bluuebunny/crossref_metadata_2025 huggingface dataset:
Proteinuria as a presenting sign of combined methylmalonic acidemia and homocysteinemia: case report
Authors: Chen Ru-Yue , Li Xiao-Zhong , Lin Qiang , Zhu Yun , Shen Yun-Yan , Xu Qin-Ying , Zhu Xue-Ming , Chen Lin-Qi , Wu Hai-Ying , Chen Xu-Qin
Published: September 2020

Background

Disorders of the metabolism and absorption of vitamin B12 can lead to decrease in activity of methionine synthetase and methylmalonate coenzyme A mutase (MMUT), which results in increased levels of methylmalonic acid and homocysteine in blood and urine. Often, combined methylmalonic acidemia (MMA) and homocysteinemia is misdiagnosed due to a lack of specific symptoms. The clinical manifestations are diverse, but proteinuria as the initial presentation is rare.

Case presentation

Two cases of MMA with homocysteinemia in children are reported. Proteinuria were a primary presenting symptom, followed by anemia and neurologic symptoms (frequent convulsions and unstable walking, respectively). Screening of amino acids and acyl carnitine in serum showed that the propionyl carnitine:acetylcarnitine ratio increased. Profiling of urinary organic acids by gas chromatography–mass spectrometry revealed high levels of methylmalonic acid. Homocysteine content in blood was increased. Comprehensive genetic analyses of peripheral blood-derived DNA demonstrated heterozygous variants of methylmalonic aciduria type C and homocystinuria (MMACHC) and amnionless (AMN) genes in our two patients, respectively. After active treatment, the clinical manifestations in Case 1 were relieved and urinary protein ceased to be observed; Case 2 had persistent proteinuria and was lost to follow-up.

Conclusions

Analyses of the organic acids in blood and urine suggested MMA combined with homocysteinemia. In such diseases, reports of renal damage are uncommon and proteinuria as the initial presentation is rare. Molecular analysis indicated two different genetic causes. Although the pathologic mechanisms were related to vitamin B12, the severity and prognosis of renal lesions were different. Therefore, gene detection provides new insights into inherited metabolic diseases.
Grow well/Crecer bien: a protocol for research on infant feeding practices in low-income families
Authors: Cheney Ann M. , Nieri Tanya , Ramirez Zarate Ana , Garcia Gretel , Vaca Lucero , Valencia Esmirna , Versteeg Colleen , Molina Arlene , Castillo Michael , Tovar Alison
Published: September 2020

Background

The prevalence of obesity among children remains high. Given obesity’s significant lifelong consequences, there is great interest in preventing obesity early in life. There is a need to better understand the relation of common infant feeding styles and practices to obesity in infants using longitudinal study designs. There is also an urgent need to understand the role of caregivers other than mothers in feeding. A better understanding of variation in feeding styles and practices can inform the identification of risk groups and the tailoring of interventions to them.

Methods

In partnership with Early Head Start programs across four counties in southern California, mothers and infants will be enrolled in a two-year longitudinal study collecting survey and anthropometric data. A subsample of mothers and their selected other caregivers will participate in qualitative research involving feeding diaries and dyadic interviews. The results will be used to develop and test an enhanced nutrition education program.

Discussion

We outline a study methodology to examine feeding styles and practices and their association with early childhood obesity risk and enhance an existing intervention to promote healthy infant feeding and growth among children in low-income families.
Spatial distribution of tuberculosis incidence in Los Angeles County
Authors: Readhead Adam , Chang Alicia H. , Ghosh Jo Kay , Sorvillo Frank , Higashi Julie , Detels Roger
Published: September 2020

Background

In Los Angeles County, the tuberculosis (TB) disease incidence rate is seven times higher among non-U.S.-born persons than U.S.-born persons and varies by country of birth. But translating these findings into public health action requires more granular information, especially considering that Los Angeles County is more than 4000 mile2. Local public health authorities may benefit from data on which areas of the county are most affected, yet these data remain largely unreported in part because of limitations of sparse data. We aimed to describe the spatial distribution of TB disease incidence in Los Angeles County while addressing challenges arising from sparse data and accounting for known cofactors.

Methods

Data on 5447 TB cases from Los Angeles County were combined with stratified population estimates available from the 2005–2011 Public Use Microdata Survey. TB disease incidence rates stratified by country of birth and Public Use Microdata Area were calculated and spatial smoothing was applied using a conditional autoregressive model. We used Bayesian Poisson models to investigate spatial patterns adjusting for age, sex, country of birth and years since initial arrival in the U.S.

Results

There were notable differences in the crude and spatially-smoothed maps of TB disease rates for high-risk subgroups, namely persons born in Mexico, Vietnam or the Philippines. Spatially-smoothed maps showed areas of high incidence in downtown Los Angeles and surrounding areas for persons born in the Philippines or Vietnam. Areas of high incidence were more dispersed for persons born in Mexico. Adjusted models suggested that the spatial distribution of TB disease could not be fully explained using age, sex, country of birth and years since initial arrival.

Conclusions

This study highlights areas of high TB incidence within Los Angeles County both for U.S.-born cases and for cases born in Mexico, Vietnam or the Philippines. It also highlights areas that had high incidence rates even when accounting for non-spatial error and country of birth, age, sex, and years since initial arrival in the U.S. Information on spatial distribution provided here complements other descriptions of local disease burden and may help focus ongoing efforts to scale up testing for TB infection and treatment among high-risk subgroups.
Effect of chlorhexidine chip as an adjunct in non-surgical management of periodontal pockets: a meta-analysis
Authors: Ma Lili , Diao Xiuchun
Published: September 2020

Background

The aim of this meta-analysis was to evaluate the difference in treatment outcomes between sub-gingival placement of chlorhexidine chip (CHX chip) in adjunct to scaling and root planing (SRP) and SRP alone for the management of periodontal pockets in patients suffering from chronic periodontitis.

Methods

We searched the MEDLINE (PubMed), SCOPUS and CENTRAL databases and identified 15 randomized clinical trials published within the last decade (2007–2019): 9 with split-mouth design and 6 with parallel study design. We extracted data and performed both qualitative and quantitative syntheses. The primary outcomes assessed were gain in clinical attachment level (CAL), reduction in probing pocket depth (PPD), improvement in gingival inflammation, and results of microbiological assays.

Results

We used meta-analysis plots to assess all the clinical outcomes. The mean differences in PPD reductions at 1 month (MD 0.63), 3 months (MD 0.69), and 6 months (MD 0.75); and the CAL gains at 1 month (MD 0.54), 3 months (MD 0.64), and 6 months (MD 0.68) showed more favorable responses in sites treated with the CHX chip as an adjuvant to SRP, than in sites treated with SRP alone.

Conclusion

SRP with adjunctive CHX chips showed better clinical outcomes than SRP alone for the management of periodontal pockets in patients with chronic periodontitis.
Pentagalloylglucose, isolated from the leaf extract of Anacardium occidentale L., could elicit rapid and selective cytotoxicity in cancer cells
Authors: Taiwo Bamigboye J. , Popoola Temidayo D. , van Heerden Fanie R. , Fatokun Amos A.
Published: September 2020

Background

The leaf of Anacardium occidentale L. has been a component of many herbal recipes in South-Western Nigeria. The work reported herein, therefore, explored the phytochemical composition of this plant and the potential anti-cancer activity of an isolated chemical constituent.

Methods

Phytochemical methods (including chromatographic analysis) combined with spectroscopic and spectrometric analyses (IR, HRMS and NMR (1D and 2D)) were used to identify chemical constituents. Cytotoxic effects were determined using the MTT viability assay and bright-field imaging. Induction of oxidative stress was determined using the fluorescence-based 2′,7′-dichlorofluorescein diacetate (DCFDA) assay.

Results

For the first time in the plant, Compound 1 was isolated from the leaf extract and identified as pentagalloylglucose. Compound 1 was significantly cytotoxic against the cancer cell lines HeLa (human cervical adenocarcinoma cell line) and MRC5-SV2 (human foetal lung cancer cell line), with IC50 of 71.45 and 52.24 μg/ml, respectively. The selectivity index (SI) for Compound 1 was 1.61 (IC50 against the normal human foetal lung fibroblast cell line MRC-5 was 84.33μg/ml), demonstrating better cancer cell-selectivity compared to doxorubicin with a SI of 1.28. The cytotoxic activity of Compound 1 in HeLa cells was also rapid, as shown by its concentration- and time-dependent 3 h and 6 h cytotoxicity profiles, an effect not observed with doxorubicin. Generation of reactive oxygen species at high concentrations of pentagalloylglucose to induce oxidative stress in cancer cells was identified as a mechanistic event that led to or resulted from its cytotoxicity.

Conclusions

We suggest that pentagalloylglucose is selectively cytotoxic to cancer cells, and at high concentrations could exhibit pro-oxidant effects in those cells, as opposed to its general anti-oxidant effects in cells. Also, the presence of Compound 1 (pentagalloylglucose) in the plant and its cancer cell-selective cytotoxicity provide some rationale for the ethno-medicinal use of the plant’s leaf extract for treating diseases associated with excessive cell proliferation. Further studies are required to dissect the molecular mechanisms and players differentially regulating the biphasic anti-oxidant and pro-oxidant effects of pentagalloylglucose in normal and cancer cells.
Nurses’ experiences and viewpoints about the benefits of adopting information technology in health care: a qualitative study in Iran
Authors: Farokhzadian Jamileh , Khajouei Reza , Hasman Arie , Ahmadian Leila
Published: September 2020

Background

Information technology (IT) plays an important role in nursing practice. Hence, nurses’ experiences and viewpoints about IT integration into healthcare help improve nurses’ adoption of IT. This study aimed to explore the nurses’ experiences and viewpoints about the benefits of IT integration and adoption in healthcare.

Methods

This study was conducted with a qualitative research approach. Participants included 14 nurses from four hospitals affiliated to a large medical university in Iran, who were selected using a purposive sampling method. Data were collected through semi-structured interviews and analyzed using the conventional content analysis of Lundman and Graneheim.

Results

Six categories in the study reflected the nurses’ experiences and viewpoints about the benefits of integrating IT into health care. These categories included improving the quality and efficiency of medical services and care, facilitating the communication management in the technological environment, improving information documentation, management, and monitoring, improving resource management, improving management performance and policymaking, and facilitating pathways of organizational and professional growth.

Conclusions

Lessons learned in this study can help overcoming the barriers of IT adoption, and developing appropriate strategies to familiarize nurses with the benefits of IT in healthcare settings. Healthcare managers are recommended to investigate the experiences of nurses with IT in their hospitals and organize courses to orient hesitant nurses toward adopting IT.
Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Southern Asia and South-eastern Asia, 1980–2015
Authors: Shrestha Poojan , Dahal Prabin , Ogbonnaa-Njoku Chinwe , Das Debashish , Stepniewska Kasia , Thomas Nigel V. , Hopkins Heidi , Crump John A. , Bell David , Newton Paul N. , Ashley Elizabeth A. , Guérin Philippe J.
Published: September 2020

Background

In the absence of definitive diagnosis, healthcare providers are likely to prescribe empirical antibacterials to those who test negative for malaria. This problem is of critical importance in Southern Asia (SA) and South-eastern Asia (SEA) where high levels of antimicrobial consumption and high prevalence of antimicrobial resistance have been reported. To improve management and guide further diagnostic test development, better understanding is needed of the true causative agents of fever and their geographical variability.

Methods

We conducted a systematic review of published literature (1980–2015) to characterise the spectrum of pathogens causing non-malarial febrile illness in SA and SEA. We searched six databases in English and French languages: MEDLINE, EMBASE, Global Health (CABI) database, WHO Global Health Library, PASCAL, and Bulletin de la Société Française de Parasitologie (BDSP). Selection criteria included reporting on an infection or infections with a confirmed diagnosis, defined as pathogens detected in or cultured from samples from normally sterile sites, or serological evidence of current or past infection.

Results

A total of 29,558 records from 19 countries in SA and SEA were screened, of which 2410 (8.1%) met the selection criteria. Bacterial aetiologies were reported in 1235 (51.2%) articles, viral in 846 (35.1%), parasitic in 132 (5.5%), and fungal in 54 (2.2%), and 143 (6.0%) articles reported more than one pathogen group. In descending order of frequency, Salmonella Typhi, Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and coagulase negative Staphylococcus were the commonly reported bacteria, while dengue virus, chikungunya virus, Japanese encephalitis virus, hepatitis B virus, and hepatitis C virus were common viral pathogens reported. Reports of rarely reported or emerging pathogens included a case report of Borrelia burgdorferi (Lyme disease) in India in 2010 and reports of Nipah virus in Singapore and India.

Conclusions

This review summarises the reported non-malaria pathogens that may cause febrile illness in SA and SEA. The findings emphasise the need of standardising the reporting of aetiological studies to develop effective, evidence-based fever management and improved surveillance. Research and development of diagnostic tools would benefit from up-to-date epidemiological reporting of the regional diversities of non-malaria fever aetiologies.

Trial registration

PROSPERO registration, CRD42016049281
High dimensional model representation of log likelihood ratio: binary classification with SNP data
Authors: pour Ali Foroughi , Pietrzak Maciej , Sucheston-Campbell Lara E. , Karaesmen Ezgi , Dalton Lori A. , Rempała Grzegorz A.
Published: September 2020

Background

Developing binary classification rules based on SNP observations has been a major challenge for many modern bioinformatics applications, e.g., predicting risk of future disease events in complex conditions such as cancer. Small-sample, high-dimensional nature of SNP data, weak effect of each SNP on the outcome, and highly non-linear SNP interactions are several key factors complicating the analysis. Additionally, SNPs take a finite number of values which may be best understood as ordinal or categorical variables, but are treated as continuous ones by many algorithms.

Methods

We use the theory of high dimensional model representation (HDMR) to build appropriate low dimensional glass-box models, allowing us to account for the effects of feature interactions. We compute the second order HDMR expansion of the log-likelihood ratio to account for the effects of single SNPs and their pairwise interactions. We propose a regression based approach, calledlinear approximation for block second order HDMR expansion of categorical observations(LABS-HDMR-CO), to approximate the HDMR coefficients. We show how HDMR can be used to detect pairwise SNP interactions, and propose thefixed pattern test(FPT) to identify statistically significant pairwise interactions.

Results

We apply LABS-HDMR-CO and FPT to synthetically generated HAPGEN2 data as well as to two GWAS cancer datasets. In these examples LABS-HDMR-CO enjoys superior accuracy compared with several algorithms used for SNP classification, while also taking pairwise interactions into account. FPT declares very few significant interactions in the small sample GWAS datasets when bounding false discovery rate (FDR) by 5%, due to the large number of tests performed. On the other hand, LABS-HDMR-CO utilizes a large number of SNP pairs to improve its prediction accuracy. In the larger HAPGEN2 dataset FTP declares a larger portion of SNP pairs used by LABS-HDMR-CO as significant.

Conclusion

LABS-HDMR-CO and FPT are interesting methods to design prediction rules and detect pairwise feature interactions for SNP data. Reliably detecting pairwise SNP interactions and taking advantage of potential interactions to improve prediction accuracy are two different objectives addressed by these methods. While the large number of potential SNP interactions may result in low power of detection, potentially interacting SNP pairs, of which many might be false alarms, can still be used to improve prediction accuracy.
The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study
Authors: Du Houwei , Pan Xiaobin , Liu Nan , Chen Junnian , Chen Xiaoling , Werring David J. , Ambler Gareth , Li Xiaoqing , Chen Ronghua , Zhang Yixian , Huang Huayao , Lin Feifei , Xia Pincang , Chen Chao , Zheng Zhenyang , Wu Sangru , Lei Hanhan , Gao Lei , Huang Mingxu , Lin Kexu , Xu Xiaoping , Luo Yukun , Zhao Ziwen , Li Chen , Lin Hailong , Lin Yu , Huang Zhenghui , Cao Rongxiang , Chen Limin ,   On behalf of the Fujian Medical Team Support Wuhan for COVID-19
Published: September 2020

Background

Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden.

Methods

We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model.

Results

Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7–27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10–6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P < 0.001) stratified by the number of vascular risk factors. After adjustment for age, sex, and comorbidities as potential confounders, vascular risk factor burden remained associated with an increasing risk of severe COVID-19 illness.

Conclusions

Patients with increasing vascular risk factor burden have an increasing risk of severe COVID-19 disease, and this population might benefit from specific COVID-19 prevention (e.g., self-isolation) and early hospital treatment measures.
Use of a Plasmodium vivax genetic barcode for genomic surveillance and parasite tracking in Sri Lanka
Authors: Dewasurendra Rajika L. , Baniecki Mary Lynn , Schaffner Stephen , Siriwardena Yamuna , Moon Jade , Doshi R. , Gunawardena Sharmini , Daniels Rachel F. , Neafsey Daniel , Volkman Sarah , Chandrasekharan Naduviladath V. , Wirth Dyann F. , Karunaweera Nadira D.
Published: September 2020

Background

Sri Lanka was certified as a malaria-free nation in 2016; however, imported malaria cases continue to be reported. Evidence-based information on the genetic structure/diversity of the parasite populations is useful to understand the population history, assess the trends in transmission patterns, as well as to predict threatening phenotypes that may be introduced and spread in parasite populations disrupting elimination programmes. This study used a previously developed Plasmodium vivax single nucleotide polymorphism (SNP) barcode to evaluate the population dynamics of P. vivax parasite isolates from Sri Lanka and to assess the ability of the SNP barcode for tracking the parasites to its origin.

Methods

A total of 51 P. vivax samples collected during 2005–2011, mainly from three provinces of the country, were genotyped for 40 previously identified P. vivax SNPs using a high-resolution melting (HRM), single-nucleotide barcode method. Minor allele frequencies, linkage disequilibrium, pair-wise FST values, and complexity of infection (COI) were evaluated to determine the genetic diversity. Structure analysis was carried out using STRUCTURE software (Version 2.3.4) and SNP barcode was used to identify the genetic diversity of the local parasite populations collected from different years. Principal component analysis (PCA) was used to determine the clustering according to global geographic regions.

Results

The proportion of multi-clone infections was significantly higher in isolates collected during an infection outbreak in year 2007. The minor allele frequencies of the SNPs changed dramatically from year to year. Significant linkage was observed in sample sub-sets from years 2005 and 2007. The majority of the isolates from 2007 consisted of at least two genetically distinct parasite strains. The overall percentage of multi-clone infections for the entire parasite sample was 39.21%. Analysis using STRUCTURE software (Version 2.3.4) revealed the high genetic diversity of the sample sub-set from year 2007. In-silico analysis of these data with those available from other global geographical regions using PCA showed distinct clustering of parasite isolates according to geography, demonstrating the usefulness of the barcode in determining an isolate to be indigenous.

Conclusions

Plasmodium vivax parasite isolates collected during a disease outbreak in year 2007 were more genetically diverse compared to those collected from other years. In-silico analysis using the 40 SNP barcode is a useful tool to track the origin of an isolate of uncertain origin, especially to differentiate indigenous from imported cases. However, an extended barcode with more SNPs may be needed to distinguish highly clonal populations within the country.
Health related quality of life utility weights for economic evaluation through different stages of chronic kidney disease: a systematic literature review
Authors: Cooper Jacie T. , Lloyd Andrew , Sanchez Juan Jose Garcia , Sörstadius Elisabeth , Briggs Andrew , McFarlane Phil
Published: September 2020

Background

A Task Force from the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) provides recommendations on how to systematically identify and appraise health state utility (HSU) weights for cost-effectiveness analyses. We applied these recommendations to conduct a systematic review (SR) to identify HSU weights for different stages of chronic kidney disease (CKD), renal replacement therapy (RRT) and complications.

Methods

MEDLINE® and Embase were searched for interventional and non-interventional studies reporting HSU weights for patients with CKD stages 1–5 or RRT. As per ISPOR Task Force Guidance, study quality criteria, applicability for Health Technology Assessment (HTA) and generalisability to a broad CKD population were used to grade studies as either 1 (recommended), 2 (to be considered if there are no data from grade 1 studies) or 3 (not recommended).

Results

A total of 17 grade 1 studies were included in this SR with 51 to 1767 participants, conducted in the UK, USA, Canada, China, Spain, and multiple-countries. Health related quality of life (HRQL) instruments used in the studies included were EQ-5D-3L (10 studies), SF-6D (4 studies), HUI2/HUI3 (1 study), and combinations (2 studies). Although absolute values for HSU weights varied among instruments, HSU weights decreased with CKD severity in a consistent manner across all instruments.

Conclusions

This SR identified HSU weights for a range of CKD states and showed that HRQL decreases with CKD progression. Data were available to inform cost-effectiveness analysis in CKD in a number of geographies using instruments acceptable by HTA agencies.
The effectiveness of sedentary behaviour interventions on sitting time and screen time in children and adults: an umbrella review of systematic reviews
Authors: Nguyen Phuong , Le Long Khanh-Dao , Nguyen Dieu , Gao Lan , Dunstan David W. , Moodie Marj
Published: September 2020

Background

There is increasing concern about the time people spend in sedentary behaviour, including screen time, leisure and occupational sitting. The number of both primary research studies (published trials) and reviews has been growing rapidly in this research area. A summary of the highest level of evidence that provides a broader quantitative synthesis of diverse types of interventions is needed. This research is to articulate the evidence of efficacy of sedentary behaviour interventions to inform interventions to reduce sitting time. The umbrella review, therefore, synthesised systematic reviews that conducted meta-analyses of interventions aiming at reducing sedentary behaviour outcomes across all age group and settings.

Method

A systematic search was conducted on six databases (MEDLINE Complete, PsycINFO, CINAHL, Global Health via EBSCOhost platform, EMBASE, and Cochrane Central Register of Systematic Reviews). Included articles were systematic reviews with meta-analysis of interventions aiming at reducing sedentary behaviour (screen time, sitting time or sedentary time) in the general population across all age group.

Results

Seventeen reviews met the inclusion criteria (7 in children and adolescent, 10 in adults). All reviews of sedentary behaviour interventions in children and adolescents investigated intervention effectiveness in reducing screen time. Six out of 11 meta-analyses (reported in 7 reviews) showed small but significant changes in viewing time. All reviews of sedentary behaviour interventions in office workplaces indicated substantial reduction in occupational sitting time (range: 39.6 to 100 min per 8-h workday). Sub-group analyses reported a trend favouring environmental change components such as sit-stand desks, active permissive workstations etc. Meta-analyses indicated that sedentary behaviour interventions were superior to physical activity alone interventions or combined physical activity and sedentary behaviour interventions in reducing sitting time.

Conclusion

The current systematic reviews and meta-analyses supported sedentary behaviour interventions for reducing occupational sitting time in particular, with small changes seen in screen time in children and adolescents. Future research should explore approaches to maintaining behaviour change beyond the intervention period and investigate the potential of sedentary behaviour reduction interventions in older age groups in non-occupational settings.
The use of mesenchymal stromal cells in the treatment of coronavirus disease 2019
Authors: Canham Maurice A. , Campbell John D. M. , Mountford Joanne C.
Published: September 2020

More than seven months into the coronavirus disease -19 (COVID-19) pandemic, infection from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to over 21.2 million cases and resulted in over 760,000 deaths worldwide so far. As a result, COVID-19 has changed all our lives as we battle to curtail the spread of the infection in the absence of specific therapies against coronaviruses and in anticipation of a proven safe and efficacious vaccine. Common with previous outbreaks of coronavirus infections, SARS and Middle East respiratory syndrome, COVID-19 can lead to acute respiratory distress syndrome (ARDS) that arises due to an imbalanced immune response. While several repurposed antiviral and host-response drugs are under examination as potential treatments, other novel therapeutics are also being explored to alleviate the effects on critically ill patients. The use of mesenchymal stromal cells (MSCs) for COVID-19 has become an attractive avenue down which almost 70 different clinical trial teams have ventured. Successfully trialled for the treatment of other conditions such as multiple sclerosis, osteoarthritis and graft versus host disease, MSCs possess both regenerative and immunomodulatory properties, the latter of which can be harnessed to reduce the severity and longevity of ARDS in patients under intensive care due to SARS-CoV-2 infection.
Anthocyanins increase serum adiponectin in newly diagnosed diabetes but not in prediabetes: a randomized controlled trial
Authors: Yang Liping , Ling Wenhua , Qiu Yun , Liu Yong , Wang Li , Yang Jing , Wang Changyi , Ma Jianping
Published: September 2020

Background

Epidemiological studies have suggested that adiponectin is associated with the development of insulin resistance and type 2 diabetes. This study first examined the effect of purified anthocyanins, a group of dietary flavonoids, on serum adiponectin in patients with prediabetes and newly diagnosed diabetes.

Methods

A total of 160 patients with prediabetes (n = 90) or newly diagnosed diabetes (n = 70) were randomly assigned to either the anthocyanins group or the placebo group for 12 weeks of intervention.
Serum adiponectin, a set of biomarkers related to glucolipid metabolism, anthropometric parameters, dietary intake and physical activity were measured before and after intervention.

Results

Anthocyanins increased serum adiponectin compared with placebo (net change 0.46 µg/mL, 95% CI [0.03, 0.90], p = 0.038) in the subjects with newly diagnosed diabetes. No significant difference in the change in adiponectin was observed between the two groups either in the overall subjects (0.02 µg/mL [− 0.32, 0.36], p = 0.906) or in prediabetes (− 0.35 µg/mL [− 0.85, 0.16], p = 0.174). Anthocyanins also decreased fasting glucose (− 0.5 mmol/L [− 1, − 0.04], p = 0.035) in the subjects with newly diagnosed diabetes, but no such change was observed in those with prediabetes.

Conclusions

Anthocyanins supplementation for 12 weeks improved serum adiponectin and fasting glucose in patients with newly diagnosed diabetes, but not in patients with prediabetes.

Trial registration

ClinicalTrials.gov, NCT02689765. Registered on 6 February 2016, https://clinicaltrials.gov/ct2/show/NCT02689765.
The effect of plant weight on estimations of stalk lodging resistance
Authors: Stubbs Christopher J. , Oduntan Yusuf A. , Keep Tyrone R. , Noble Scott D. , Robertson Daniel J.
Published: September 2020

Background

Stalk lodging (breaking of agricultural plant stalks prior to harvest) is a multi-billion dollar a year problem. Stalk lodging occurs when bending moments induced by a combination of external loading (e.g. wind) and self-loading (e.g. the plant’s own weight) exceed the stalk bending strength of plant stems. Previous studies have investigated external loading and self-loading of plants as separate and independent phenomena. However, these two types of loading are highly interconnected and mutually dependent. The purpose of this paper is twofold: (1) to investigate the combined effect of external loads and plant weight on the flexural response of plant stems, and (2) to provide a generalized framework for accounting for self-weight during mechanical phenotyping experiments used to predict stalk lodging resistance.

Results

A mathematical methodology for properly accounting for the interconnected relationship between self-loading and external loading of plants stems is presented. The method was compared to numerous finite element models of plants stems and found to be highly accurate. The resulting interconnected set of equations from the derivation were used to produce user-friendly applications by presenting (1) simplified self-loading correction factors for common loading configurations of plants, and (2) a generalized Microsoft Excel framework that calculates the influence of self-loading on crop stems. Results indicate that ignoring the effects of self-loading when calculating stalk flexural stiffness is appropriate for large and stiff plants such as maize, bamboo, and sorghum. However, significant errors result when ignoring the effects of self-loading in smaller plants with larger relative grain sizes, such as rice (8% error) and wheat (16% error).

Conclusions

Properly accounting for self-weight can be critical to determining the structural response of plant stems. Equations and tools provided herein enable researchers to properly account for the plant’s weight during mechanical phenotyping experiments used to determine stalk lodging resistance.
“All about the money?” A qualitative interview study examining organizational- and system-level characteristics that promote or hinder shared decision-making in cancer care in the United States
Authors: Scholl Isabelle , Kobrin Sarah , Elwyn Glyn
Published: September 2020

Background

Despite decades of ethical, empirical, and policy support, shared decision-making (SDM) has failed to become standard practice in US cancer care. Organizational and health system characteristics appear to contribute to the difficulties in implementing SDM in routine care. However, little is known about the relevance of the different characteristics in specific healthcare settings. The aim of the study was to explore how organizational and health system characteristics affect SDM implementation in US cancer care.

Methods

We conducted semi-structured interviews with diverse cancer care stakeholders in the USA. Of the 36 invited, 30 (83%) participants consented to interview. We used conventional content analysis to analyze transcript content.

Results

The dominant theme in the data obtained was that concerns regarding a lack of revenue generation, or indeed, the likely loss of revenue, were a major barrier preventing implementation of SDM. Many other factors were prominent as well, but the view that SDM might impair organizational or individual profit margins and reduce the income of some health professionals was widespread. On the organizational level, having leadership support for SDM and multidisciplinary teams were viewed as critical to implementation. On the health system level, views diverged on whether embedding tools into electronic health records (EHRs), making SDM a criterion for accreditation and certification, and enacting legislation could promote SDM implementation.

Conclusion

Cancer care in the USA has currently limited room for SDM and is prone to paying lip service to the idea. Implementation efforts in US cancer care need to go further than interventions that target only the clinician-patient level. On a policy level, SDM could be included in alternative payment models. However, its implementation would need to be thoroughly assessed in order to prevent further misdirected incentivization through box ticking.
The choice of screw internal fixation and hemiarthroplasty in the treatment of femoral neck fractures in the elderly: a meta-analysis
Authors: Cui Shuai , Wang Dehui , Wang Xuejie , Li Zehui , Guo Wenlai
Published: September 2020

Background

Femoral neck fractures are common fractures in the elderly. Common treatment options include internal fixation (IF) and hemiarthroplasty (HA). However, the clinical application of these two options is always controversial due to the potential clinical trauma, postoperative function, early complications, and other factors.

Materials and methods

Randomized controlled trials and cohort studies comparing screw fixation and hemiarthroplasty in elderly patients with displaced femoral neck fractures were extracted from databases such as PubMed, Web of Science, EMBASE, and Cochrane. The revised Jadad scale or NOS treatment evaluation form was used to evaluate the quality of the included studies. After extracting the data, the standard deviation of continuous data and the relative risk of binary data were used. The operation time, blood loss during operation, EQ-5D (EuroQol-5 Dimension) score, mortality rate, reoperation rate, and postoperative common complications were reviewed using Review Manager software (RevMan 5.3) were compared.

Results

There were 7 randomized controlled trials and 5 cohort studies. The results showed that the operation time, intraoperative blood loss, and short-term EQ-5D score of the internal fixation group were lower than those of the hemi-hip replacement group, but the reoperation rate was higher. There was no statistically significant difference in mortality and common complications such as deep vein thrombosis, pulmonary embolism, infection, and pressure sores during short-term follow-up.

Conclusions

In the treatment of elderly femoral neck fractures, the screw internal fixation group has shorter operation time and less intraoperative bleeding, and the perioperative advantage is more obvious. However, the hemi-hip replacement group had more advantages in postoperative functional scoring and reoperation.
Incidence of neonatal mortality and its predictors among live births in Ethiopia: Gompertz gamma shared frailty model
Authors: Tessema Zemenu Tadesse , Tesema Getayeneh Antehunegn
Published: September 2020

Background

Neonatal mortality remains a serious public health concern in developing countries including Ethiopia. Ethiopia is one of the countries with the highest neonatal mortality in Africa. However, there is limited evidence on the incidence and predictors of neonatal mortality at the national level. Therefore, this study aimed to investigate the incidence of neonatal mortality and its predictors among live births in Ethiopia. Investigating the incidence and predictors of neonatal mortality is essential to design targeted public health interventions to reduce neonatal mortality.

Methods

A secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 11,022 live births was included in the analysis. The shared frailty model was applied since the EDHS data has hierarchical nature, and neonates are nested within-cluster, and this could violate the independent and equal variance assumption. For checking the proportional hazard assumption, Schoenfeld residual test was applied. Akakie Information Criteria (AIC), Cox-Snell residual test, and deviance were used for checking model adequacy and for model comparison. Gompertz gamma shared frailty model was the best-fitted model for this data since it had the lowest deviance, AIC value, and the Cox-Snell residual graph closet to the bisector. Variables with a p-value of less than 0.2 were considered for the multivariable Gompertz gamma shared frailty model. In the multivariable Gompertez gamma shared frailty model, the Adjusted Hazard Ratio (AHR) with a 95% confidence interval (CI) was reported to identify significant predictors of neonatal mortality.

Results

Overall, the neonatal mortality rate in Ethiopia was 29.1 (95% CI: 26.1, 32.4) per 1000 live births. In the multivariable Gompertz gamma shared frailty model; male sex (AHR = 1.92, 95% CI: 1.52, 2.43), twin birth (AHR = 5.22, 95% CI: 3.62, 7.53), preceding birth interval less than 18 months (AHR = 2.07, 95% CI: 1.51, 2.85), small size at birth (AHR = 1.64, 95% CI: 1.24, 2.16), large size at birth (AHR = 1.53, 95% CI: 1.16, 2.01) and did not have Antenatal Care (ANC) visit (AHR = 2.10, 95% CI: 1.44, 3.06) were the significant predictors of neonatal mortality.

Conclusion

Our study found that neonatal mortality remains a public health problem in Ethiopia. Shorter birth interval, small and large size at birth, ANC visits, male sex, and twin births were significant predictors of neonatal mortality. These results suggest that public health programs that increase antenatal care service utilization should be designed to reduce neonatal mortality and special attention should be given for twin births, large and low birth weight babies. Besides, providing family planning services for mothers to increase birth intervals and improving accessibility and utilization of maternal health care services such as ANC is crucial to improve neonatal survival.
The expression of TLR2 and TLR4 in the kidneys and heart of mice infected with Acanthamoeba spp.
Authors: Kot Karolina , Kosik-Bogacka Danuta , Wojtkowiak-Giera Agnieszka , Kolasa-Wołosiuk Agnieszka , Łanocha-Arendarczyk Natalia
Published: September 2020

Background

Acanthamoeba spp. are cosmopolitan protozoans that cause infections in the brain, as well as extracerebral infections in the cornea, lungs and skin. Little is known about the mechanisms of the immunological response to these parasites in organs which are not their main biotope. Therefore, the purpose of this study was to determine the expression of TLR2 and TLR4 in the kidneys and heart of Acanthamoeba spp.-infected mice, with respect to the host’s immunological status.

Methods

The mice were grouped into four groups: immunocompetent control mice; immunosuppressed control mice; immunocompetent Acanthamoeba spp.-infected mice; and immunosuppressed Acanthamoeba spp. infected mice. In the study, we used the amoebae T16 genotype which was isolated from a patient. The TLRs expressions in the kidneys and heart of mice were assessed by quantitative real-time polymerase chain reaction. Moreover, we visualized TLR2 and TLR4 proteins in the organs by immunohistochemical staining.

Results

In the kidneys, we observed a higher TLR2 expression in immunosuppressed mice at 24 days post-Acanthamoeba spp. infection (dpi) compared to the uninfected mice. There were no statistically significant differences in TLR4 expression in the kidneys between the immunocompetent and immunosuppressed mice, both of infected and uninfected mice. In the heart, we observed a difference in TLR2 expression in immunocompetent mice at 24 dpi compared to immunocompetent mice at 8 dpi. The immunocompetent Acanthamoeba spp.-infected mice had higher TLR4 expression at 8 dpi compared to the immunocompetent uninfected mice.

Conclusions

Our results indicate that TLR2 is involved in response to Acanthamoeba spp. infection in the kidneys, whereas in the heart, both studied TLRs are involved.
Surveillance of Aedes aegypti populations in the city of Praia, Cape Verde: Zika virus infection, insecticide resistance and genetic diversity
Authors: Campos Monica , Ward Daniel , Morales Raika Francesca , Gomes Ana Rita , Silva Keily , Sepúlveda Nuno , Gomez Lara Ferrero , Clark Taane G. , Campino Susana
Published: September 2020

Background

Aedes spp. are responsible for the transmission of many arboviruses, which contribute to rising human morbidity and mortality worldwide. The Aedes aegypti mosquito is a main vector for chikungunya, dengue and yellow fever infections, whose incidence have been increasing and distribution expanding. This vector has also driven the emergence of the Zika virus (ZIKV), first reported in Africa which spread rapidly to Asia and more recently across the Americas. During the outbreak in the Americas, Cape Verde became the first African country declaring a Zika epidemic, with confirmed cases of microcephaly. Here we investigate the prevalence of ZIKV and dengue (DENV) infected Ae. aegypti mosquitoes in the weeks following the outbreak in Cape Verde, and the presence of insecticide resistance in the circulating vector population. Genetic diversity in the mosquito population was also analysed.

Methods

From August to October 2016, 816 Ae. aegypti mosquitoes were collected in several locations across Praia, Cape Verde, the major hot spot of reported ZIKV cases in the country. All mosquitoes were screened by reverse transcription PCR for ZIKV and DENV, and a subset (n = 220) were screened for knockdown insecticide resistance associated mutations in the voltage gated sodium channel (VGSC) gene by capillary sequencing. The mitochondrial NADH dehydrogenase subunit 4 (nad4) gene was sequenced in 100 mosquitoes. These data were compared to 977 global sequences in a haplotype network and a phylogenetic tree analysis.

Results

Two Ae. aegypti mosquitoes were ZIKV positive (0.25%). There were no SNP mutations found in the VGSC gene associated with insecticide resistance. Analysis of the nad4 gene revealed 11 haplotypes in the Cape Verdean samples, with 5 being singletons. Seven haplotypes were exclusive to Cape Verde. Several of the remaining haplotypes were frequent in the global dataset, being present in several countries (including Cape Verde) across five different continents. The most common haplotype in Cape Verde (50.6 %) was also found in Africa and South America.

Conclusions

There was low-level Zika virus circulation in mosquitoes from Praia shortly after the outbreak. The Ae. aegypti population did not appear to have the kdr mutations associated with pyrethroid resistance. Furthermore, haplotype and phylogenetic analyses revealed that Cape Verde Ae. aegypti mosquitoes are most closely related to those from other countries in Africa and South America.
A20: a master regulator of arthritis
Authors: Wu Yongyao , He Xiaomin , Huang Ning , Yu Jiayun , Shao Bin
Published: September 2020

A20, also known as TNF-α-induced protein 3 (TNFAIP3), is an anti-inflammatory protein that plays an important part in both immune responses and cell death. Impaired A20 function is associated with several human inflammatory and autoimmune diseases. Although the role of A20 in mediating inflammation has been frequently discussed, its intrinsic link to arthritis awaits further explanation. Here, we review new findings that further demonstrate the molecular mechanisms through which A20 regulates inflammatory arthritis, and we discuss the regulation of A20 by many factors. We conclude by reviewing the latest A20-associated mouse models that have been applied in related research because they reflect the characteristics of arthritis, the study of which will hopefully cast new light on anti-arthritis treatments.