDP per capita regions (male: 32.75, 95% CI 32.41–33.08%; female: 32.12, 95% CI: 31.78–32.47%) and high GDP per capita areas (male: 39.74, 95% CI: 39.33–40.16%; female: 35.19, 95% CI: 34.74–35.65%). There was an inverse relationship between hypertension and household income in the low and high GDP areas and an U-shaped association in the medium GDP per capita areas. Higher hypertension prevalence was observed in males across all GDP per capita areas. The negative correlation between hypertension and household income (across all GDP per captia areas) was stronger in females than in males.

Conclusions

The present study underlined the important influence of regional economic development, household income and gender on hypertension. Interventions for hypertension prevention and management should take into consideration the influence of sex difference and socioeconomic disparities at both micro- and macro- levels, in addition to a person-centered approach.
Prevalence of ligamentous knee injuries in pedestrian versus motor vehicle accidents
Authors: Steinmetz R. Garrett , McDonald Matthew , Tkach Shaun , Hamilton John , Heigle Gregory , Hollabaugh Kimberly , Teague David , Rowles Douglas
Published: June 2020

Background

The purpose of this study was to determine the prevalence and characteristics of ligamentous knee injuries and to compare patient demographics, associated injuries and hospital stay to pedestrians who did not sustain a ligamentous knee injury.

Methods

A retrospective review of all adult patients presenting as pedestrians struck by a motor vehicle to a level 1 trauma center over a three-year period was performed. Demographics, length of stay, orthopedic and non-orthopedic traumatic injuries were recorded. Magnetic resonance imaging was reviewed for ligamentous, bony and chondral injuries.

Results

Five hundred thirty-nine patients were included. Sixty-seven (12.4%) patients sustained a total of 84 ligamentous knee injuries. OF these knee injuries that had MRI (55/84), the majority (96%) were multi-ligamentous in nature. Patients with ligamentous knee injury were more likely to also be affected by traumatic brain injury, solid organ injury, cervical and lumbar spine injury, pelvic ring injuries, distal femur fractures, patella fractures, knee dislocations, tibial plateau fractures, tibial pilon fractures, and deep vein thrombosis when compared to patients who did not sustain ligamentous knee injury. Patients who sustained ligamentous knee injury were more likely to require hospital and intensive care admission and had a longer overall hospital stay.

Conclusion

Given the high prevalence of ligamentous knee injuries in this patient population, these patients should be thoroughly evaluated for a ligamentous knee injury. If ligamentous knee injury is suspected, MRI should be considered as a majority of these injuries involved multiple structures. Patients with ligamentous knee injuries often had multi-system injuries with resulting longer hospital stay when compared to those without ligamentous knee injuries.
Clinical characteristics and health care received among patients with type 2 diabetes attending secondary and tertiary healthcare facilities in Mwanza Region, Tanzania: a cross-sectional study
Authors: Munyogwa Mariam J. , William Reuben , Kibusi Stephen M. , Gibore Nyasiro S.
Published: June 2020

Background

Tanzania is among the sub-Saharan African countries facing a tremendous increase in the burden of type 2 diabetes mellitus. In order to provide diabetes health care services, the government has established diabetes care clinics in secondary and tertiary healthcare facilities. However, previous studies have demonstrated a disparity in availability of supplies and equipment for provision of diabetes health care services at these healthcare facilities. This study aims to assess the clinical characteristics and health care received among patients with type 2 diabetes attending secondary and tertiary healthcare facilities in Mwanza Region, Tanzania.

Methods

A cross-sectional study was conducted in Mwanza Region from June to September, 2018.Three hundred and thirty patients were selected by systematic random sampling from three healthcare facilities. A structured questionnaire was utilized to collect information on patient characteristics, health care received and patient perception of care. Patient blood pressure, blood glucose, weight and height were measured during the study. Percentages, chi-square tests and multivariable analysis were conducted to obtain the proportions, make comparisons and determining the correlates of tertiary-level healthcare facility.

Results

Approximately half of respondents (54.5%) were from secondary healthcare facilities. The prevalence of hypertension (63.3%), hyperglycemia (95.8%) and obesity (93.3%) were high. The prevalence of hyperglycemia was slightly higher at secondary-level healthcare facility (p = 0.005). The proportion of respondents recently diagnosed with diabetes (≤ 10 years) was significantly higher at tertiary-level healthcare facility (p = 0.000). The prevalence of diabetes related complications was higher at tertiary-level healthcare facility (80.7% versus 53.3%, p = 0.000). Assessments of body weight, blood pressure, blood glucose, feet and eye examination were conducted on a monthly basis at all facilities. None of the respondents had undergone lipid profile testing. All of the respondents (100%) received care from a nurse during diabetes clinic visits and half of the respondents (49.7%) also received care from a clinician. Relatively young patients, married and recently diagnosed patients were more likely to attend clinic at tertiary facilities. Tertiary-level healthcare facilities were more likely to have patients with complications and to have a dietitian available at the clinic.
Serum-derived three-circRNA signature as a diagnostic biomarker for hepatocellular carcinoma
Authors: Sun Xiang-Hong , Wang Yu-Tong , Li Guo-Fu , Zhang Nan , Fan Ling
Published: June 2020

Background

Hepatocellular carcinoma (HCC) is a common tumor characterized by high morbidity and mortality rates. The importance of circRNA in cancer diagnosis has been established. The study aimed to identify differentially-expressed circRNAs (DECs) in human blood exosomes from patients with HCC and to investigate their diagnostic value.

Methods

The circRNA expression profiles of HCC and normal human blood samples were downloaded and processed from the exoRBase database. At the cutoff criteria of a fold change (FC) > 2.0 and P < 0.05, DECs were screened utilizing the limma package in the R software. A receiver operator characteristic curve (ROC) was used to study its diagnostic value. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) analysis was performed to confirm the three-circRNAs expression in the blood samples with HCC. Various bioinformatics tools were used to characterize the potential biological pathways induced by circRNAs.

Results

Compared with the normal samples, seven up-regulated and five down-regulated circRNAs were determined in the HCC samples. ROC analyses demonstrated that hsa_circ_0004001, hsa_circ_0004123, hsa_circ_0075792, and a combination of the three biomarkers exhibited higher sensitivity and specificity. The qRT-PCR confirmed that the three circRNAs were upregulated in the blood samples with HCC. Chi squared tests implied that the expression of three circRNAs was positively correlated with the TNM stage and tumor size. The circRNAs participated in VEGF/VEGFR, PI3K/Akt, mTOR, and Wnt signaling pathways by targeting miRNAs.

Conclusions

The study established the existence of seven up-regulated and five down-regulated circRNAs in HCC. Additionally, hsa_circ_0004001, hsa_circ_0004123, hsa_circ_0075792, and a combination of the three were utilized as valuable diagnostic biomarkers in HCC.
The role of N6-methyladenosine (m6A) modification in the regulation of circRNAs
Authors: Zhang Lele , Hou Chaofeng , Chen Chen , Guo Yaxin , Yuan Weitang , Yin Detao , Liu Jinbo , Sun Zhenqiang
Published: June 2020

N6-methyladenosine (m6A), the most abundant modification in eukaryotic cells, regulates RNA transcription, processing, splicing, degradation, and translation. Circular RNA (circRNA) is a class of covalently closed RNA molecules characterized by universality, diversity, stability and conservatism of evolution. Accumulating evidence shows that both m6A modification and circRNAs participate in the pathogenesis of multiple diseases, such as cancers, neurological diseases, autoimmune diseases, and infertility. Recently, m6A modification has been identified for its enrichment and vital biological functions in regulating circRNAs. In this review, we summarize the role of m6A modification in the regulation and function of circRNAs. Moreover, we discuss the potential applications and possible future directions in the field.
Gaps in beliefs and practice in dyslipidaemia management in Japan, Germany, Colombia and the Philippines: insights from a web-based physician survey
Authors: Barter Philip J. , Yamashita Shizuya , Laufs Ulrich , Ruiz Alvaro J. , Sy Rody , Fang Mark David G. , Folco Emanuela , Libby Peter , Matsuzawa Yuji , Santos Raul D.
Published: June 2020

Background

Implementing evidence-based management of dyslipidaemia is a challenge worldwide.

Objectives

To understand physician beliefs and behaviour and identify uncertainties in dyslipidaemia management across four world regions.

Methods

Web-based survey of 1758 physicians in Japan, Germany, Colombia and the Philippines who were selected randomly from existing databases. Key inclusion criteria were 1) for cardiologists and diabetes/endocrinology specialists: ≥50 dyslipidaemia patients examined in the last month; 2) for specialists in neurology/neurosurgery/stroke medicine: ≥50 dyslipidaemia patients and ≥ 20 patients with a history of ischaemic stroke examined in the last month; and 3) for specialists in nephrology and general medicine: based at centres with ≥20 beds and ≥ 50 dyslipidaemia patients examined in the last month. The self-report survey covered dyslipidaemia management, target low-density lipoprotein cholesterol (LDL-C) levels in different patient groups, and statin safety. All physicians gave voluntary consent and all data were anonymised. Analysis was solely descriptive.

Results

The survey highlighted key areas of uncertainty in dyslipidaemia management in the four countries. These related to LDL-C targets in different patient groups, the safety of low LDL-C levels, the safety of statins, especially for effects on cognitive, renal and hepatic function and for haemorrhagic stroke risk, and lipid management strategies in patients with chronic kidney disease, including those with concomitant hypertriglyceridaemia.

Conclusions

This survey of physicians in Japan, Germany, Colombia and the Philippines has identified key gaps in knowledge about dyslipidaemia management. These relate to the safety of low LDL-C levels, the safety of statins, and lipid management of chronic kidney disease. The findings from this survey highlight the need for further education to improve the implementation of guideline recommendations for dyslipidaemia management.
Androgen deprivation therapy improves the in vitro capacity of high-density lipoprotein (HDL) to receive cholesterol and other lipids in patients with prostate carcinoma
Authors: Albuquerque Cicero P. , Freitas Fatima R. , Martinelli Ana Elisa M. , Lima Josefa H. , Coelho Rafael F. , Serrano Carlos V. , Nahas Willian C. , Kalil Filho Roberto , Maranhão Raul C.
Published: June 2020

Background

Androgen deprivation therapy (ADT) is widely used in the treatment of testosterone-dependent prostate carcinomas. ADT often increases plasma LDL and HDL cholesterol and triglycerides. The aim was to test whether ADT changes the transfer of lipids to HDL, an important aspect of this metabolism and HDL protective functions, and related parameters.

Methods

Sixteen volunteers with advanced prostate carcinoma submitted to pharmacological ADT or orchiectomy had plasma collected shortly before and after 6 months of ADT. In vitro transfer of lipids to HDL was performed by incubating plasma with donor emulsion containing radioactive lipids by 1 h at 37 °C. After chemical precipitation of apolipoprotein B-containing lipoprotein, the radioactivity of HDL fraction was counted.

Results

ADT reduced testosterone to nearly undetectable levels and markedly diminished PSA. ADT increased the body weight but glycemia, triglycerides, LDL and HDL cholesterol, HDL lipid composition and CETP concentration were unchanged. However, ADT increased the plasma unesterified cholesterol concentration (48 ± 12 vs 56 ± 12 mg/dL, p = 0.019) and LCAT concentration (7.15 ± 1.81 vs 8.01 ± 1.55μg/mL, p = 0.020). Transfer of unesterified (7.32 ± 1.09 vs 8.18 ± 1.52%, p < 0.05) and esterified cholesterol (6.15 ± 0.69 vs 6.94 ± 1.29%, p < 0.01) and of triglycerides (6.37 ± 0.43 vs 7.18 ± 0.91%, p < 0.001) to HDL were increased after ADT. Phospholipid transfer was unchanged.

Conclusion

Increase in transfer of unesterified and esterified cholesterol protects against cardiovascular disease, as shown previously, and increased LCAT favors cholesterol esterification and facilitates the reverse cholesterol transport. Thus, our results suggest that ADT may offer anti-atherosclerosis protection by improving HDL functional properties. This could counteract, at least partially, the eventual worse effects on plasma lipids.
Patient and clinician opinions of patient reported outcome measures (PROMs) in the management of patients with rare diseases: a qualitative study
Authors: Aiyegbusi Olalekan Lee , Isa Fatima , Kyte Derek , Pankhurst Tanya , Kerecuk Larissa , Ferguson James , Lipkin Graham , Calvert Melanie
Published: June 2020

Background

Rare diseases may be life-threatening or chronically debilitating conditions. Patient care needs are often complex and challenging to coordinate and deliver effectively. Rare diseases and their clinical management may therefore substantially impact on patients’ health-related quality of life (HRQOL). The use of patient-reported outcome measures (PROMs) may complement clinical assessments by elucidating patients’ perspectives on their health status and care priorities. This study explored the opinions of patients and clinicians on the use of PROMs in the management of patients with rare diseases in routine clinical practice.

Methods

A total of 15 semi-structured one-to-one interviews were conducted with four patients with primary sclerosing cholangitis (PSC); five renal transplant recipients; and six PSC doctors from University Hospitals Birmingham (UHB) NHS Foundation Trust. A focus group session was also conducted with 10 clinical staff members (doctors, nurses and other allied health professionals from UHB). The suitability and acceptability of the Chronic Liver Disease Questionnaire (CLDQ) and the Short Form 12 (SF12) were assessed by patients with PSC and their doctors while the Paediatric quality of life inventory Transplant Module (PedsQL-TM) and the EuroQoL-5 dimensions (EQ. 5D) were evaluated by the renal transplant recipients and their doctors. The discussions were audio recorded and transcribed verbatim. Coding of the transcripts was done using the Nvivo 11 Plus software. Thematic analysis was conducted to identify the main themes and subthemes.

Results

Four themes were identified, namely: (i) potential benefits of PROMs in the management of rare diseases; (ii) views on selected questionnaires; (iii) practical considerations for implementation; and (iv) potential facilitators and barriers of implementation. Patients and clinicians suggested that the use of ePROMs may facilitate patient-centred care by promoting patient-clinician communication, highlighting aspects of HRQOL that are important to patients and encouraging patient involvement in their care. They also felt that the disease-specific CLDQ and PedsQL-TM were more relevant than the generic SF12 and EQ-5D.

Conclusions

Patients with rare diseases often experience impaired HRQOL. The use of an ePROM system may enhance the routine management of patients with rare diseases.
Reproductive health status and related knowledge among women aged 20–39 years in rural China: a cross-sectional study
Authors: Chen Mingzhu , Luo Yang , Fu Jingxia , Wang Ting , Meng Yanting , Xu Chen , Qin Si
Published: June 2020

Background

Reproductive health is the core science of human life and is critical to the healthy and sustainable development of human society. Since 1980, China has enforced a “one child” policy. With the implementation of the Universal Two-Child Policy in 2016, every couple is allowed to have two children instead of one, which will lead to more pregnancies, births, and advanced maternal age. Thus, women aged 20–39 years, at the peak of sexual activity and fertility, will face more reproductive health problems related to pregnancies and births. This study aimed to investigate the current reproductive health status, knowledge, and factors associated with reproductive health knowledge among women aged 20–39 years in rural China.

Methods

A cross-sectional study was conducted in five villages of five cities in China. The data were collected using pre-tested and structured questionnaires through face-to-face interviews. The data were entered into Epidata version 3.0, and analyzed using SPSS version 18.0. A descriptive summary of the data and logistic regression were used to identify associated factors.

Results

One-third of the participants reported that they had suffered from gynecopathy, and 38.89% of participants with gynecopathy-related discomfort did not seek medical treatment. Condoms and intrauterine devices were the main contraceptive measures used, and 28.70% of women had a history of induced abortion. Over half of the respondents (53.00%) were classified as having a low reproductive health knowledge score. Factors associated with lower knowledge levels were lower education, no history of gynecopathy, and lack of acquiring knowledge from medical staff, WeChat/micro-blog, or the internet.

Conclusion

A poor reproductive health situation and low level of health knowledge were found among women aged 20–39 years in rural China. More specific interventions promoting reproductive health and targeting rural women aged 20–39 years are needed.
Frontline treatments in extremely elderly patients with diffuse large B-cell lymphoma: a population-based study in Taiwan, 2010–2015
Authors: Huang Huai-Hsuan , Ko Bor-Sheng , Chen Ho-Min , Chen Li-Ju , Wang Chen-Yu , Hsiao Fei-Yuan
Published: June 2020

Background

The standard frontline therapy for patients with diffuse large B cell lymphoma (DLBCL) is R-CHOP. However, patients older than 80 years are excluded from clinical trials. The importance of rituximab and anthracycline remains unknown in extremely elderly DLBCL patients. Here, we incorporated data from the Taiwan Cancer Registry Database (TCRD), National Health Insurance Research Database (NHIRD), and National Death Registry to evaluate the clinical benefits of rituximab and anthracycline in elderly patients. From the TCRD and NHIRD, we included DLBCL patients aged older than 60 years who received R-CHOP, R-CVP, CHOP, or CVP between 2010 and 2015.

Results

Of the 3228 eligible patients, 2559 were between 60 and 79 years (the 60–79 group), and 669 were older than 80 years (the 80+ group). The proportions of patients in the different Ann Arbor stages and the practice settings were similar in both groups. The male-to-female ratio and the Charlson comorbidity index (CCI) scores in the 80+ group were higher than those in the 60–79 group. Patients in the 60–79 group received R-CHOP more frequently than those in the 80+ group. In the 60–79 group, the median age of the patients receiving R-CVP or CVP was older than those receiving R-CHOP or CHOP. In the analysis of overall survival (OS) and time to treatment failure (TTF), R-CHOP, female sex, younger age, lower Ann Arbor stage, lower CCI score, and care at a medical center predicted a favorable prognosis in the 60–79 group. However, only R-CHOP, younger age, and lower Ann Arbor stage remained independent favorable prognostic factors in the 80+ group.

Conclusions

Our population-based study demonstrated the clinical benefits of rituximab and anthracycline in extremely elderly Asian patients with DLBCL.
Correction to: Immune landscape in Burkitt lymphoma reveals M2-macrophage polarization and correlation between PD-L1 expression and non-canonical EBV latency program
Authors: Granai Massimo , Mundo Lucia , Akarca Ayse U. , Siciliano Maria Chiara , Rizvi Hasan , Mancini Virginia , Onyango Noel , Nyagol Joshua , Abinya Nicholas Othieno , Maha Ibrahim , Margielewska Sandra , Wei Wenbin , Bibas Michele , Piccaluga Pier Paolo , Quintanilla-Martinez Leticia , Fend Falko , Lazzi Stefano , Leoncini Lorenzo , Marafioti Teresa
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Subjective well-being of left-behind children: a cross-sectional study in a rural area of eastern China
Authors: Ye Lihong , Qian Yu , Meng Shuyang , Ye Ding , Rong Chao , Vandenhouten Eric E. , Jing Fangyuan , Mao Yingying
Published: June 2020

Purpose

Psychological well-beings of left-behind children (LBC) in rural areas of China remain under-studied. In this cross-sectional study, we aimed to explore the subjective well-being (SWB) in LBC and its associated factors in a rural area in eastern China.

Methods

Stratified random cluster sampling was used to select middle school and high school students in Qingyuan County of Zhejiang Province. Relevant information including sociodemographic characteristics was collected from each participant using an organized questionnaire. SWB was measured using the modified scale developed for Chinese adolescents. Univariable and multivariable regression analyses were performed using R version 3.3.0.

Results

A total of 1086 children were recruited and examined in the current analysis, with 365 (33.61%) being left-behind. Compared with non-left-behind children (NLBC), LBC had significantly lower scores in family satisfaction (P = 0.003) and environment satisfaction (P = 0.020). Multivariable regression analysis uncovered that frequent parent–child communication was associated with high positive affect (P = 0.003) and life satisfaction (P < 0.001), and the type of caregivers was associated with negative affect among LBC (P = 0.037).

Conclusions

Our results suggest SWB was lower in LBC, and targeted interventions including strengthening parental-child communication should be developed and implemented to improve LBC’s SWB in rural areas of China.
The accelerated aging model reveals critical mechanisms of late-onset Parkinson’s disease
Authors: Li Shiyan , Liu Hongxin , Bian Shiyu , Sha Xianzheng , Li Yixue , Wang Yin
Published: June 2020

Background

Late-onset Parkinson’s disease (LOPD) is a common neurodegenerative disorder and lacks disease-modifying treatments, attracting major attentions as the aggravating trend of aging population. There were numerous evidences supported that accelerated aging was the primary risk factor for LOPD, thus pointed out that the mechanisms of PD should be revealed thoroughly based on aging acceleration. However, how PD was triggered by accelerated aging remained unclear and the systematic prediction model was needed to study the mechanisms of PD.

Results

In this paper, an improved PD predictor was presented by comparing with the normal aging process, and both aging and PD markers were identified herein using machine learning methods. Based on the aging scores, the aging acceleration network was constructed thereby, where the enrichment analysis shed light on key characteristics of LOPD. As a result, dysregulated energy metabolisms, the cell apoptosis, neuroinflammation and the ion imbalances were identified as crucial factors linking accelerated aging and PD coordinately, along with dysfunctions in the immune system.

Conclusions

In short, mechanisms between aging and LOPD were integrated by our computational pipeline.
Tendon morphological changes after a prolonged ski race can be detected by ultrasound echo intensity
Authors: Schneebeli Alessandro , Visconti Lorenzo , Cescon Corrado , Clijsen Ron , Giardini Guido , Arizzio Maria Elisabetta , Barbero Marco
Published: June 2020

Background

Ultrasound imaging techniques have been used to assess the characteristics of skeletal muscles and tendons. Such techniques (gray scale analysis) allow qualitative evaluation and have been used recently to assess the internal structure of muscles and tendons by computer‐aided gray scale analysis. We hypothesized that changes in the internal structure of the Achilles and patellar tendons after a ski mountaineering race competition could be detected with ultrasound.

Methods

Twenty athletes were recruited during the 19th Millet Tour du Rutor extreme, a three‐day ski mountaineering competition. Ultrasound measurements of the Achilles and patellar tendons were carried out before the first race and immediately after each of the three competition days. Tendon thickness, cross‐sectional area (CSA), and ultrasound gray scale analysis were calculated.

Results

Significant differences (p < 0.05) were observed between the pre‐ and post‐race measurements for the Achilles tendon thickness and CSA, while no significant differences were noted for the patellar tendon thickness and CSA. However, gray scale analysis of both the Achilles and patellar tendons showed significantly higher post‐race values, than the pre‐race values (p < 0.05).

Conclusions

Achilles and patellar tendons of healthy athletes are highly responsive to an acute increase in mechanical load. Those changes can be detected from classical (thickness and CSA) and innovative (gray scale) ultrasound‐based parameters.

Trial registration

This study was approved by the Azienda USL Valle d'Aosta Ethics Committee (protocol no. 23/03/2018.0026243.I).
Auxological and endocrinological features in internationally adopted children
Authors: Stagi Stefano , Papacciuoli Valeria , Boiro Djibril , Maggioli Chiara , Ndambao Niane Ndeye , Losi Stefania , Chiappini Elena , Toni Sonia , Ndiaye Ousmane
Published: June 2020

In internationally adopted children disorders of linear growth, puberty development, thyroid function, and bone metabolism are frequently reported. It is important that these children receive careful auxological and endocrinological evaluations and follow-up.

Pediatricians and other healthcare providers should be aware that auxological and endocrinological problems are common in newly arrived international adoptees.
The need for new vector control approaches targeting outdoor biting anopheline malaria vector communities
Authors: Sougoufara Seynabou , Ottih Emmanuel Chinweuba , Tripet Frederic
Published: June 2020

Since the implementation of Roll Back Malaria, the widespread use of insecticide-treated nets (ITNs) and indoor residual spraying (IRS) is thought to have played a major part in the decrease in mortality and morbidity achieved in malaria-endemic regions. In the past decade, resistance to major classes of insecticides recommended for public health has spread across many malaria vector populations. Increasingly, malaria vectors are also showing changes in vector behaviour in response to current indoor chemical vector control interventions. Changes in the time of biting and proportion of indoor biting of major vectors, as well as changes in the species composition of mosquito communities threaten the progress made to control malaria transmission. Outdoor biting mosquito populations contribute to malaria transmission in many parts of sub-Saharan Africa and pose new challenges as they cannot be reliably monitored or controlled using conventional tools. Here, we review existing and novel approaches that may be used to target outdoor communities of malaria vectors. We conclude that scalable tools designed specifically for the control and monitoring of outdoor biting and resting malaria vectors with increasingly complex and dynamic responses to intensifying malaria control interventions are urgently needed. These are crucial for integrated vector management programmes designed to challenge current and future vector populations.
Amaryllidaceae alkaloids with anti-Trypanosoma cruzi activity
Authors: Martinez-Peinado Nieves , Cortes-Serra Nuria , Torras-Claveria Laura , Pinazo Maria-Jesus , Gascon Joaquim , Bastida Jaume , Alonso-Padilla Julio
Published: June 2020

Background

Chagas disease, caused by the protozoan Trypanosoma cruzi, is a neglected disease that affects ~7 million people worldwide. Development of new drugs to treat the infection remains a priority since those currently available have frequent side effects and limited efficacy at the chronic stage. Natural products provide a pool of diversity structures to lead the chemical synthesis of novel molecules for this purpose. Herein we analyzed the anti-T. cruzi activity of nine alkaloids derived from plants of the family Amaryllidaceae.

Methods

The activity of each alkaloid was assessed by means of an anti-T. cruzi phenotypic assay. We further evaluated the compounds that inhibited parasite growth on two distinct cytotoxicity assays to discard those that were toxic to host cells and assure parasite selectivity.

Results

We identified a single compound (hippeastrine) that was selectively active against the parasite yielding selectivity indexes of 12.7 and 35.2 against Vero and HepG2 cells, respectively. Moreover, it showed specific activity against the amastigote stage (IC50 = 3.31 μM).

Conclusions

Results reported here suggest that natural products are an interesting source of new compounds for the development of drugs against Chagas disease.
Efficacy and safety of sarilumab in combination with csDMARDs or as monotherapy in subpopulations of patients with moderately to severely active rheumatoid arthritis in three phase III randomized, controlled studies
Authors: Genovese Mark C. , Fleischmann Roy , Kivitz Alan , Lee Eun-Bong , van Hoogstraten Hubert , Kimura Toshio , St John Gregory , Mangan Erin K. , Burmester Gerd R.
Published: June 2020

Background

The interleukin-6 receptor inhibitor sarilumab demonstrated efficacy in combination with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or as monotherapy in patients with moderately to severely active rheumatoid arthritis (RA) with an inadequate response (IR) or intolerant (INT) to methotrexate (MTX) or tumour necrosis factor (TNF)-α inhibitors. This analysis investigated the efficacy and safety of sarilumab in patient subgroups.

Methods

Data were included from phase III studies: two placebo-controlled studies of subcutaneous sarilumab 150/200 mg every 2 weeks (q2w) either + MTX in MTX-IR patients (52 weeks) or + csDMARDs in TNF-IR/INT patients (24 weeks), and a monotherapy study of sarilumab 200 mg q2w vs. adalimumab 40 mg q2w in MTX-IR/INT patients (24 weeks). Prespecified and post hoc subgroups included patient demographics, disease characteristics, and prior treatments. Prespecified and post hoc endpoints included clinical, radiographic, and physical function measures, and p values are considered nominal. Safety was assessed during double-blind treatment.

Results

The superiority of sarilumab (either as monotherapy vs. adalimumab or in combination with csDMARDs vs. placebo + csDMARDs) across clinical endpoints was generally consistent across subgroups defined by patient demographics, disease characteristics, and prior treatments, demonstrating the benefit of sarilumab treatment for a wide range of patient types. Interaction p values of < 0.05 were consistently observed across studies only for baseline anti-cyclic citrullinated peptide antibody (ACPA) status for American College of Rheumatology 20% response, but not American College of Rheumatology 50% or 70% response. Adverse events and worsening laboratory parameters occurred more frequently in sarilumab-treated vs. placebo-treated patients and were more frequent in the small number of patients ≥ 65 years (n = 289) vs. patients < 65 years (n = 1819). Serious infections occurred in six patients aged ≥ 65 years receiving sarilumab, although the incidence of serious infections was generally higher in patients aged ≥ 65 years regardless of treatment.

Conclusions

Apart from ACPA status, there were no consistent signals indicating differential effects of sarilumab in any of the subpopulations assessed. Sarilumab demonstrated consistent efficacy and safety across a wide range of patients with RA.

Trial registration

ClinicalTrials.gov NCT01061736, registered on February 03, 2010; ClinicalTrials.gov NCT01709578, registered on October 18, 2012; ClinicalTrials.gov NCT02332590, registered on January 07, 2015
Effects of stone mining on woody plant species diversity and selected soil properties in northern Ethiopia
Authors: Belay Leake , Birhane Emiru , Zenebe Amanuel , Weldu Askal , Chiemela Stella Nwawulu , Solomon Negasi
Published: June 2020

Background

Stone mining is one of the main livelihood activities in areas close to major cities in Ethiopia. Mining tends to make a notable impact on woody plant species and soil properties. Information regarding the effect of stone mining on woody plant species diversity and soil properties is limited in Ethiopia. It is also less known how people perceive the impact of stone mining on existing natural resource in the watershed after mining. Therefore, this paper analyzed the effect of stone mining on woody plant species diversity, selected soil properties and perception of nearby community on mining in northern Ethiopia.

Methods

Vegetation and soil sampling were conducted using 6.32 ha sample plots. Samples were randomly selected from mining and adjacent unmined areas. Species abundance, density, basal area, selected soil physical and chemical properties were analyzed. The differences in species diversity and soil physical and chemical properties between the mined and unmined areas were analyzed using independent t test. Household survey was also conducted to assess the view of the local people regarding the effect of mining on ecology.

Results

A total of 35 species representing 19 families in the mining site were recorded while 43 species representing 27 families were recorded in the unmined site. Abundance and density of species were higher in unmined than in mining areas. The most abundant species in the mining and unmined sites wereEuclea racemosasubsp.schimperi,Senna singueana,Maytenus arbutifolia,Calpurnia aureaandBuddleja polystachya. Woody species diversity at mining (1.97) was significantly different from that unmined (2.49) site (p = 0.0005). Bulk density significantly varied between the mined (1.9 g cm−3) and unmined (1.38 g cm−3) sites (p < 0.0005). Furthermore, significantly higher TN and AvP was recorded at unmined areas as compared to the mining areas (p < 0.05). Discussion with communities is mandatory before deciding a site for mining. Respondents argued that mining negatively affects the vegetation and other resources that brought devastating effect on the downstream farms. The communities’ were recommended for immediate rehabilitation of abandoned lands to restore it and reduce the negative impact of mining.

Conclusions

Stone mining causes an adverse impact on plant species and soil physico-chemical properties. Discussion with communities at the planning stage, immediate restoration activities and monitoring are crucial to reduce the negative impacts of stone mining for further sustainable natural resources development and management.
Assessment of the pesticidal behaviour of diacyl hydrazine-based ready-to-use nanoformulations
Authors: Pandey Alka , Srivastava Shivani , Aggarwal Nisha , Srivastava Chitra , Adholeya Alok , Kochar Mandira
Published: June 2020

Background

Application of nanotechnology for crop protection in the form of nanopesticide has attracted significant interest in modern agriculture for the management of devastating polyphagous pests. In the present work, highly stable, ready-to-use water-based nanoformulations of hydrazine-based pesticides were evaluated for their Insect Growth Regulatory potential against the polyphagous insect pest—Spodoptera litura. Also, the nanoformulations were screened for their antifungal behaviour against plant pathogenic fungi; Colletotrichum gloeosporioides, Rhizoctonia solani, Fusarium solani, and Alternaria solani.

Results

Nanoformulation of sulfonyl acyl hydrazine derivative, NF7, emerged as the best insect growth regulator with GI90 value 0.010 mg L−1 followed by NF4 and NF6 with GI90 0.012 and 0.013 mg L−1, respectively. Results of diet incorporation method showed enhanced efficacy of nanoformulations when compared with topical application method. Antifungal screening showed that many nanoformulations displayed at least 50% growth inhibition for treatment dosage 50–200 mg L−1 against the fungal pathogens tested (C. gloeosporioides, R. solani, F. solani, and A. solani). NF6, NF7, and NF8 were more potent antifungal agents at lower treatment dosages, while at high doses (400 and 800 mg L−1), 100% growth inhibition at concentration was observed against R. solani and F. solani, except NF1 having 64% growth inhibition against F. solani.

Conclusion

Results presented here are very promising and deliver new nanoformulations of diacyl and sulfonyl acyl hydrazine-based derivatives to be employed as nanopesticide for sustainable crop protection.
Extraction of phytochemicals and study of its antimicrobial and antioxidant activity of Helicteres isora L.
Authors: Mahire S. P. , Patel S. N.
Published: June 2020

Background

Herbal medicines are used for the treatment of many infectious diseases throughout the history of mankind. The increasing antibiotic resistance exhibited by microorganisms has led to the phytochemical screening of medicinal plants for antimicrobial activity. Many infections can be treated by phytochemicals possessing potent antibacterial efficiency. The pharmacological activities of any plant is because of the presence of primary metabolites, secondary metabolites and its secretary products, comprising the phenolic compounds, alkaloids, tannins, saponins, carbohydrates, glycosides, flavanoids, steroids, etc. Helicteres isora L. is a medicinal plant used in traditional medicine. The root and bark are expectorant, demulcent, astringent to the bowels, antigalactagogue, lessen gripping; a cure for scabies when applied topically.

Method

Soxhlet extraction or hot continuous extraction: In this method, finely ground sample was placed in thimble chamber of the Soxhlet apparatus. Extraction solvents was heated in the bottom flask, vaporizes into the sample thimble, condenses in the condenser and drip back. When the liquid content reaches the siphon arm, the liquid contents emptied into the bottom flask again and the process is continued. Gram positive bacteria Staphylococcus aureus NCIM 2079, Gram negative bacteria Escherichia coli NCIM 2109, Fungi (Yeast) Candida albicans NCIM 3471, Fungi (Mould) Aspergillus niger NCIM 545 are used as reference Strain for antimicrobial activity. Antioxidant activity was tested by DPPH method.

Result

Chloroform Extracts of leaves, Stem and fruits of Helicteres isora L. exhibited potent antimicrobial activity against Escherichia coli, Staphylococcus aureus, Candida albicans and Aspergillus, niger. The stem extract showed highest antimicrobial activity against Escherichia coli with zone of inhibition of 19.24 mm and leaves lowest activity against Candida albicans with zone of inhibition of 11.26 mm. Antioxidant activity was tested by DPPH method.

Conclusion

The use of herbal crude drugs, in tracts and their remedies have significantly increased throughout the world. Efforts must be made to ensure safe, effective and affordable treatments for wide range of diseases by traditional methods which use locally available medicinal plants. The scientific and authentic researches on these aspects are to be done in order to exploit traditional knowledge of medicinal plants.
The values of Transgelin, Stathmin, BCOR and Cyclin-D1 expression in differentiation between Uterine Leiomyosarcoma (ULMS) and Endometrial Stromal Sarcoma (ESS); diagnostic and prognostic implications
Authors: Alabiad Mohamed Ali , Harb Ola A. , Abdelfattah Mustafa Taha , El-Shafaay Basant Sh. , El-Taher Ahmed K. , El-Hendawy Elsayed I.
Published: June 2020

Background

Morphologic distinction between uterine leiomyosarcoma (ULMS) and endometrial stromal sarcoma (ESS) alone is not straightforward and has been shown to be challenging especially with poor differentiation, so immunohistochemistry (IHC) is often employed as an adjunct to morphology in uterine sarcoma.

Aim

We aimed to assess the diagnostic utility of Transgelin, Stathmin, BCOR and Cyclin-D1 separately and in-combinations in distinguishing ULMS from ESS, and to evaluate their prognostic value in patients with such sarcoma subtypes.

Material and Methods

We included 44 patients with uterine sarcoma. The diagnostic performances of Transgelin, Stathmin, BCOR and Cyclin-D1 were assessed in samples from all patients using immunohistochemistry.

Results

The combination of Stathmin and Transgelin expression has high sensitivity and specificity for diagnosis of LMS and differentiating it from ESS; 95.5% and associated with poor prognosis in LMS patients.

The combination of BCOR and Cyclin-D1 expression has high sensitivity and specificity for diagnosis of ESS and differentiating it from LMS; 90.9% and 95.5% respectively and associated with poor prognosis in ESS patients. The combination of Stathmin and Transgelin, BCOR and CyclinD1 expression has high sensitivity and specificity for diagnosis of LMS and differentiating it from ESS; 100%.

Conclusion

Combination of Stathmin, Transgelin, BCOR and Cycline-D1 raised the accuracy of differentiation between ULMS and ESS to 100% and has prognostic roles in such sarcomas.
Dexmedetomidine versus remifentanil infusion for controlled hypotension in shoulder arthroscopy: a comparative study
Authors: Menshawi Mohammed Abdelsalam , Fahim Hany Magdy
Published: June 2020

Study objective

The correct performance of the shoulder arthroscopic technique requires appropriate visualization through a video camera which raises the need for providing satisfactory bloodless surgical field. The current study was conducted to evaluate the clinical efficacy of dexmedetomidine infusion compared to that of remifentanil for controlled hypotension in patients undergoing shoulder arthroscopy.

Patients and methods

Forty patients undergoing elective arthroscopic shoulder surgery under general anesthesia were enrolled in the current study. Patients were randomly distributed into one of two equal groups: dexmedetomidine group (D group) and remifentanil group (R group) according to the agent used for controlled hypotension. In group D, IV dexmedetomidine l μg/kg was infused over 10 min before anesthesia induction, followed by a continuous infusion of 0.3-0.6 μg/kg/h during the operation. In group R, 1 μg/kg remifentanil IV bolus was administered before induction of anesthesia and continued 0.25-0.50 μg/kg/min during the operation. In both groups, the drug infusion was titrated to achieve a mean arterial pressure (MAP) of 60-70 mmHg. Hemodynamic parameters, surgical field condition, recovery profile, and the incidence of perioperative adverse events were assessed.

Results

Controlled hypotension was achieved successfully in both study groups. There was no intergroup significant difference as regards the intraoperative MAP and heart rate (HR) recordings (P> 0.05) except for the significantly lower HR recorded after extubation,30 min and 1 h postoperative in group D when compared with group R (P< 0.05). The surgical field condition was satisfactory on surgeon assessment in both groups (P> 0.05). Extubation time, time to reach modified Aldrete score ≥ 9 and time to 1st postoperative analgesic requirement were significantly longer in the group D when compared with group R (P< 0.05). Postoperative Ramsay sedation score recordings were significantly higher in the group D when compared with group R (P< 0.05) except at 2 h postoperative recordings and all the VAS score recordings were significantly lower in group D when compared with group R (P< 0.05). There was no intergroup significant difference as regards the incidence of perioperative adverse events.

Conclusion

Both remifentanil and dexmedetomidine can induce adequate levels of hypotensive anesthesia and satisfactory surgical field visibility in patients undergoing shoulder arthroscopy under general anesthesia. Patients treated with dexmedetomidine had better quality and more extended postoperative analgesia but longer postoperative anesthesia recovery and higher postoperative sedation scores when compared with remifentanil.
Guideline “diagnosis and non interventional therapy of neuropathic pain” of the German Society of Neurology (deutsche Gesellschaft für Neurologie)
Authors: Schlereth Tanja
Published: June 2020

2019 the DGN (Deutsche Gesellschaft für Neurology) published a new guideline on the diagnosis and non-interventional therapy of neuropathic pain of any etiology excluding trigeminal neuralgia and CRPS (complex regional pain syndrome). Neuropathic pain occurs after lesion or damage of the somatosensory system. Besides clinical examination several diagnostic procedures are recommended to assess the function of nociceptive A-delta and C-Fibers (skin biopsy, quantitative sensory testing, Laser-evoked potentials, Pain-evoked potentials, corneal confocal microscopy, axon reflex testing). First line treatment in neuropathic pain is pregabalin, gabapentin, duloxetine and amitriptyline. Second choice drugs are topical capsaicin and lidocaine, which can also be considered as primary treatment in focal neuropathic pain. Opioids are considered as third choice treatment. Botulinum toxin can be considered as a third choice drug for focal limited pain in specialized centers only. Carbamazepine and oxcarbazepine cannot be generally  recommended, but might be helpful in single cases. In Germany, cannabinoids can be prescribed, but only after approval of reimbursement. However, the use is not recommended, and can only be considered as off-label therapy within a multimodal therapy concept.