bluuebunny/crossref_metadata_2025 huggingface dataset:
Is there a relationship between the morphological characteristics of developmental venous anomalies and the presence of parenchymal abnormalities?
Authors: ŞİRİN ÖZCAN Ayşe Nur , HASANOV Behruz , UNAL Ozlem
Published: October 2020

Objectives: Developmental venous anomaly (DVA) is a benign vascular malformation. Hyperintensity in the fluid-attenuated inversion recovery (FLAIR) sequence in the adjacent white matter has been previously identified. Although there are different theories, it is not yet clear why these hyperintensities occur. In this study, we aimed to investigate the factors affecting hyperintensity formation by examining the relationship between the morphological findings of DVA and the presence of FLAIR hyperintensity.
Methods: The study included 84 cases diagnosed with DVA. Patients with susceptibility weighted imaging (SWI) and/or postcontrast T1-weighted sequences in addition to conventional MRI sequences were included. The patients were divided into two groups as hyperintensity FLAIR (+) and FLAIR (-) in the examination performed around DVA. There were 24 patients in the FLAIR (+) group and 60 patients in the FLAIR (-) group. The localization of DVAs, drainage localization of the intramedullary vein, collector vein diameter, collector vein length, DVA location depth, and patient ages were compared between the two groups.
Results: When examining the relationship between the groups and variables in the statistical evaluation, there was no difference between the groups in terms of DVA localization, the venous system of drainage, DVA depth, and the length of the collector vein. However, a significant difference was observed between the groups in terms of the collector vein diameter and age.
Conclusions: The results of this study indicating a relationship between collector vein diameter and patient age. The relationship between this diameter and age suggests that there is a correlation between the degree and duration of venous congestion and the change in white matter.
Guillain-Barré syndrome in a child: a clinical case
Authors: Ryabchenko A. Yu. , Grankin E. V.
Published: October 2020

Guillain-Barré syndrome is an orphan autoimmune disease associated with the involvement of the peripheral nervous system. The clinical course of the syndrome has four main types. We present a clinical case of Guillain-Barré syndrome in a 6-year old child. Against the background of a previous infection, he developed oculomotor dysfunction, peripheral tetraparesis, sensory abnormalities with subsequent severe weakness of the respiratory muscles. The differential diagnosis included inflammatory, infectious and neoplastic spinal cord disorders, spinal cord magnetic resonance imaging, and examination of the cerebrospinal fluid. The patient's electromyographic data confirmed peripheral nerve damage. Based on all of these, the patient was diagnosed with Guillain-Barré syndrome. Specific treatment, including plasmapheresis and intravenous human immunoglobulin G at a dose of 0.4 mg daily for 5 days, and symptomatic treatment resulted in gradual improvement and complete regression of the neurological symptoms completely resolved. Since Guillain-Barré syndrome is a rare disease of the peripheral nervous system, the awareness of the specifics of its clinical course allows for earlier correct diagnosis and effective treatment.
Falta de Equipamento de Protecção Individual no Brasil
Authors: Coelho da Maia Maria Eduarda , Dreer Matthaus , Baggio Aline , Marcon Chaiana Esmeraldino Mendes
Published: October 2020

N/a.
Certezas Incertas: Desafios Próximos no Diagnóstico Laboratorial da COVID-19
Authors: Cabral Pedro , Gomes Bernardo , Felgueiras Mafalda
Published: October 2020

N/a.
Relationship between Dietary Fiber Intake and the Prognosis of Amyotrophic Lateral Sclerosis
Authors: Yu Haelim , Kim Seung Hyun , Noh Min-Young , Lee Sang-Gon , Park Yongsoon
Published: October 2020

The gut microbiota has been suggested as an important factor in the pathogenic mechanisms of amyotrophic lateral sclerosis (ALS). This study aimed to investigate whether the intake of different kinds of dietary fiber was related to the disease progression rate (∆FS) and survival time. In total, 272 sporadic ALS patients diagnosed according to the revised EI Escorial criteria were recruited from March 2011 and were followed-up until the occurrence of events or the end of September 2020. The events included percutaneous endoscopic gastrostomy, tracheostomy, and death. Dietary fiber intake was calculated based on a 24-hour dietary recall and classified according to five major fiber-rich foods: vegetables, fruits, grains, legumes, and nuts/seeds. Among the total participants, the group with ∆FS values lower than the mean ∆FS (0.75) was noted in the highest tertiles of total and vegetable fiber intake. Participants with the highest tertile of vegetable fiber intake showed longer survival in the Kaplan–Meier analysis (p = 0.033). Notably, vegetable fiber intake was negatively correlated with pro-inflammatory cytokine (interleukin [IL]-1β, IL-6, and monocyte chemoattractant protein-1) levels in the cerebrospinal fluid. This study showed that vegetable fiber intake could influence the disease progression rate and survival time. Further clinical trials are needed to confirm whether dietary fiber supplementation improves the prognosis of ALS.
Multiple Introductions and Predominance of Rotavirus Group A Genotype G3P[8] in Coastal Kenya in 2018, 4 Years After Nationwide Vaccine Introduction
Authors: Mwanga Mike J. , Verani Jennifer R. , Omore Richard , Tate Jacqueline E. , Parashar Umesh D. , Murunga Nickson , Gicheru Elijah , Breiman Robert F. , Nokes D. James , Agoti Charles N.
Published: October 2020

Globally, rotavirus group A (RVA) remains a major cause of severe childhood diarrhea, despite the use of vaccines in > 100 countries. RVA sequencing for local outbreaks facilitates investigation into strain composition, origins, spread, and vaccine failure. In 2018, we collected 248 stool samples from children aged <13 years admitted with diarrheal illness to Kilifi County Hospital, coastal Kenya. Antigen screening detected RVA in 55 samples (22.2%). Of these, VP7 (G) and VP4 (P) segments were successfully sequenced in 48 (87.3%) and phylogenetic analysis based on the VP7 sequences identified seven genetic clusters with six different GP combinations; G3P[8], G1P[8], G2P[4], G2P[8], G9P[8] and G12P[8]. The G3P[8] strains predominated the season (n=37, 67.2%) and comprised three G3 genetic clusters that fell within Lineage I and IX (the latter also known as equine-like G3 lineage). Both two G3 lineages have been recently detected in several countries. Our study is the first to document African children infection with G3 lineage IX. These data highlight the global nature of RVA transmission and the importance of increasing global rotavirus vaccine coverage.
In-silico Characterization and Comparative Analysis of BLB Disease Resistance Xa genes in Oryza sativa
Authors: Ramzan Muhammad Anas , Asghar Hasib , Rehman Abdul , Rashid Muhammad , Jankuloski Ljupcho
Published: October 2020

Globally, rice is utilized as staple food, belongs to the family Poaceae. From the past few decades under variable climate conditions, it greatly affected by the bacterial leaf blight (BLB) disease caused by a bacterium Xanthomonas oryzae pv. oryzae (Xoo). Scientists studied causes of the disease and found more than 61 isolates of Xoo. About 39 Xa genes were noted that cause race specifically resistance either individually or in pairs against Xoo. The canvas on the characterization of these genes is still unrevealed. In this study, amino acid sequences of Xa15, Xa19, Xa20 and Xa21 were mined and used for motif-domain identification, characterization, and comparative analysis. It includes screening of physical and chemical characteristics, sequence comparison to find sequence similarity between them and their phylogenetic comparison with other Xa genes and other species based upon LRR and S_TKc domains to find evolutionary relationship among them. The comparison-based modeling was performed and assessed by different tools to gain better understanding and structural evaluation. The results showed identified domains are specific in function, each domain involved in resistance against biotic and abiotic stresses through regulating different cellular processes. This study also revealed high similarity (>98% sequence identity) between these genes and encode a similar leucine-rich repeat receptor kinase like protein. It will optimize the breeding programs as it will be useful for the selection of effective genes to produce resistance in rice varieties against the specific strains of Xoo that will be more effective against BLB than the other Xa genes.
A Multilayered Healthcare Architecture Using Relational Trust Network
Authors: Chakraborty Somyajit , Gayen Avijit
Published: October 2020

Medical Trust-Network is one of the most promising fields of study in network science. Establishment of trust within medical entities ensures better treatment and increases better medical facilities. The word ‘Trust’ signifies a very important behavioral aspect between any human entities, especially among doctors and patients. To represent such relationships Trust Network Models are built to express the interactions between human entities within such networks. Though the idea of a Trust-Network has traditionally been one of the major areas of research, yet the concept of a medical trust network model is relatively a new domain. In this paper, we introduce an overall multilayered Trust Network to represent the entire healthcare architecture. More specifically our model is based on an evolutionary graph system with a discrete relationship between the three most important entities of any healthcare system, namely – Doctors, Departments, and Hospitals. Observations indicate that based on our model, the medical healthcare system is a multilayered model unlike a feed-forward model as indicated by previous studies.
Profile of conceptual photosynthesis and creative thinking: Study of 7th-grade students
Authors: Sumarni Elis , Setiandi Anandita Eka , Sunandar Ari
Published: October 2020

Profile of students’ creative thinking and conceptual understanding is essential to create an initial description of students’ competencies in overcoming their learning difficulties. The research aims to describe profile of concept understanding and creative thinking skills of 7thgrade students of all SMP Negeri (public junior high school) in Rasau Jaya sub-district, Kubu Raya Regency, West Kalimantan, Indonesia in photosynthesis content. The research uses qualitative descriptive method. The sampling technique employs disproportionate stratified random sampling. Samples consist of 143 students of 7th grade from three SMP Negeri in Rasau Jaya Sub-district, Kuburaya Regency, West Kalimantan, Indonesia. The data collection technique utilizes creative thinking skill test in the form of an essay with fluency, flexibility, originality, and elaboration aspects. Students’ concept understanding test is in the form of four-tier diagnostic test. Data analysis employs descriptive statistics with percentage of creative thinking and conceptual understanding in categories of understanding, partial understanding, misconception, and not understanding. The creative thinking skill percentage of SMPN students in Rasau Jaya, Indonesia in the originality and flexibility aspect is in a fairly creative category, whereas in the elaboration and fluency aspect the category is still less creative. The highest percentage of students’ conceptual understanding is misconception of 45.25% and followed by an understanding of 30.64%, not understand of 13.2%, and partial understanding of 10.97%. The obtained data give evidence that natural sciences (IPA) learning knowledge among junior high school students, especially concept understanding and creative thinking, is still low. Therefore, teachers could develop students’ creative thinking skills so their concept understanding could be improved.
Relación entre el maltrato infantil y las habilidades de regulación emocional en adolescentes: una revisión sistemática
Authors: Bonet Cristina , Palma Carol , Gimeno-Santos Mercè
Published: October 2020

Las habilidades de regulación emocional constituyen un factor transdiagnóstico de psicopatologías y pueden verse especialmente afectadas en individuos con historia de maltrato, y la adolescencia es una etapa crítica para su desarrollo y prevención. Sin embargo, la heterogeneidad conceptual y metodológica en la evaluación de las habilidades de regulación emocional y las formas de maltrato dificultan comprender su relación. La presente revisión analizó la relación entre el maltrato infantil y las habilidades de regulación emocional de los adolescentes entre 12 y 18 años a través de los estudios que la exploraron, incidiendo en la relación diferencial entre las distintas tipologías de maltrato (maltrato físico, abuso sexual, maltrato emocional y negligencia) y las habilidades de regulación emocional (regulación o disregulación emocional e inteligencia emocional), así como en el papel que estas últimas ejercen sobre las problemáticas asociadas al maltrato. Se realizaron búsquedas en PsycINFO, MedLine y PsicoDoc. De los 191 estudios encontrados, 28 cumplieron los criterios de inclusión. Se hallaron relaciones significativas y consistentes entre las medidas globales de maltrato y de disregulación emocional. Sin embargo, cuando se analizan tipos de maltrato o estrategias específicas, los resultados son dispares. Asimismo, las habilidades de regulación emocional influyen en la aparición de problemáticas asociadas al maltrato, siendo la sintomatología internalizada y las autolesiones las más exploradas. La heterogeneidad conceptual y metodológica de los estudios revisados dificultó la extracción de conclusiones sólidas respecto a las tendencias identificadas, por lo que se debe continuar explorando en esta relación.
Group Post-Admission Cognitive Therapy for Suicidality vs Individual Supportive Therapy for the prevention of repeat suicide attempts: a randomized controlled trial.
Authors: Chaïb Laurent Stephane , Lopez-Castroman Jorge , Abbar Mocrane
Published: October 2020

Background: Suicide is a serious public health problem. The development and use of effective treatments for people hospitalized for suicide attempts remain a priority. Regarding psychosocial treatment, the evidence for treatments that effectively prevent suicide repetition of suicide attempts is extremely thin. There is some evidence that cognitive behavioural therapy may be effective for reducing suicide behaviour. The primary aim of this study is to compare Group Post-Admission Cognitive Therapy for Suicidality (GPACTS) versus Individual Supportive Therapy (IST) for preventing suicide. Methods: 240 participants with a high suicide risk score according to a Mini international Neuropsychiatric Interview (MINI) will be randomly to either GPACTS or IST. This is a multicentre, parallel group, randomized (1:1 ratio), two-tailed-superiority trial with endpoint-assessor blinding. Patients meeting inclusion criteria during a screening visit will be enrolled in the study and randomized into two groups: one group will undergo six weeks of GPACTS, and the second group will undergo six weeks of IST. Following six weeks of interventional therapy, patients are followed-up for 12 months. Follow-up for both groups is identical and includes the administration of questionnaires at baseline and then within 10 days after the end of therapy sessions and then at 3, 6 and 12 months following the end of GPACTS/IST sessions.Discussion: To our knowledge, this is the first RCT of its kind to be conducted in France and so far, there are no studies in the literature on group psychotherapy for the treatment of individuals who have attempted suicide. The outcomes will provide clear guidance for professionals to apply psychological intervention with suicide attempts. The protocol respect ethical principles and ethical approval were obtained from the local ethics committee. The results will be disseminated through an original research published as original research in peer-reviewed manuscript, through a therapist manual for cognitive therapy, and presentations at research conferences. Trial registration: ClinicalTrials.gov Identifier NCT02664701, registered on January 27, 2017.
How mHealth can facilitate collaboration in diabetes care: qualitative analysis of co-design workshops
Authors: Bradway Meghan , Morris Rebecca L , Giordanengo Alain , Årsand Eirik
Published: October 2020

Background: Individuals with diabetes are using mobile health (mHealth) to track their self-management. However, individuals can understand even more about their diabetes by sharing these patient-gathered data (PGD) with health professionals. We conducted experience-based co-design (EBCD) workshops, with the aim of gathering end-users’ needs and expectations for a PGD-sharing system. Methods: N=15 participants provided feedback about their experiences and needs in diabetes care and expectations for sharing PGD. The first workshop (2017) included patients with Type 2 Diabetes (T2D) (n=4) and general practitioners (GPs) (n=3). The second workshop (2018) included patients with Type 1 Diabetes (T1D) (n=5), diabetes specialists (n=2) and a nurse. The workshops involved two sessions: separate morning sessions for patients and healthcare providers (HCPs), and afternoon session for all participants. Discussion guides included questions about end-users’ perceptions of mHealth and expectations for a data-sharing system. Activities included brainstorming and designing paper-prototypes. Workshops were audio recorded, transcribed and translated from Norwegian to English. An abductive approach to thematic analysis was taken. Results: Emergent themes were mHealth technologies’ impacts on end-users, and functionalities of a data-sharing system. Within these themes, similarities and differences between those with T1D and T2D, and between HCPs, were revealed. Patients and providers agreed that HCPs could use PGD to provide more concrete self-management recommendations. Participants’ paper-prototypes revealed which data types should be gathered and displayed during consultations, and how this could facilitate shared-decision making. Conclusion: The diverse and differentiated results suggests the need for flexible and tailorable systems that allow patients and providers to review summaries, with the option to explore details, and identify an individual’s challenges, together. Participants’ feedback revealed that both patients and HCPs acknowledge that for mHealth integration to be successful, not only must the technology be validated but feasible changes throughout the healthcare education and practice must be addressed. Only then can both sides be adequately prepared for mHealth data-sharing in diabetes consultations. Subsequently, the design and performance of the joint workshop sessions demonstrated that involving both participant groups together led to efficient and concrete discussions about realistic solutions and limitations of sharing mHealth data in consultations.
Cancer-specific survival by stage of bladder and urinary tract cancers and factors collected by Mallorca Cancer Registry associated to survival.
Authors: Ramos Maria , Ripoll Joana , Montaño Juan José , Pons Jaume , Ameijide Alberto , Franch Paula
Published: October 2020

Background: Information about survival by stage in bladder cancer is scarce. Objectives: 1) to find out the distribution of bladder and urinary tract cancers by stage; 2) to determine cancer-specific survival by stage of bladder and urinary tract cancers; 3) to identify factors that explain and predict the likelihood of survival and the risk of dying from these cancers.Methods: Incident bladder and urinary tract cancer cases diagnosed between 2006 and 2011 were identified through the Mallorca Cancer Registry. Inclusion criteria: cases with codes C65–C68 (ICD-O 3) with any behaviour. DCO cases were excluded. We collected: sex; age; date and method of diagnosis; histology (ICD-O 3); T, N, M and stage at the time of diagnosis; and date of follow-up or death. End of follow up was 31 December 2015. Multiple imputation (MI) was performed to estimate cases with unknown stage. Actuarial and Kaplan-Meier methods and Cox regression models were used.Results: 2060 cases were identified. 15% were women and 65.2% were 65 years or older. 3.7% had no stage (benign or undetermined behaviour) and 12.5% had unknown stage. After MI, 35.7% were in stage Ta (non-invasive papillary carcinoma), 3.1% in stage Tis (carcinoma in situ), 33.3% in stage I, 11.9 % in Stage II, 4.7% in stage III, and 11.1% in stage IV. Survival was 73% at 5 years. Survival by stage: 98% at stage Ta, 88% at stage Tis, 84% at stage I, 44% at stage II, 33% at stage III, and 7% at stage IV. The Cox model showed that age, histology, and stage were associated with survival.Conclusion: Bladder and urinary tract cancers survival vary greatly with stage. The percentage of non-invasive cancers was high. Stage, age and histology are associated to survival, but sex has no association.
Straight stem and threaded cup in patients under 60 years of age. 28.8-30.2 years of follow-up
Authors: Pisecky Lorenz , Allerstorfer Jakob , Schauer Bernhard , Hipmair Günter , Hochgatterer Rainer , Böhler Nikolaus , Gotterbarm Tobias , Klotz Matthias
Published: October 2020

Purpose: The aim of this retrospective observational study of one cohort was to evaluate the long-term outcome in patients younger than 60 years after total hip arthroplasty using a straight uncemented stem and an uncemented threaded cup.Methods:Between 1986 and 1987, 75 hips of 75 patients (mean age: 53.35±6.17 years) were consecutively implanted with an Alloclassic Zweymüller/Alloclassic SL stem and an Alloclassic CSF cup. 44 patients had died over the last 30 years. The remaining 31 patients (mean age: 82.9±6.4years) were reinvited for follow-up examinations. Clinical and radiographic evaluations were carried out.Results: At a mean follow-up of 29.5 (28.8-30.2), 4 patients (5.3%) were lost to follow up.For the endpoint aseptic loosening (defined as the removal of stem or the cup for 2 cases), the overall survival rate is 97.3%. For the endpoint revision for any reason (22 patients), the survival rate is 70.6%. Eleven patients needed an exchange of head and liner, caused by wear. The average time from implantation until change of head and liner was 21.44 years (SD 5.92). Other reasons for revison surgery were septic loosening (3 cases), aseptic loosening of stem and cup (1 case), aseptic loosening of stem (1 case), periprosthetic calcification (2 cases), implant fracture (1 case), periprosthetic fracture (1 case), intraoperative fissure of stem (1 case), total wear of liner including cup (1 case).Conclusion: The combination of a straight stem (Alloclassic) and a screw cup (CSF) shows excellent results in young patients under the age of 60 at ultra-longterm follow up at 30 years. Revisions due to wear of the polyethylene liner are more likely than in the older patients.
Calculating the Most Likely Intron Splicing Orders in S. pombe, Fruit Fly, Arabidopsis thaliana, and Humans
Authors: Li Meng
Published: October 2020

Background Introns have been shown to be spliced in a defined order, and this order influences both alternative splicing regulation and splicing fidelity, but previous studies have only considered neighbouring introns. The detailed intron splicing order remains unknown.Results In this work, a method was developed that can calculate the intron splicing orders of all introns in each transcript. A simulation study showed that this method can accurately calculate intron splicing orders. I further applied this method to real S. pombe, fruit fly, Arabidopsis thaliana, and human sequencing datasets and found that intron splicing orders change from gene to gene and that humans contain more not in-order spliced transcripts than S. pombe, fruit fly and Arabidopsis thaliana. In addition, I reconfirmed that the first introns in humans are spliced slower than those in S. pombe, fruit fly, and Arabidopsis thaliana genome-widely. Both the calculated most likely orders and the method developed here are available on the web.Conclusions A novel computational method was developed to calculate the intron splicing orders and applied the method to real sequencing datasets. I obtained intron splicing orders for hundreds or thousands of genes in four organisms. I found humans contain more number of not in-order spliced transcripts.
Clinical effects of two-stage joint replacement on septic arthritic knee
Authors: Ni Ming , Fu Jun , Deng Tao , Niu Erlong , Xu Chi , Li Xiang , Chai Wei , Zhang Guoqiang , Chen Jiying
Published: October 2020

Objective: To assess the clinical effect of staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer.
Methods: 23 patients (24 knee joints) treated with staged joint replacement for septic arthritis knee were retrospectively reviewed between March 2014 and April 2018. At the first-stage, thoroughly debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer was performed; After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, second-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement.
Results: All patients finished follow-up and the mean follow-up time was 27.3 months (12-54 months). Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved post-operation (p<0.05). And there was no significant difference in post-surgery ROM (P=0.153) and the HSS score (P = 0.054) between the two groups.
Conclusion: Staged joint replacement is an efficacious way for septic arthritic knees, whether tibial plateau spacer or antibiotic cement beads were used, which can effectively control infection and improve knee function.
Chicken cecal DNA methylome alteration in the response to Salmonella enterica serovar Enteritidis inoculation
Authors: Wang Yuanmei , Liu Liying , Li Min , Lin Lili , Su Pengcheng , Tang Hui , Fan Xinzhong , LI Xianyao
Published: October 2020

Background: Salmonella enterica serovar Enteritidis (SE) is one of the pathogenic bacteria, which affects poultry production and poses a severe threat to public health. Chicken meat and eggs are the main sources of human salmonellosis. DNA methylation is involved in regulatory processes including gene expression, chromatin structure and genomic imprinting. To understand the methylation regulation in the response to SE inoculation in chicken, the genome-wide DNA methylation profile following SE inoculation was analyzed through whole-genome bisulfite sequencing in the current study. Results: There were 185,362,463 clean reads and 126,098,724 unique reads in the control group, and 180,530,750 clean Reads and 126,782,896 unique reads in the inoculated group. The methylation density in the gene body was higher than that in the upstream and downstream regions of the gene. There were 8,946 differentially methylated genes (3,639 hypo-methylated genes, 5,307 hyper-methylated genes) obtained between inoculated and control groups. Methylated genes were mainly enriched in immune-related Gene Ontology (GO) terms and metabolic process terms. Cytokine-cytokine receptor interaction, TGF-beta signaling pathway, FoxO signaling pathway, Wnt signaling pathway and several metabolism-related pathways were significantly enriched. The density of differentially methylated cytosines in miRNAs was the highest. HOX genes were widely methylated. Conclusions: The genome-wide DNA methylation profile in the response to SE inoculation in chicken was analyzed. SE inoculation promoted the DNA methylation in the chicken cecum and caused methylation alteration in immune- and metabolic- related genes. Wnt signal pathway, miRNAs and HOX gene family may play crucial roles in the methylation regulation of SE inoculation in chicken. The findings herein will deepen the understanding of epigenetic regulation in the response to SE inoculation in chicken.
Effect of precision antiplatelet therapy based on CYP2C19/11-dhTxB2 variability in prognosis of ischemic stroke/TIA patients: study protocol for a multicenter randomized controlled trial
Authors: Wang JiaJing , Tu Jianglong , Kuang Jie , Starcevich Katherine , Ge Yanqiu , Peng Chen , Yi Yingping , Yin Shujuan , Zhang Xiaolin , Chen Jibiao
Published: October 2020

Background: Clopidogrel and aspirin are conventional drugs for treating ischemic stroke (IS) and transient ischemic attack (TIA). However, with the increase of clinical application, many patients have shown clopidogrel resistance (CR) and/or aspirin resistance (AR). clopidogrel resistance is related with cytochrome P450-2C19 (CYP2C19) polymorphism, and aspirin resistance is related to urine concentration of 11-dehydroxetane B2. At present, the effect of precision antiplatelet medication based on the cytochrome CYP2C19 genotype test and the 11-dhTxB2 test has not been evaluated prospectively in a large sample. Methods: This is a randomized controlled trial evaluating the effects of precision antiplatelet medication based on the CYP2C19 genotype test and the 11-dhTxB2 test on IS/TIA patients over 12 months. Outcomes of interest including stroke recurrence, neurologic disabilities defined by the Modified Rankin Scale (mRS), bleeding events, other adverse events, and all-cause mortality will be assessed at the 1st, 3rd, 6th and 12th-month post-discharge. Demographics, risk factors, laboratory investigations, medications, physiological tests, and brain imaging will also be assessed.Discussion: Some stroke patients have resistance to clopidogrel or aspirin, but there is still no personalized medicine. Our study will conduct free antiplatelet resistance tests and individualized antiplatelet medication for patients in the intervention group, ultimately evaluating individualized medication effectiveness through a one-year follow-up. The research results will help to assess the impact of personalized antiplatelet drug therapy on the prognosis of stroke, thus providing a reference for precise clinical treatment.Trial registration: Chinese Clinical Trial Registry, ChiCTR1900026492. Registered on 12 October 2019.
NGS based expanded carrier screening for genetic disorders in North Indian population reveals unexpected results – a pilot study.
Authors: Singh Kanika , Bijarnia-Mahay Sunita , Ramprasad Vedam Lakshmi , Puri Ratna Dua , Nair Sandhya , Sharda Sheetal , Saxena Renu , Kohli Sudha , Kulshreshtha Samarth , Gujral Kanwal , Ganguli Indrani , Verma Ishwar Chander
Published: October 2020

Background: To determine the carrier frequency and pathogenic variants of common genetic disorders in the north Indian population by using next generation sequencing (NGS).Methods: After pre-test counselling, 200 unrelated individuals (including 88 couples) were screened for pathogenic variants in 88 genes by NGS technology. The variants were classified as per American College of Medical Genetics criteria. Pathogenic and likely pathogenic variants were subjected to thorough literature-based curation in addition to the regular filters. Variants of unknown significance were not reported. Individuals were counselled explaining the implications of the results, and cascade screening was advised when necessary.Results: Of the 200 participants, 52 (26 %) were found to be carrier of one or more disorders. Twelve individuals were identified to be carriers for congenital deafness, giving a carrier frequency of one in 17 for one of the four genes tested (SLC26A4, GJB2, TMPRSS3 and TMC1 in decreasing order). Nine individuals were observed to be carriers for cystic fibrosis, with a frequency of one in 22. Three individuals were detected to be carriers for Pompe disease (frequency one in 67). None of the 88 couples screened were found to be carriers for the same disorder. The pathogenic variants observed in many disorders (such as deafness, cystic fibrosis, Pompe disease, Canavan disease, primary hyperoxaluria, junctional epidermolysis bullosa, galactosemia, medium chain acyl CoA deficiency etc.) were different from those commonly observed in the West. Conclusion: A higher carrier frequency for genetic deafness, cystic fibrosis and Pompe disease was unexpected, and contrary to the generally held view about their prevalence in Asian Indians. In spite of the small sample size, this study would suggest that population-based carrier screening panels for India would differ from those in the West, and need to be selected with due care. Testing should comprise the study of all the coding exons with its boundaries in the genes through NGS, as all the variants are not well characterized. Only study of entire coding regions in the genes will detect carriers with adequate efficiency, in order to reduce the burden of genetic disorders in India and other resource poor countries.
Using geo-spatial analysis for assessing the risk of hospital admissions due to community-acquired pneumonia in under-5 children and its association with socially vulnerable areas (Brazil).
Authors: Pina Juliana Coelho , Alves Luana Seles , Arroyo Luiz Henrique , Arcêncio Ricardo Arcêncio , Gondim Ellen Cristina , Furtado Maria Cândida de Carvalho , de Mello Débora Falleiros
Published: October 2020

Background: The concentration of under-5 child morbidity and mortality due to pneumonia in developing countries reflects the social inequities. This study aimed to map and assess the spatial risk for hospitalization due to Community-Acquired Pneumonia in children under 5 years of age and its association with vulnerable areas.Methods: Ecological study in the city of Ribeirão Preto, state of São Paulo, Brazil. The study population consisted of hospitalized under-5 children, diagnosed with community-acquired pneumonia, in Ribeirão Preto-São Paulo-Brazil, from 2012 to 2013. Data were collected in different databases, by a trained team, between March 2012 and August 2013 and from the 2010 Demographic Census of the Brazilian Institute of Geography and Statistics. The 956 urban census tracts were considered as the units of analysis. The incidence of cases per 10,000 inhabitants was calculated by census tracts during the study period. For the identification of the spatial risk clusters, the Kernel density estimator and the Getis-Ord Gi* technique were performed. Generalized additive models were used to verify the association between areas with social vulnerability and the occurrence of childhood pneumonia.Results: The study included 265 children under the age of five, hospitalized due to community-acquired pneumonia. A concentration of cases was identified in the regions with greater social vulnerability (low income, poor housing conditions and homelessness), as well as a lower occurrence of cases in the most developed and economically privileged area of the city. The majority of the children lived in territories served by traditional primary healthcare units, in which the health surveillance and family and community focus are limited. It is important to highlight that the tracts with the highest degrees of vulnerability, such as those identified as high vulnerability (urban) and very high vulnerability (subnormal urban clusters).Conclusions: The results contribute to the comprehension of the social factors involved in child hospitalization due to pneumonia, based on the analysis of the spatial distribution. This approach revealed a strategic tool for diagnosing the disparities as well presenting evidences for the planning in health and strength health care system in achieving equity, welfare and social protection of children.
Age-related Changes of Microbiota in Midlife Associated with Reduced Saccharolytic Potential: An In Vitro Study
Authors: Chen Junkui , Pi Xionge , Liu Wei , Ding Qunfang , Wang Xin , Jia Weiguo , Zhu Liying
Published: October 2020

Background: Gut microbiota is critical in maintaining human health, of which diversity and abundance are subject to significantly reduce in seniors. Gut microbiota is reported to be stable across the long adulthood in general, but lack of careful examination, especially for the midlife people.Results: To characterize the gut microbiota in midlife, we investigated the faecal microbiota between two groups of healthy people, young, 20-39 years old, n=15; and midlife, 40-60 years old, n=15. Metabolic responses of the microbiota were studied through in vitro batch fermentation model. Although no difference was observed in the diversity indices between the two age groups, a wide range taxonomic changes were found in the faecal microbiota. Furthermore, substantial Bifidobacterium reduction was also found in both faecal and fermented samples. The faecal SCFAs are similar in both groups，as well as in starch fermentation broth. However, after inulin fermentation, the acetate concentration and inulin degradation rate decreased while the gas production increased in midlife group, suggesting a deficiency of saccharolytic potential in midlife, especially for non-digestible carbohydrate.Conclusions: Our data demonstrate that gut microbiota begin to change as early as in midlife. The reduction in Bifidobacterium dominates the change of the microbiota composition in midlife resulting in attenuated saccharolytic capacity of inulin, leading to insufficient acetate production which might be associated with healthy problems in this transition period from young to elderly.
Public knowledge of risk factors and warning signs for cardiovascular disease among young and middle-aged adults in rural Tanzania
Authors: Muhihi Alfa , Anaeli Amani , Mpembeni Rose N.M , Sunguya Bruno F. , Leyna Germana , Kakoko Deodatus , Kessy Anna Tengia , Sando Mary Mwanyika , Njelekela Marina , Urassa David P.
Published: October 2020

Background: Improving cardiovascular health requires public knowledge and reduction of modifiable cardiovascular disease (CVD) risk factors. This study assessed knowledge of risk factors and warning signs for CVDs among young and middle-aged adults in Morogoro, Tanzania.Methods: We conducted a community-based survey as part of cluster randomized controlled study of community health workers (CHWs) intervention for reduction of blood pressure among young and middle-aged adults in rural Morogoro. Information on socio-demographic characteristics, knowledge of risk factors and warning signs for CVDs was collected using an interviewer administered questionnaire. Knowledge was assessed using open-ended questions followed by closed-ended questions. Descriptive statistics were used to describe knowledge of risk factors and warning signs. Logistic regression analysis was used to investigate factors associated with adequate knowledge of risk factors and warning signs for CVDs.Results: Two-thirds (65.7%) of the participants had heard about CVDs. The main sources of information were mainly relatives/ neighbors (64.8%) and radio (53.0%). Only 28.3% of the participants reported health care providers as source of information about CVDs. More than half of the participants (52.4%) did not mention even one risk factor spontaneously while 55.2% were unable to mention any warning sign. When asked to select from a list, 6.9% were unable to correctly identify any risk factor whereas 11.8% could not correctly identify even a single warning sign. Quarter of participants (25.4%) had good knowledge score of risk factors, 17.5% had good knowledge score of warning signs and 16.3% had overall good knowledge of both risk factors and warning signs. Residing in Ulanga, having higher education level, having ever checked blood pressure and being overweight/obese predicted adequacy of knowledge score for both risk factors and warning signs.Conclusion: Knowledge of risk factors and warning signs in this rural population of young and middle-aged adults was generally low. Health care providers were less likely to provide health education regarding risk factors and warning signs for CVDs. Health promotion interventions to increase population knowledge of risk factors and warning signs should be implemented for successful reduction of CVDs in Tanzania.
Assessing the effect of gotfried reduction with positive buttress pattern in the young femoral neck fracture
Authors: Huang Kai , Fang Xiaohui , Li Guijun , Yue Jiajun
Published: October 2020

Background: Although many available surgical procedures for displaced femoral neck fractures in young patients, there are still many challenges to achieve satisfactory results. The incidence of avascular necrosis and nonunion rates remain relatively high despite the progress in our understanding and surgical technique. The purpose of this study was to evaluate the clinical efficacy of gotfried reduction and cannulated screw fixation in the treatment of femoral neck fracture for young adults. Methods: A retrospective analysis was made on 67 cases from May 2013 to March 2019. They were divided into three groups according to the first postoperative anteroposterior view of hip X-ray: Anatomic reduction (group A), Gotfried positive buttress reduction (group B), and Gotfried negative buttress reduction (group C). The incidence of avascular osteonecrosis of the femoral head ( AVN ) and the Harris scores of hip joints were compared in three groups at the last follow-up. Results: The mean follow-up period after surgery was 22.5 ± 11.3 (range, 11–34) months. There were 21 cases (mean age,49.7 ± 11.6) in group A, 24 cases (mean age, 48.6 ± 11.3) in group B, 22 cases (mean age,48.3 ± 12.4) in group C. No significant difference in general preoperative demographics (P>0．05). The incidence of avascular necrosis of femoral head in Group A, B, and C was 19.05%,20.83%, and 22.73 %, respectively, showing no significant difference between groups(P=0．156). The mean Harris hip scores at the final follow-up for groups A (85．6±6．7)and B (84．5±6．2) were significantly higher than group C (74．3±8.3), and the difference was statistically significant(P=0．043). The incidence of femoral neck shortening in group A and group B was significantly lower than that in group C in postoperative one year, and the difference was statistically significant (P<0.05). Conclusions: Gotfried positive buttress reduction and fixation for femoral neck fracture may lead to similar clinical results with anatomic reduction, but much better than Gotfried negative buttress reduction. For the patients of femoral neck fracture with severe displacement and difficulty reduction, it is not necessary to pursue anatomical reduction。 Achieving positive valgus reduction can also obtain satisfactory clinical results, and should try to avoid negative buttress.
Diagnosis and Prognostic Value of SPARC in Gastric Carcinoma: database mining for GCTA
Authors: Ying Diqi , Li Ding , Jin Xiao
Published: October 2020

Gastric carcinoma (GC) remains high incidence and mortality both in developed and developing countries. SPARC is extracellular non-structural matrix glycoprotein. Previous studies were closely associated with bone disease. However, the role of SPARC in GC remains largely unclear. In our study, we explored the diagnosis, prognosis and pathway enrichments value of SPARC in GC. Here, with the data from The Cancer Genome Atlas (TCGA), we used receiver operating characteristic (ROC) curve analysis to estimate the diagnosis value of the SPARC expression, Univariate and multivariate analysis to the prognosis, Gene set enrichment analysis (GSEA) to the signal pathway enrichments. As a result, SPARC expression was significantly higher in the GC tissue samples. Those with high SPARC expression of GC patients were worse prognosis. GSEA shows the gene sets related signal pathways including transforming growth factor (TGF) beta signaling pathway, pathways in cancer, Wnt signaling pathway, Mitogen-activated protein kinase (MAPK) signaling pathway etc. In brief, those results suggest that SPARC can serve as a potential biomarker for GC in diagnosis and prognosis.
Measles and Rubella Serosusceptibity among Population Vaccinated with Different Schedule of Vaccination: the potential impact on measles elimination in Iran.
Authors: Saffar Hana , Khalifeloo Maryam , Saffar mohammed-Jafar , Abdollahi Ali-Reza , Parsaei Mohammad-Reza , Ghorbani Gholam-Reza , Salarvand Samaneh , Aarabi Mohsen
Published: October 2020

Background: In addition to scheduled 2-doses monovalent measles vaccine (mMV) immunization of Iranian children since 1984, a nationwide campaign of measles-rubella (MR) immunization among 5- 25 years-old population in December 2003 was conducted. From 2004 mMV was replaced with measles- mumps-rubella (MMR) vaccine. Despite a high vaccination coverage, outbreaks of measles occurred in the country. Study was designed to investigate seroimmunity status against measles and rubella among various age groups of population who were vaccinated with different schedule since 1984. Also, immunologic response to revaccination in seronegative subjects was evaluated. Methods: From 1 November 2017 to 30 June 2018 a cross- sectional study among 7- 33 year old (born 1984-2011) healthy population with documented history of measles vaccination was conducted. Based on their age and history of vaccination status categorized as GA: 20-2333 years old; vaccinated with 1-2 dose of mMV, and also MR revaccinated. GB: 15-19 years, vaccinated only with 2- doses of mMV at the ages of 9 and 15 months and MMR 2-5 years later. GC: 12-14 years and GD: 7-11 years; vaccinated with 2- dose of MMR vaccine at the ages 15 months - 6 years, and 12-18 months respectively. Collected sera were assessed to measure antimeasles and antirubella IgG antibodies concentration. Four to 6 weeks after revaccination of seronegative subjects, antimeasles-antirubella IgM and IgG antibodies were rechecked. Collected data were analyzed using descriptive statistical methods.Results: Totally 635 individuals, 312 female were included. Relative distribution of subjects in each group was as: GA: 98, GB: 295, GC: 139, and GD: 103 persons. Overall, 12.28% and 18.4% of population were soronegative, and varied greatly between groups: 2%-0/0%, 15.2%- 25.0%, 11.5%- 17.2%; and 14.6%-18.4%, to measles and rubella, respectively. After revaccination, 92% and 94.9% showed 1gG response to measles and rubella vaccine respectively.Conclusion: Despite high coverage rate with measles and rubella containing vaccine, a significant numbers of vaccinated subjects lost their seroprotection were seronegative, possibly because of secondary vaccine failure. This may affect measles-rubella elimination goal in the country. If these data were confirmed by further studies, more strengthen regional/ national supplementary immunization activity should be considered.
Lactoferrin Suppresses LPS-Induced Expression of HMGB1, microRNA 155, 146, and TLR4/MyD88/NF-кB Pathway in RAW264.7 Cells
Authors: Nemati Maryam , Akseh Saeideh , Amiri Maryam , Nejabati Hamid Reza , Jodati Ahmadreza , Maroufi Nazila Fathi , Faridvand Yousef , Nouri Mohammad
Published: October 2020

Objective: This current study evaluated the underlying mechanisms of LF against the inflammatory microRNAs (miRNAs), HMGB1 expression and TLR4-MyD88-NF-кB pathway in LPS-activated murine RAW264.7 cells. Methods: MTT assay was used to assess cell metabolism and the cell culture levels of the cytokines (TNF-α, IL-6) were evaluated by Enzyme-linked immunosorbent assay (ELISA). The expression of miRNAs was quantified by using qPCR and expression of HMGB1, TLR4, MyD88, and phosphorylated NF-κB (P-p65) were determined with Western blot and qPCR, respectively. Results: The results indicated that LF downregulates IL-6 and TNF-α expression. LF exhibited the degradation of P-p65 and reduced the production of HMGB1, TLR4, and MyD88 in LPS-induced inflammatory response. Importantly, in parallel with the suppression of cytokines and HMGB1-TLR4-MyD88-NF-кB pathway, LF could induce a decrease in inflammatory selected miRNAs, mmu-mir-155 and mmu-mir-146a expression. Conclusions: Altogether, these findings provide LF as a prominent anti-inflammatory agent could modulate HMGB1, mmu-mir-155, mmu-mir-146a and TLR4/MyD88/NF-кB pathway.