bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics
Authors: Ouh Yung-Taek , Lee Kyu-Min , Ahn Ki Hoon , Hong Soon-Cheol , Oh Min-Jeong , Kim Hai-Joong , Han Sung Won , Cho Geum Joon
Published: November 2019

Obstetric hemorrhage is one of the most common causes of obstetrical morbidity and mortality, and transfusion is the most important management for hemorrhage. The aim of our study was to investigate the pre-pregnancy and pregnancy risk factors for peripartum transfusion. Methods: Women who delivered a baby from 2010 to 2014 and participated in the National Health Screening Program for Infants and Children were included. To analyze pre-pregnant risk factors for peripartum transfusion, an additional analysis was done for women who underwent a National Health Screening Examination within one year before pregnancy, including maternal waist circumference, body mass index, blood pressure, laboratory tests and history of smoking. Results: Of the total 1,980,126 women who met the inclusion criteria, 36,868 (1.86%) were transfused at peripartum. In a multivariable regression model, the pregnancy risk factors for peripartum transfusion included maternal age above 35 years [odds ratio (OR): 1.41; 95% confidence interval (CI): 1.32–1.50], preterm birth (OR: 2.39; 95% CI: 2.15–2.65), and maternal hypertension (OR: 2.49; 95% CI: 2.24–2.77). Pre-pregnancy risk factors including fasting glucose level of more than 126 mg/dL (OR: 1.11; 95% CI: 1.02–1.20), current-smoker status (OR: 1.20; 95% CI: 1.06–1.37), and waist-circumference less than 80 cm (OR: 1.18; 95% CI: 1.06–1.30) were independently associated with peripartum blood transfusion. Conclusions: Several pre-pregnancy and pregnancy risk factors were associated with peripartum blood transfusion. Some identified factors are modifiable before conception, and our study validated peripartum blood transfusion as a form of triage. Keywords: Peripartum, Blood transfusion, Postpartum hemorrhage
How heterogeneous are MSM from Brazilian cities? An analysis of sexual behavior and perceived risk and a description of trends in awareness and willingness to use PrEP.
Authors: Torres Thiago S , Marins Luana M. S. , Veloso Valdilea G. , Grinsztejn Beatriz , Luz Paula M.
Published: November 2019

Background: Brazil has the largest population of individuals living with HIV/AIDS in Latin America, with a disproportional prevalence of infection among gays, bisexuals and other men who have sex with men (MSM). Of relevance to prevention and treatment efforts, Brazilian MSM from different regions may differ in behaviors and risk perception related to HIV. Methods: We report on MSM living in 29 different cities: 26 Brazilian state capitals, the Federal District and two large cities in São Paulo state assessed in three web-based surveys (2016-2018) advertised on Grindr, Hornet and Facebook. Using logistic regression models, we assessed the association of risk behavior with HIV perceived risk as well as factors associated with high-risk behavior. Results: A total of 16,667 MSM completed the survey. Overall, MSM from the North and Northeast were younger, more black/mixed-black, of lower income and lower education compared to MSM from the South, Southeast and Central-west. Though 17% had never tested for HIV (with higher percentages in the North and Northeast), condomless receptive anal sex (previous 6 months) and high-risk behavior as per HIV Incidence Risk scale for MSM were observed for 41% and 64%, respectively. Sexual behaviors and HIV perceived risk had low variability by city and high-risk behavior was strongly associated with high HIV perceived risk. Younger age, being gay/homosexual, having a steady partner, binge drinking, report of sexually transmitted infection (STI) and ever testing for HIV were associated with increased odds of high-risk behavior. Awareness and willingness to use PrEP increased from 2016 to 2018 in most cities. Conclusions: Overall, MSM socio-demographic characteristics were heterogeneous among Brazilian cities, but similarities were noted among the cities from the same administrative region with a marked exception of the Federal District not following the patterns for the Central-West. Combination HIV prevention is most needed among young men who self-identify as gay/homosexual, report binge drinking or prior STI.
Inhibition of Type I Interferon Signaling Abrogates Early Mycobacterium bovis Infection
Authors: Wang Jie , Hussain Tariq , Zhang Kai , Liao Yi , Yao Jiao , Song Yinjuan , Sabir Naveed , Cheng Guangyu , Dong Haodi , Li Miaoxuan , Ni Jiamin , Mangi Mazhar Hussain , Zhao Deming , Zhou Xiangmei
Published: November 2019

Background: Mycobacterium bovis (M. bovis) is the principal causative agent of bovine tuberculosis; however, it may also cause serious infection in human being. Type I IFN is a key factor in reducing viral multiplication and modulating host immune response against viral infection. However, the regulatory pathways of Type I IFN signaling during M. bovis infection are not yet fully explored. Here, we investigate the role of Type I IFN signaling in the pathogenesis of M. bovis infection in mice. Methods: C57BL/6 mice were treated with IFNAR1-blocking antibody or Isotype control 24 hour before M. bovis infection. After 21 and 84 days of infection, mice were sacrificed and role of Type I IFN signaling in the pathogenesis of M. bovis was investigated. ELISA and qRT-PCR was performed to detect the expression of Type I IFNs and related genes. M. bovis induced lung lesions were assessed by histopathological examination and viable bacterial count was determined by CFU assay. Results: We observed an abundant expression of Type I IFNs in the serum and lung tissues of M. bovis infected mice. In vivo blockade of Type I IFN signaling reduced the recruitment of neutrophils to the lung tissue, mediated the activation of macrophages leading to an increased pro-inflammatory profile and regulated the inflammatory cytokine production. However, no impact was observed on T cell recruitment and activation in the early acute phase of infection. Additionally, blocking of type I IFN signaling reduced bacterial burden in the infected mice as compared to untreated infected mice. Conclusions: Altogether, our results reveal that Type I IFN mediates a balance between M. bovis-mediated inflammatory reaction and host defense mechanism. Thus, modulating Type I IFN signaling could be exploited as a therapeutic strategy against a large repertoire of inflammatory disorders including tuberculosis.
Reliability and validity of miniscrews as references in cone-beam computed tomography and intraoral scanner digital models: study on goat heads
Authors: JIANG YIRAN , CHEN GUI
Published: November 2019

Miniscrews have been used to superimpose three-dimensional (3D) craniofacial images as well as explore stable structures in jaws. Our purpose was to evaluate the reliability and validity of linear and angular measurements made with miniscrews on a 3D cone-beam computed tomography (CBCT) at two voxel sizes and compared to models created by an intraoral scanner (IOS). Methods: Altogether, 64 miniscrews were placed in 12 goat jaws. The jaws were scanned by CBCT machine at 0.12 mm and 0.3 mm voxels and by the IOS. Linear and angular measurements between miniscrews on CBCT at the two voxel settings and the IOS were compared with actual measurements and with each other. Results: An intra-and inter-class correlation of 0.961–1.000 were obtained by each method. Linear measurements showed significant overestimations of 0.27±0.24, 0.14±0.22 and 0.15±0.26 mm, and angular measurements showed non-significant differences of 0.11±1.97°, 0.15±2.79° and 0.41±2.34° for the CBCT at 0.12-mm, 0.3-mm voxels and the IOS, respectively. Equal magnification of linear measurements was on homolateral and contralateral sides using CBCT, whereas significantly greater magnification on the homolateral side than on the opposite was observed using the IOS. There was no significant difference with angular measurements between digital CBCT models at two voxels and IOS. In addition, all angular measurements were comparable to actual measurement results. Conclusions: Miniscrews in CBCT and IOS are reliable and clinical valid when used as a reference measuring tooth movement. However, when miniscrews are involved in high precision measurement in CBCT or IOS image, systematic error should be taken into consideration. When comparing CBCT images, using the same voxel size is recommended for miniscrew related measurements to reduce error.
Exploring transcriptomic landscapes in red blood cells, in their extracellular vesicles and on a single-cell level
Authors: Kerkelä Erja , Lahtela Jenni , Larjo Antti , Impola Ulla , Mäenpää Laura , Mattila Pirkko
Published: November 2019

Circulating human red blood cells (RBCs) consist of mature erythrocytes and immature reticulocytes. Being anucleated, RBCs lack typical transcriptomes, but are known to contain small amounts of diverse long transcripts and microRNAs. However, the exact role and importance of these RNAs is lacking. Results To study this further, we explored the transcriptomes of RBCs and extracellular vesicles (EVs) of RBCs using next-generation sequencing. Furthermore, to understand the dynamics of the RBC transcriptome, we performed single-cell RNA sequencing on RBCs. An analysis of the single-cell transcriptomes revealed that approximately 10% of the cells contained detectable levels of mRNA and fell into three subpopulations based on their transcriptomes. Decrease in the mRNA quantity was observed across the populations. Qualitative changes included the differences in the globin transcripts and changes in the expression of ribosomal genes. A specific short splice form of a long non-coding RNA, Metastasis Associated Lung Adenocarcinoma Transcript 1 (MALAT1), was the most enriched marker in one subpopulation of RBCs, co-expressing with ribosomal structural transcripts. MALAT1 expression was confirmed by qPCR in CD71-enriched reticulocytes, which were also characterized with imaging flow cytometry at single cell level. Conclusions Analysis of the RBC transcriptome shows enrichment of pathways and functional categories required for the maturation of reticulocytes and erythrocyte functions. The RBC transcriptome was detected in their EVs, proposing vesiculation as a mechanism to remove the cellular contents from RBCs throughout their life cycle. Our experiments on single cell level revealed that lncRNA MALAT1 is the marker for one of the three RBC populations co-expressing with a group of ribosomal protein transcripts.
Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children
Authors: Hsu Yao-Jen , Fu Yu-Wei , Chin Taiwai
Published: November 2019

Background
Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months.
Methods
The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed.
Results
The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups.
Conclusions
The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.
Impact of First Metatarsal Shortening on Forefoot Loading Pattern: A Finite Element Model Study
Authors: Xiang Geng , Jiaqi Shi , Wenming Chen , Ma Xin , Xu Wang , Chao Zhang , Li Chen
Published: November 2019

Backgrounds There has long been agreement that shortening of the first metatarsal during hallux valgus reconstruction could lead to postoperative transfer metatarsalgia. But appropriate shortening is sometimes beneficial for correcting severe deformities or relieving stiff joints. So this study is to investigate, from the biomechanical perspective, whether and how much shortening of the first metatarsal could be allowed.
Methods A finite element model of the human foot simulating the push-off phase of the gait was established and validated by subject-specific plantar pressure data. Shortening of the first metatarsal for 2mm, 4mm, 6mm, 8mm were sequentially applied to the model, and the corresponding instant forefoot loading pattern during push-off phase, especially the loading ratio at the central rays, was respectively calculated. The effect of depressing the first metatarsal head was also observed at last.
Results With increasing shortening level of first metatarsal, the plantar pressure of the first ray decreased, while the lateral rays continued to rise. When the shortening reaches 6 mm, the load ratio of the central rays exceeds a critical threshold of 55%, which was considered risky. But it could still be manipulated to normal if the distal end of the first metatarsal displaced plantarly by 3 mm.
Conclusions During the first metatarsal osteotomy, a maximum of 6 mm of shortening is considered to be within the safe range. Whenever a higher level of shortening is necessary, pushing down the distal metatarsal segment could be a compensatory procedure to maintain normal plantar force distributions.
An alarming rise of non-albicans Candida species and uncommon yeasts in the clinical samples; a combination of various molecular techniques for identification of etiologic agents
Authors: Taei Mohireh , Chadeganipour Mostafa , Mohammadi Rasoul
Published: November 2019

Objective: Yeasts are unicellular microorganisms may cause systemic infection in immunocompromised patients. The aim of this study was to identify yeast strains isolated from clinical specimens using molecular techniques.
Results: A total of 202 yeast strains isolated from 341 clinical samples between February 2017 and May 2019. All clinical isolates were identified using phenotypic and molecular tests including PCR-RFLP, duplex-PCR, multiplex-PCR, and PCR-sequencing. The most yeast fungal isolates were obtained from urine (66.8%), nail (9.4%), skin lesion (7.9%), bronchoalveolar lavage (5.9%), and blood (3.9%). One hundred and twenty-one Candida species were identified as non-albicans versus 76 Candida albicans. Trichosporon asahii, and Pichia terricola were uncommon non-Candida yeasts isolated from urine samples. For the first time, we isolated P. terricola as etiological agent of urinary tract infection in a pregnant female. Since Candida species show different levels of resistance to antifungal agents, precise identification of clinical isolates is critical for better treatment of infection.
Zerumbone ameliorates behavioral impairments and neuropathology in transgenic APP/PS1 mice by suppressing MAPK signaling
Authors: Li Lei , Wu Xiang-Hui , Zhao Xiao-Jing , Xu Lu , Pan Cai-Long , Zhang Zhi-Yuan
Published: November 2019

Background: Alzheimer’s disease (AD) is a major clinical problem, but there is a distinct lack of effective therapeutic drugs for this disease. We investigated the potential therapeutic effects of zerumbone, a subtropical ginger sesquiterpene, in transgenic APP/PS1 mice, rodent models of AD which exhibit cerebral amyloidosis and neuroinflammation. Methods: The N9 microglial cell line and primary microglial cells were cultured to investigate the effects of zerumbone on microglia. APP/PS1 mice were treated with zerumbone, and non-cognitive and cognitive behavioral impairments were assessed and compared between the treatment and control groups. The animals were then sacrificed, and tissues were collected for further analysis. The potential therapeutic mechanism of zerumbone and the signaling pathways involved were also investigated. Results: Zerumbone suppressed the expression of pro-inflammatory cytokines and induced a switch in microglial phenotype from the classic inflammatory phenotype to the alternative anti-inflammatory phenotype by inhibiting the mitogen-activated protein kinase (MAPK)/nuclear factor-kappa B signaling pathway in vitro. After a treatment period of 20 days, zerumbone significantly ameliorated deficits in both non-cognitive and cognitive behaviors in transgenic APP/PS1 mice. Zerumbone significantly reduced β-amyloid deposition and attenuated pro-inflammatory microglial activation in the cortex and hippocampus. Interestingly, zerumbone significantly increased the proportion of anti-inflammatory microglia among all activated microglia, potentially contributing to reduced β-amyloid deposition by enhancing phagocytosis. Meanwhile, zerumbone also reduced the expression of key molecules of the MAPK pathway, such as p38 and extracellular signal-regulated kinase. Conclusions: Overall, zerumbone effectively ameliorated behavioral impairments, attenuated neuroinflammation, and reduced β-amyloid deposition in transgenic APP/PS1 mice. Zerumbone exhibited substantial anti-inflammatory activity in microglial cells and induced a phenotypic switch in microglia from the pro-inflammatory phenotype to the anti-inflammatory phenotype by inhibiting the MAPK signaling pathway, which may play an important role in its neuroprotective effects. Our results suggest that zerumbone is a potential therapeutic agent for human neuroinflammatory and neurodegenerative diseases, in particular AD.
Water, sanitation and hygiene practices associated with improved height-for-age, weight-for-height and weight-for-age z-scores in Nepal.
Authors: Shrestha Som Kumar , Vicendese Don , Erbas Bircan
Published: November 2019

Abstract: Background: Evidence of the influence of water, sanitation and hygiene (WASH) behaviors on childhood nutritional status is inconsistent. Few studies have examined their interactive effects. This study aimed to examine associations and interactions between WASH variables and preschool child undernutrition. Methods: Data from a nationally representative sample of 2352 children assessed during the 2016 Nepal Demographic and Health Survey were analyzed by multi-variable linear regression to obtain β-coefficients representing change in height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-scores associated with WASH variables. Interactions between WASH variables, sex and area of residence on childhood nutritional status were also examined. Results: The mean z-score [standard deviation] for children’s WAZ, HAZ and WHZ scores were -1.33 [1.1], -1.52 [1.3] and -0.65 [1.1], respectively. A unit increase in cluster sanitation coverage was associated with an increase of 0.30 (95%CI: 0.12, 0.48) for WAZ and 0.28 (95%CI: 0.001, 0.56) for HAZ scores. Household water purification practice was associated with an increase of 0.24 (95%CI: 0.07, 0.41) in WHZ score. Handwashing practice with water and soap was associated with an increase of 0.15 (95%CI: 0.04, 0.25) in WAZ and 0.13 (95%CI: 0.01, 0.24) in WHZ scores. The effect of water purification practice was higher for rural areas compared to urban settings for HAZ scores (p-value for interaction=0.002). Conclusions: Consistent with findings from other countries in the South Asian region, findings of this study highlight the potential importance of good WASH practices, and therefore the potential of WASH interventions, to contribute to improved nutritional status in rural Nepal.
An observational study of Patho-oncological outcomes of various surgical methods in rectal cancer: a single center analysis
Authors: CHEN YI-TING , HUANG CHING-WEN , MA CHENG-JEN , TSAI HSIANG-LIN , YEH YUNG-SUNG , SU WEI-CHIH , CHAI CHEE-YIN , Wang Jaw Yuan
Published: November 2019

Total mesorectal excision (TME) with or without neoadjuvant concurrent chemoradiotherapy (CCRT) is the treatment for rectal cancer (RC). Recently, the use of conventional laparoscopic surgery (LS) or robotic-assisted surgery (RS) has been on a steady increase cases. However, various oncological outcomes from different surgical approaches are still under investigation.Materials and methods This is a retrospective observational study comprising 300 consecutive RC patients who underwent various techniques of TME (RS, n = 88; LS, n = 37; Open surgery, n = 175) at a single center of real world data to compare the pathological and oncological outcomes, with a median follow-up of 48 months.Results Upon multivariate analysis, histologic grade ( P =0.048), tumor depth ( P =0.003), and pre-operative CCRT ( P =0.038) were the independent factors of circumferential resection margin (CRM) involvement. The Kaplan-Meier survival analysis determined RS, early pathologic stage, negative CRM involvement, and pathologic complete response to be significantly associated with better overall survival (OS) and disease-free survival (DFS) (all P <0.05). Multivariable analyses observed the surgical method ( P =0.037), histologic grade ( P =0.006), and CRM involvement ( P =0.043) were the independent factors of DFS, whereas histologic grade ( P =0.011) and pathologic stage ( P =0.022) were the independent prognostic variables of OS.Conclusions This study determined that RS TME is feasible because it has less CRM involvement and better oncological outcomes than the alternatives have. The significant factors influencing CRM and prognosis depended on the histologic grade, tumor depth, and pre-operative CCRT. RS might be an acceptable option owing to the favorable oncological outcomes for patients with RC undergoing TME.
Evaluation of the safety and efficacy of suction-tip forceps, a new tool for laparoscopic surgery, in patients with gastric cancer: Preliminary results from a prospective trial
Authors: Sakurazawa Nobuyuki , Harada Jun-ichiro , Ando Fumihiko , Arai Hiroki , Kuge Komei , Matsumoto Satoshi , Kawano Youichi , Matsuda Akihisa , Suzuki Hideyuki , Yoshida Hiroshi
Published: November 2019

Background
Laparoscopic surgery is widely accepted as minimally invasive surgery; however, obstacles to its functional optimization remain. One such challenge is that each surgical port can accommodate only one instrument at a time. Complex manipulations are therefore necessary to exchange one laparoscopic tool with another during surgery (e.g., removal of forceps and placement of a suction tube), which increases operation times and risk to patients. We developed a new laparoscopic instrument that functions as both forceps and a suction tube, which renders intraoperative tool exchange unnecessary. This prospective pilot study was undertaken to evaluate the safety and efficacy of this novel dual-function device in laparoscopic surgery for gastric cancer.
Methods
This single-center prospective pilot study was undertaken with 15 patients who required laparoscopic distal gastrectomy for gastric cancer. To assess patient safety, intraoperative video was used to document any tissue damage associated with the new instrument. To evaluate instrument efficacy, we measured the time interval between the start of bleeding and the start of aspiration (“suction access time”) and compared this time with that of a conventional surgical setup.
Results
All procedures were successful, and no excess tissue damage occurred during surgery with the suction-tip forceps. Bleeding occurred 158 times. Suction access time was significantly shorter in cases of bleeding when the suction-tip forceps were used (2.01 seconds) than when an ordinary suction tube was used for aspiration (12.5 seconds; P < 0.01).
Conclusion
These findings suggest that our new suction-tip forceps are a useful, safe, and efficacious operative tool. This surgical innovation may considerably simplify gastric laparoscopic surgery. This pilot study was registered with Japan Clinical Trial Registration on June 22, 2017 (registration number: UMIN000027879).
Sleep disordered breathing, insomnia, and excessive daytime sleepiness among Japanese pregnant women without gestational complications do not negatively impact delivery outcomes
Authors: Kondo Hideaki , Umeno Shiho , Eto Hiromi , Kato Chiho , Nagaura Yuki
Published: November 2019

Frequently observed sleep/wake problems among pregnant women need comprehensive evaluation. This study was conducted to clarify the sleep/wake problems among pregnant women without gestational complications at the second and third trimester and the effects of sleep/wake problems on delivery outcomes. Methods: A total of 88 Japanese pregnant women participated in this study. At the second and third trimester, subjective sleep quality, insomnia severity, excessive daytime sleepiness (EDS), and restless legs syndrome/Willis-Ekbom disease (RLS/WED) were assessed using questionnaires; also, sleep disordered breathing (SDB) was screened using a pulse oximeter. Results: From the second to third trimester, an increasing tendency of sleep/wake problems was observed. At the third trimester, the percentage of women experiencing decreased subjective sleep quality, difficulty maintaining sleep (DMS), EDS, RLS/WED, and 3% oxygen desaturation index (ODI) values ≥ 5/h were 62.5%, 45.5%, 48.9%, 9.1%, and 29.5%, respectively. In a logistic regression analysis for EDS at the third trimester, the adjusted odds ratio (95% confidence interval) of total sleep time < 6 hours, moderate to severe DMS, and 3% ODI ≥ 5/h were 3.25 (1.16–9.10), 4.74 (1.60–14.00), and 0.90 (0.28–2.89), respectively. Decreased subjective sleep quality, insomnia severity, EDS, and SDB did not affect the delivery outcome or infant’s condition. Conclusions: Sleep/wake problems were frequent during pregnancy, especially at the third trimester. EDS among pregnant women was associated with shorter sleep time and DMS, rather than SDB. However, there were no significant effects of sleep/wake problems on the delivery outcomes or infant’s conditions.
The Influence of Experiential Knowledge and Societal Perceptions on Decision-Making Regarding Non-Invasive Prenatal Testing (NIPT)
Authors: Montgomery Sophie , Thayer Zaneta M.
Published: November 2019

Non-invasive prenatal testing (NIPT) allows women to access genetic information about their fetuses without the physical risk inherent to prior testing methods. The advent of NIPT technology has yielded concerns among bioethicists regarding the quality and process of informed consent, as the routinization of this technology could degrade the intentionality of women choosing whether to undergo testing. Prior studies evaluating the NIPT decision-making process have focused on the clinical encounter as the primary environment for acquisition of biomedical information and decision formation. While important, this conceptualization fails to consider how additional sources of knowledge, including both embodied and empathetic experiential knowledge, shape perceptions of risk and the societal use of NIPT.
In order to address this issue, qualitative, semi-structured interviews with 25 women who had been offered NIPT were performed. Women were categorized by NIPT use/non-use, as well as whether their described decision-making process was routinized. Qualitative analysis of the data using a phenomenological approach was used to explore themes in the data, develop a framework of NIPT decision-making, and compare the perceptions of women with differential decision-making processes and outcomes.
A framework for decision-making regarding NIPT was developed based on three emergent factors: perceptions of the societal use of NIPT, expected emotional impact of genetic information, and perceived utility of genetic information. Qualitative analysis revealed that perceptions of widespread use of NIPT, pervasive societal narratives of NIPT use as progressive and “forward-thinking,” and a perception of more information as anxiety-relieving contributed to routinized uptake of NIPT. In contrast, women who displayed a lack of routinization expressed fewer stereotypes regarding the audience for NIPT and relied on communication with their social networks in-person and online to consider how they might use the information provided by NIPT.
The findings of this study reveal the societal narratives and perceptions that shape differential decision-making regarding NIPT. Understanding and addressing these perceptions that influence NIPT decision-making, especially routinized uptake of NIPT, is important as the use and scope of this technology increases.
Chemotherapy for breast cancer during pregnancy induces vascular alterations and impaired development of placental villi: a preliminary histopathological study.
Authors: Gobbo Alessandro Del , Scarfone Giovanna , Peccatori Fedro Alessandro , Villa Antonella , Ossola Wally , Ercoli Giulia , Bosari Silvano , Ferrero Stefano , Boggio Francesca Laura , Grossi Elena , Cribiù Fulvia Milena
Published: November 2019

Breast cancer is diagnosed in approximately 1/3000 pregnant women. Chemotherapy may be administered after the first trimester, with improved maternal outcome and relatively few pregnancy and offspring complications. Nonetheless, no information about the effects of different chemotherapy regimens on placenta architecture and vasculature are available. Methods To evaluate histological alterations in placentas of women affected by breast cancer and treated with chemotherapy during pregnancy, we retrospectively analyzed 23 placentas of patients affected by breast cancer and treated with chemotherapy during pregnancy and 23 control placentas of women without breast cancer and with physiological pregnancies of the same gestational age. Results All the patients had breast ductal infiltrating carcinoma, 19 of 23 cases had a G3 cancer. All patients were treated with 2-6 cycles of chemotherapy starting after 16 weeks of gestation, with different protocols. No hypertensive complications and no pre-eclampsia episodes were observed; birth weight was consistent with gestational age in all babies in both group with no uneventful outcomes and no perinatal mortality or fetal malformations. Twenty out of 23 cases (86%) showed hypoxia-induced villous alterations, including increased syncytial knotting (Tenney-Parker changes), perivillar fibrin deposits, distal villous hypoplasia or accelerated maturation and focal villous chorangiosis. These alterations were found in 19 out of 23 controls (83%), with no statistically significant difference between the two groups. Conclusions These results shows that chemotherapy in the second and third trimester of pregnancy may lead to non-specific alterations in placental vasculature and morphology.
High manganese exposure decreased the risk of high triglycerides in male workers: a cross-sectional study
Authors: luo xiaoyu , liu zhenfang , ge xiaoting , huang sifang , zhou yanting , li defu , li longman , chen xiang , huang lulu , hou qingzhi , cheng hong , xiao lili , liu chaoqun , zou yunfeng , Yang Xiaobo
Published: November 2019

Manganese (Mn) is to be involved in lipids metabolism. However, few epidemiological studies have investigated the association between elevated exposure to Mn and the risk of dyslipidemia. Methods: This was a cross-sectional study based on follow-up of the manganese-exposed workers healthy cohort (MEWHC) in 2017. A total of 803 Mn-exposed workers were divided into the low-exposure, and high-exposure group according to Mn-Time Weighted Average (Mn-TWA) ≤0.15mg/m3 or >0.15mg/m3. And we evaluated the associations between Mn-TWA levels and dyslipidemia, and assessed the interaction between Mn-TWA levels and each of the potential interacting factors. Results: After adjustment for potential confounders, we observed mainly significant negative association between high triglycerides (TG) risk and Mn-TWA levels in male (OR = 0.60; 95% CI: 0.39, 0.94; p <0.01). In interaction analyses of male, we did not observe a significant interaction between Mn-TWA levels and pack-years on high TG risk (relative excess risk for the interaction (RERI) = -1.30, 95% CI: -3.29, 0.70, RERI = -1.62, 95% CI: -3.92, 0.67). Similarly, analysis of smoking status, drinking status, high-fat diets frequency, and BMI were nonsignificant interaction with Mn-TWA levels on high TG risk as well. Conclusions: Our study indicated that high Mn exposure was significantly associated with low risk of hyper TG in male workers.Keywords: Manganese; Occupation; Dyslipidemia; Triglycerides
Does Xpert MTB/RIF Assay Give Rifampicin Resistance Results Without Identified Mutation? Review of Cases from Addis Ababa, Ethiopia.
Authors: Alemu Ayinalem , Tadesse Mengistu , Seid Getachew , Mollalign Helina , Eshetu Kirubel , Sinshaw Waganeh , Abebaw Yeshiwork , Amare Misikir , Dagne Biniyam , Diriba Getu , Yenew Bazezew , Getu Melak , Zerihun Betselot
Published: November 2019

Background: Xpert MTB/RIF Assay is currently used in Ethiopia for the rapid diagnosis of Mycobacterium tuberculosis (MTB) and mutations that confer Rifampicin resistance. Rifampicin resistance is determined based on any mutation in the 81 bp of rpoB gene using five overlapping probes represented as Probe A (codons 507–511), Probe B (codons 512–518), Probe C (codons 518–523), Probe D (codons 523–529) and Probe E (codons 529–533). In this review, we assessed the frequency of missed probe types for Rifampicin Resistance results. Methods: Data were reviewed from specimens received and tested using Xpert® MTB/RIF Assay at Ethiopian National Tuberculosis Reference Laboratory, in Addis Ababa from 15 July 2016 to 31 December 2018 retrospectively. All archived data were reviewed carefully to describe missed probe types and quantity of DNA in the sample. Results: A total of 100 specimens were reported as MTB Detected Rifampicin Resistance Detected by Xpert MTB/RIF assay. More than half (55%) of these results were reported from male patients. The median age was 28.0 years (5 months to 88 years). Majorities (62%) of the cases were detected from sputum. Among the total of 38 extra pulmonary samples, lymph node aspirates were accounted 50% (19/38). The most common mutations (81.0%) were found in Probe E region followed by Probe D (10.0%), and Probe B (3.0%). Mutations in Probe A and Probe C regions were not observed. However six (6.0%) Rifampicin resistance cases were found without any missed probe type. The delta Ct max is ≥4.3. No specimen yielded Rifampicin resistance associated with more than one probe failure or mutation combinations. Conclusion: Mutations associated with Probe E (codons 529–533) region were identified as the commonest rpoB gene mutations. The Rifampicin resistance results found without any identified missing probe needs a further study. Lower DNA amount was observed in extrapulmonary specimens compared with sputum. Keywords: Rifampicin-resistance, Molecular Beacon, DNA probes, Xpert MTB/RIF Assay
Association between Vitamin D receptor gene polymorphism and the risk of Multiple Sclerosis: Systematic review and meta-analysis
Authors: Imani Danyal , Razi Bahman , Motallebnezhad Morteza , rezaei Ramazan
Published: November 2019

Background The association between the vitamin D receptor ( VDR ) gene polymorphism and the risk of Multiple sclerosis (MS) has been evaluated in several studiese. However, the findings were inconsistent and inconclusive.Methods All relevant studies reporting the association between the FokI (rs2228570) or/and TaqI (rs731236) or/and BsmI (rs1544410) or/and ApaI (rs7975232) polymorphisms of the VDR and susceptibility to multiple sclerosis published up to September 2019 were identified by comprehensive systematic database search in web of science, Scopus, and PubMed.Results A total of 30 case–control studies were included in this meta-analysis. The overall results suggested a significant association between TaqI gene polymorphism and MS risk under heterozygote contrast (OR = 1.27, 95%CI = 1.01–1.59, REM). Moreover, the pooled results of subgroup analysis decline presence of significant association under all defined genotype model. In subgroup analysis, BsmI gene polymorphism was associated with increased risk of MS under the recessive model in Asian population. In other hand, ApaI gene polymorphism was associated with decreased risk of MS under recessive and homozygote contrast (aa vs AA) models in Asian population.Conclusions This meta-analysis suggested a significant association between TaqI gene polymorphism and MS susceptibility. Furthermore, BsmI gene polymorphism was associated with an increased risk of MS in Asian population. In contrast, ApaI gene polymorphism was associated with a decreased risk of MS in Asian population. Future large scale studies on gene–environment and gene– gene interactions are required to estimate related risk factors and assist early diagnosis of patients at high risk for MS.
Expression and Purification of Active Human Kinases Using Pichia pastoris as A General-Purpose Host
Authors: Aziz May H. Abdel , Fan Yao , Liu Lijun , Moasser Mark , Fu Haian , Jura Natalia , Arkin Michelle
Published: November 2019

The heterologous expression of human kinases in good purity and monomer, soluble and active form can become a challenging feat. Most of the reported successful attempts are carried out in insect cells as a host. The use of E. coli for expression is limited to a few kinases and usually is facilitated by large solubility tags that can limit biophysical studies and affect protein–protein interactions. In this report, we evaluate the methylotrophic yeast Pichia pastoris as a general-purpose host for expression of human kinases. Methods: Six diverse kinases were chosen due to their therapeutic importance in human cancers. Tested proteins include serine/threonine kinases cyclin-dependent kinases 4 and 6 (CDK4 and 6) and aurora kinase A (AurKA), receptor tyrosine kinase erbB-2 (HER2), and dual specificity kinase mitogen-activated protein kinase kinase 3 (MKK3b). Two challenging targets, CDK6 and HER2, were fused to the highly basic, N-terminal domain of the secreted tyrosine-protein kinase VLK. Standard expression procedure in Pichia pastoris used. Purification was done using affinity chromatography, purity and identity of the proteins were confirmed and compared. Results: Some of the tested kinases expressed with good yield and purity and comparable activity to commercially available versins. Addition of the VLK domain improved expression and decreased aggregation of two of the challenging CDK6 and HER2. This can be attributed to a correlation we observed between the protein pI and its expression level in P. pastoris, where basic proteins are more likely to be expressed and purified. Conclusions: This study introduces P. pastoris as a promising host for expression of soluble and active human kinases.
Factor structure and measurement invariance of the Problematic Mobile Phone Use Questionnaire-Short Version across gender in Chinese adolescents and young adults
Authors: Wang YingYing , Long Jiang , Liu YueHeng , Liu TieQiao , Billieux Joël
Published: November 2019

Background Problematic mobile phone use (PMPU) has become an international public health issue, particularly in adolescents and young adults. The Problematic Mobile Phone Use Questionnaire-Short Version (PMPUQ-SV) is a validated instrument that measures multiple aspects of PMPU. The current study aimed to test the psychometric characteristics of a Chinese adaption of the PMPUQ-SV and examine its measurement invariance across gender. Methods A total of 2086 participants were recruited form nine schools (six undergraduate colleges and three vocational colleges) through an online platform. Measures included socio-demographic variables, patterns of mobile phone use, the Chinese version of the PMPUQ-SV (C-PMPUQ-SV), the Chinese version of the Smartphone Addiction Proneness Scale, and the Depression Anxiety Stress Scales-21. Results Exploratory and confirmatory factor analyses conducted in two independent subsamples confirmed that the postulated dimensions fit the data well. Four items, judged as either outdated or not adapted to the Chinese context, performed poorly and were removed, resulting in a shorter 11-item scale. Convergent validity was established through meaningful correlations between emotional symptoms and the C-PMPUQ-SV and addictive smartphone use. Additional measurement invariance analyses showed that the scale performed largely similarly in male and female participants. Conclusions The present study demonstrated that the C-PMPUQ-SV is an adequate instrument to study various types of PMPU in Chinese adolescents and young adults. The updated 11-item scale shortens the evaluation time and is adapted to assess contemporary smartphone use.
A Quantitative MRI Index for Assessing the Severity of Hippocampal Sclerosis in Temporal Lobe Epilepsy
Authors: Dou Wanchen , Zhao Lei , Su Changbao , Lu Qiang , Liu Qi , Guo Jinzhu , Zhao Yuming , Luo Yishan , Shi Lin , Zhang Yiwei , Wang Renzhi , Feng Feng
Published: November 2019

Background Hippocampal sclerosis (HS) is associated with post-surgery outcome in patients with temporal lobe epilepsy (TLE), and an automated method that quantifies HS severity is still lacking. Here, we aim to propose an MRI-based HS index (HSI) that integrates hippocampal volume and FLAIR signal to measure the severity of HS.Methods Forty-two pre-surgery TLE patients were included retrospectively, with T1-weighted (T1W) and FLAIR images acquired from each subject. Two experienced neurosurgeons (W.D. and C.S.) and one neurologist (Q.L.) rated HS severity, where both the hippocampal volume loss and increased FLAIR signal were considered to provide a four-class grading scale (normal, mild, moderate and severe). A consensus of HS severity for each subject was made by voting among the three visual rating results. Regarding the automatic quantification, the hippocampal volume was quantified by AccuBrain on T1W image, and the FLAIR signal of hippocampus was calculated as the mean intensity of hippocampal region on the FLAIR image (normalized by the mean intensity of gray matter). To fit the HSI from visual rating, we applied ordinal regression with the voted visual rating as the dependent variable, and hippocampal volume and FLAIR signal as the independent variables. The HSI was calculated by weighting the predictive probabilities of the four-class grading scales from ordinal regression.Results The intra-class correlation coefficient (single measure) of the three raters was 0.806. The generated HSI was significantly correlated with the visual rating scales (W.D.: 0.823, Q.L.: 0.817, C.S.: 0.717). HSI scores differentiated well between each pair of groups defined by the agreed HS visual rating (normal vs. mild: p<0.001, mild vs. moderate: p<0.001, moderate vs. severe: p=0.001).Conclusions The proposed HSI was consistent with visual rating scales from neurosurgeons and sensitive to HS severity. This MRI-based index may help to evaluate HS severity in clinical practice. Further validations are needed to associate HSI with post-surgery outcomes.
Postoperative collateral formation after indirect bypass for hemorrhagic moyamoya disease
Authors: Ge Peicong , Zhang Qian , Ye Xun , Liu Xingju , Deng Xiaofeng , Wang Jia , Wang Rong , Zhang Yan , Zhang Dong , Zhao Jizong
Published: November 2019

Background: The study on postoperative collateral formation for hemorrhagic moyamoya disease (MMD) evaluated by using digital subtraction angiography (DSA) is limited. Our study objective was to investigate the postoperative collateral formation after indirect bypass for hemorrhagic MMD. Methods: All consecutive inpatients with hemorrhagic MMD received indirect bypass at Beijing Tiantan Hospital, Capital Medical University from January 2010 through December 2018 were screened. Postoperative collateral formation was evaluated on lateral views using Matsushima scale. Univariate and multivariate logistic regression analysis was carried out to determine the influence factors for postoperative collateral formation. Results: 64 patients (64 hemispheres) were included in this study. After a median 8.5 months DSA follow-up, 14 (21.9%) hemispheres was graded as A collateral circulation, 13 (20.3%) was graded as B, and 37 (57.8%) was graded as C. Twenty-seven (43.2%) hemispheres had good postoperative collateral formation and 37 (57.8%) had poor postoperative collateral formation. Univariate logistic regression analyses showed that age at operation (OR, 0.954; 95% CI, 0.908–1.003; p=0.066), hemorrhagic site (OR, 4.694; 95% CI, 1.582–13.923; p=0.005), and PCA involvement (OR, 3.474; 95% CI, 0.922–13.086; p=0.066) may effect postoperative collateral formation. Multivariate logistic regression analyses showed that only anterior hemorrhage (OR, 5.222; 95% CI, 1.605–16.987; p=0.006) was significantly related to good postoperative collateral formation. Conclusion: Anterior hemorrhage was significantly related to good postoperative collateral formation.
Prevalence of microhematuria in renal colic and urolithiasis: a systematic review and meta-analysis
Authors: Minotti Bruno , Treglia Giorgio , Pascale Maria Rosa , Ceruti Samuele , Cantini Laura , Anselmi Luciano , Saporito Andrea
Published: November 2019

Background This systematic review and meta-analysis aims to investigate the prevalence of microhematuria in patients presenting with suspected acute renal colic and/or confirmed urolithiasis at the emergency department. Methods A comprehensive literature search was conducted to find relevant data on prevalence of microhematuria in patients with suspected acute renal colic and/or confirmed urolithiasis. Data from each study regarding study design, patient characteristics and prevalence of microhematuria were retrieved. A random effect-model was used for the pooled analyses. Results Forty-nine articles including 15’860 patients were selected through the literature search. The pooled microhematuria prevalence was 77% (95%CI: 73-80%) and 84% (95%CI: 80-87%) for suspected acute renal colic and confirmed urolithiasis, respectively. This proportion was much higher when the dipstick was used as diagnostic test (80% and 90% for acute renal colic and urolithiasis, respectively) compared to the microscopic urinalysis (74% and 78% for acute renal colic and urolithiasis, respectively). Conclusions This meta-analysis revealed a high prevalence of microhematuria in patients with acute renal colic (77%), including those with confirmed urolithiasis (84%). Intending this prevalence as sensitivity, we reached moderate values, which make microhematuria alone a poor diagnostic test for acute renal colic or urolithiasis. Microhematuria could possibly still important to assess the risk in patients with renal colic.