bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and Predictors of Tuberculosis Occurrence among Adults on Antiretroviral Therapy at Debre Markos Referral Hospital, Northwest Ethiopia: Retrospective Follow-up Study
Authors: Aemro Agazhe , Jember Abebaw , Anlay Degefaye Zelalem
Published: August 2019

Abstract
Background: In resource limited settings, Tuberculosis (TB) is the major cause of morbidity and mortality among patients on antiretroviral treatment. Ethiopia is one of the 30 high TB burden countries and it causes burden in healthcare system and challenge the effectiveness of HIV care. This study was to assess incidence and predictors of Tuberculosis among adults on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia, 2019.
Methods: Institution based retrospective follow up study was conducted among adults on ART newly enrolled from 2014 to 2018 at Debre Markos Referral Hospital. Simple random sampling technique was used to select charts. Data was entered to EPI- INFO version 7.2.2.6 and analyzed using Stata 14.0. Tuberculosis incidence rate was computed and described using frequency tables. Both bivariable and multivariable Cox proportional hazard models was fitted to identify predictors of TB.
Results: Out of the 536 charts reviewed, 494 patient records were included in the analysis. A total of 62 patients have developed new TB cases during the follow up period of 1000.22 Person Years (PY); which gives an overall incidence rate of 6.19 cases per 100 PY (95% CI: 4.83 - 7.95). The highest rate was seen within the first year of follow up. TB free survival probability for the total cohort decreased with follow up year. Base line Hemoglobin < 10 g/dl (AHR= 5.25; 95% CI: 2.52 - 10.95), ambulatory/bedridden patients at enrolment (AHR = 2.31; 95% CI: 1.13 - 4.73), having fair or poor ART adherence (AHR = 3.22; 95% CI: 1.64 – 6.31) were increase the risk of tuberculosis whereas taking Isoniazid Preventive Therapy (IPT) (AHR = 0.33; 95% CI: 0.12 - 0.85) were protective factors of TB occurrence.
Conclusion: TB Incidence was high among adults on ART especially in the first year of enrollment to ART. Low hemoglobin level, ambulatory or bedridden functional status, non-adherence to ART and IPT usage status were found to be independent predictors. Hence, continuous follow up for ART adherence and provision of IPT has a great importance to reduce the risk of TB.
Key words: Ethiopia, Incidence, HIV Infection, TB/HIV infection
Combined RNA-seq, small RNA and degradome sequencing approaches insights into salt-stress responses in Beta vulgaris
Authors: Li Junliang , Cui Jie , Cheng Dayou , Dai Cuihong , Liu Tianjiao , Wang Congyu , Luo Chengfei
Published: August 2019

Background

Salinity is one of the most serious threat to agriculture worldwide. Sugar beet is an important sugar-yielding crop and has a certain tolerance to salt. While a genome-wide analysis of genes involved in salt-stress remains largely unknown in B. vulgaris.

Results

Three high-throughput sequencing approaches, namely, RNA-seq, small RNA and degradome sequencing were used to exploring the molecular basis of salt-resistance in beta vulgaris. A total of 12 230 differentially expressed genes were identified, which were mainly related to transcription factors, protein kinases, and enzymes. The small RNA sequencing resulted in the identification of 476 miRNAs included 219 known and 257 novel miRNAs, of which 130 were differentially expressed under salt-stress. A total of 2534 targets were predicted for 317 miRNAs by bioinformatics and degradome sequencing. Functional analysis of these targets suggested that miRNA-mediated post-transcriptional regulation plays a crucial role in transcriptional reprogramming under stress. The combination analysis of multi-omics revealed 209 negative correlation mRNA-miRNA pairs. All these data were used to construct a hypothetical regulatory network of beta vulgaris in response to salt stress.

Conclusion

These components and the preliminary network provides better insights into the molecular mechanism of salt-stress response, and also offers candidate genes for beet improvement.
Exosomal Bta-miR-185 and Bta-miR-378 Are Potential Markers for Quality Control of Milk Infected by Staphylococcus aureus
Authors: Ma Shaoyang , Tong Chao , Ibeagha-Awemu Eveline M. , Zhao Xin
Published: August 2019

MicroRNAs (miRNA) in milk-derived exosomes may reflect pathophysiological changes caused by mastitis. This study profiled miRNAs in milk exosomes and potential markers for quality control of milk infected by Staphylococcus aureus (S. aureus). Total RNA from milk exosomes was collected from healthy cows (n=3) and S. aureus infected cows (n=6). Two hundred ninety miRNAs (221 known and 69 novel ones) were identified. Among them, 22 known and 15 novel miRNAs were differentially expressed (DE). Target genes of DE miRNAs were significantly enriched in intracellular protein transport, endoplasmic reticulum and identical protein binding. Two miRNAs (bta-miR-378 and bta-miR-185) with high read counts and log2 fold changes (>3.5) were considered as potential milk exosome biomarker miRNAs for S. aureus mastitis and milk quality. One target gene (VAT1L) of bta-miR-378 and five target genes (DYRK1B, MLLT3, HP1BP3, NPR2 and PGM1) of bta-miR-185 were validated. DE miRNAs in exosomes from normal and S. aureus infected milk were identified. Two DE miRNAs could be used as potential biomarkers for the infection. The linkage between the validated target genes and diseases suggest that we should pay particular attention to exosome miRNAs from mastitic milk in terms of milk safety.
Patient’s perception of kidney stone prevention within the emergency department and its adherence factors: A single institution study
Authors: Moussa Mohamad , Chakra Mohamed Abou
Published: August 2019

BackgroundNo known data in the literature assessing practice of kidney stone prevention in the emergency department (ED) is available. Objectives: Assess patient perception and compliance to kidney stone prevention given within the emergency department. It also indirectly detects the attitude and practice patterns of primary care providers in kidney stone prevention.Materials and MethodsThis is a qualitative study done in a single institution from January 2018 to January 2019 that includes 99 patients that were diagnosed with kidney or ureteral stone in ED and were discharged home, all of them where stone formers. They were asked to fill a self- administered questionnaire when they are able to read, or interviewed by the resident within the ED when they are unable to read.ResultsThe majority of patients (68%) did not receive any instructions about kidney stones prevention within the ED. Most of patients who follow instructions if it was given were educated (90 %), had an insurance coverage (85%), and had an income higher than $1000 per month (76%), (p<0.05). Seventy one percents of patients believe in the effectiveness of stone prevention if it was provided and most of them are interested in learning about these preventive strategies (82%). Reasons for not following the instructions about kidney stones prevention measures were the cost (53.1%) following by the lack of explanation by ED physicians (18.8%). The majority of patients (62.6%) prefer to receive kidney stones prevention measures from urologists.ConclusionMost of patients in our institute did not receive kidney stones prevention measures in ED despite that they declared their interest in following these measures. Most of the time they did not adhere to those measures due to socioeconomic factors and lack of clarifications. If these instructions were given within the ED, it could lead to an acceptable compliance rate.
The association of change in serum cholesterol levels and clinical treatment response in patients with schizophrenia: a prospective, randomized and open-label study
Authors: Chen Yi-Lung , Chiu Chih-Chiang , Chen Kun-Po , Tai Ming-Hong , Lung For-Wey
Published: August 2019

Background: In the past, it was suggested that dyslipidemia was associated with clinical improvement in patients with schizophrenia treated with antipsychotics; however, measurement at a single time point post-treatment, as done in most studies, could have contributed to the inconsistent results. The aim of this study was to investigate whether changes in serum levels of lipid and other covariates were associated with clinical response in patients with schizophrenia treated with atypical antipsychotics, using repeated measurements and considering time effects.

Method: A total of 90 patients with schizophrenia were enrolled in this 12-week prospective, randomized and open label study. Positive and Negative Syndrome Scale (PANSS) score and a standard serum lipid profile were measured at baseline (day 0) and subsequently followed up at weeks 4, 8 and 12. The generalized estimating equation (GEE) model was applied to examine the relationship between serum lipids and treatment response, controlling for other potential variables.

Results: The results of GEE analysis showed that the increase in serum total cholesterol levels during 12 weeks’ antipsychotic treatment was significantly associated with a reduction in PANSS total score (β = −0.37, p = 0.02) and positive symptom score (β = −0.34, p = 0.01) over time.

Conclusions: These findings revealed that the change in serum total cholesterol level was positively associated with the therapeutic efficacy of atypical antipsychotics. Serum total cholesterol may be a potential predictor of clinical response in patients with schizophrenia treated with atypical antipsychotics.

Trial Registration:
ClinicalTrials.gov identifier: NCT03730857. The trial was retrospectively registered on 11 Feb, 2019.
Effectiveness of cross-sectoral treatment models for patients with mental disorders - meta-analysis of 13 controlled studies from Germany
Authors: Baum Fabian , Schoffer Olaf , Neumann Anne , Seifert Martin , Kliemt Roman , March Stefanie , Swart Enno , Häckl Dennis , Pfennig Andrea , Schmitt Jochen
Published: August 2019

Background

Individuals with mental disorders demand for a continuous and efficient collaboration between different sectors of care. In 2012, a new law in Germany enabled the implementation of cross-sectoral and patient-centered treatment models in psychiatry (FIT64b). These projects have been evaluated by a scientific consortium in controlled cohort studies. We present results of effectiveness based on a meta-analysis from 13 FIT64b hospitals.

Methods/Design

We undertook a series of claims-data-based controlled cohort studies. Data from over 70 statutory health insurance (SHI) funds in Germany were analyzed. All patients insured by any of the participating SHI funds and treated in one of the FIT64b hospitals for any of 16 pre-defined mental disorders were compared with matched control patients from routine care. The collective was subdivided into hospital-new and hospital-known patients. Primary outcomes were duration of inpatient care and duration of sick leave. Individual treatment effects of the 13 FIT64b hospitals were pooled in a random-effects meta-analysis. Meta-regression analysis was used to explore potential reasons for heterogeneity in model effectiveness.

Results

Meta-analyses indicated a significant effect of a reduction by over 5 days on the cumulated duration of inpatient care in hospital-new intervention (IG) compared to control patients (CG). This effect was even stronger among FIT64b hospitals with a pre-existing FIT64b-like environment. Regarding the duration of sick leave there was no overall significant effect between the two groups. Further meta-regression for hospital-new patients revealed that sick leave duration was significantly reduced by almost 13 days in intervention hospitals with a pre-existing FIT64b-like contract compared to hospitals without such a contract.

Conclusions

This meta-analysis suggests positive effects of FIT64b for patients with mental disorders with shorter duration of inpatient treatment. We additionally found a trend towards a reduced duration of sick leave days in FIT64b hospitals with a pre-existing FIT64b–like structure in the pre period. Pre-existing FIT64b-like contracts appear to have facilitated the transition into the new treatment environment. The results should still be interpreted with caution, as this manuscript only covers the first year of the five-year evaluation period in thirteen of eighteen FIT64b hospitals.
Oxytocin Receptor Gene, Childhood Maltreatment and Borderline Personality Disorder among Male Inmates in China
Authors: Zhang Min , Liu Na , Chen Haocheng , Zhang Ning
Published: August 2019

Background

Borderline personality disorder (BPD) is caused by a variety of biological and environmental factors. Accumulating evidence suggests that childhood maltreatment is a risk environmental factor in the development of BPD, but research on the genetic pathology of BPD is still in its early stages, and very little is known about the oxytocin receptor (OXTR) gene. The purpose of this study is to further explore the interaction between OXTR gene polymorphism and childhood maltreatment in BPD.

Methods

A total of 1804 prison inmates and 196 normal controls participated in this study. Childhood maltreatment was measured by a self-reported questionnaire, as was BPD. Venous blood was collected for the genotype test.

Results

Analyses revealed that the BP group had higher rs53576 AA genotype frequency and rs237987 AA genotype frequency than the non-BP group. Childhood maltreatment and its dimension could positively predict BPD risk. Among the prison samples, rs53576 GG genotype carriers had higher BPD scores at higher levels of emotional abuse, physical abuse and sexual abuse and lower BPD scores at lower levels of physical abuse and sexual abuse.

Conclusions

The finding suggests that the interaction between childhood maltreatment and OXTR gene variations is an important mechanism for the development of BPD. The moderating role of the OXTR gene provides evidence for gene plasticity.
Clinical, genetical and microbiological characterization of pediatric patients with Cystic Fibrosis in Ecuador
Authors: Lascano-Vaca Yazmina , Ortiz-Prado Esteban , Gomez-Barreno Lenin , Simbaña-Rivera Katherine , Vasconez Eduardo , Lister Alexander , Arteaga-Espinosa María Emilia , Perez Geovanny F
Published: August 2019

Summary

Objective

To characterize the epidemiology and the clinical, pathological, microbiological and genetical profile of children with cystic fibrosis treated in Ecuador.

Methods

We conducted a cross-sectional analysis of the pediatric population with a confirmed diagnosis of cystic fibrosis (CF) attending to one of the biggest III-level hospitals in Ecuador. All demographic, clinical and genetical variables were obtained from the electronic medical records (EMR) from 2017-2018.

Results

47 patients with CF were observed and followed for more than a year. Gender distribution was similar between male (48.9%, n = 23) and female patients (51.1%, n = 24). The Tiffeneau-Pinelli index (FEV1/FVC) changed significantly after 9 months post-diagnosis (85.55 ± 13.26; p <0.05). The most common pathogenic genetical mutation was F508del, found in 52.78% of the cohort (n = 19); H609R, found in 36.11% (n = 13) and the G85E and the N1303K with 11.11% respectively (n = 3). Finally, there were 14.1% (n = 7) of patients with a mutation g.204099A> C, which has only been reported among Ecuadorians.

Conclusions

This is the first study carried out in Ecuador exploring the clinical, genetical and bacteriological analysis of patients with CF. Children with CF are often colonized by four species of gram-positive bacteria (S. aureus, Coagulase-Negative Staphylococcus, Streptococcus pneumoniae and M. catarrhalis) were the most predominant this condition atients were hospitalized for complications related to cystic fibrosis, with an average of 19 days of stay.
The pattern of blood loss during correction surgery combined with three column osteotomy for adult spine deformity
Authors: Qiao Jun , Liu Zhen , Xu Leilei , Shi Benlong , Sun Xu , Qian Bangping , Zhu Zezhang , Qiu Yong
Published: August 2019

Background: It is of great importance to perform a precise management for blood loss according to stage of surgery. To analyze blood loss during different stages of three column osteotomy (3CO) surgery for scoliosis and to find predictors of blood loss during different stages and to evaluate effectiveness of some blood conservative technique modalities.

Methods: A retrospective review was performed for adult spine deformity (ASD) patients who underwent posterior-only correction along with 3CO. Surgical procedure was divided into four stages: Stage A, exposure; Stage B, screw placement; Stage C, osteotomy; Stage D, rod installment and wound closure. EBL was recorded at the end of each stage. Demographic and radiographic data were collected.

Results: Highest EBL was observed at neuromuscular scoliosis group, while least at idiopathic. 9 patients experienced massive blood loss (EBL>5000 ml). Multivariate linear regression identified fusion level main curve Cobb angle and use of TXA as influential factors for stage A; fusion level, use of TXA and use of navigation system for stage B; kyphosis and use of bone scalpel for stage C; fusion level and main curve Cobb angle for stage D (P<0.05).

Conclusion: Etiology significantly influences blood loss of scoliosis surgery with 3CO. Risk factors of blood loss were varied among different surgical stages. Use of TXA, navigation system and ultrasonic bone scalpel could reduce blood loss.
Clinical features of inflammatory bowel disease combined with severe complications: a retrospective study of hospitalized patients
Authors: Yang Shanbing , Li Lei , Du Shuwen , Zhang Limin , Fan Xin , Li Shu , Kang Zilin , Su Hui , Lu Xiaojuan , Tang Yufen , Tao Yurong , Jia Yan , Yang Xinyan , Jin Peng , Fan Ruying , Sheng Jianqiu , Han Ying , Li Shirong , Wang Jiheng
Published: August 2019

Background

The population characteristics of Inflammatory Bowel Disease (IBD) in China are different from those of western countries, and this population lacks large sample clinical data. This study aimed to analyze the clinical characteristics of inpatients with severe complications of IBD in our center. Methods In this study, medical records of 510 hospitalized IBD patients (excluding pediatrics) were included, digestive tract perforation, massive digestive tract hemorrhage, thrombosis, toxic megacolon, digestive tract fistula, digestive tract stenosis, severe malnutrition, severe infection, and carcinogenesis were defined as severe complications. The clinical process and follow-up were retrospectively analyzed. Results The incidence of severe complications in patients with IBD was 39.02%, 71.31%, 23.81% and 50.68% for CD, UC and IBDU, respectively, and the incidence of severe complications in CD was significantly higher than that in UC (P<0.005). The cumulative incidence of serious complications in IBD patients with the course of 0-10 years was 36.99%, which was significantly lower than 48.35% of the course of >10 years (χ2=4.054, P=0.044). The incidence of carcinogenesis in UC patients with the course of 0-10 years was 1.56%, which was significantly lower than 8.47% of UC patients with the course of >10 years (P<0.01). The incidence of severe complications of UC patients with onset age ≥50 years old was 37.18%, which was significantly higher than 19.00% of that with onset age 20-49 years (P=0.001). The surgical rate of IBD patients was 10.39%, the surgical rate of CD patients was 27.87%, which was significantly higher than 5.08% of UC patients and 4.11% of IBDU patients (P<0.001), and the mortality rate of IBD patients was 1.57%, that of CD and UC was 3.28% and 1.27%, respectively. Conclusions Compared with western countries, IBD patients in China have similar incidence of severe complications, but the surgical rate was lower and the prognosis was better. The onset age ≥50 years old may be an independent risk factor for severe complications of UC patients, and the disease course of > for 10 years is an independent risk factor for carcinogenesis of UC patients.
Working Well: Strategies to Strengthen the Workforce of the Indigenous Primary Healthcare Sector
Authors: Jongen Crystal , McCalman Janya , Campbell Sandy , Fagan Ruth
Published: August 2019

Background: The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce.

Methods: Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce.

Results: Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together. A range of enabling factors at the macro, community, organisational and individual levels were also identified.

Conclusion: Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts.
Integration of mental health care in private not-for-profit health centres in Guinea, West Africa: a systemic entry point towards the delivery of more patient-centred care?
Authors: Sow Abdoulaye , De Man Jeroen , De Spiegelaere Myriam , Vanlerberghe Veerle , Criel Bart
Published: August 2019

Abstract

Background

Patient-centred care is an essential component of quality of health care. We hypothesize that integration of a mental health care package into versatile first-line health care services can strengthen patient participation, an important dimension of patient-centred care. The objective of this study is to analyse whether consultations conducted by providers in facilities that integrated mental health care score higher in terms of patient participation.

Methods

This study was conducted in Guinea in 12 not-for-profit health centres, 4 of which had integrated a mental health care package (MH+) and 8 had not (MH-). The study involved 450 general curative consultations (175 in MH+ and 275 in MH- centres), conducted by 18 care providers (7 in MH+ and 11 in MH- centres). Patients were interviewed after the consultation on how they perceived their involvement in the consultation, using the Patient Participation Scale (PPS). The providers completed a self-administered questionnaire on their perception of patient’s involvement in the consultation. We compared scores of the PPS between MH+ and MH- facilities and between patients and providers.

Results

The mean PPS score was 24.21 and 22.54 in MH+ and MH- health centres, respectively. Participation scores depended on both care providers and the health centres they work in and ranged from 19.12 to 26.96 (p <0.001) for providers and from 20.49 to 26.96 (p <0.001) for the health centres. When adjusting for health providers and the duration of consultation, the patients consulting an MH+ centre were scoring higher on patient participation score than the ones of an MH- centre (adjusted odds ratio of 4.06 with a 95% CI of 1.17-14.10, p = 0.03). All care providers agreed they understood the patients' concerns, and patients shared this view. All patients agreed they wanted to be involved in the decision-making concerning their treatment; providers, however, were reluctant to do so.

Conclusion

Integrating a mental health care package into versatile first-line health services can promote more positive attitudes of care provider-patient interactions, even though this process by its own is not sufficient.
REASONS WHY PATIENTS BYPASS LOWER LEVEL PUBLIC FACILITIES: A CROSS SECTIONAL STUDY FROM UGANDA
Authors: OKORI SAMUEL , BESIGYE INNOCENT , NAMATOVU JANE FRANCIS
Published: August 2019

Background

The quality of services in Uganda at higher level health facilities are usually affected negatively by congestion when patients bypass care from their primary care health facilities (PCHF). The reason behind this bypass phenomenon in Uganda is limited. This study was conducted among patients receiving care at Lira Regional Referral Hospital in northern Uganda to identify reasons why patients bypass their PCHF.

Methods

We performed a descriptive cross-sectional study between 29/12/2014 & 30/1/2015, 484 respondents attending the outpatient department were recruited by systematic random sampling. Four focus group discussions (FGDs) each involving 10 participants were conducted. Quantitative data was collected using a validated questionnaire, entered, analysed by Epidata Entry 3.1 and SPSS 18 versions respectively. Descriptive statistics and chi square test for differences in the study population were used. For qualitative data, thematic analysis of transcripts was done. Codes and categories were developed and interrogated following an iterative process based on grounded theory.

Results

The majority (80.4%) of respondents (71.7% females, mean age 18-35 years, SD 0.85) bypassed their PCHF. Factors associated with bypass were: marital status, distance travelled of >10 km and tertiary education. FGDs reported lack of trust in the health care providers, lack of medicines and diagnostic equipment.

Conclusions

Poor quality of health services at PCHF encourages seeking care from higher-level facilities. Utilization of PCHF is limited due to poor infrastructure, shortage of medicines and human resource. Improvement of these issues will support PCHF which in turn can help reverse bypass phenomenon.
Changes in Practitioners’ Attitudes, Perceived Training Needs and Self-Efficacy over the Two-Year Implementation of an Evidence-Based Parenting Program
Authors: Côté Marie-Kim , Gagné Marie-Hélène
Published: August 2019

Background: Evidence-based family support programs such as the Triple P – Positive Parenting Program have the potential to enhance the well-being of children and families. However, they cannot achieve their expected outcomes if insufficient attention is paid to the implementation process. It has been demonstrated that practitioners’ attitudes towards evidence-based programs (EBPs), perceived training needs and self-efficacy for working with parents influence implementation outcomes (e.g., program acceptability, adoption, adherence and sustainability). At the same time, the experience of being involved in the implementation process of an EBP could enhance practitioners’ perceptions of the initiative. This study aimed to assess changes in practitioner’s attitudes, perceived training needs and self-efficacy over a two-year EBP implementation process, in interaction with their appraisal of their organization’s capacity to implement the EPB
Methods: In the province of Quebec, Canada, Triple P was implemented and evaluated in two communities. Ninety-nine practitioners from various organizations completed questionnaires shortly before their training in Triple P and two years later.
Results: Findings show that practitioners who displayed more initial skepticism regarding their organization’s capacity to implement the program reported greater improvements in attitudes over time, while practitioners who showed more optimism at baseline reported a greater decrease in their perceived training needs. Practitioners’ self-efficacy increased moderately regardless of perceived organizational capacity.
Conclusions: These results are encouraging given that more positive perceptions of EBPs could foster the systematic use of these programs in communities, for the potential benefit of a greater number of families.
Obesity, Diabetes and the Risk of Colorectal Adenoma and Cancer
Authors: Soltani Ghodratollah , Poursheikhani Arash , Yassi Maryam , Hayatbakhsh Abdorasool , Kerachian Matin , Kerachian Mohammad Amin
Published: August 2019

Background: Colorectal cancer (CRC) is the fourth most commonly diagnosed gastrointestinal (GI) malignancy and the third leading cause of cancer-related death worldwide. In the current case-control study, an association between diagnosis of CRC, obesity and diabetes was investigated.
Methods: Demographic characteristics, colonoscopy reports, history of drug, smoking, and medical history were collected from patients referred to a colonoscopy unit. The location, size and number of the polyps were recorded during the colonoscopy. Statistically, t-test was conducted for mean comparison for the groups. Pearson's chi-squared test (χ2) was applied to categorize variables. Five classification methods based on the important clinicopathological characteristics such as age, BMI, diabetes, family history of colon cancer was performed to predict the results of colonoscopy.
Results: Overall, 693 patients participated in this study. In the present study, 115 and 515 patients were evaluated for adenoma/adenocarcinoma and normal colonoscopy, respectively. The mean age of patients positive for adenoma or adenocarcinoma were significantly higher than the negative groups (p value <0.001). Incidence of overweight and/or obesity (BMI> 25 kg/m2) were significantly higher in adenoma positive patients as compared to controls (49.9% and 0.9% respectively, p value= 0.04). The results also demonstrated a significant association between suffering from diabetes and having colon adenoma (OR=1.831, 95%CI=1.058–3.169, p value=0.023). The experimental results of 5 classification methods on higher risk factors between colon adenoma and normal colonoscopy data were more than 82% and less than 0.42 for the percentage of classification accuracy and root mean squared error, respectively.
Conclusions: In the current study, the occurrence of obesity measured based on BMI and diabetes in the adenoma positive patient group was significantly higher than the control group although there was no notable association between obesity, diabetes and adenocarcinoma.
Nanopore native RNA sequencing of a human poly(A) transcriptome: RNA extraction, cDNA conversion and direct RNA and cDNA library preparation for Oxford Nanopore
Authors: Workman Rachael E. , Tang Alison D. , Tang Paul S. , Jain Miten , Tyson John R. , Razaghi Roham , Zuzarte Philip C. , Gilpatrick Timothy , Payne Alexander , Quick Joshua , Sadowski Norah , Holmes Nadine , Jesus Jaqueline Goes de , Jones Karen L. , Snutch Terrance P. , Loman Nicholas , Paten Benedict , Loose Matthew , Simpson Jared T. , Olsen Hugh E. , Brooks Angela N. , Akeson Mark , Timp Winston
Published: August 2019

High throughput cDNA sequencing technologies have dramatically advanced our understanding of transcriptome complexity and regulation. However, these methods lose information contained in biological RNA because the copied reads are often short and because modifications are not carried forward in cDNA. We address these limitations using a native poly(A) RNA sequencing strategy developed by Oxford Nanopore Technologies (ONT). Our study focused on poly(A) RNA from the human cell line GM12878, generating 9.9 million aligned sequence reads. These native RNA reads had an aligned N50 length of 1294 bases, and a maximum aligned length of over 21,000 bases. A total of 78,199 high-confidence isoforms were identified by combining long nanopore reads with short higher accuracy Illumina reads. We describe methods for extracting intact RNA, poly-A selection, cDNA conversion for a portion of sample, and library preparation for both direct RNA and cDNA libraries.
MR Imaging Features of Orbital Langerhans Cell Histiocytosis
Authors: wu chunnan , Mu xuetao , Hei yan , lan pengyu , li kuncheng
Published: August 2019

Background: To investigate the magnetic resonance imaging (MRI) features of orbital Langerhans cell histiocytosis (LCH) to improve diagnostic accuracy.
Methods: We retrospectively reviewed clinical manifestations and MRI findings of 23 patients with histopathology-confirmed LCH of the orbit. The findings were evaluated for the following: (a) symptoms, (b) disease duration，(c) location, (d) configuration, (e) margin, (f) MR imaging signal intensity and enhanced performance. Results: Eighteen patients (78%) in our series were male, only five (22%) patients were female, and the mean age at presentation was 6.3 years. The common symptoms include swollen eyelids, exophthalmos, and a palpable mass. Fourteen patients presented with swollen eyelids and/or exophthalmos. Twenty-two cases involved unilateral orbits, and one case involved bilateral orbits. In our study, there was one patient with cough and expectoration, and one patient with polydipsia and polyuria. Lesions were located in the superior or superlateral orbital roof of seventeen patients (74%). Lesions formed masses or irregular shapes. The 12 out of 23 (52.2%)cases appeared heterogeneous isointense and 10 out of 23 (43.5%) cases showed iso-hypointense on T1-weighted imaging, there were 15 out of 23 (65.2%) cases showed hyper-hypointense mixed signals on T2-weighted imaging. 7 cases found patchy hyperintense signal on T1WI, and 11 cases showed markedly hyperintense signal near the edge of lesions on T2WI. After enhancement, 21 out of 23 (91.3%) cases lesions presented marked enhancement at the edges and the surrounding tissues, and with heterogeneous obvious enhancement of the lesion center. Besides, four cases lesions were surrounded by a low circular signal. Conclusion: There were several characteristics MRI features that can provide crucial information for clinicians and improve our understanding and the diagnostic accuracy of the orbital LCH.
MSCs helped reduce scarring in the cornea after fungal infection when combined with anti-fungal treatment
Authors: Zhou Yue , Chen Yuqing , Wang Suiyue , Qin Fangyuan , liya Wang
Published: August 2019

Background

Fungal Keratitis (FK) is an infective keratopathy with extremely high blindness rate. The damaging effect of this disease is not only the destruction of corneal tissue during fungal infection, but also the cornea scar formed during the healing period after infection control, which can also seriously affect a patient's vision. The purpose of the study was to observe the effect of umbilical cord mesenchymal stem cells (uMSCs) on corneal scar formation in FK.

Methods

The FK mouse model was made according to a previously reported method. Natamycin eye drops were used for antifungal treatment 24 hours after modeling. There are four groups involved in the study, including control group, FK group, vehicleinj FK group and uMSCsinj FK group. Mice in uMSCsinj FK group received repeated subconjunctival injections of uMSCs for 3 times at the 1d, 4d and 7d after FK modeling. At 14d, 21d and 28d after trauma, clinical observation, histological examination, second harmonic generation and molecular assays were performed.

Results

The uMSCs topical administration reduced corneal scar formation area and corneal opacity, accompanying with decreased corneal thickness and inflammatory cell infiltration, following down-regulated fibrotic-related factors α-SMA, TGFβ1, CTGF, and COLI and finally inhibited phosphorylation of TGFβ1/Smad2 signaling pathway during FK corneal fibrosis.

Conclusion

The results confirmed that uMSCs can improve corneal opacity during the scar formation stage of FK, and exert anti-inflammatory and anti-fibrotic effects..
Ultrasound-guided quadratus lumborum block for postoperative pain control in patients undergoing unilateral inguinal hernia repair, a comparative study between two approaches
Authors: Fawzy Maher , Nasr Mohamed AR. , Ahmed Abeer , Waheb Mohsen M. , Hussam Ayman M. , Fouad Eman , Aboeldahb Hesham , Saad Dalia , Osman Safinaz , Fahmy Rania Samir , Farid Mohamed
Published: August 2019

Background: early postoperative ambulation and reduction of hospital stay necessitate efficient postoperative analgesia. Quadrates Lumborum Block (QLB) has been described to provide adequate postoperative analgesia after abdominal surgery. This randomized comparative trial was designed to compare the duration of analgesia provided by two different QLB approaches; the posterior QLB (QLB-2) and transmuscular QLB (QLB-3) in patients undergoing surgical repair of unilateral inguinal hernia.
Methods: Forty patients, aged from 18-50 years, ASA physical status I or II, scheduled for unilateral inguinal hernia repair were enrolled. At the end of the surgical procedure and before recovery from general anesthesia, Patients were randomly assigned into two groups to receive either posterior QLB (Group QLB-2) or transmuscular QLB (Group QLB-3) using 20 ml 0.25% bupivacaine. Duration of analgesia, postoperative VAS and postoperative opioid consumption were recorded.
Results: duration of block was significantly longer in QLB-3 group when compared to QLB-2 group (20.1 + 6.2 hours versus 12.0 + 4.8 respectively) with P value of < 0.001. A statistically significant lower VAS score was recorded in QLB-3 group immediately and 12 hrs postoperative. QLB-3 group showed a statistically significant delayed time of first analgesic request and less postoperative morphine consumption with P value of < 0.001 and 0.001 respectively.
Conclusions: Ultrasound guided postsurgical transmuscular approach of QLB (QLB-3) using 20 ml 0.25% bupivacaine produces more postoperative analgesic effect and less postoperative opioid consumption when compared to posterior QLB approach (QLB-2) in patients underwent unilateral inguinal hernia repair under general anesthesia.
Trial Registration: ClinicalTrials.gov identifier: NCT03526731- on 16 May 2018
Keywords: Quadratus lumborum block - Ultrasound-guided transmuscular quadratus lumborum blockade - ultrasound-guided lumbar plexus technique – ultrasound guided transversus abdominus plan block.
Load monitoring on Pilates training: a study protocol for a randomized clinical trial
Authors: Cavina Allysiê P. S. , Junior Eduardo Pizzo , Machado Aryane Flauzino , Biral Taise Mendes , Pastre Carlos Marcelo , Vanderlei Franciele Marques
Published: August 2019

Background: Currently there are campaigns to raise the awareness of the need to practice some physical exercise with several objectives, mainly as a preventive character. From this perspective, we can see the use of the Pilates method as an instrument of therapeutic exercise for the protection and promotion of health. However, despite being popularly performed, there is still no scientific evidence on the standardization of the use of the method and its progression to an adequate prescription of physical training. Therefore, the purpose of the study was to develop a protocol to monitor the progression of Pilates loads daily between the basic, intermediate and advanced levels, as well as to analyze the effect of the method on the psychometric, cardiorespiratory and autonomic parameters. Methods: there will be a total of 36 sessions of Pilates mat for 54 healthy men. In each training session, initially, cardiorespiratory parameters, pain through the Visual Analogue Scale (VAS), and a psychometric questionnaire will be collected for the volunteers. Heart rate (HR), subjective perception of effort (SPE), and RR intervals will be measured during the sessions for subsequent use to analyze the progression of the loads by monitoring the internal training load and heart rate variability (HRV), respectively. At the end of the sessions, cardiorespiratory parameters, the VAS, the psychometric questionnaire will be measured again and the participants will only be released after 15 minutes of rest for the final HR analysis and to re-respond to the PSE scale. Before and after the 36 sessions of training, participants will also be evaluated in relation to psychometric, cardiorespiratory, and autonomic parameters. Discussion: this study deserves to be highlighted as it is a parallel randomized clinical trial with standardization of training, with the purpose of monitoring the prescription of loads of the method, as well as verifying its efficacy in clinical, cardiorespiratory, and autonomic outcomes. The easy reproducibility of the protocol from its description, also improves the study, besides providing support for prescribing the method to the professionals involved.
The efficacy and safety of Shenzhu Guanxin Recipe Granules for treatment of patients with coronary artery disease: protocol for a double-blind, randomized controlled trial
Authors: jin xiao , Biqi Pan , Wu Huanlin , Wu Bingxin , Li Yukai , Wang Xia , Liu Guoqing , Dang Xiaojing , Xu Danping
Published: August 2019

Background

Coronary artery disease (CAD) is one of the most common types of the cardiovascular diseases, previous pilot trials suggested that Traditional Chinese Medicine brought clinical benefits for patients with CAD. We will conduct this trial to determine the efficacy and safety of Shenzhu Guanxin Recipe Granules for treatment of patients with coronary artery disease.

Patients and Methods

This randomized controlled trial recruited 194 patients who were diagnosed CAD by clinical manifestations and examinations, in which coronary computed tomography angiography (CCTA) showed 50-70% of stenosis, with soft or mixed plaque. The included participants were randomly assigned to the case group and control group with a 1:1 allocation ratio; patients in the case group received SGR and usual care, and those in the control group received placebo (6 g/day for 6 months) and usual care. The endpoint of the study included calcium coverage score (CCS), C-Reactive protein (CRP), and the levels of blood lipids, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), interleukin-6 (IL-6), and ATP-binding membrane cassette transporter A1 (ABCA1) were calculated before recruiting at6th month. The indicators were Seattle Angina Questionnaire (SAQ) and TCM syndrome questionnaire scores at 0th, 3rd, and 6th months.

Discussion

This clinical trial may provide a reliable evidence regarding the clinical effectiveness and safety of SGR therapy for patients with CAD by clinical manifestations and examinations, in which coronary computed tomography angiography (CCTA) showed 50-70% of stenosis, with soft or mixed plaque.
Comparative study between intrathecal dexmedetomidine and intrathecal magnesium sulfate in prevention of post spinal shivering in uroscopic surgery. (RCT)
Authors: Omar Heba , adel Wessam , Hassan Mohamed Mahmoud , Hassan Amany , Hassan Passaint , Elshall Ahmed , Khalid Dalia , Mostafa Maha , Zarif pierre , hossameldin Mona , Wedad Mai , abdelhamid Bassant Mohamed
Published: August 2019

Background: Hypothermia and shivering are associated common complications after spinal anesthesia especially in uroscopic procedures when large amounts of cold intraluminal irrigating fluids are used. Magnesium sulphate and dexmedetomidine are the most effective adjuvants with least side effects. Our aim of the study is to compare the effect of intrathecal dexmedetomidine versus intrathecal magnesium sulfate in prevention of post spinal shivering.
Methods: This prospective randomized, double-blinded controlled study was conducted at Kasr El-Aini Hospital on 105 patients scheduled for uroscopic surgeries. patients were randomly allocated into three groups using computerized generated random tables, Group C (n=35) received 2.5 ml hyperbaric bupivacaine 0.5% (12.5 mg) +0.5 ml normal saline, Group M (n=35) received 2.5 ml hyperbaric bupivacaine 0.5% (12.5 mg) +25 mg magnesium sulfate in 0.5 ml saline and Group D (n=35) received 2.5 ml hyperbaric bupivacaine 0.5% (12.5mg) + 5 μg dexmedetomidine in 0.5 ml saline. Primary outcomes were the incidence and intensity of shivering. Secondary outcomes were incidence of hypothermia (Temp < 36° C), sedation, the use of meperidine to control shivering and complications, bradycardia, nausea and vomiting.
Results: C group showed statistically significant higher number of total patients who developed shivering (21), patients who developed grade IV shivering (20) and patients who needed meperidine (21) to treat shivering than M group (8,5,5) and D group (5,3,6) which were comparable to each other.
Time needed to give meperidine after giving the block was similar in the three groups. Hypothermia didn’t occur in any patient in the three groups.
The three groups were comparable regarding occurrence of nausea, vomiting, bradycardia & hypotension. All patients of C group, 32 patients in M group and 33 patients in D group had sedation score of 2. 3 patients in M group and 2 patients in D group had a sedation score of 3.
Conclusions: intrathecal injection of dexmedetomidine and magnesium sulfate were both effective in reducing the incidence of post spinal shivering. So, we encourage the use of magnesium sulphate being more physiological, readily available in most operating theatres and much cheaper than dexmedetomidine.
Acupuncture for poststroke hemiplegia focusing on bilateral cerebral connections: study protocol for a randomized controlled trial
Authors: Jiang Lan , Geng Hualei , Lu Mengxin , Du Zhongming , Chen Pei , Han Xiao , Wang Yue , Tang Lixin , Tan Zhongjian , Zhang Hua , Zou Yihuai
Published: August 2019

Background:
Acupuncture is safe and effective for improving the motor function of poststroke hemiplegic patients, but there still exists a certain gap between clinical practice and its neural mechanisms. The cerebral functional reconstruction after unilateral motor pathway injury exhibits a bilateral tendency, however current studies seldom pay attention to it. Hence, based on bilateral cerebral connections, the underlying mechanism of acupuncture in stroke rehabilitation remains research space to date.
Methods: This is a single-center, randomized controlled, paralleled neuroimaging trial, with patients, outcome assessors, and data statisticians blinded. Stroke patients with motor dysfunction meeting the inclusion criteria will be randomly assigned (2:1) to receive either true acupoints treatment or sham acupoints treatment (5 sessions per week for 2 weeks). All the patients will receive conventional treatment and rehabilitation. Participants will undergo the neuroimaging scanning before and after the entire acupuncture treatment. The voxel-mirrored homotopic connectivity (VHMC) will be the primary outcome and the primary effect indicator. The secondary outcomes comprise clinical part and neuroimaging part, which included Fugl-Meyer assessments (FMA), the National Institutes of Health stroke scales (NIHSS), fractional anisotropy (FA) and gray matter volume (GMV). The Needle Sensation Assessment Scale (NSAS) is an additional outcome. The correlation analysis will be explored between the neuroimage indicators and clinical motor assessments.
Discussion:
From the perspective of bilateral connections, this trial will investigate the cerebral influence of acupuncture treatment on poststroke patients with motor dysfunction, promoting application of acupuncture in stroke rehabilitation.
Trial registration:
Chinese Clinical Trials Registry, ChiCTR 1800016263. Registered on 22 May, 2018.
Keywords: Acupuncture, Poststroke hemiplegia, Functional magnetic resonance imaging, Diffusion tensor imaging, Cerebral mechanism, Bilateral cerebral connections