bluuebunny/crossref_metadata_2025 huggingface dataset:
MicroRNA-21 inhibitor (miR-21i) and Simvastatin-loaded poly (D,L-lactide-co-glycolide)/polyethylenimine (PLGA/PEI) nanoparticles for synergistic anticancer effect in Gastric Cancers
Authors: Liu Yuxia , Yang Bin , Zhang Lirong , Cong Xianling , Liu Hongyu , Yu Mengxi , Song Bin
Published: December 2019

Background: In this study, we have successfully developed a simvastatin (SMV) and miR-21i-loaded poly (D,L-lactide-co-glycolide)/polyethylenimine (PLGA/PEI) nanoparticles (NP) to enhance the therapeutic efficacy in gastric cancers. Methods: The PLGA/PEI nanoparticles by sonication method. The nanoparticles were characterized for in vitro physicochemical and biological assays and pharmacokinetic study was performed in rats. Results: CLSM/FACS results clearly showed the ability of SMV/miR-21i-loaded PLGA/PEI NP (PPN-S21i) to deliver the combinational therapeutics of SMV and miR-21i to the cancer cells. Combination of SMV+miR-21i showed significantly lower cell viability compared to that of free SMV. Our results clearly highlight the importance of simultaneous interaction of SMV+miR-21i and that it could significantly decrease the cell proliferation in BGC-823, SGC-7901 and HGC-27 gastric cancer cells while it was significantly less cytotoxic to normal gastric mucosa cells (GES-1). Cell apoptosis of SMV+miR-21i was significantly higher compared to that of individual drug or miRNA. Finally, pharmacokinetic analysis revealed that PPN-S21i significantly prolonged the blood circulation time of SMV compared to that of free SMV indicating the potential of carrier system. Conclusion: Overall, results clearly indicate that the combination of SMV+miR-21i (gene + drug therapy) might provide a valuable strategy for the clinical management of gastric cancers.
Coronary heart disease mortality is decreasing in Argentina and Colombia, but keeps increasing in Mexico: a time trend study
Authors: Arroyo-Quiroz Carmen , Barrientos-Gutierrez Tonatiuh , O'Flaherty Martin , Guzman-Castillo Maria , Mejia Lina Sofia Palacio , Saldarriaga Elkin de Jesus Osorio , Rodriguez Andrea Yanira Rodriguez
Published: December 2019

Background: Coronary heart disease (CHD) mortality rates have decreased in most countries, but increased in low and middle-income countries. Few studies have analyzed CHD mortality trends in Latin America, specifically the trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes). Objective: To describe and compare standardized, age-specific, and garbage-code corrected mortality trends for CHD from 1985 to 2015 in Argentina, Colombia, and Mexico. Methods: CHD deaths were grouped by country, year of registration, sex, and 10-year age bands to calculate age-adjusted and age and sex specific rates for adults aged ≥25. We corrected for garbage-codes using the Global Burden of Disease methodology. Finally, we fitted Joinpoint regression models. Results: In 1985, age-standardized mortality rates per 100,000 were 136.6 in Argentina, 160.6 in Colombia and 87.51 in Mexico. Compared to 2015, mortality fell in Argentina and Colombia (51% and 6.5% respectively) and increased by 61% in Mexico. The steepest decline was observed in Argentinian women and the sharpest increment in Mexican men. There has been an upward trend in young Mexicans since 1985. Garbage-code corrections produced increases in mortality rates, particularly in Argentina: approximately 80 additional deaths per 100,000 (14 in Colombia and 13 in Mexico). Conclusions: Latin American countries are at different stages of the epidemic. The disease burdens are bigger after correcting for misclassification. Although CHD mortality is falling in Argentina, the modest falls in Colombia and substantial rises in Mexico highlight the region’s need for effective, population-wide prevention policies.
Association between motoric cognitive risk syndrome and frailty among Chinese older adults
Authors: Shen Shanshan , Zeng Xingkun , Xu Liyu , Chen Lingyan , Liu Zixia , Chu Jiaojiao , Yang Yinghong , Wu Xiushao , Chen Xujiao
Published: December 2019

Background: Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome incorporating subjective cognitive complaints and slow gait. Previous studies have shown that subjective cognitive complaints and slow gait are reported to be associated with frailty in cognitively unimpaired older adults, but little is known giving attention to the link between MCR and frailty in older adults. Therefore, the aim of the study was to explore the associations of MCR and its components and frailty in Chinese older adults. Methods: In an observation cross-sectional study, a total of 429 older adults aged 60 years and older were admitted to the geriatric department. According to MCR criteria, all participants were classified to 4 groups: 1) MCR group; 2) subjective cognitive complaints only group; 3) slow gait only group; 4) healthy control group. Physical frailty was assessed by Clinical Frailty Scale (CFS). The multivariate logistic regression analysis was used to examine the association between MCR and frailty in older adults. Results: The prevalence of subjective cognitive complaints, slow gait and MCR was 15.9%, 10.0% and 4.0%, respectively. After adjusting for confounding variables, the logistic regression analysis showed that slow gait (odds ratio [OR] 3.40, 95% confidence interval [CI] 1.40-8.23, P=0.007) and MCR (odds ratio [OR] 5.53, 95% confidence interval [CI] 1.46-20.89, P=0.012) were independently associated with frailty, but not subjective cognitive complaints. Conclusions: MCR and slow gait were significantly associated with frailty in Chinese older adults. Further study should prospectively determine the causal relationship between MCR and frailty.
Evaluation of dialysis centres: Values and criteria of the stakeholders
Authors: Parra Eduardo , Arenas María Dolores , Luis María José Fernandez-Reyes , Forcén Angel Blasco , Alvarez-Ude Fernando , Joven Juan Aguarón , Casas Alfredo Altuzarra , Moreno-Jiménez José María
Published: December 2019

Bacground Evaluation of renal replacement therapy with haemodialysis is essential for its improvement. However, the methods used have important epistemological limitations. The present study aimed to determine the opinions and preferences of stakeholders (patients, clinicians, and managers) and establish their relative importance to facilitating an adequate evaluation. Methods Successive working groups (WGs) were established using a multicriteria methodology. WG1 created a draft of criteria and sub-criteria, WG2 agreed, and WG3 was composed of three face-to-face subgroups (WG3-A, WG3-B, and WG3-C) that weighted them using two methodologies: weighting sum (WS) and analytic hierarchy process (AHP). Subsequently, they determined a preference for the WS or AHP results. Finally, via the Internet, WG4 weighted the criteria and sub-criteria by the method preferred by WG3, and WG5 analysed the results. Results WG1 and WG2 identified and agreed on the following evaluation criteria: evidence-based variables (EBVs), annual morbidity, annual mortality, PROMs, and PREMs. The EBVs consisted of five sub-criteria: type of vascular access, dialysis dose, haemoglobin concentration, ratio of catheter bacteraemia, and bone mineral disease. The patients rated the PROMs with greater weight than the other stakeholders in both face-to-face WG3 (WS and AHP) and WG4 via the Internet. The type of vascular access was the most valued sub-criterion. A performance matrix of each criterion and sub-criterion is presented as a reference for assessing the results based on the preferences of the stakeholders. Conclusions The use of a multicriteria methodology allows the relative importance of the indicators to be determined, reflecting the values of the different stakeholders. In a performance matrix, the inclusion of values and intangible aspects in the evaluation could help in making clinical and organizational decisions.
Toric Intraocular Lens Implantation in Cataract Patients with Corneal Opacity.
Authors: Ra Ho , Hwang Ho Sik , Kim Hyun Seung , Kim Man Soo , Kim Eun Chul
Published: December 2019

Purpose: To evaluate the effect of toric intraocular lens implantation in cataract patient with corneal opacity and high astigmatism. Methods: 31 eyes of 31 patients who underwent cataract surgery with toric intraocular lens implantation were included. All patients had corneal opacity with astigmatism. Preoperative total corneal astigmatism was determined considering posterior astigmatism using a rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany). At 2 months after toric intraocular lens implantation, we evaluated residual astigmatism, uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA). Results: Postoperative UCVA and BCVA (0.30 ± 0.17, 0.22 ± 0.16LogMAR) statistically improved compared to preoperative UCVA and BCVA (1.2 ± 0.34, 1.1 ± 0.30LogMAR, respectively) (P<0.01). Postoperative residual refractive astigmatism (1.2 ± 0.35D) was statistically reduced compared to preoperative refractive astigmatism (2.4 ± 0.65D) (P<0.05). Preoperative and postoperative total corneal astigmatism values were not statistically different. All eyes achieved postoperative visual acuity as good as or better than preoperative one. The size of corneal opacity covering pupil had significant negative correlation with postoperative UCVA and BCVA (logMAR) (R=0.91 P<0.05 and R=0.92 P<0.05, respectively). Conclusion: Toric intraocular lens implantation can improve UCVA, BCVA, and refractive astigmatism in cataract patient with corneal opacity. The size of corneal opacity covering pupil is the major prognostic factor for postoperative visual improvement. Therefore, toric intraocular lens implantation should be considered for cataract patients who have corneal opacity with high astigmatism.
Heart rate and heart rate variability comparison between postural orthostatic tachycardia syndrome versus healthy participants; a systematic review and meta-analysis.
Authors: Swai Joel Dominic , Hu Zixuan , Zhao Xiexiong , Rugambwa Tibera , Ming Gui
Published: December 2019

Background: A number of published literature has reported that, physiologically, heart rate variability (HRV) in patients with postural orthostatic tachycardia syndrome (POTS) to be greatly confounded by age, sex, race, physical fitness, and circadian rhythm. The purpose of this study was to compare between POTS patients versus healthy participants, in terms of heart rate (HR) and HRV after Head-Up tilt test (HUTT), by systematic review and meta-analysis of available published literature. Methods: MEDLINE (using PubMed interphase), EMBASE and SCOPUS were systematically searched for observational studies comparing POTS patients versus healthy patients, in terms of HR and HRV. HRV was grouped into Time and frequency domain outcome measurements. The time domain was measured as mean RR- interval and mean the square root of the mean of squares of successive R-R waves (rMSSD) in milliseconds. The frequency domain was measured as mean values of Low frequency power (LF), High frequency power (HF), LF/HF-ratio, LF-normalized units (LF(n.u)) and HF-normalized units (HF(n.u)). Demographic data, comorbidities, and mean values of HR, RR- interval, rMSSD, LF, HF, LF/HF-ratio, LF-(n.u) and H.F-n.u were extracted from each group and compared, by their mean differences as an overall outcome measure. Computer software, RevMan 5.3 was utilized, at a 95% significance level. Results: Twenty (20) eligible studies were found to report 717 POTS and 641 healthy participants. POTS group had a higher mean HR (p<0.05), lower mean RR-Interval (p<0.05), lower rMSSD (p<0.05) than healthy participants. Furthermore, POTS group had lower mean HF(p>0.05), lower mean LF(p>0.05), and lower mean HF(n.u) (p>0.05), higher LF/HF-Ratio (p>0.05) and higher LF(n.u) (p>0.05) as compared to healthy participants. Conclusion: POTS patients have a higher HR than healthy patients after HUTT and lower HRV in terms of time domain measure but not in terms of frequency domain measure. HR and time domain analyses of HRV are more reliable than frequency domain analysis in differentiating POTS patients from the healthy participants. We call upon sensitivity and specificity studies.
Increasing pelvic incidence is associated with more global sagittal imbalance in ankylosing spondylitis with thoracolumbar kyphosis
Authors: Song Diyu , Zheng Guoquan , Wang Tianhao , Qi Dengbin , Wang Yan
Published: December 2019

Background: Ankylosing spondylitis (AS) patients with kyphosis have an abnormal spinopelvic alignment and pelvic morphology. Most studies focus on the relationship of pelvic tilt (PT) or sacral slope (SS) and deformity, and relatively few studies have addressed the relationship between pelvic incidence (PI) and kyphosis in AS patients. The purpose of this study is to analyze the correlation between pelvic incidence (PI) and the spinopelvic parameters describing local deformity or global sagittal balance in AS patients with thoracolumbar kyphosis. Methods: A total of 94 patients with AS (91 males and 3 females) and 30 controls were reviewed. Sagittal spinopelvic parameters, including PI, PT, SS, thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis(LL), sagittal vertical axis(SVA), the first thoracic vertebra pelvic angle(TPA), spinosacral angle(SSA) and spinopelvic angle(SPA) were measured. Pearson correlation (r) and unary linear regression model were used to analysis the relationship between PI and other spinopelvic parameters. Results: Compared with the control group, the AS patients had significantly higher PI(47.4˚ vs. 43.2˚, P<0.001). PI in AS patients was found to be significantly positively correlated with TPA(r=0.533, R2=0.284, P<0.001), and negatively correlated with SPA(r=-0.504, R2=0.254, P<0.001). However, no correlations were found between PI and SVA, SSA, TK, TLK or LL in AS patients. Conclusion: This study revealed that increasing PI was significantly correlated with more global sagittal imbalance, not with the local deformity in AS patients with thoracolumbar kyphosis. Key Words: ankylosing spondylitis, pelvic incidence, sagittal spinopelvic parameters, global sagittal balance
Prognostic value and clinicopathological characteristics of PD-L1 overexpression in non-Hodgkin lymphoma: a meta-analysis
Authors: Zeng Qiang , Liu Zhigang , Liu Ting
Published: December 2019

Background: Programmed cell death ligand 1 (PD-L1) has already been detected in various carcinomas. In non-Hodgkin lymphoma (NHL), however, the prognostic value of PD-L1 overexpression remains unclear.Methods: A meta-analysis of 2,321 NHL patients from 12 studies was performed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to evaluate the correlation between PD-L1 overexpression and prognosis of NHL, and odds ratios (ORs) with 95% CIs were used to assess the association of PD-L1 overexpression with clinicopathological factors.Results: The results showed that no significant difference between PD-L1 positive and negative groups was detected in NHL (HR: 1.40, 95% CI: 0.90–2.19; P = 0.137). Nevertheless, the results indicated that PD-L1 overexpression was associated with poor prognosis in the subtype of diffuse large B cell lymphoma (DLBCL) (HR: 1.70, 95%CI: 1.05–2.74; P = 0.031). We also performed subgroup analyses and meta-regression. The pooled OR showed that PD-L1 overexpression was associated with B symptoms, higher international prognostic index (IPI) score (3, 4, and 5 points) and Ann Arbor Stages III and IV.
Conclusions: The meta-analysis demonstrated that PD-L1 expression was not associated with prognosis of NHL but was associated with prognosis of DLBCL.
Children with Autism spectrum disorder are associated with gut microbiota disorder
Authors: Sun Hairong , You Zhong , Jia Libo , Wang Fang
Published: December 2019

Purpose The aim of this study was to evaluate the occurrence and clinical characteristics of autism spectrum disorder (ASD) associated to the stable state of the gut microbiota. Methods A total of 9 children with ASD and 6 healthy children used as control were selected and feces samples were collected from all of them. The 16S gene ribosomal RNA sequencing was used to analyze the difference in gut microbiota between healthy control children and ASD patients. Results The results of 16S sequencing based on operational taxonomic units (OTUs) analysis showed that the ASD group and the healthy control (HC) group had a large difference in the abundance of microbiota at the level of family, genus and species. The abundance of Bacteroidales and Selenomonadales was significantly lower in the ASD group than in the HC group (p=0.0110 and p=0.0076, respectively). The abundance of Ruminococcaceae in the ASD group was higher than that in the HC group (p=0.0265), while the amount of Prevotellaceae was significantly lower in the ASD group than in the HC group (p=0.0265). The Tax4Fun analysis based on Kyoto Encyclopaedia of Genes and Genomes (KEGG) data indicated differentially expressed functional pathway between the ASD group and healthy control group associated to the nervous system, environmental information processing and cellular processing. Conclusions The abundance of gut microbiota in the ASD group is different from that in the healthy control children. These differences affect the biological function of the host. These results suggest that a disorder in the gut microbiota may be associated, at least in part, with ASD in children.
Rising serum CA-125 levels within the normal range is strongly associated recurrence risk and survival of ovarian cancer
Authors: Piatek Szymon , Panek Grzegorz , Lewandowski Zbigniew , Bidzinski Mariusz , Piatek Dominika , Kosinski Przemyslaw , Wielgos Miroslaw
Published: December 2019

Background: In clinical practice alterations in CA125 concentration within normal range in patients with ovarian cancer after first-line treatment are common. Even minor increase in CA125 concentration is associated with patients’ anxiety and difficult interpretation and counselling for clinicians. The aim of this study was to evaluate the significance of CA125 fluctuations within reference level in patients who suffered from ovarian cancer with complete response after first-line treatment.Results: 168 patients with epithelial ovarian cancer, who achieved complete remission after first line treatment were enrolled in the study. CA125 concentration assessment was carried out during follow up visits. The recurrence of the disease was diagnosed on the first appearance of symptoms: clinical, radiological or histopathological/cytological. PFS and 5-year survival rate was calculated with Kaplan-Meier plots. Statistical analysis was performed with SAS / STAT® 9.4 / 14.4, SAS Institute Inc., Cary, NC, USA, 2017. Median concentration of CA125 after first-line therapy was 10 U/ml. Increasing CA125 concentration by > 5U/ml, 3 and 6 months after the treatment was associated with higher risk of relapse (HR=7.6, p<0.0001 and HR=5.29, p<0.0001 respectively). 5-year survival rate was significantly lower in patients with increased CA125 by 5 U/ml, 3 and 6 months after therapy (56.79% vs 0% and 50.62% vs 15.55%).Conclusions: Increased concentration of CA125 by > 5 U/ml within normal range, 3 and 6 months after treatment was unfavorable prognostic factor in ovarian cancer patients with complete response to primary therapy.
Incidence, risk factors and outcomes of postoperative acute kidney injury in elderly patients undergoing abdominal surgery
Authors: Shen Jianghua , Zhao Simiao , Ma Denglei , Chen Minghui , Yan Suying
Published: December 2019

Objectives To investigate the incidence, risk factors and outcomes of acute kidney injury (AKI) in elderly patients undergoing abdominal surgery. Methods A retrospective study exploring the incidence of AKI in patients older than 75 years within 48 hours after abdominal surgery was conducted. Patients' preoperative characteristics, intraoperative management including medication and outcomes were evaluated for associations with AKI using a logistic regression model.Results During the 2.5-year period, a total of 409 abdominal surgeries were performed. Both pre- and post-operative SCr measurements were available for 329 (80.4%) cases. 26 patients (7.9%) developed AKI, of whom 25 (7.6%) and 1 (0.3%) reached the AKI stages 1 and 2 respectively. Older age (83.0 vs 80.4 years; p=0.002), preoperative liver function damage represented by AST (47.5 vs 21.0 IU/L; p=0.023), intraoperative combined administration of hydroxyethyl starch(HES) and furosemide (15.38% vs 1.65%; p=0.003) were independent risk factors for the development of postoperative AKI. Furthermore, AKI patients had significantly longer ICU stay (3 vs 0 days; p<0.001) and higher in-hospital mortality (23.08% vs 2.31%; p<0.001)Conclusion Intraoperative combined administration of HES and furosemide is an independent factor which can be controlled by anesthesiologists and surgeons for AKI. This provides important recommendations for reducing the incidence of postoperative AKI.
Arg72Pro polymorphism in P53 gene and Breast Cancer Risk Population: a meta-analysis of case-control studies matched
Authors: Diakite Brehima , Kassogue Yaya , Dolo Guimogo , Wang Jun , Neuschler Erin , Kassogue Oumar , Keita Mamadou , Traore Cheick Bougari , Kamate Bakarou , Dembele Etienne , Sellama Nadifi , Murphy Robert , Doumbia Seydou , Hou Lifang , Maiga Mamoudou
Published: December 2019

Background: The effect of the Arg72Pro variant of the P53 gene on the risk of developing breast cancer remains variable in populations. However, using strategies like grouping age-matched controls with disease cases may provide a strong meta-analysis. Our goal was to perform a meta-analysis in order to study the association of Arg72Pro variant of P53 gene and breast cancer.
Methods: Databases such as PubMed, Genetics Medical Literature, Harvard University Library, Web of Science and Genesis Library were used to search articles. Age-matched control studies on breast cancer that evaluated the genotype frequencies of the Arg72Pro P53 gene were selected. Fixed and random effects (Mantel-Haenszel) were calculated using pooled odds ratio of 95% CI to determine the disease risk. Hardy-Weinberg equilibrium test was used to measure deviation in the distribution of genotypes in controls. Inconsistency was calculated to determine heterogeneity among the studies. Estimated publication bias was performed through the funnel plot and Egger’s test.
Results: Nine publications with controls age-matched cases including 4684 disease cases and 4636 controls were evaluated in this meta-analysis, all were in the Caucasian population. Our results suggested that Arg72Pro P53 was associated with a risk for breast cancer in the dominant model (Pro/Pro+Arg/Pro vs. Arg/Arg: OR= 1.16, 95% CI = 1.04-1.31) and the additive model (Pro vs. Arg: OR= 1.13, 95% CI = 1.03-1.24, P= 0.007), but not in the recessive model (Pro/Pro vs. Arg/Arg + Arg/Pro, OR = 1.18, 95% CI = 0.96-1.44; P= 0.12).
Conclusions: This meta-analysis found significant association between the Arg72Pro polymorphism in the P53 gene and the breast cancer risk. Individuals carrying at least one Pro allele of the P53 gene are more likely to have breast cancer with dominant and additive models than individuals carrying the Arg allele.
Sex-on-Premise Venues, Associated Risk Behaviors, and Attitudes toward Venue-Based HIV Testing among Men Who Have Sex with Men in Lima, Perú
Authors: Lankowski Alexander , Sánchez Hugo , Hidalgo José , Cabello Robinson , Duerr Ann
Published: December 2019

Background: In Perú, HIV disproportionately affects men who have sex with men (MSM). Despite widespread access to treatment, the rate of new HIV infections has not slowed over the last decade. Low knowledge of HIV status is a key factor underlying the high HIV incidence observed in this setting – creating conditions for efficient onward transmission in the population. Improving access to HIV testing and prevention services for those at highest risk is an important public health priority. Sex-on-premise venues (SOPVs) – saunas, sex clubs, pornographic movie theaters, hourly hotels, and bars/discos with areas where sex is permitted – may be opportune sites for outreach; however, further research on SOPVs and the populations who frequent them is needed to inform such efforts. Methods: We conducted a cross-sectional online survey of adult MSM in Lima, Perú to evaluate patterns of SOPV attendance, associated sexual risk behaviors, and attitudes toward SOPV-based interventions. Participants were recruited through outreach to social media networks affiliated with local LGBTQ-aligned community groups. Our primary analytic objective was to estimate the association of HIV-related sexual risk behaviors and SOPV attendance. Additionally, we performed exploratory analyses to describe risk behavior stratified by SOPV category and to examine the relationship between SOPV attendance and the use of online platforms to meet sex partners.Results: Overall, 389 MSM completed the survey from November 2018 through May 2019, of whom 68% reported attending an SOPV in the last three months. SOPV attendance was associated with multiple sexual risk behaviors, including transactional sex, group sex, sex while intoxicated, and higher number of total partners. Over two thirds of SOPV attendees indicated they would accept HIV testing if offered at SOPVs. Conclusions: SOPV attendance was common among MSM in Lima who participated in our survey, and SOPV attendees reported significantly greater engagement in sexual risk behaviors related to HIV transmission. Attitudes toward hypothetical SOPV-based interventions were generally favorable. These findings suggest that outreach at SOPVs may be an effective mechanism for reaching a particularly high-risk sub-population of MSM in Perú to deliver targeted HIV testing and prevention interventions.
Comparative analyses on epidemiological characteristics of dengue fever in Guangdong and Yunnan, China, 2004-2018
Authors: Yue Yujuan , Liu Qiyong , Liu Xiaobo , Wu Haixia
Published: December 2019

Dengue fever occurred most severely in Guangdong and Yunnan, accounting for 93.7% of indigenous cases and 65.9 % of imported cases in mainland China. Epidemiological and spatial-temporal analysis methods were used to compare epidemiological characteristics of dengue cases in Guangdong and Yunnan, China, 2004-2018, including time-series, spatial and crowd features. Much more indigenous cases were widely distributed in Guangdong, while imported cases were more common in Yunnan. 55,970 and 5,938 indigenous cases occurred in 108 counties, Guangdong and 25 counties, Yunnan. 1,146 and 3,050 imported cases occurred in 84 counties, Guangdong and 72 counties, Yunnan. There existed similar seasonal characteristics from July to November for indigenous cases, but there was a longer peak period for imported cases in Guangdong (May to December) than that in Yunnan (July to December). There existed clustering characteristics for dengue fever. 85.1% of indigenous cases in Yunnan were located in Ruili City and Jinghong City along the southwestern border. Most dengue cases in Guangdong occurred in the Pearl River Delta region, especially with more than 70.0% in Guangzhou City. 93.9% of imported cases in Guangdong and Yunna were from 9 countries of Southeast Asia. Thailand, Cambodia and Malaysia were the main imported origins in Guangdong. Myanmar and Laos were the main imported origins in Yunnan. There was a strong male predominance among imported cases and an almost equal gender distribution for indigenous cases. Most dengue cases were from individuals in 21-50 years old, with 57.3% and 62.8% for indigenous cases and 83.2% and 62.6% for imported cases in Guangdong and Yunnan, respectively. There existed differences in main occupation compositions of dengue cases. However, there were similar major occupations as housework or unemployment, retiree and businessman for indigenous cases, and similar major occupation as businessman for imported cases. Farmers accounted for a larger proportion of dengue cases in Yunnan. The findings of epidemiological characteristics and differences of dengue fever in Guangdong and Yunnan are helpful to formulate targeted, strategic plans and implement effective public health prevention and control measures in China.
Comparing national dementia plans and strategies in Europe – Is there a focus of care for people with dementia from a migration background?
Authors: Schmachtenberg Tim , Monsees Jessica , Hoffmann Wolfgang , Berg Neeltje van den , Stentzel Ulrike , Thyrian Jochen René
Published: December 2019

Background: People with migration background and dementia are a vulnerable group. Providing care for this group is a public health challenge in Europe. An increasing number of countries are issuing national dementia plans, but a systematic overview of national dementia plans of European countries focusing on care for people with migration background is lacking. This study aims to illustrate how European countries identify the dementia-related needs of people with migration background and whether there are specific healthcare services for them at the national level.Methods: A qualitative analysis of national dementia plans of the EU and EFTA (European Free Trade Association) countries was carried out. Using the discourse analysis model according to Rainer Keller (2011), documents were systematically screened for their relation to migration via keyword and context analysis. The content of the migration-related sections was analysed using the methods of paraphrasing, memos, comments, and open coding.Results: Twenty-three of the 35 EU and ETFA countries have a national dementia plan, ten of these documents refer to migration and one country (Austria) has a national dementia plan with a chapter on migration. Eight national dementia plans identify the specific needs of people with migration background and dementia, and actions to care for this group are planned in nine countries. However, only Norway, Northern Ireland, and the Netherlands have specific healthcare services for people with migration background. Overall, the topic of migration plays a subordinate role in the national dementia plans of European countries.Conclusions: The current lack of migrant-specific healthcare services in almost all European countries may lead to denying the right to appropriate care to a growing population. The topic of migration must be given greater attention in national dementia plans. European countries should develop strategies with specific services that address the needs of people with migration background. To improve comparability at the European level, a common definition of migration is needed. Further studies should include country-specific problems related to dementia and migration.
NTP42, a novel antagonist of the thromboxane receptor, attenuates experimentally induced pulmonary arterial hypertension
Authors: Mulvaney Eamon , Reid Helen , Bialesova Lucia , Bouchard Annie , Salvail Dany , Kinsella B. Therese
Published: December 2019

BackgroundNTP42 is a novel antagonist of the thromboxane prostanoid receptor (TP), currently in development for the treatment of pulmonary arterial hypertension (PAH). PAH is a devastating disease with multiple pathophysiological hallmarks including excessive pulmonary vasoconstriction, vascular remodelling, inflammation, fibrosis, in situ thrombosis and right ventricular hypertrophy. Signalling through the TP, thromboxane (TX) A2 is a potent vasoconstrictor and mediator of platelet aggregation. It is also a pro-mitogenic, pro-inflammatory and pro-fibrotic agent. Moreover, the TP also mediates the adverse actions of the isoprostane 8-iso-prostaglandin F2α, a free-radical-derived product of arachidonic acid produced in abundance during oxidative injury. Mechanistically, TP antagonists should treat most of the hallmarks of PAH, including inhibiting the excessive vasoconstriction and pulmonary artery remodelling, in situ thrombosis, inflammation and fibrosis. This study aimed to investigate the efficacy of NTP42 in the monocrotaline (MCT)-induced PAH rat model, alongside current standard-of-care drugs.MethodsPAH was induced by subcutaneous injection of 60 mg/kg MCT in male Wistar–Kyoto rats. Animals were assigned into groups: 1. ‘No MCT’; 2. ‘MCT Only’; 3. MCT + NTP42 (0.25 mg/kg BID); 4. MCT + Sildenafil (50 mg/kg BID), and 5. MCT + Selexipag (1 mg/kg BID), where 28-day drug treatment was initiated within 24 h post-MCT.ResultsFrom haemodynamic assessments, NTP42 reduced the MCT-induced PAH, including mean pulmonary arterial pressure (mPAP) and right systolic ventricular pressure (RSVP), being at least comparable to the standard-of-care drugs Sildenafil or Selexipag in bringing about these effects. Moreover, NTP42 was superior to Sildenafil and Selexipag in significantly reducing pulmonary vascular remodelling, inflammatory mast cell infiltration and fibrosis in MCT-treated animals.ConclusionsThese findings suggest that NTP42 and antagonism of the TP signalling pathway have a relevant role in alleviating the pathophysiology of PAH, representing a novel therapeutic target with marked benefits over existing standard-of-care therapies.
The effect of CYP3A4 genetic variants on the susceptibility to chronic obstructive pulmonary disease in the Hainan Han population
Authors: Shi Huifang , Xu Jianguang , Feng Qiong , Sun Juan , Yang Yixiu , Zhao Jie , Zhou Xiaoli , Niu Huan , He Ping , Liu Jianfang , Li Quanni , Ding Yipeng
Published: December 2019

PurposeGenetic polymorphisms act crucial role in chronic obstructive pulmonary disease (COPD) progression. This study was designed to investigate the correlation between CYP3A4 variants and COPD risk.MethodsWe carried out a case-control study of 821 individuals (313 patients and 508 healthy subjects) to identify the correlation of CYP3A4 SNPs with COPD risk in the Hainan Han population. The association was assessed by Odds ratios (OR) and 95% confidence intervals (CI).ResultsOur study showed that rs4646437 polymorphism was related to an increased susceptibility to COPD (OR = 1.45, 95% CI = 1.10-1.90, p = 0.008). Stratified analyses indicated that the rs4646437 polymorphism was significantly associated with an increased risk of COPD in males (OR = 1.95, 95% CI = 1.19-3.20, p = 0.008). However, rs4646440 played a protective role in females (OR = 0.54, 95% CI = 0.31-0.93, p = 0.024). The rs4646437 SNP was identified significantly improve the risk of COPD in smoking subjects (OR = 1.67, 95% CI = 1.12-2.48, p = 0.011). While rs4646440 had a significantly lower susceptibility to COPD with non-smoking individuals (OR = 0.64, 95% CI = 0.45-0.90, p = 0.010). Haplotype analysis revealed that Ars4646440Trs35564277 and Grs4646440Trs35564277 haplotypes of CYP3A4 were found to reduce the risk of COPD in non-smoking (OR = 0.61, 95% CI = 0.49-0.94, p = 0.024).ConclusionOur results would give some new understanding of the association between CYP3A4 gene and COPD in the Hainan Han population.
Pre-existing interstitial lung disease is associated with onset of nivolumab-induced pneumonitis in patients with solid tumors: A retrospective analysis
Authors: Yamaguchi Teppei , Shimizu Junichi , Hasegawa Takaaki , Horio Yoshitsugu , Inaba Yoshitaka , Hanai Nobuhiro , Muro Kei , Hida Toyoaki
Published: December 2019

BackgroundNivolumab, an anti-programmed death 1 (PD-1) monoclonal antibody, has shown survival benefit in clinical trials of various malignant tumors. Nivolumab-induced pneumonitis is major immune-related adverse event (irAE) that is occasionally serious and life-threatening. The aim of this study was to examine the association between pre-existing interstitial lung disease (ILD) on chest computed tomography (CT) and nivolumab-induced pneumonitis among different types of solid tumors.MethodsWe retrospectively collected the clinical data of 311 patients who were diagnosed with non-small cell lung cancer (NSCLC), head and neck cancer (HNC), or gastric cancer (GC), and treated with nivolumab monotherapy. Patients who underwent chest CT immediately before starting nivolumab without previous thoracic radiotherapy or other immune checkpoint inhibitors were eligible. We collected baseline patient characteristics and assessed pre-existing ILD on baseline chest CT.ResultsFinally, 188 patients were included in the analysis: 96 patients with NSCLC, 43 patients with HNC, and 49 patients with GC. NSCLC patients had a significantly higher rate of pre-existing ILD compared with HNC/GC patients (P=0.047). Nivolumab-induced pneumonitis occurred in 11.7% (22 of 188), including 14.6% (14 of 96) of NSCLC, and 8.7% (8 of 92) of HNC/GC. Univariate and multivariate logistic regression analyses revealed that pre-existing ILD (odds ratio, 5.92; 95% confidence interval (CI), 2.07–18.54, P=0.0008) and male sex (odds ratio, 5.58; 95% CI, 1.01–104.40, P=0.049) significantly increased the risk of nivolumab-induced pneumonitis.ConclusionOur results indicated that pre-existing ILD and male sex are risk factors for nivolumab-induced pneumonitis in solid tumors.
Stem vacuole-targetted sucrose isomerase enhances sugar accumulation in sorghum
Authors: Liu Guoquan , Zhang Yan , Pan Yunrong , Davis Christopher Eric , Jing Hai-Chun , Wu Luguang , Godwin Ian D.
Published: December 2019

Background: Sugar accumulation is critically important in determining sugar crop productivity. Sorghum, especially high biomass sweet sorghum has shown great potential for biofuel. However, improvement in sugar content has been stagnant among sugar crops for decades. In this study, sorghum was investigated as a C4 diploid model for more complicated genomes such as maize and sugarcane. To promote sugar accumulation in sorghum, the sucrose isomerase (SI) gene, driven by stem-specific promoters (A2 or LSG) with a signal peptide, was designed to target the stem vacuole in grain sorghum inbred line (Tx430) and sweet x grain hybrids (Rio x Tx430). Results: The study demonstrated that transgenic lines of grain sorghum, containing 50-60% isomaltulose, accumulated sevenfold (804 mmol/L) more total sugar than the control Tx430 did (118 mmol/L) in stalks. Subsequently, the best-engineered line (LSG9) was crossed with an elite sweet sorghum variety (Rio). The total sugar concentrations (over 800 mmol/L) measured by HPLC (high-performance liquid chromatography), were significantly higher in both F1 and F2 progenies than the sweet sorghum Rio, representing a 57% and 69% increase respectively. Those total sugar contents in engineered sorghum lines are higher than in the field-grown sugarcane (normal range 600-700 mmol/L). Physiological characterization demonstrated that the superior progenies had notably increased rates of photosynthesis, sucrose transport, and sink strength. Conclusion: The genetic engineering approach has significantly enhanced total sugar concentration in grain sorghum and hybrids of (grain x sweet) sorghum. This research has put sorghum in the spotlight and frontier as a biofuel crop. More importantly, our results prove that the phenotype of high sugar accumulation is inheritable in the grain sorghum as well as hybrids. The massive increase in sugar accumulation would lead to enormous financial benefits for industrial and biofuel use. This study would have a substantial impact on renewable energy due to the supreme capacity of total sugar accumulation in sorghum.
Prevalence of plasmid-mediated AmpC beta-lactamases in Enterobacteria isolated from urban and rural folks in Uganda
Authors: Najjuka Christine Florence , Kateete David Patrick , Lodiongo Dennis K , Mambo Obede , Mocktar Chunderika , Kayondo William , Baluku Hannington , Kajumbula Henry M , Essack Sabiha Y , Joloba Moses L
Published: December 2019

Background: AmpC beta-lactamases are associated with increased resistance to third-generation cephalosporins. Here, we describe plasmid-mediated AmpC beta-lactamase-producing enterobacteria isolated from urban and rural dwellers in Uganda. Methods: Stool and urine from 1,448 individuals attending outpatient clinics in Kampala and two rural districts in central Uganda (Kayunga and Mpigi) were processed for isolation of Escherichia coli and Klebsiella. Following antibiotic susceptibility testing, cefoxitin resistant isolates, and amoxicillin/clavulanate resistant but cefoxitin susceptible isolates, were tested for AmpC beta-lactamase production using the cefoxitin-cloxacillin double-disc synergy test. Carriage of plasmid-mediated AmpC beta-lactamase-encoding genes (pAmpC) and extended spectrum beta-lactamase (ESBL) encoding genes was determined by PCR. Results: Nine hundred and thirty E. coli and 55 Klebsiella were recovered from the cultured samples, yielding 985 isolates (one per participant) investigated. One hundred and twenty nine isolates (13.1%, 129/985) were AmpC beta-lactamase producers, of which 111 were molecularly characterized for pAmpC/ESBL gene carriage. pAmpC genes were detected in 60% (67/111) of the AmpC beta-lactamase producers; pAmpC genes were also detected in 18 AmpC beta-lactamase non-producers and in 13 isolates with reduced susceptibility to third-generation cephalosporins, yielding a total of 98 isolates that carried pAmpC genes. Overall, the prevalence of pAmpC genes in cefoxitin resistant and/or amoxicillin/clavulanate resistant E. coli and Klebsiella was 59% (93/157) and 26.1% (5/23), respectively. The overall prevalence of pAmpC-positive enterobacteria was 10% (98/985); 16.4% (45/274) in Kampala, 6.2% (25/406) Kayunga, and 9.2% (28/305) Mpigi. Ciprofloxacin use was associated with carriage of pAmpC-positive bacteria, while residing in rural districts was associated with protection from carriage of pAmpC-positive bacteria. Conclusion: pAmpC beta-lactamase producing enterobacteria are prevalent in urban and rural dwellers in Uganda, therefore, cefoxitn should be included during routine susceptibility testing in this setting.
Characterisation of "ESKAPE" Pathogens with Special Reference to Multidrug Resistance and Biofilm Production in a Nepalese Hospital
Authors: Pandey Rosy , Shrestha Angela , Mishra Shyam Kumar
Published: December 2019

Background: “ESKAPE” is an acronym for group of organisms as Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter calcoaceticus baumannii complex, Pseudomonas aeruginosa and Enterobacter spp. They are associated in causing life threatening infections. Global efforts on controlling multidrug resistant (MDR) organisms have been hampered by their rapid emergence, inadequate tests for rapid detection and their ability to escape the antibacterial drugs. The objective of this study was to determine the prevalence of ESKAPE pathogens with prime focus on biofilm production and antibiotic resistance. Methods: A total of 8756 clinical specimens were processed for the isolation and identification of ESKAPE pathogens following standard microbiological protocol. These isolates were subjected to antibiotic sensitivity test as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Detection of resistance phenotypes, viz., extended-spectrum-beta-lactamase (ESBL), metallo-beta-lactamase (MBL), Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE) was done by disk diffusion method and E- test method as applicable. The VRE isolates were subjected for detection of Van A and Van B genes. All the isolates were processed for biofilm detection by tube adherence method. Results: The percentage distribution of Staphylococcus aureus was 33.5%, followed by Klebsiella pneumoniae 33.0%, Pseudomonas aeruginosa 18.3%, Acinetobacter calcoaceticus baumannii complex 8.7%, Enterococcus faecium 5.6% and Enterobacter aerogenes 0.9%. MRSA was 57.6% and Vancomycin resistance among Enterococcus faecium was 20%. ESBL and MBL producing Klebsiella pneumoniae were 16.1%, and 8.1%, Acb complex 10.3% each and Pseudomonas aeruginosa 10.7% and 8.3% respectively. A total of 42.3% of isolates were biofilm producers. Linezolid was drug of choice for VRE isolates. Piperacillin- tazobactam was found to be effective against Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter aerogenes; Ampicillin-sulbactam was the most effective drug against Acb complex excluding polymyxins. Van A gene was detected in all the VRE isolates. Conclusion: This study estimates the burden of the ESKAPE organisms and their antibiotic resistance pattern in a Nepalese hospital. The increasing percentages of drug resistance among these biofilm-producing pathogens pose great threat in medical setting. Surveillance targeting ESKAPE pathogens should be incorporated in infection control policy in Nepal.
Solidarity, Vulnerability and Mistrust: How Context, Information and Government Affect the Lives of Women in Times of Zika
Authors: Arias Ana Rosa Linde , Roura Maria , Siqueira Eduardo
Published: December 2019

Background and Objectives The public health response to Zika outbreak has mostly focused on epidemiological surveillance, vector control, and individual level preventative measures. This qualitative study employs a social-ecological framework to examine how macro (historical, legislative, political, socio-economic factors), meso (sources of information, social support, social mobilization) and micro level factors (individual actions, behavioral changes) interacted to influence the response and behavior of women with respect to Zika in different contexts. Methods A qualitative study was carried out. Women were recruited through the snowball sampling technique from various locations in Brazil, Puerto Rico, and the United States. They were of different nationalities and ethnicities. Data were collected through semi-structured interviews. The data transcripts were analyzed using thematic analysis. Results Women in this study deemed the information provided as insufficient, which led them to actively reach out and access a variety of media sources. Social networks played a vital role in sharing information but also resulted in the spread of hoaxes or rumors. Participants in our research perceived socio-economic inequities but focused on how to remedy their microenvironments. They did not engage in major social activities. Lack of trust in governments placed women in vulnerable situations by preventing them to follow the guidance of health authorities. These impacts were also a result of the response tactics of health and government administrations in their failed attempts to ensure the well-being of their countries’ populations. Conclusions Our findings call for a broad spectrum of public health interventions that go beyond individual level behavioral change campaigns, to more comprehensively address the broader meso and macro level factors that influence womens’ willingness and possibility to protect themselves.