bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of homologous recombination on core genome phylogenies
Authors: Stott Caroline Marie , Bobay Louis-Marie
Published: June 2020

Background. Core genome phylogenies are widely used to build the evolutionary history of individual prokaryote species. By using hundreds or thousands of shared genes, these approaches are the gold standard to reconstruct the relationships of large sets of strains. However, there is growing evidence that bacterial strains exchange DNA through homologous recombination at rates that vary widely across prokaryote species, indicating that core genome phylogenies might not be able to reconstruct true phylogenies when recombination rate is high. Few attempts have been made to evaluate the robustness of core genome phylogenies to recombination, but some analyses suggest that reconstructed trees are not always accurate.Results. In this study, we tested the robustness of core genome phylogenies to various levels of recombination rates. By analyzing simulated and empirical data, we observed that core genome phylogenies are relatively robust to recombination rates; nevertheless, our results suggest that many reconstructed trees are not completely accurate even when bootstrap supports are high. We found that some core genome phylogenies are highly robust to recombination whereas others are strongly impacted by it, and we identified that the robustness of core genome phylogenies to recombination is highly linked to the levels of selective pressures acting on a species. Stronger selective pressures lead to less accurate tree reconstructions, presumably because selective pressures more strongly bias the routes of DNA transfers, thereby causing phylogenetic artifacts.Conclusions. Overall these results have important implications for the application of core genome phylogenies in prokaryotes.
Short birth interval predicts the risk of preterm birth among pregnant women in Sub-Saharan Africa: A systematic review and meta-analysis
Authors: Mohammed Shikur , Abayneh Mahlet , Bekele Delayehu , Chan Grace , Worku Alemayehu , Girma Eshetu
Published: June 2020

Background: World health organization recommends that women wait at least 2 years after a live birth to reduce the risk of adverse birth outcomes, like preterm birth, in the subsequent pregnancy. However, studies have reported inconsistent finding regarding short birth interval as risk factor for preterm birth. Therefore, the aim of this systematic review and meta-analysis is to summarize and estimate the pooled effect of short birth interval on preterm birth among pregnant women with previous live birth.Methods: The search strategy aimed to find both published and unpublished studies. The search was conducted from MEDLINE/PubMed, EMBASE, CINAHL, Web of science, MedNar, Google, Google scholar and African Journals online (AJOL). Observational studies which reported the association between short birth interval and preterm birth were included. The methodological quality of selected papers was assessed by two independent individuals prior to their inclusion in the review using standardized Joanna Briggs Institute (JBI) quality assessment tools. The analysis was done using RevMan software. A random effect meta-analysis was used to estimate the pooled effect with a 95% confidence interval. Forest plot was used to visualize the presence of heterogeneity. Funnel plot was used to check for publication bias.Results: From a total of 234 published and unpublished studies identified, 10 studies that were conducted from 2015 to 2019 in Sub-Saharan African countries were included in the analysis. The meta-analysis result showed that Short birth interval had significant effect on preterm birth. The odds of having preterm birth was 2.21 times higher (OR = 2.21, 95% CI = 1.53, 3.21) among pregnant women with short (less than 2 years) birth interval compared to their counter parts. The sub-group analysis showed that the case-control studies showed statistically significant association between short birth interval and preterm birth, but not the cohort studies.Conclusion: Based on our review findings we may recommend that health planner or clinical practitioners should counsel or educate women, considering the health and economic consequence of premature birth, to increase birth interval to at least two years.
Progression of Pregnancy Induced Diabetes Mellitus to type two Diabetes Mellitus, an Ambidirectional cohort study.
Authors: feleke berhanu elfu , Feleke Teferi Elfu , Kassahun Melkamu Beyene , Adane Wondemu Gebrekirose , Achenefe Desalegn Nigatu , Genetu Abere , Nigussie Azezu Asres , Engedaw Hailemariam Awoke
Published: June 2020

Introduction:
Diabetes Mellitus (DM) is a metabolic disorder characterized by elevated level of blood glucose. It affects more than 422 million people globally. In resource limited settings, the progression of gestational diabetes (GDM) to DM was not well investigated and this research work was conducted to estimate the incidence of DM after GDM and their predictors in resource limited settings.
Methods
Both retrospective and Prospective cohort studies were implemented from January 2010 until December 2019. The data were collected using patients chart review, interview and collecting blood sample. Initially, baseline data were collected from GDM and GDM free women and update data were collected every 3 months. Clinical nurses were used to extract the necessary data from medical charts and to collect the data using patient interview. Laboratory technologists were used to measure the blood glucose level of the study participants. The study was conducted in pregnant women presenting themselves in the referral hospitals of Amhara regional state. The sample size was calculated using Epi-info software. Descriptive statistics were used to describe the profile of study participants. Kaplan Meier survival curve and life-table were used to estimate the survivals of study participants. Incidence density was used to estimate the incidence of DM. Cox regression was used to identify the predictors DM.
Results
A total of 4892 women were followed giving for the response rate of 88.62%. The mean age of study participants at the start of the study was 28.34 years with standard deviation [SD] ± 7.48 years. DM was associated with Gestational diabetes mellitus [AHR(adjusted hazard ratio) ;2.53, 95% CI: 2.14–2.99], Frequency of breastfeeding [AHR; 0.72, 95% CI: 0.69–0.74], age [AHR; 1.04, 95% CI: 1.03–1.05], Parity [AHR; 1.14, 95% CI: 1.07–1.21], Regular physical exercise [AHR; 0.45, 95% CI: 0.37–0.55], Family history of DM [AHR; 2.04, 95% CI: 1.76–2.37],Stillbirth increases [AHR;1.67: 95% CI: 1.34–2.07], Abortion [AHR; 2.64, 95%CI: 2.25–3.09].
Conclusion
The progression of GDM to DM was very high and special follow up should be implemented for women with a history of abortion, stillbirth, and family history of DM.
Evaluation of a Multi-disciplinary Medical Model in Vancomycin Treatment in Chinese Adult Patients: A Randomized Controlled Trial
Authors: Ma Lingyun , Zhou Ying , Chen Chaoyang , Gao Feifei , Li Xueying , Que Chengli , Jiao Hongmei , Li Shuangling , Zheng Xizi , Lv Jicheng , Cui Yimin , Yang Li
Published: June 2020

Background Acute kidney injury (AKI) is a common adverse drug reaction of vancomycin which is associated with increased mortality and morbidity. To investigate the roles of a multi-disciplinary medical model in preventing vancomycin-induced AKI (VI-AKI) through a standardized clinical path. Methods This study was a single center open-label randomized clinical trial which included adult pneumonia patients using vancomycin in Peking University First Hospital. In the intervention group (multi-disciplinary medical model), a standardized clinical path was conducted as (1) pharmacists-driven PopPK formula-based vancomycin regimen. (2) pharmacists-driven TDM monitor. (3) physicians-driven SCr monitor. (4) nephrologists-driven multi-disciplinary kidney protection. Pharmacists or nephrologists did not intervene patients; treatment in the control group (routine medical model). The primary outcome was the incidence of VI-AKI. Results145 patients including 72 in the intervention arm and 73 in the control arm, aged 69.0 (60.0-79.0) years with male in 74.5%, were included in the outcome analysis. The incidence of AKI was 23.6% (17/72) in the intervention arm and 34.2% (25/73) in the control arm (P=0.16). Among the 57 patients in the intervention arm who accepted PopPK based vancomycin regimen, AKI incidence was significantly decreased compared to patients in the control arm (15.8% vs. 34.2%, P=0.02). Conclusions Intervention with a multi-disciplinary medical model through standardized clinical path has the potential to reduce the incidence of VI-AKI. Multicenter and large sample size studies are warranted. This trial is registered with chictr.org (number ChiCTR1900021115, http://www.chictr.org.cn/edit.aspx?pid=35376&htm=4) on 29th Jan 2019 by retrospective registration.
Multidisciplinary Approach to Enhancing Provider Well-Being in a Metropolitan Medical Group
Authors: Shields Lisa Barbara , Jennings James T. , Honaker Joshua T.
Published: June 2020

Background
Physician burnout refers to depersonalization, emotional exhaustion, and a sense of lower personal accomplishment. Affecting approximately 50% of physicians in the United States, physician burnout negatively impacts both the physician and patient. Over a 3-year-period, this prospective study evaluated the multidisciplinary approach to decreasing provider burnout and improving provider well-being in our metropolitan community.
Methods
A multidisciplinary Well-Being Task Force was established at our Institution in 2017 to assess the myriad factors that may play a role in provider burnout and offer solutions to mitigate the stressors that may lead to decreased provider well-being. Providers at our Institution took the Mayo Clinic’s well-being index survey on 3 occasions over 3 years. Their scores were compared to those of providers nationally at baseline and at 1 and 2 years after implementing organizational and individualized techniques to enhance provider well-being. Lower well-being index scores reflected better well-being.
Results
The average overall well-being index scores of our Institution’s providers decreased from 1.76 at baseline to 1.32 2 years later compared to an increase in well-being index scores of physicians nationally (1.73 to 1.85). Both male and female providers’ average well-being index scores at our Institution decreased over the 3 years of this study, from 1.72 to 1.58 for males and 1.78 to 1.21 for females, while physicians’ scores nationally increased for both genders. The average well-being index scores were highest for providers at our Institution who graduated from medical school less than 5 years earlier (2.0) and who graduated 15–24 years earlier (2.3), whereas the average lowest scores were observed in providers who graduated ≥25 years earlier (1.37). Obstetricians/gynecologists and internal medicine physicians had the highest average well-being index scores (2.48 and 2.4, respectively) compared to other medical specialties. The turnover rate of our Institution’s providers was 5.6% in 2017 and 3.9% in 2019, reflecting a 30% decrease.
Conclusion
This study serves as a model to reduce provider burnout and enhance well-being through both organizational and individual interventions by the following multifaceted strategies: (1) provider engagement & growth; (2) workflow/office efficiencies; (3) relationship building; and (4) communication.
Sex differences in gut microbiome in high-fat-diet fed rats.
Authors: Shi Ying , Yue Fangzhi , Xing Lin , Wu Shanyu , Wei Lin , Xiang Xingwei , Lam Sin Man , Shui Guanghou , Russell Ryan , Xia Ke , Zhang Dongmei
Published: June 2020

Background

Sex differences in obesity and related metabolic diseases are well recognized, however, the mechanism has not been elucidated. Gut microbiota and its metabolites may play a vital role in the development of obesity and metabolic diseases. The aim of the present study was to investigate sex differences in gut microbiota and its metabolites in a high-fat-diet (HFD) obesity rats and identify microbiota genera potentially contributing to such differences in obesity and non-alcoholic fatty liver disease (NAFLD) susceptibility.

Results

Sprague–Dawley rats were divided into the following groups (seven animals per group): (1) male rats on a normal diet (MND), (2) male rats on HFD (MHFD), (3) female rats on a normal diet (FND), and (4) female rats on HFD (FHFD). HFD induced more body weight gain and fat storage in female rats, however, lower hepatic steatosis in FHFD than in MHFD rats was observed. When considering gut microbiota composition, FHFD rats had lower microbiome diversity than MHFD. A significant increase of Firmicutes phylum and Bilophila genus was detected in MHFD rats, as compared with FHFD, which showed increased relative abundance of Murimonas and Roseburia . Moreover, propionic and lauric acid levels were higher in FHFD than those in MHFD rats.

Conclusion

HFD induced sex-related alterations in gut microbiome and fatty acids. Furthermore, the genus Bilophila and Roseburia might contribute to sex differences observed in obesity and NAFLD susceptibility.
Development and validation of genome-wide InDel markers with high levels of polymorphism in bitter gourd (Momordica charantia)
Authors: Cui Junjie , Peng Jiazhu , Cheng Jiaowen , Hu Kailin
Published: June 2020

Background: The preferred choice for molecular marker development is identifying existing variation in populations through DNA sequencing. With the genome resources currently available for bitter gourd ( Momordica charantia ), it is now possible to detect genome-wide insertion-deletion (InDel) polymorphisms among bitter gourd populations, which guides the efficient development of InDel markers. Results: Here, using bioinformatics technology, we detected 389,487 InDels from 61 Chinese bitter gourd accessions with an average density of approximately 1,298 InDels/Mb. Then we developed a total of 2,502 unique InDel primer pairs with a polymorphism information content (PIC) ≥0.6 distributed across the whole genome. Amplification of InDels in two bitter gourd lines ‘47-2-1-1-3’ and ‘04-17,’ indicated that the InDel markers were reliable and accurate. To highlight their utilization, the InDel markers were employed to construct a genetic map using 113 ‘47-2-1-1-3’×‘04-17’ F 2 individuals. This InDel genetic map of bitter gourd consisted of 164 new InDel markers distributed on 15 linkage groups with a coverage of approximately half of the genome. Conclusions: This is the first report on the development of genome-wide InDel markers for bitter gourd. The validation of the amplification and genetic map construction suggests that these unique InDel markers may enhance the efficiency of genetic studies and marker-assisted selection for bitter gourd.
T cell immunoglobulin and mucin domain-3 is associated with disease activity and progressive joint damage in rheumatoid arthritis patients
Authors: Matsumoto Haruki , Fujita Yuya , Asano Tomoyuki , Matsuoka Naoki , Temmoku Jumpei , Sato Shuzo , Furuya Makiko Yashiro , Watanabe Hiroshi , migita kiyoshi
Published: June 2020

Background
T cell immunoglobulin and mucin domain-3 (TIM-3) is a surface molecules expressed on immune cells which play a role in immune regulation. The aims of the present study were to determine whether circulating soluble T cell immunoglobulin and mucin domain-3 (sTIM-3) is elevated in rheumatoid arthritis (RA) patients, and investigate the relationships between sTIM-3 and clinical features of RA.
Methods
The study included 116 patients with established RA and 27 healthy control subjects. Serum levels of sTIM-3 were measured via the enzyme-linked immunosorbent assays (ELISA). Correlations between serum sTIM-3 and a range of parameters including ACPA titer, erythrocyte sedimentation rate (ESR) and matrix metalloproteinase-3 (MMP-3) were assessed.
Results
Serum sTIM-3 was significantly elevated in RA patients compared with healthy subjects, and it was positively correlated with ACPA titer (r = 0.27 p = 0.005), ESR (r = 0.27, p = 0.004) and MMP-3 (r = 0.35, p < 0.001). In RA patients with high ACPA titers (≥ 200 U/mL), sTIM-3 was not correlated with ESR or MMP-3. Whereas, sTIM-3 was significantly correlated with ESR and MMP-3 in RA patients with low ACPA titers (< 200 U/mL).
Conclusions
Serum sTIM-3 was increased in RA patients, and it was associated with proinflammatory markers and disease activity in RA patients under a particular ACPA status. Our data suggest that circulating sTIM-3 may be a useful biomarker for the determination of disease activity in RA patients.
WITHDRAWN: HIV patient access to healthcare services in post-austerity era in Greece
Authors: Tsiakalakis George , Golna Christina , Dedes Nikos , Athanasakis Kostas , Souliotis Kyriakos
Published: June 2020

Background The ten-year economic crisis and the ensuing fiscal adjustment that Greece experienced between 2009 and 2018 has had a major impact on patient access to healthcare services and resulted in an increase in unmet population health needs. The present study assesses the impact of economic crisis and ensuing austerity on HIV patient access to healthcare services. Methods A cross-sectional study was carried out between February and April 2019 to assess barriers in access to HIV care faced by people living with HIV. 329 HIV-positive individuals participated in the study. An online, self-reporting questionnaire was developed on the basis of the HOPE studies tool (2,3,9,10) and adapted to the specific clinical and societal characteristics of HIV. Results 94.2% of respondents were male and 67.80% lived in Athens. Most of them were diagnosed with HIV 1 to 10 years ago. 37,40% of respondents reported obstacles in accessing HIV care over the past year, such as shortages in antiretroviral medicine, restricted opening hours of pharmacies and delays in booking an appointment with physicians. 24,30% reported they were not tested for viral load in the last six months and received a result. Individuals, who self-evaluate their financial status as very bad or bad, were more likely to be unaware of their viral load (55.60%) compared to individuals with better financial status (33,5%) (P<0.01). Only 33.3% of uninsured participants were aware of their viral load, and this figure rose to 63.30% (P <0.01) amongst insured participants. Conclusion Our study suggests that a critical proportion of HIV patients in Greece face significant barriers to receiving optimal HIV care, according to diagnostic and clinical guidelines. Financial and social insurance status are the main variables that impact on access, despite the comprehensive and universal NHS coverage of antiretroviral treatment and HIV monitoring. Reforming and integrating NHS service provision together with addressing social barriers and discrimination are critical to ensuring care is offered as per standards to all people living with HIV in Greece.
Underweight and associated factors among lactating women in Uganda: evidence from the Uganda demographic health survey 2016.
Authors: sserwanja quraish , Mukunya David , Mutisya Linet M. , Musaba Milton , Kagwisagye Mathew , Kato Ivan Arinda , Tuke Robert , Habumugisha Theogene , Kawuki Joseph
Published: June 2020

BackgroundLactating mothers are at increased risk of underweight due to physiological changes that lead to disproportionately higher energy and nutrient requirements than non-pregnant and non-lactating women. Maternal underweight has been shown to negatively affect the secretion of nutrients in breast milk leading to increased risk of child morbidity and mortality. We aimed to determine the prevalence and factors associated with underweight among lactating women in Uganda.MethodsWe used the Uganda Demographic and Health Survey (UDHS) 2016 data of 1,356 women aged 20 to 49 years. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight among 20 to 49-year-old lactating women in Uganda.ResultsThe prevalence of underweight was 8.2% (111/1356) (95% CI: 7.0–10.0). Women who were working were more likely to be underweight compared to those who were not working (AOR = 0.51; 95% CI: 0.28–0.96). Women in the Northern region were more likely to be underweight compared to women in the Western (AOR = 0.14; 95% CI: 0.06–0.29), Eastern (AOR = 0.34; 95% CI: 0.18–0.64) and Central (AOR = 0.24; 95% CI: 0.10–0.57) regions. Women who had no education (AOR = 9.27; 95% CI: 1.61–53.52) or, primary education (AOR = 6.00; 95% CI: 1.13–31.98) were more likely to be underweight compared to those who had higher (post-secondary) education level.ConclusionOur study established that the factors associated with underweight among Ugandan lactating women were level of education, working status and region. Based on the findings of this and other studies, it is important for the government to design targeted underweight reduction programs with special emphasis on working, women from the Northern region and those whose highest level of education is primary.
Risk of knee replacement after anterior cruciate ligament injury: a systematic review
Authors: Nguyen Milan Duong , Årøen Asbjørn
Published: June 2020

BACKGROUND: It is recognized that patients suffering rupture of the anterior cruciate ligament (ACL) are prone to accelerated osteoarthritis (OA), thus, this patient group is at increased risk of undergoing knee replacement (KR) at a younger age compared to the general population. There are limited data directly determining the risk of KR in ACL-injured patients. The purpose of this study is to estimate the risk of undergoing KR in patients with a history of primary ACL injury (ACLi).STUDY DESIGN: Systematic review.METHODS: A systematic literature search with keywords and MeSH terms was performed using PubMed and Cochrane Library. We identified all studies reporting KR as an outcome in individuals with primary ACLi. Individuals with concomitant and secondary intra-articular injuries were included. A modified version of the Coleman Methodology Score (CMS) was used to evaluate the quality of the included studies. The risk was estimated by using the total number of ACL-injured patients and the total number of KRs within this cohort, consisting of both patients with reconstruction and patients with non-operative treatment.RESULTS: A total of 152 390 ACL-injured patients and a total of 1071 KRs were assembled from 5 prospective and 7 retrospective studies, which revealed a mean modified CMS of 70. Mean follow-up time was 16 years (ranging from 4.6 to 30 years). Mean age among the patients was 29.8 years. Estimated risk of undergoing KR after ACLi was 0.7 % with values between 0.54 % and 9.5 % among the included studies.CONCLUSION: This systematic review suggests an estimated risk of KR among ACL-injured patients to be 0.7 %. Our findings are based on the results from the included studies, which, to some degree, showed divergence. The discrepancy may be due to variability in several factors, both research variables and patient factors, including follow-up time, sample size, subsequent injuries, obesity, sex, age and activity level. No consensus about OA development after ACLi has been established, however, OA is a common topic in the conversation between the doctor and the patient. This data may be helpful for physicians and clinicians when informing patients about the long-term risk of symptomatic OA, eventually requiring KR.
Developing Physical Activity Interventions for the School and Home Settings: Lessons Learned from a Community-Academic Partnership
Authors: Ramsey Zachary , Northrup Karen , Workman Charlotte , Jarrett Traci , Tompkins Nancy O’Hara , Cottrell Lesley
Published: June 2020

Background

Physical activity interventions designed for children living in the rural setting, particularly those that are cost effective and utilize common resources, are increasingly requested. Interventions for school and home settings are available but can be complicated and expensive to deliver.
Methods

In this study, we developed two physical activity interventions to be implemented in the school and home environments within rural settings of varying sizes and resources. This study, Activate!, was based on the socioecological model (SEM) and informed by local school personnel, families, and community health workers. Community members contributed to the development and implementation of the program.
Results

The resulting intervention package included several resources that were either already available in the school or home settings or could be easily collected by facilitators. Recommendations for frequency of use, capturing whether it is working, and methods for encouraging children and families were included in the packaging.
Conclusions

In this project, we successfully incorporated community (school and home) needs from a largely rural state within Appalachia to develop physical activity interventions for children. The Activate! interventions were designed for easy implementation by community members directly in both the school and home environments using common materials and easily reviewed packaging and guidance.
Does free of charge policy increase care-seeking for children under five in Sierra Leone? Evidence from population-based studies from 2008-2016
Authors: Bognini Joel Dofinissery , Bogninni Joel Dofinissery , Samadoulougou Sekou , Smart Francis , Kangoye David Tiga , Sankoh Osman , Kirakoya-Samadoulougou Fati
Published: June 2020

Background

In 2010, the Government of Sierra Leone has implemented the Free Health Care Initiative (FHCI) in the country with the objective to reduce under five mortality. The biggest share of this mortality in the country is attributable to infectious diseases. Care-seeking for children under five is a key point to reduce mortality due to infectious diseases as it permits early diagnosis and prompt and correct treatment. The objective of this study was therefore to assess the trend in the prevalence of care-seeking as well as to identify determinants of utilization of healthcare services by under-five (U5) caregivers under the policy initiative.
Methods

The analysis of care-seeking behavior was done using data from three population-based studies in Sierra Leone (2008-before FHCI and 2013, and 2016-After FHCI). Care-seeking behavior was assessed through care-seeking of caregivers of children U5 with a history of fever in the 2 weeks prior to the survey. We compared the percentages of care-seeking and performed modified Poisson modeling to evaluate the determinants of care-seeking during the period of FHCI (2013–2016).
Results

In 2008, a total of 1,208 feverish children were identified, as compared with 2,823 children in 2013, and 1,633 in 2016. Fewer children had seeking care for fever in 2008 (51% [95% CI (46.4–55.5)]) than in 2013 (71.5% [95% CI (68.4–74.5)]) and in 2016 (70.3% [95% CI (66.6–73.8)] (p < 0.001)). Care-seeking was low when the household head was a man, when the head of the household was 15–24 years old, when the child was living in a poorest household, in north or west region and when the child was more than one year old.
Conclusions

The increase of care-seeking in children under five with fever coincided with the initiation of the FHCI in Sierra Leone. Effective interventions to improve the health facilities’ visitation of the children under five should target the identified factors.
Clinical Analysis of 123 Cases of Acute Colonic Diverticulitis
Authors: Chen Zhi , Zhang Bing , wu dan , Jin Ye
Published: June 2020

Objective: To study the characteristics of acute colonic diverticulitis and the differences between different treatment options.Methods: A retrospective analysis of 123 patients with acute colonic diverticulitis treated in our hospital from April 2013 to April 2020, including operation group (n = 30) and non-operation group (n = 93). The characteristics of acute colonic diverticulitis were analyzed, and the therapeutic effects of acute colonic diverticulitis were compared between the operation group and the non-operation group.Results:111 cases of Caecal and ascending colonic diverticulitis (proportion 90.2%, male to female ratio 2.26: 1, average age 39.6 ± 14.4 years, surgery ratio 24.3%, mean hospital stay 7.4 ± 4.3 days, recurrence rate 3.6%); 3 cases of transverse colonic diverticulitis; 3 cases of descending colonic diverticulitis; 6 cases of Sigmoid diverticulitis (proportion 4.9%, male: female 1: 1, average age 67.7 ± 4.5 years, surgery ratio 33.3%, mean hospital stay 11.7 ± 5.5 Days, recurrence rate 0%).30 patients received surgical treatment, including 15 cases of abdominal drainage, 14 cases of colonic diverticulectomy and repair, and 1 case of sigmoidectomy. There was a statistically significant difference in the length of hospitalization between the operative group and the non- operative group (P = 0.018), and the length of hospitalization was longer in the operative group. There was no significant difference in the recurrence rate between the operative group and the non-operative group of colonic diverticulitis (P = 0.595). Colonic diverticulitis usually relapsed within 1 year. The total recurrence rate was 4.1%.Conclusions: The right-sided colonic diverticulitis is more common in young and middle-aged. There is a higher incidence in males. The effect of non-operative treatment of acute diverticulitis is better than that of surgical treatment. Resection and repair of the diverticulum or abdominal drainage can be used in patients with acute uncomplicated diverticulitis.
Shockwave Treatment Enhances the Extracellular Matrix Production in Articular Chondrocyte Through Activation of the ROS/MAPK/Nrf2 Signaling Pathway.
Authors: Shen Po-Chih , Chou Shih-Hsiang , Lu Cheng-Chang , Huang Hsuan-Ti , Chien Song-Hsiung , Huang Peng-Ju , Liu Zi-Miao , Shih Chia-Lung , Su Shu-Jem , Chen Li-Min , Tien Yin-Chun
Published: June 2020

Background: Shockwaves are acoustic pulses that have been widely used in the management of musculoskeletal disease. In current study, we investigated the biological effect of shockwaves on articular chondrocytes and clarified the mechanism by which chondrocytes sense and respond to the mechanical stimulation of shockwave treatment. Methods: Porcine articular chondrocytes and human osteoarthritis (OA) chondrocytes were cultured in a three-dimensional pellet culture model and subjected to shockwaves. Then alamarBlue assay, Hoechest DNA assay, fluorescence-activated cell sorter, real-time polymerase chain reaction immunofluorescence staining, and western blotting were used to determine biological function and signaling transduction of chondrocytes after shockwaves.Results: Shockwaves increased the sulfated glycosaminoglycan (GAG), Col2a1, and Acan production of chondrocytes without affecting cell viability and proliferation. Furthermore, shockwaves increased transient reactive oxygen species (ROS) production primarily through the action of xanthine oxidase and subsequently through phosphorylation of Erk1/2 and p38. Shockwaves also activated the nuclear translocation of Nrf2 and the Nrf2-related downstream gene expression of Ho-1 and Nqo-1. We suppressed the xanthine oxidase activity by allopurinol or speciﬁc siRNA, which signiﬁcantly abrogated shockwave-induced mitogen-activated protein kinase (MAPK) phosphorylation, Nrf2 nuclear translocation, and extracellular matrix (ECM) synthesis. U0126 and SB203580, the specific inhibitors of MAPKs MEK1/2 and p38, respectively, significantly abolished shockwave-induced Nrf2 nuclear translocation and ECM synthesis. Inhibition of Nrf2 by both shRNA knockdown and brusatol reduced the shockwave-increased GAG, Col2a1, and Acan production. Conclusions: Maintaining the homeostasis of the ECM of the articular cartilage is crucial for preventing the development OA. Our data indicate that shockwaves enhanced the ECM synthesis of chondrocytes through the activation of the ROS/MAPK/Nrf2 signaling axis. This study demonstrates that shockwaves holds promising therapeutic potential for OA and provides fundamental evidence for developing an optimal therapeutic strategy.
Chromosomal aberration arises during somatic reprogramming to pluripotent stem cells
Authors: Liu Xinyu , Zheng Kang , Zhao Xiaofeng , Xu Xiaofeng , Yang Aifeng , Yi Min , Tao Huaping , Xie Binghua , Qiu Mengsheng , Yang Junlin
Published: June 2020

Background: Reprogramming somatic cells to induced pluripotent stem cells (iPSCs) has opened new therapeutic possibilities. However, karyotypic abnormalities detected in iPSCs compromised their utility, especially chromosomal aberrations found at early passages raised serious safety concerns. The mechanism underlying the chromosomal abnormality in early-passage iPSCs is not known.Methods: Human dermal fibroblasts (HDFs) were stimulated with KMOS (KLF4, cMYC, OCT4 and SOX2) proteins to enhance their proliferative capacity and many vigorous clones were obtained. Clonal reprogramming was carried out by KMOS mRNAs transfection to confirm the ‘chromosomal mutagenicity’ of reprogramming process. Subculturing was performed to examine karyotypic stability of iPSCs after the re-establishment of stemness. And antioxidant N-acetyl-cysteine (NAC) was added to the culture medium for further confirmming the mutagenicity in the first few days of reprogramming.Results: Chromosomal aberrations were found in a small percentage of newly induced iPS clones by reprogramming transcription factors. Clonal reprogramming ruled out the aberrant chromosomes inherited from rare karyotypically abnormal parental cell subpopulation. More importantly, the antioxidant NAC effectively reduced the occurrence of chromosomal aberrations at the early stage of reprogramming. Once iPS cell lines were established, they restored karyotypic stability in subsequent subculturing.Conclusions: Our results provided the first line of evidence for the ‘chromosomal mutagenicity’ of reprogramming process.
Knowledge, attitude and practice of the Sudanese people towards COVID-19: An online survey
Authors: Mohamed Amal , Elhassan Eilaf , Mohamed Abdelrahim O. , Mohammed Awab Aldow , edris Hassan Alshaikh , Mahgoop Mohamed Alhadi , Sharif Mohamed Emadaldin , Bashir Maab Imadeldin , Abderlahim Rania Bashir , Idriss Wegdan Ibraheim , Malik Elfatih Mohamed
Published: June 2020

Background: The Novel Corona Virus (SARS-CoV-2) had emerged to affect the human population in 2019 causing COVID-19 pandemic. The disease has no vaccine and no definitive treatment; the only preventive measures available are social distancing, hand washing and masks. This study aims to assess the knowledge, attitude and practice of the Sudanese people towards COVID-19.Methods: A cross-sectional study targeting adult Sudanese people was conducted out in Sudan in April 2020. The study used an online self-administered questionnaire and utilized social media such as Facebook and WhatsApp. The total number of eligible questionnaires was 987.Results: The mean (SD) age of respondents was 30.13 (9.84) years with males representing 55.4%. The majority were university and higher educated (95.2%) and residing in Khartoum (71.7%). The knowledge of the participants was rated as good in 90.6% and was found to be associated with education level (p-value = 0.001). The attitude was found good in 81.8% and was associated with females gender (p=0.02). The practice related to COVID-19 preventive measures was found good in 89.8% of the participants and was associated with sex and area of residence (p= 0.003, and p = 0.001 respectively).Conclusions: This study showed that there was good knowledge, attitude and practices among the participants who are mostly young and educated. Females tend to be superior in their attitudes and practices.
Estimation of the basic reproduction number of novel coronavirus (COVID-19) in Bangladesh: A 65-day outbreak data-driven analysis
Authors: Hasan Md. , Hossain Akhtar , Bari Wasimul , Islam Syed Shariful
Published: June 2020

BackgroundThe outbreak of novel coronavirus disease (COVID-19), started from Wuhan, China, at the end of December 2019, hits almost the entire world. In Bangladesh, the first case was officially reported on March 8, 2020. We estimated the basic reproductive number, R0, of COVID-19 for Bangladesh using the first 65-day data of the outbreak.MethodsWith time-varying disease reporting rate, epidemic curves were estimated using the exponential growth model utilizing daily COVID-19 diagnosis data in Bangladesh from March 8 to May 11, 2020. We estimated R0 using the estimated intrinsic growth rate (γ). Serial intervals (SI) have been used from two well-known coronaviruses’ outbreaks, SARS and MERS; and the early estimate of SI of COVID-19 in Wuhan, China.ResultsThe COVID-19 epidemic in Bangladesh followed an exponential growth model. We found the R0 to be 1.84 [95% CI: 1.82–1.86], 1.82 [95% CI: 1.81–1.84], and 1.94 [95% CI: 1.92–1.96], for MERS, COVID-19, and SARS SI respectively without adjusting reporting rate. With the adjusted reporting rate, R0 reduced to 1.63 [95% CI: 1.62–1.65], 1.62 [95% CI: 1.61–1.64], and 1.71 [95% CI: 1.70–1.73] for a five-fold increase. Inverse association between the reporting rate and the basic reproduction number was observed.ConclusionThe R0 was found to be 1.87 for existing cases and was reduced to 1.65 for the five-fold increase of the early reporting rate. Findings suggest a continued COVID-19 outbreak in Bangladesh and immediate steps need to be taken to control.
HGF Protected Against Diabetic Nephropathy via Autophagy-Lysosome Pathway in Podocyte by Modulating PI3K/Akt-GSK3β-TFEB Axis
Authors: Hou Bo , Li Yankun , Li Xue , Zhang Congying , Zhao Zhonghua , Chen Qi , Zhang Nong , Li Hui
Published: June 2020

Background: Podocyte loss is a detrimental feature and major cause of proteinuria in diabetic nephropathy (DN). Our previous study revealed that hepatocyte growth factor (HGF) prevented high glucose-induced podocyte injury via enhancing autophagy. In the current study, we aimed to assess the role of HGF on podocyte homeostasis in DN and clarify its mechanisms further. Methods: Streptozotocin (STZ)-induced DN mice were applied as a model to verify the impact of HGF on the prevention of type 1 diabetes. To study the mechanism involved, the autophagy flux and related signaling pathway upon HGF were examined and the relevance of lysosome acidification in cultured podocytes were investigated.Results: Diabetic mice treated with HGF had markedly reduced ratio of kidney weight to body weight, urinary albumin excretion, podocyte loss and matrix expansion compared with that in the non-treated counterpart. Simultaneously, HGF-treated diabetic mice exhibited increased autophagy activity as indicated by the decreased accumulation of sequestosome 1 (SQSTM1/ p62) and increased microtubule-associated proteins 1 light chains 3 (LC3) II/LC3I ratio. These beneficial effects of HGF were blocked by HGF/c-Met inhibitor Crizotinib or phosphatidylinositide 3-kinases (PI3K) inhibitor LY294002. Moreover, HGF treatment obviously prevented inactivation of the protein kinase B (Akt)-glycogen synthase kinase 3 beta (GSK3β)-transcription factor EB (TFEB) axis in high glucose-stimulated podocytes, which was associated with improved lysosome function and autophagy. Accordingly, adenovirus vector encoding constitutively active GSK3β (Ad-GSK3β-S9A) offset whereas small interfering RNA against GSK3β (GSK3β siRNA) recapitulated salutary effects of HGF on lysosome number and autophagy in podocytes. Conclusions: These results suggested that HGF protected against diabetic nephropathy through restoring podocyte autophagy, which at least partially involved PI3K/Akt-GSK3β-TFEB axis-mediated lysosomal function improvement.
Rsp Activates Expression of the Cnt System in Staphylococcus aureus
Authors: Vinué Laura , Hooper David C.
Published: June 2020

Background
The Cnt system is crucial for the optimal import of essential metals in metal-limiting conditions and contributes to virulence in S. aureus. In a screen for regulators of efflux pumps and other exporters in a phage-based ultra-high-density transposon library, we identified Rsp as a candidate regulator of the cntE exporter gene.
Results
A two-fold decrease in expression of all genes of the cnt operon was observed by RT-qPCR in the rsp mutant compared to the parental strain, indicating that Rsp acts as an activator of the cnt operon. To determine whether the Rsp activation depends on iron, we compared mutant and parent cnt expression under varying metal conditions. A 2-fold reduction in cnt gene expression was detected in the rsp mutant in TSB, and a slightly smaller decrease (1.9, 1.7, and 1.5-fold changes for cntK, cmtA, and cntE respectively) was observed after addition of dipyridyl. The greatest decrease was seen with addition of FeSO4 (4.1, 5.3 and 6.3-fold changes for cntK, cmtA and cntE respectively). These findings suggest that Rsp activates the cnt operon in both low and high iron conditions. To study the relationship between Rsp and the cnt repressors Fur and Zur, we created single and double mutants. A decrease in the expression of cntK (1.5-fold) and cntA (1.6-fold) was seen for Δfur Δrsp compared to Δfur strain. Similarly decreased expression of cntK (1.3-fold), cntA (1.6-fold) and cntE (1.6-fold) genes was seen comparing Δzur Δrsp and Δzur mutants but statistically not significant, indicating that Rsp is dependent on Fur and Zur. To determine if Rsp directly modulates expression of cnt genes, incubation of purified Rsp caused a DNA-specific band shift for both the cntK and cntA promoters.
Conclusions
Rsp activation may act to maintain basal cellular levels of staphylopine to scavenge free metals when needed, in addition to metal dependent regulation by Fur and Zur.
Revealing Oral Microbiota Composition and Functionality Associated with Heavy Cigarette Smoking.
Authors: Bataineh Mohammad Tahseen AL , Dash Nihar Ranjan , Elkhazendar Mohammed , Alnusairat Dua'a Mohammad Hasan , Darwish Islam Mohammad Ismail , Al-Hajjaj Mohamed Saleh , Hamid Qutayba
Published: June 2020

Background: Heavy tobacco smoking, a hallmark feature of lung cancer is drastically predominant in Middle Eastern populations. The precise links between nicotine dependence and the functional contribution of the oral microbiota remain unknown in these populations. Methods: We evaluated the functional capabilities of the oral microbiota with relation to cigarette smoking in 105 adults through shotgun metagenomics. Results: The four major enterotypes initially described in westernized cohorts were retrieved in this population. Differential relative abundance testing unveiled relative abundance of Streptobacillus hongkongensis (Log2FoldChange 4.78, P. adjusted value < 0.00004), Fusobacterium massiliense (Log2FoldChange 4.63, P. adjusted value < 0.00000004), Prevotella bivia (Log2FoldChange 2.46, P. adjusted value < 0.00024) in high nicotine dependent compared to low nicotine dependent profiles based on Fagerström test for Nicotine Dependence. Functional profiling showed marked differences between smokers and non-smokers controls with an enrichment of Tricarballylate utilization (Log2FoldChange 2.52, P. adjusted value < 0.0013) and Lactate racemization (Log2FoldChange 1.003, P. adjusted value < 0.0001) among others in smokers vs . non-smokers group. According to nicotine dependence, we detected enrichment of Xanthosine utilization (Log2FoldChange 3.38, P. adjusted value < 0.00007), p-Aminobenzoyl-Glutamate utilization (Log2FoldChange 1.33, P. adjusted value < 0.00056), and Multidrug efflux pump in Campylobacter jejuni (Log2FoldChange 1.14, P. adjusted value < 0.00007) biosynthesis modules in the high nicotine dependent group. Conclusions: These differences provide a critical insight on how variations in the oral microbiota may predispose to smoke cessation relapse, serious respiratory illnesses, and lung cancer in heavy cigarette smokers. The observed enrichment of Fusobacterium and Prevotella suggest an intriguing linkage to lung and gut cancers. This information may eventually lead to the development of screening biomarkers to predict early cancer development.
Ar-23 Derivatives With High Endosomal Disrupting Ability Enhance Poly(L-lysine)-mediated Gene Transfection
Authors: Zhang Shikun , Gong Lin , Zhang Xue , Yun Zhi-min , Li Su-Bo , Gao Hong-Wei , Dai Cong-Jie , Yuan Jian-Jun , Chen Jing-ming , Gong Feng , Tan Ying-Xia , Ji Shou-Ping
Published: June 2020

Background：pH-sensitive peptides are a relatively new strategy for conquering poor endosomal release of cationic polymer-mediated transfection. Modification of antimicrobial peptides (AMPs) by exchanging positively-charged residues with negatively-charged glutamic acid residues (Glu) greatly improved its lytic activity at the endosomal pH, which could improve cationic polymer-mediated transfection.Methods：In the present study, we investigate the effect of the number of Glu substituted for positively-charged residues on the endosomal escape activity of AR-23 and the ability of mutated AR-23 for enhancing cationic polymer-mediated transfection. Three analogs were synthesized by replacing the positively-charged residues in AR-23's sequence with Glu one-by-one. The pH-sensitive lysis ability of the peptides, the effect of peptides on the physicochemical characteristics, the intracellular trafficking，the transfection efficiency, and the cytotoxicity of the polyplexes were determined.Results：Increased lytic activity of peptides was observed with the increased number of Glu replacement in the AR-23 sequence at acidic pH. The number of Glu substituted for positively-charged residues of AR-23 dramatically affects its lysis ability at neutral pH. Triple-Glu substitution in AR-23's sequence greatly improved PLL-mediated gene transfection efficiency while maintaining low cytotoxicity.Conclusion：The results indicate that replacement of positively-charged residues with enough Glu residues may be considered a method for designing pH-sensitive peptides, which could be applied as potential enhancers for improving cationic polymer-mediated transfection.
Research HealthSWEDE: Costs With Sublingual Immunotherapy - A Swedish Questionnaire Study
Authors: Olsson Petter , Sköder Carl , Ahlbeck Lars , Hjalte Frida , Welin Karl-Olof , Westin Ulla , Andersson Morgan , Emanuelsson Cecilia Ahlström , Cardell Lars-Olaf
Published: June 2020

BackgroundThe aim of this cross-sectional survey was to compare the health-economic consequences for allergic rhinitis (AR) patients treated with sublingual Immunotherapy (SLIT) in terms of direct and indirect costs with a reference population of patients receiving standard of care pharmacological therapy. MethodsPrimary objective was to analyse the health-economic consequences of SLIT for grass pollen allergy in Sweden vs reference group waiting for subcutaneous immunotherapy (SCIT). A questionnaire was mailed to two groups of AR patients. ResultsThe questionnaire was distributed to 548 patients, 307 with SLIT and 241 in reference group (waiting for SCIT). Response rate was 53.8%. Mean annual costs were higher for reference patients than SLIT group; € 3907 (SD 4268) vs € 2084 (SD 1623) p < 0.001. Mean annual direct cost was higher for SLIT-patients, € 1191 (SD 465) than for reference, € 751 (SD 589) p< 0.001. Mean annual indirect costs for combined absenteeism and presenteeism were lower for patients treated with SLIT, € 912 (SD 1530), than for reference, € 3346 (SD 4120) p< 0.001, with presenteeism as main driver.ConclusionsSLIT seems to be a cost-beneficial way to treat seasonal AR. This information might be used to guide future recommendations.