bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons learned, challenges and outlooks for decision-making after a decade of experience monitoring the impact of Indoor Residual Spraying in Benin, West Africa
Authors: Akogbéto Martin C , Dagnon Fortuné , Aikpon Rock , OSSE Razaki , Salako Albert , AHOGNI Idelphonse , AKINRO Bruno , SOMINAHOUIN André , Sidick Aboubakar , Tokponnon Filémon , PADONOU Germain Gil
Published: January 2020

Background Since 2008, Indoor Residual Spraying (IRS) has been performed in Benin in 19 districts, including 4 in southern Benin, 9 in Atacora, and 8 in Atacora, Alibori and Donga in northern Benin. However, Benin still struggles with questions about IRS cost benefit and epidemiological impact. We discussed lessons learned and challenges from 10 years of IRS in Benin to be shared with the stakeholders involved in vector control implementation for decisions making. Methods We have assessed entomological parameters in IRS communes since 2008. In all IRS intervention communes, decreases in Human Biting Rate (HBR) of An. gambiae , blood feeding inhibition and Entomological Inoculation Rate (EIR) as compared to control district have been measured. Results EIR was reduced by 80-90%, which is encouraging, but should be observed with caution because: (i) the reduction may be insufficient to decrease epidemiological indicators given that the residual EIR in IRS districts is still higher than it is in some regions of stable malaria; (ii) the reduction in EIR is based on comparisons with control communes, but it is difficult to select control areas with the same environmental characteristics as intervention areas; (iii) despite the reduction, half of all mosquitoes that entered IRS-treated houses succeeded in taking human blood meals. Further, there are behaviors among Benin’s population that limit IRS efficacy, including recent data showing that >90% of people are not protected by IRS between 7-10 PM. This is due to the fact that they remain outside and that most people are not protected from mosquito bites after 10 PM because they either sleep outside without IRS protection or inside without an ITN. Moreover, people have large amounts of clothing hanging on walls where mosquitoes can rest instead of IRS-treated walls. Finally, other components are important to consider in implementing IRS among which: (i) Vector resistance management strategies are sometimes poorly understood; this is actually different from replacing an insecticide by another after the emergence of resistance; (ii) African countries should prepare to finance IRS themselves. Conclusion To curtail residual malaria transmission, additional interventions able to target vectors escaping IRS should be prioritized. Keywords: IRS, Lessons learned, challenges, outlooks, Benin
Prognostic effect of professional oral care in estrogen receptor-positive metastatic breast cancer patients treated with everolimus and exemestane enrolled in Oral Care-BC: a randomized controlled trial
Authors: nakatsukasa katsuhiko , Niikura Naoki , Kashiwabara Kosuke , Amemiya Takeshi , Watanabe Kenichi , Hata Hironobu , Kikawa Yuichiro , Taniike Naoki , Yamanaka Takashi , Mitsunaga Sachiyo , Nakagami Kazuhiko , Adachi Moriyasu , Kondo Naoto , Shibuya Yasuyuki , Hayashi Naoki , Naito Mariko , Yamashita Toshinari , Umeda Masahiro , Mukai Hirofumi , Ota Yoshihide
Published: January 2020

Background: The Oral Care BC-trial reported that professional oral care (POC) reduces the incidence and severity of oral mucositis in patients receiving everolimus (EVE) and exemestane (EXE). However, the effect of POC on clinical response among patients receiving EVE and EXE was not established. We compared outcomes for estrogen receptor-positive metastatic breast cancer patients that received POC to those that had not and evaluated clinical prognostic factors. All patients simultaneously received EVE and EXE. Methods: Between May 2015 and Dec 2017, 174 eligible patients were enrolled in the Oral Care-BC trial. The primary endpoint was the comparative incidence of grade 1 or worse oral mucositis, as evaluated by an oncologist over 8 weeks between groups. The secondary endpoints were progression-free survival (PFS) and overall survival (OS). Data were collected after a follow-up period of 13.9 months. Results: There were no significant differences in PFS between the POC and Control Groups ( P = 0.801). A BMI < 25 mg/m 2 and non-visceral metastasis were associated with longer PFS ( P = 0.018 and P = 0.003, respectively) and the use of bone modifying agents (BMA) was associated with shorter PFS ( P = 0.028). The PFS and OS between the POC and control groups were not significantly different in the Oral-Care BC trial. Conclusions: POC did not influence the prognosis of estrogen receptor-positive metastatic breast cancer patients. Patients with non-visceral metastasis, a BMI < 25 mg/m 2 , and who did not receive BMA while receiving EVE and EXE may have better prognoses. Trial registration: The study protocol was registered online at the University Hospital Medical Information Network (UMIN), Japan (protocol ID 000016109), on January 5, 2015 and at ClinicalTrials.gov (NCT02376985).
The influence of dietary supplementation with the leucine metabolite β-hydroxy-β-methylbutyrate (HMB) on chemotaxis, phagocytosis and respiratory burst of peripheral blood granulocytes and monocytes in calves
Authors: Wójcik Roman , Małaczewska Joanna , Zwierzchowski Grzegorz , Miciński Jan , Kaczorek-Łukowska Edyta
Published: January 2020

Background The objective of this study was to evaluate the effect of HMB on the chemotactic activity, phagocytic activity and respiratory metabolism of peripheral blood granulocytes and monocytes in calves.Method The experiment was performed on 14 calves aged 30±2 days, divided into two equal groups of control (group I) and experimental (group II) animals. The feed administered to experimental group calves was supplemented with HMB (Metabolic Technologies Inc. Ames, IA, USA) at 40 mg/kg BW, whereas control calves were administered standard farm-made feed without supplementation. Blood was sampled from the jugular vein immediately before the experiment (day 0) and on experimental days 15, 30 and 60 to determine: chemotactic activity (MIGRATEST® kit), phagocytic activity (PHAGOTEST® kit) and respiratory metabolism (BURSTTEST® kit) of peripheral blood granulocytes and monocytes by flow cytometry.Results An analysis of granulocyte and monocyte chemotactic activity and phagocytic activity revealed significantly higher levels of phagocytic activity in calves administered HMB than in the control group, expressed in terms of the percentage of phagocytising cells and mean fluorescence intensity (MFI). HMB also had a positive effect on the oxidative metabolism of both granulocytes and monocytes after stimulation with Escherichia coli bacteria and with PMA (4-phorbol-12-β-myristate-13-acetate), expressed in terms of the percentage of oxidative metabolism and MFI.Conclusion HMB stimulates non-specific cell-mediated immunity, which is a very important consideration in newborn calves that are exposed to adverse environmental factors in the first weeks of their life. The supplementation of animal diets with HMB for both preventive and therapeutic purposes can also reduce the use of antibiotics in animal production.
An examination of trends in antibiotic prescribing by area-level deprivation in England
Authors: Thomson Katie , Berry Rachel , Robinson Tomos , Brown Heather , Bambra Clare , Todd Adam
Published: January 2020

Background As part of an approach to reduce antimicrobial resistance, there has been strategic focus placed on reducing antibiotic prescribing. Given these policy drivers, there is a pressing need to understand the nature of antibiotic prescribing by primary care, and to understand how this changes by socioeconomic deprivation, when controlling for confounding variables. This is crucial in order to inform future antibiotic prescribing targets to ensure such targets do not impact on people with the most health need and thus potentially widen health inequalities.Methods Antibiotic prescribing data for the years 2014-2018 were matched with the Index of Multiple Deprivation (IMD 2015) deciles and graphically presented to explore trends over time. Multi-level analysis on antibiotic use was used to assess the impact of deprivation alongside a range of other confounding variables, including health need, geographic region and GP quality rating.Results Our study highlighted three key results: (1) GP surgeries located in the most deprived areas had the highest levels of antibiotic prescribing (adjusting for health need accounted for most of this variation); (2) there was inequalities in the prescribing of broad spectrum antibiotics according to deprivation; (3) there was significant geographical variation in antibiotic prescribing.Conclusion Future antibiotic prescribing targets should account for deprivation and/or health need to ensure GP practices located in the most deprived communities are not inappropriately penalised.
The chloroplast genome sequencing of two important annual Trifolium species T. alexandrinum and T. resupinatum and comparative analysis with other congeneric species
Authors: xiong yanli , xiong yi , he jun , yu qingqing , zhao junming , lei xiong , dong zhixiao , yang jian , peng yan , zhang xinquan , Ma Xiao
Published: January 2020

Background: Chloroplast (cp) genome of most plant species has two typical inverted-repeats (IRs) regions. However, in some species this IR structure is lost for unknown reasons and the consequence still needs to be revealed . Here, we present whole cp genome sequencing of Trifolium alexandrinum (Egyptian clover) and T. resupinatum (Persian clover) from the IR lacking clade (IRLC) . Results: Global aligning of T. alexandrinum and T. resupinatum to other eight Trifolium species revealed a large amount of rearrangement and repetitive events in these ten species. We found that IR lacking species have lower GC content and higher percentage of repetition than IR containing species. Abundant single nucleotide polymorphisms (SNPs) and insertions/deletions (In/Dels) were discovered between those two species. As hypothetical cp open reading frame (ORF) and RNA polymerase subunits severally, two genes ycf1 and rpoC2 in the cp genomes, which both contain vast repetitive sequences and high Pi values (0.6656, 0.455) between T. alexandrinum and T. resupinatum , possessed highly variation among ten Trifolium species. Thus they could greatly influence evolutionary process of Trifolium species. In addition, IR containing and IR lacking Trifolium species were estimated to split during the upper Cretaceous period, which was potentially related to the violent crustal movement and sea-land changes. Conclusions: Cp genomes of T. alexandrinum and T. resupinatum, which belong to IRLC were sequenced and annotated in present study, and compared with cp genomes of other eight Trifolium species reported previously. This valuable information will provide insight into the evolution of IR lacking species. Nevertheless, further investigating of the detailed reason of IR lacking is still challenging, but it may be related to the violent crustal movement and sea-land changes of the Cretaceous period presented in this study.
Frequent fragility of randomized controlled trials for HCC treatment
Authors: Hao Zhang , Jingtao Li , Zeng Wenting
Published: January 2020

Background The fragility index (FI) of trial results can provide a measure of confidence in the positive effects reported in randomized controlled trials (RCTs). The aim of this study was to calculate the FI of RCTs supporting HCC treatments.Methods A methodological systematic review of RCTs in HCC treatments was conducted. Two-arm studies with randomized and positive results for a time-to-event outcome were eligible for the FI calculation.Results A total of 11 trails were included in this analysis. The median FI was 0 (range 0-19). FI was ≤ 5 in 8 (72.73%) of 11 trials; in those trials the fragility quotient was ≤ 1%.Conclusion Many phase 3 RCTs supporting HCC treatments have a low FI, which challenges the confidence in concluding the superiority of these drugs over control treatments.
Testing the Hypothesis that the Nylonase NylB Protein Arose de novo via a Frameshift Mutation
Authors: Cordova Salvador T , Sanford John
Published: January 2020

Background In 1984, Susumu Ohno hypothesized that the nylon-degrading enzyme NylB arose de novo via a frameshift mutation within a hypothetical precursor protein (PR.C). However, the frameshift hypothesis was never actually tested, and there was no actual supporting biological evidence supporting the hypothesis. For decades, the frameshift hypothesis has been uncritically accepted as the correct explanation for the origin of NylB. In this paper we have surveyed the literature relevant to the frameshift hypothesis as well as the various alternative models that have been published regarding the origin of NylB. We have employed bioinformatic methods and leveraged databases not available when the frameshift hypothesis was first put forward.Results We searched multiple protein databases to determine the distribution of NylB and any possible homologs. We then determined the distribution of other known nylonases and their possible homologs. We also determined the distribution of Ohno’s hypothetical PR.C. protein and any possible homologs. Lastly, we determined what protein families the various nylonases belong to. We found that the NylB protein is widely occurring, has thousands of homologs, and is found in diverse organisms and diverse habitats. It is not a new or unique protein. Likewise, we found that the other known nylonases are also widely occurring, have thousands of homologs, and are found in diverse organisms and diverse habitats. However, the hypothetical PR.C protein does not show up in any of the same databases, and there is no evidence of any homologs. Conserved domain searches showed that NylB is a member of the beta lactamase protein family – a highly conserved family of enzymes. Likewise, the other known nylonases belong to well-characterized enzyme families.Conclusions Our results very effectively falsify the NylB frameshift hypothesis, while they strongly support an alternative hypothesis by Yomo. Like NylB, none of the other nylonases that we examined were substantively new or unique. All had thousands of homologs, and they were found in diverse organisms and diverse habitats. Our findings not only falsify the NylB frameshift hypothesis, they also falsify the long-held assumption that all nylonases evolved after the invention of nylon in 1935.
Increased viral suppression among people on first line antiretroviral treatment in Ethiopia: Meeting the third 90’s
Authors: Maru Minwuyelet , Dagne Daniel , Tesfie Addisu , Missaye Asefa , Yismaw Gizachew , Mulu Andargachew
Published: January 2020

Background Antiretroviral treatment (ART) is aimed for complete suppression of viral replication but it fails for a variety of reasons. The aim of this study was to determine the prevalence and associated factors of treatment failure among people on first line ART in Amhara region, North east Ethiopia.Methods A cross sectional study was conducted from March, 2018 to July, 2018. Questionnaire survey using a pre-structured questionnaire was taken focusing on demographic data and possible risk factors of antiretroviral treatment failure. Clinical history including baseline characteristics was extracted by reviewing medical records using data abstraction sheet and data was analyzed using STATA version 14.Results A total of 640 clients of all age from 16 health facilities were enrolled in the study. The overall antiretroviral treatment failure was 16.45% from which clinical, immunologic and virologic failure were 0.47%, 13.59% and 3.13% respectively. The viral suppression was 91.09%, but more than half, 29 (50.88%) study participants with high first viral load (>1000copies/ml) were defaulted and not tested for the 2 nd viral load testing. Binary and multivariable logistic regression analysis showed significance association of treatment failure with age at treatment initiation (OR, 1.029), duration on ART (OR, 0.87) and adherence (AOR, 4.22). High proportion of treatment failure was also found in females (62.75%) and in those below primary education (76.47%).Conclusions In conclusion increased viral suppression is observed but the rate of default during 3 month of enhanced adherence counseling is high. The overall magnitude of treatment failure in Amhara region is 16.45%. Fair/poor adherence, older age at treatment initiation and shorter duration on ART are significantly independent factors of treatment failure. Therefore improving client follow up to adherence to treatment should be strengthened.
Emergency department presentations by children in remote Australia: a population-based study
Authors: Dossetor Philippa Jane , Fitzpatrick Emily FM , Glass Kathryn , Douglas Kirsty , Watkins Rochelle , Oscar June , Carter Maureen , Harley David , Jeffery Heather E , Elliott Elizabeth , Martiniuk Alexandra LC
Published: January 2020

Background Aboriginal leaders invited us to examine the frequency and reasons for children presenting to Fitzroy Crossing Hospital emergency department (ED), Western Australia.Methods ED presentations (2007-11 inclusive) were examined for children born in the Fitzroy Valley in 2002-03.Results ED data were examined for 127/134 (94.7%) eligible children, with 1058 presentations for 1743 conditions in children aged 3-9 over 5 years. Most (81%) had at least one ED presentation (median 9.0, range 1-50). There were no differences by sex or season but numbers of presentations increased over time. Common presentations included: injury (15.1%), diseases of the ear (14.9%), skin (13.8%), respiratory tract (13.4%), infectious and parasitic diseases (9.8%), screening, follow up, and social reasons (16.0%). Household over-crowding, financial and food insecurity were common socio-economic factors recorded at ED presentation. Prenatal alcohol exposure (PAE) was significantly associated with high-frequency (>10) ED presentations.Conclusion Children in very remote Fitzroy Crossing communities have high rates of preventable ED presentations, with higher rates in those with than without PAE. Support for culturally appropriate preventative programs and improved access to health services need to be provided in remote Australia.
Prognostic nutrition index as a predictor of coronary artery lesions in Kawasaki Disease
Authors: Tai I Hsin , Wu Pei-Lin , Guo Mindy Ming-Huey , Lee Jessica , Chu Chi-Hsiang , Hsieh Kai-Sheng , Kuo Ho-Chang
Published: January 2020

Background: Kawasaki Disease (KD) is considered a major acquired heart disease in children under the age of 5. Coronary artery lesions (CAL) can occur in serious cases despite extreme therapy efforts. Previous studies have reported low serum albumin level was associated with disease outcome, but no further investigation was addressed yet. Method: This retrospective (case-control) study randomly included children with KD who were admitted and underwent laboratory tests before undergoing IVIG treatment in this institution, the largest tertiary medical center in southern Taiwan from 2012-2016. PNI, an albumin-based formula product, was evaluated as a predictor of CAL the first time. The progression of CAL was monitored using serial echocardiography for six months. We performed multivariable logistic regression analysis on the laboratory test and PNI with the disease outcome of the KD patients. Result: Of the 284 children, 158 had CAL, including transient dilatation, while the other 126 did not develop CAL during the 6-month follow-up period. A multivariate logistic regression model revealed that PNI and platelet count are significant predictors of CAL with a 95% confidence interval estimator of 2.532 (1.394-4.599) and1.004 (1.002-1.006), respectively. Using PNI to predict CAL presence gave an area under the receiver-operating-characteristics (ROC) curve of 0.596, and the PNI cut-off point is taken as 55.24, with a sensitivity of 0.509 and specificity of 0.678. Conclusion: This is the first study to demonstrate that PNI, an albumin-based formula product, is a useful index with clearly cut-off value for predicting CAL formation prior to initial IVIG therapy and thus warn clinicians to adopt aggressive therapeutic and coronary arteries imaging surveillance strategies before CAL can develop.
Newborn feeding recommendations and practices increase the risk of development of overweight and obesity
Authors: Watchmaker Brittany , Boyd Bridget , Dugas Lara
Published: January 2020

Background: The prevalence of obesity among infants less than 2 years of age has increased by more than 60 percent over the last three decades. Obese infants and toddlers are at an increased risk for staying overweight into adolescence and adulthood. Metabolic programming has been demonstrated in animal models whereby early life feeding habits result in life-long changes in hormone balance and metabolism. Our study explores if newborn over-nutrition on the first day of life (DOL1) is associated with risk for future overweight and obesity in childhood. Methods: Retrospective chart data was collected for full-term formula-fed infants born between January 2008 and December 2012 who continued care at the same institution. Data included the volume of formula (ml) consumed on DOL1 as well as subsequent yearly BMI measures from well child check-ups. (WCC). Overfeeding was categorized as any feed greater than or equal to 30 ml on any of the first seven feeds while controlling for birth weight. Results: The final data set included 1106 infants (547 male; 559 female). 1023 of the 1106 newborns (93%) were overfed at least once during DOL1, while 789 of 1106 (71%) were overfed 3 or more times during their first 7 feeds. After adjusting for birth weight, infants who were overfed 5 of the first 7 feeds were 5 times as likely to be overweight or obese at their 4th year well child check-up (p<0.05) compared to children not overfed. Infants who were overfed on all 7 of their first 7 feeds were 7 times more likely to be overweight or obese at their 4th year WCC (p=0.017). Conclusions: Infants overfed on DOL1 were significantly more likely to be overweight or obese at their 4 th year WCC, compared to infants not overfed on their first day of life. Newborn families may benefit from counseling regarding age-appropriate volumes of formula during this early critical and impressionable time period. Future studies will aim to look at effect of smaller feeding bottle size on DOL1 on reducing overfeeding practices and future overweight and obesity.
The application and epidemiological research of xTAG-GPP multiplex PCR in the Diagnosis of children persistent and chronic diarrhea
Authors: Wang Chunli , Zhou Xiaoying , Zhu Mengshu , Yin Hanjun , Tang Jiamei , Huang Yan , Zheng Bixia , Jin Yu , Liu Zhifeng
Published: January 2020

Background Persistent and chronic diarrhea is difficult to treat, and infection is still the main causes. Clearly infected pathogens are essential for treatment. In this study, we investigate the application value of xTAG gastrointestinal pathogen panel (xTAG GPP) multiplex PCR in the early diagnosis of children with persistent and chronic diarrhea and understand the epidemiology of intestinal diarrhea pathogens. Methods One hundred and ninety-nine specimens were collected from Nanjing Children's Hospital Affiliated to Nanjing Medical University (Nanjing, China). Comparing the xTAG GPP multiplex PCR Assay with the traditional methods (culture, rapid enzyme immunoassay chromatography, microscopic examination) and madding the statistical analysis. Results The positive rate of 199 patients with diarrhea specimens was 72.86% (145/199). The virus detection rate was 48.7%, Rotavirus A was the most common organism detected (34.6%), concentrated in winter, popular in children. Secondly, Norovirus GI/GII (20.6%). The positive rate of bacteria was 40.2%, Campylobacter (22.11%, 44/199) was most frequently detected. With C. difficile toxins A/B and Salmonella detected 44 and 17 samples, respectively. Infections with Shigella occurred 4 times, E. coli O157 was only detected once. There were three samples with parasitic (1.51%), two samples were positive for Entamoeba histolytica, one for Cryptosporidium. Adenovirus40/41, STEC, ETEC, Giardia, Yersinia enterocolitica and Vibriocholera were not detected. Totally 86 (43.2%) infected specimens with single pathogen were detected. There were 57 co-infections (28.64% of samples) of viruses and/or bacteria and/or parasites. Co-infections involved 29 double infections (23.62%) samples, 9 triple infections (4.52%) and 2 quadruple infections (0.5%). Norovirus GI/GII was found to have the highest involvement in co-infections 30(15.08%). Conclusion xTAG GPP multiplex PCR is simple, sensitive, specific and can be used as a quick way to diagnose the children persistent and chronic diarrhea.
Hyponatremia as a Predictor of Adverse Outcome in Children With Severe Lower Respiratory Tract Infection in Tribhuvan University Teaching Hospital (Tuth), Nepal
Authors: Lamichhane Machhindra , Shrestha Laxman , Bajracharya Luna , Bagale Archana
Published: January 2020

Introduction: Lower respiratory tract infection (LRTI) is one of the major causes of mortality in children with estimated 1 million deaths every year. Hyponatremia is the most common electrolyte abnormality seen in LRTI. Objective: To find association of hyponatremia (serum sodium<135meq/l) with severe LRTI. Design: Prospective cross sectional study Settings: Pediatric Emergency, Ward and Pediatric Intensive Care Unit of Tribhuvan University Teaching Hospital(TUTH) Subjects: Children between 2 months to 16 years presenting with cough for less than 3 weeks, fast breathing and chest indrawing. Methods: Children between 2 month to 16 years of age having cough, fast breathing and chest indrawing admitted in emergency, ward or PICU of TUTH were screened and among them, children having pediatric respiratory severity score of 4-5 were enrolled in the study. Serum sodium was sent during admission and collected within 2 hours. Daily follow up was done to find need of respiratory support, duration to resolve hypoxia, total duration in hospital and final outcome of patient. Statistical test applied were Chi-square test and Fisher exact test. Results: 47.5% of study population had hyponatremia, of whom 65.79% had mild hyponatremia 26.31% had moderate and 7.89%had severe hyponatremia. Association of hyponatremia with need of non rebreathing face mask (p=0.001), ventilatio r (p=0.009), duration of hospital stay (p=0.047) were significant. The study also found the association of severity of hyponatremia with need of non rebreathing facemask (p=0.001),ventilator (p=0.01), outcome (p=0.001), duration of stay (0.002). Mean time to resolve hypoxia in children with hyponatremia (4.5 days) was longer compared to normal sodium (2.58 days). Four patients died during the study period and all of them had hyponatremia. Conclusion- Association of hyponaremia and severity of hyponatremia in severe LRTI with need of non-rebreathing face mask, ventilatior, outcome, duration of stay was significant.
Exploring barriers and facilitators to integrated hypertension-HIV management in Ugandan HIV clinics using the Consolidated Framework for Implementation Research (CFIR)
Authors: Muddu Martin , Tusubira Andrew K. , Nakirya Brenda , Nalwoga Rita , Semitala Fred C. , Akiteng Ann R. , Schwartz Jeremy I , Ssinabulya Isaac
Published: January 2020

BackgroundPersons Living with HIV (PLHIV) receiving antiretroviral therapy have increased risk of cardiovascular disease (CVD). Integration of services for hypertension (HTN), the primary CVD risk factor, into HIV clinics is recommended in Uganda. Our prior work demonstrated multiple gaps in implementation of integrated HTN care along the HIV treatment cascade. In this study, we sought to explore barriers to, and facilitators of, integrating HTN screening and treatment into HIV clinics in Eastern Uganda.MethodsWe conducted a qualitative study at three HIV clinics with low, intermediate, and high HTN care cascade performance, which we classified based on our prior work. Guided by the Consolidated Framework for Implementation Research (CFIR), we conducted semi-structured interviews with health services managers, health care providers and hypertensive PLHIV (n=83). Interviews were transcribed verbatim. Three qualitative researchers used both deductive (CFIR model-driven) and inductive (open coding) methods to develop relevant codes and themes. Ratings were performed to determine valence and strengths of each CFIR construct regarding influencing HTN/HIV integration. ResultsOf the 39 CFIR constructs assessed, 17 were relevant to either barriers or facilitators to HTN/HIV integration. Six constructs strongly distinguished performance and were barriers, three of which were in the Inner setting (Organizational Incentives & Rewards, Available Resources, Access to Knowledge & Information); two in Characteristics of individuals (Knowledge & Beliefs about the Intervention and Self-efficacy) and one in Intervention characteristics (Design Quality & Packaging). Four additional constructs were weakly distinguishing and negatively influenced HTN/HIV integration. There were four facilitators for HTN/HIV integration related to the intervention (Relative advantage, Adaptability, Complexity and Compatibility). The remaining three constructs negatively influenced HTN/HIV integration but were non-distinguishing. ConclusionUsing the CFIR, we have shown that while there are modifiable barriers to HTN/HIV integration in the Inner setting, Outer setting, Characteristics of individuals and implementation Process, HTN/HIV integration is of interest to patients, health care providers and managers. Improving access to HTN care among PLHIV will require overcoming barriers and capitalizing on the facilitators using a health system strengthening approach. These findings are a springboard for designing contextually appropriate interventions for HTN/HIV integration in low- and middle-income countries.
Efficacy of transversus abdominis plane block on the chronic pain after colorectal surgery: a retrospective cohort study
Authors: Pan Zi-Ye , Hu Zhong-Hua , Zhang Fan , Xie Wen-Xiu , Tang Yong-Zhong , Liao Qin
Published: January 2020

Background: Chronic postsurgical pain (CPSP) is common and would reduce the quality of life of patients. Transversus abdominal plane (TAP) block has been widely used in lower abdominal surgery and many researchers demonstrated that it could improve acute postsurgical pain. We aim to determine whether TAP block could improve chronic postoperative pain at 3 months and 6 months after colorectal surgery.Methods: A total of 307 patients received selective colorectal surgery under general anesthesia between January, 2015 and January, 2019 in a single university hospital were included: 128 patients received TAP block combined with patient-controlled intravenous analgesia (PCIA) for postsurgical analgesia (group TP) and 179 only administrated with PCIA (group P). Main outcome was the incidence of pain at 3 months and 6 months after colorectal surgery, and NRS score of pain at 24 hours, 48 hours, 3 months and 6 months after colorectal surgery. The data was analyzed by two-way repeated measures anova and the chi-square test.Results: The NRS score decreased significantly at 24 hours after surgery (rest NRS 1.07±1.34 vs 1.65±1.67, P=0.003; and movement NRS 3.00±1.45 vs 3.65±1.89; p=0.003) and at 3 months after surgery (movement NRS 0.59±1.23 vs 0.92±1.65, p=0.045 )in group TP than that in group P. There were no significant difference of NRS score at 48 hours and 6 months after surgery (all p>0.05). Among 307 patients, 62/307(20.2%) developed chronic post-surgical pain (CPSP) at 3 months after surgery, and 42/307(13.7%) experienced CPSP at 6 months after surgery. The prevalence of CPSP in group TP showed no significant difference compared with group P at 3 months (19.5% vs 20.7%, p=0.806) and 6 months (13.2% vs 13.9%, p=0.863) after surgery.Conclusions: TAP block could decrease the movement pain score at 3 months after surgery, but could not reduce the incidence of CPSP at 3 months and 6 months after selective colorectal surgery. TAP block may have positive effect on chronic postsurgical pain.
Outcome impact of individualized fluid management during spine surgery A before-after prospective comparison study
Authors: Che Lu , Zhang Xiu H , Li Xu , Zhang Yue L , Huang Yu G , Xu Li
Published: January 2020

Background: Individualized fluid management (IFM) has been shown to be useful to improve the postoperative outcome of patients undergoing major abdominal surgery. A limited number of clinical studies have been done in orthopaedic patients and have yielded conflicting results. We designed the present study to investigate the clinical impact of IFM in patients undergoing major spine surgery. Methods: This is a before-after study done in 300 patients undergoing posterior spine arthrodesis. Postoperative outcomes were compared between control group implementing standard fluid management (n = 150) and IFM group (n = 150) guided by fluid protocol based on continuous stroke volume monitoring and optimization. The primary outcome measure was the proportion of patients who developed one or more complications within 30 days following surgery.Results: During surgery, patients received on average the same volume of crystalloids (7.4 vs 7.2 ml/kg/h) and colloids (1.6 vs 1.6 ml/kg/h) before and after the implementation of IFM. During 30 days following surgery, the proportion of patients who developed one or more complications was lower in the IFM group (32 vs 48%, p<0.01). This difference was mainly explained by a significant decrease in post-operative nausea and vomiting (from 38 to 19%, p<0.01), urinary tract infections (from 9 to 1%, p<0.01) and surgical site infections (from 5 to 1%, p<0.05). Median hospital length of stay was not affected by the implementation of IFM. Conclusions: In patients undergoing major spine surgery, the implementation of IFM was associated with a significant decrease in postoperative morbidity.
Increased circulating total bile acid levels were associated with organ failure in patients with acute pancreatitis
Authors: Li Weiqin , Xie Xiaochun , Dong Jie , Lu Guotao , Gao Kun , Li Xiaoyao , Mao Wenjian , Chen Faxi , Tong Zhihui , Li Baiqiang
Published: January 2020

Background: Recent studies have shown that bile acids (BAs) are closely related to metabolic and inflammatory diseases. Our study aimed to investigate whether circulating total bile acid (TBA) levels were associated with the severity of acute pancreatitis (AP).Methods: We retrospectively collected data on patients diagnosed with AP in a tertiary center from 01 January 2014 to 31 December 2016. Patients were divided into the high TBA (HTBA) group and the normal TBA (NTBA) group according to whether the highest TBA value (TBAmax) within 7 days after admission was ≥10μmol/L. The prognosis and complications, including death, organ failure (OF) and pancreatic necrosis, were compared between the two groups. Univariate and multivariate logistic regression analysis were used to evaluate the relationship between circulating TBA and organ failure in AP patients.Results: 293 patients were included in this study, of whom 18.43% (54/293) were in the HTBA group. The incidence of OF in the HTBA group was significantly higher than that in the NTBA group (59.3% vs 17.2%; P < 0.001), and the AP severity classification in the HTBA group was more serious than that in the NTBA group. The pancreatic necrosis rate, percutaneous catheter drainage (PCD) rate, open surgery rate and mortality rate in the HTBA group were higher than those in the NTBA group. Multivariate regression analysis showed that HTBA (odds ratio (OR), 4.894; P = 0.002) was an independent risk factor for AP complicated with OF. Conclusions: The increase of circulating TBA in early stage of AP is independently related to organ failure, which indicates the adverse prognosis of AP patients.
Transcriptome and metabolite analyses provide insights into zigzag-stem formation in tea plants (Camellia sinensis)
Authors: Cao Hongli , Wang Feiquan , Lin Hongzheng , Ye Yijun , Zheng Yucheng , Li Jiamin , Hao Zhilong , Ye Naixing , Yue Chuan
Published: January 2020

BackgroundShoot orientation is important for plant architecture formation, and the zigzag shoot is a special trait of many plants. The zigzag-shaped shoot has been selected and well studied in Arabidopsis, however, the regulatory mechanism of zigzag-shaped shoot development in other plants especially woody plants is largely unknown.ResultsIn this study, tea plants with zigzag shoots, namely, Qiqu (QQ) and Lianyuanqiqu (LYQQ), were investigated and compared with the erect-shoot tea plant Meizhan (MZ) in an attempt to reveal the regulation of zigzag-shoot formation. Tissue section observation showed that the cell arrangement and shape of zigzag stems were aberrant compared with those of normal shoots. Moreover, a total of 2175 DEGs were identified from the zigzag shoots of the tea plants QQ and LYQQ compared to the shoots of MZ using transcriptome sequencing, and the DEGs involved in the “Plant-pathogen interaction”, “Phenylpropanoid biosynthesis”, “Flavonoid biosynthesis” and “Linoleic acid metabolism” pathways were significantly enriched. Additionally, the DEGs associated with cell expansion, vesicular trafficking, phytohormones, and transcription factors were identified and analysed. Metabolomic analysis showed that 13 metabolites overlapped and were significantly changed in the shoots of QQ and LYQQ compared to MZ.ConclusionsOur results suggest that zigzag-shaped shoot formation might be associated with the gravitropism response and polar auxin transport in tea plants and provides a valuable foundation for further understanding the regulation of plant architecture formation and for the cultivation and application of horticultural plants in the future.
Genome-wide association studies on heat stress tolerance during grain development in wheat (Triticum aestivum L.)
Authors: Guo Jie , Shi Weiping , Guo Jiahui , Yue Linqi , Zhuang Lei , Zhang Wenying , Tian Xiaohai , Xu Yanhao , Zhou Meixue
Published: January 2020

BackgroundHeat stress at the late reproductive stages is a common problem encountered in autumn-sown wheat production regions in China with the affected area covering as much as two-thirds of the crop. In order to develop wheat cultivars with heat-tolerance, it is crucial to explore favorable alleles for use in breeding programs.ResultsIn this study, we performed a 90K iSelect SNP genotyping assay on a collection of 207 wheat cultivars subjected to heat stress during grain-fill growth stage in three years (2015-2017). Genotypic analyses of 19 phenotypic traits revealed that heat stress had major impacts on grain weight, size, and quality. Correlation analyses indicated that thousand kernel weight (TKW) was significantly correlated with grain width (GW) and grain perimeter (GP), whereas grain protein content (GPC) was negatively correlated with total starch content (TSC) (P <0.01). We applied heat susceptibility indices (HSI) for different traits to assess heat tolerance. Genome-wide association studies (GWAS) revealed a total of 125 marker-trait associations (MTAs) at 63 SNP loci on 16 chromosomes each accounting for phenotypic variation (R2) of 3.0-21.4%. 17 loci showed significant associations in three environments. The analysis of selective sweeps indicated that RAC875_c19042_2102 (2B), wsnp_Ex_c257_491667 (3B), wsnp_Ex_rep_c101323_86702413 (5A) and BS00061911_51 (7A) were selected between two subpopulations (top 5%).ConclusionsThese four key MTAs detected in the present study are candidates for further genetic dissection and development of molecular markers.
Mouse skeletal muscles infected with Plasmodium berghei and Plasmodium chabaudi reveal a crosstalk between lipid mediators and gene expression
Authors: Marrelli Mauro Toledo , Wang Zhiying , Huang Jian , Brotto Marco
Published: January 2020

Background Malaria is one of the most prevalent infectious disease in the world with 3.2 billion humans at risk. Malaria causes splenomegaly and damage in other organs including skeletal muscles. Skeletal muscles comprise nearly 50% of the human body and are largely responsible for the regulation and modulation of overall metabolism. it is essential to understand how malaria damages muscles in order to develop effective preventive measures and/or treatments. Using a pre-clinical animal model, we investigated the potential molecular mechanisms of plasmodia infection affecting skeletal muscles of mice.Methods We employed the Mouse Signal Transduction Pathway Finder PCR Array to monitor gene expression changes of 10 essential signaling pathways in skeletal muscles from mice infected with Plasmodium berghei and P. chabaudi . We then applied our new targeted-lipidomic approach using liquid chromatography with tandem mass spectrometry to profile 158 lipid signaling mediators (LMs), mostly arachidonoids, eicosanoids and docosanoids. We further quantified 16 key LMs directly associated with inflammation, oxidative stress, and tissue healing in skeletal muscles. Results Our results showed that the expression of key genes altered by malaria infection associate with inflammation, oxidative stress, and atrophy. In support to our gene profiling, lipidomics revealed higher concentrations of LMs in skeletal muscles directly related to inflammatory responses, while on the levels of LMs crucial in resolving inflammation and tissue repair reduced significantly.Conclusion Our results provide new insights into the molecular mechanisms of malaria-induced muscle damage and revealed a potential mechanism modulating inflammation in malarial muscles. These pre-clinical studies should help with future clinical studies in humans aimed at monitoring of disease progression and development of specific interventions for the prevention and mitigation of long-term chronic effects on skeletal muscle function.
The effect of microinjection of CART 55-102 into the nucleus accumbens shell on morphine-induced conditioned place preference in rats: Involvement of the NMDA receptor
Authors: Bakhtazad Atefeh , Vousooghi Nasim , Nasehi Mohammad , Sanadgol Nima , Garmabi Behzad , Zarrindast Mohammad Reza
Published: January 2020

Background The addictive properties of opioids may be mediated to some extent by cocaine- and amphetamine-regulated transcript (CART) in the reward pathway. There are also some claims regarding the interaction of CART and glutamate system. Drug-paired learning and memory may induce conditioned place preference (CPP) or conditioned place aversion (CPA). Here, we have evaluated whether intra-nucleus accumbens (NAc) shell infusions of CART induces CPP or CPA and affect morphine reward. In addition, we have measured the expression of the NR1 subunit of the N-methyl-D-aspartate (NMDA) glutamate receptor in various parts of the reward pathway (NAc, prefrontal cortex (PFC), and hippocampus) after conditioning tests. Bilateral cannulas were implanted in the rats NAc shell and then the animals were exposed to place conditioning. Animals were place-conditioned with several doses of subcutaneous (s.c.) morphine prior to the intra-NAc shell infusion of artificial cerebral spinal fluid (aCSF). Immunohistochemistry (IHC) data showed a dose-dependent increase in the expression of the NR1 subunit in all examined parts. Then, rats were conditioned with intra-NAc shell infusion of different doses of CART. CPP and CPA were induced with 2.5 and 5 μg/side, respectively.Results IHC showed an elevated level of NR1 with 2.5 μg/side and a decrease with 5 μg/side in all areas. Administration of a sub-rewarding dose of CART (1.25 μg/side) prior to the injection of a sub-rewarding dose of morphine (2.5 mg/kg) induced CPP and IHC analysis showed an increased amount of NR1 in all examined tissues. However, infusion of an aversive dose of CART (5 μg/side) prior to the injection of a rewarding dose of morphine (5 mg/kg) produced neither CPP nor CPA and IHC data showed a significant decrease in the amount of NR1 subunit in the NAc and hippocampus.Conclusions It seems that the rewarding or aversive effects of intra-NAc shell CART and its facilitating or inhibiting effects on morphine reward are dose-dependent. Furthermore, the NMDA receptor may be closely involved in the affective properties of opioids and CART in the reward pathway.
Transcriptomics analysis reveals the high biodegradation efficiency of white-rot fungus Phanerochaete sordida YK-624 on native lignin
Authors: Wang Jianqiao , Suzuki Tomohiro , Dohra Hideo , Mori Toshio , Kawagishi Hirokazu , Hirai Hirofumi
Published: January 2020

Background Lignocellulosic biomass is an organic matrix composed of cellulose, hemicellulose, and lignin. In nature, lignin degradation by basidiomycetes is the key step in lignocellulose decay. The white-rot fungus Phanerochaete sordida YK-624 (YK-624) has been extensively studied due to its high lignin degradation ability. In our previous study, it was demonstrated that YK-624 can secrete lignin peroxidase and manganese peroxidase for lignin degradation. However, the underlying mechanism for lignin degradation by YK-624 remains unknown.Results Here, we analyzed YK-624 gene expression following growth under ligninolytic and nonligninolytic conditions and compared the differentially expressed genes in YK-624 to those in the model white-rot fungus P. chrysosporium by next-generation sequencing. More ligninolytic enzymes and lignin-degrading auxiliary enzymes were upregulated in YK-624. This might explain the high degradation efficiency of YK-624. In addition, the genes involved in energy metabolism pathways, such as the TCA cycle, oxidative phosphorylation, lipid metabolism, carbon metabolism and glycolysis, were upregulated under ligninolytic conditions in YK-624.Conclusions In the present study, the first differential gene expression analysis of YK-624 under ligninolytic and nonligninolytic conditions was reported. The results obtained in this study indicated that YK-624 produces more energy- and lignin-degrading enzymes for more efficient lignin biodegradation.
Psychometric properties of a Chinese version of the Fraboni Scale of Ageism: evidence from medical students sample
Authors: Fan Jun-Yao , Zhao Hui-Min , Liu Yue-Ting , Kong Ling-Lin , Mao Jing , Li Jie
Published: January 2020

Background The increasing of older adults has led to enormous demand for medical care. However, as a group with unique needs and characteristics, older adults are often discriminated against in the medical field. In this paper, we aimed to translate the Fraboni Scale of Ageism (FSA) into Chinese and examine its construct validity, content validity, and reliability in Chinese mainland medical students. In order to evaluate the prevalence of ageism in Chinese medical students and prompt medical college to adopt necessary teaching methods to mitigate ageism in medical students.Methods By Brislin's translation guidelines, FSA was translated to Chinese. The convenient sampling method was used to select samples for this survey, including 1,974 students from two medical schools in central and north China. Construct validity was verified by the exploratory and confirmatory factor analysis. The content validity index (CVI) was used to assess content validity. The Cronbach's alpha coefficients and intraclass correlation coefficient (ICC) were used to estimate reliability.Results The alpha coefficients for FSA (Chinese version) was 0.81 and ICC was 0.87. The CVI was 0.93. Three factors were identified by exploratory factor analysis explaining 34.84% of the total variance and a three-factor model was confirmed to fit by confirmatory factor analysis.Conclusions FSA (Chinese version) is a reliable and valid scale for measuring discrimination degree against the older adults in Chinese medical students.