bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Sclerosis in the Emirati Population: Onset Disease Characterization by MR Imaging
Authors: Ahmed Manzoor , Mir Ruqqiya , Shakra Mustafa , Al Fardan Safana
Published: November 2019

Background and Objectives. Multiple Sclerosis (MS) epidemiology is on the path of globalization mainly due to changing environmental factors. The prevalence of MS is on the rise in the Middle East and Persian Gulf region. Our observations has led us to hypothesize a heavy MRI lesion load at the onset of disease in a relatively younger native population. We aimed to estimate and characterize the onset disease on MRI using McDonald’s criteria while applying its terms of “Dissemination in Space (DIS) and Dissemination in Time (DIT)”. Materials and Methods. Retrospective review of onset MRI studies of 181 Emirati (native) individuals. Basic demographics were captured. Only 47 patients with Clinically Definite MS (CDMS) were included who had onset diagnostic MRI available. Lesion load was quantified using the specific zones of involvement designated for DIS: (1) Periventricular (PVZ) (I), (2) Juxta-cortical (II) (3) Infra-tentorial (III) and, (4) Spinal cord (IV). PVZ was sub-classified and lesions were quantified. A single enhancing lesion was required for DIT. Results. Average age of onset was about 26 years with female dominance of about 2 : 1. About 50% had all 4 zones and about 85% had at least 3 zones involved at the onset. Involvement of only 1 zone was rare. Dissemination in time (DIT) in brain and/or cord was present in approximately 50%. Each of the 4 zones were involved in at least 70% of cases. PVZ was not spared in any case with at least 3 lesions present in approx. 95% and ≥12 lesions in approx. half of the patients. Spinal cord specifically cervical cord was involved in up to 80% with typical patchy lesions. Conclusion. Onset disease characterization using MRI in a young Emirati cohort showed a heavy lesion load in the brain and spinal cord at the onset, signifying cumulative disease before presentation. Disseminated disease also facilitated early diagnosis of MS. The findings have significant potential ramifications for local environmental and cultural factors, as well as disease course and disability progression.
Knowledge, Attitudes, and Prevention Practices of Drug Resistant Tuberculosis in the Eastern Cape Province, South Africa
Authors: Fana Thanduxolo Elford , Ijeoma Edwin , Sotana Lizo
Published: November 2019

The aim of this study was to assess community members’ knowledge and awareness levels, attitudes, and practices of Drug Resistant Tuberculosis. A quantitative descriptive cross sectional study was carried out in the Eastern Cape Province of South Africa. The sample size consisted of four hundred (400) respondents aged 18 years and above on their last birthday who were purposively and conveniently selected from Port Elizabeth area in the Nelson Mandela Municipality. Data were collected using close-ended questions, which were administered by the researcher and two research assistants to the selected respondents. Data were analysed using descriptive statistics. The results of this study show poor knowledge and awareness levels, unfavourable attitudes, but good prevention practices of Drug Resistant Tuberculosis among Port Elizabeth community members. This study also found a statistically significant association between knowledge and attitudes (p value = <0.001), and no statistically significant association between knowledge and practices and attitude and practices, respectively (p values = 0.120 and 0.136). The study also revealed low literacy levels, inadequate information, misconceptions and erroneous beliefs about causes, transmission, prevention, treatment, and management of Drug Resistant Tuberculosis among the respondents. This study also highlighted the use and existence of dual healthcare system (traditional spiritual and western).The study found that the main source of Drug Resistant TB information was radio and television among the majority of research respondents. It is recommended that in future health education interventions and awareness campaigns need to be intensified in the area so that misconceptions and erroneous beliefs that exist in society can be addressed. It is also recommended that training programs that are culturally sensitive should be developed and delivered taking into account different languages and literacy levels that exist in society. Such education interventions should be facilitated in collaboration with people living with Drug Resistant Tuberculosis. A multidisciplinary approach should be fostered and collaborations with spiritual healers and various congregational leaders, traditional health practitioners, community leaders, and government leaders in the health sector should be promoted in order to deal with Drug Resistant Tuberculosis. It is also recommended that a similar study be conducted using a qualitative research approach in urban and rural areas of the Eastern Cape. Lastly, assessment of knowledge, attitudes, and practices of spiritual and traditional healers with regard to Drug Resistant Tuberculosis should be conducted as they can influence health-seeking behaviour.
Localized Metabolomic Gradients in Patient-Derived Xenograft Models of Glioblastoma
Authors: Randall Elizabeth C. , Lopez Begoña G.C. , Peng Sen , Regan Michael S. , Abdelmoula Walid M. , Basu Sankha S. , Santagata Sandro , Yoon Haejin , Haigis Marcia C. , Agar Jeffrey N. , Tran Nhan L. , Elmquist William F. , White Forest M. , Sarkaria Jann N. , Agar Nathalie Y.R.
Published: November 2019

Glioblastoma (GBM) is increasingly recognized as a disease involving dysfunctional cellular metabolism. GBMs are known to be complex heterogeneous systems containing multiple distinct cell populations and are supported by an aberrant network of blood vessels. A better understanding of GBM metabolism, its variation with respect to the tumor microenvironment, and resulting regional changes in chemical composition is required. This may shed light on the observed heterogeneous drug distribution, which cannot be fully described by limited or uneven disruption of the blood–brain barrier. In this work, we used mass spectrometry imaging (MSI) to map metabolites and lipids in patient-derived xenograft models of GBM. A data analysis workflow revealed that distinctive spectral signatures were detected from different regions of the intracranial tumor model. A series of long-chain acylcarnitines were identified and detected with increased intensity at the tumor edge. A 3D MSI dataset demonstrated that these molecules were observed throughout the entire tumor/normal interface and were not confined to a single plane. mRNA sequencing demonstrated that hallmark genes related to fatty acid metabolism were highly expressed in samples with higher acylcarnitine content. These data suggest that cells in the core and the edge of the tumor undergo different fatty acid metabolism, resulting in different chemical environments within the tumor. This may influence drug distribution through changes in tissue drug affinity or transport and constitute an important consideration for therapeutic strategies in the treatment of GBM.

Significance:

GBM tumors exhibit a metabolic gradient that should be taken into consideration when designing therapeutic strategies for treatment.

See related commentary by Tan and Weljie, p. 1231
Intake or Blood Levels of n-3 Polyunsaturated Fatty Acids and Risk of Colorectal Cancer: A Systematic Review and Meta-analysis of Prospective Studies
Authors: Kim Youngyo , Kim Jeongseon
Published: November 2019

Background:

Previous results of the association between n-3 polyunsaturated fatty acids (PUFA) and colorectal cancer were inconsistent. We conducted a systematic review and meta-analysis of prospective studies.

Methods:

The PubMed and Embase databases were searched through July 10, 2019, followed by a manual search. A random-effects model was used.

Results:

Twenty prospective studies, including 18,102 cases and 1,360,046 participants, were included. The pooled RR of colorectal cancer for the highest versus lowest category of n-3 PUFA intake was 0.97 [95% confidence interval (CI), 0.90–1.04]. Regarding the type of n-3 PUFA, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intakes were inversely associated with 11% (RR = 0.89; 95% CI, 0.80–0.99) and 12% (RR = 0.88; 95% CI, 0.81–0.96) lower colorectal cancer risks, respectively, in the comparison of the highest versus lowest category. Increments of 0.1 g/day of EPA (RR = 0.95; 95% CI, 0.92–0.98) and DHA (RR = 0.97; 95% CI, 0.95–0.99) intakes were associated with a lower colorectal cancer risk. Regarding the blood levels of n-3 PUFAs, the pooled RR of colorectal cancer for the highest versus lowest category of blood levels of n-3 PUFAs was 0.79 (95% CI, 0.64–0.98). The risk of colorectal cancer decreased by 4% for every 1% increase in blood n-3 PUFA levels (RR = 0.96; 95% CI, 0.92–1.00).

Conclusions:

High blood n-3 PUFA levels are inversely associated with colorectal cancer risk, and high n-3 PUFA intake is suggestively associated with lower colorectal cancer risk.

Impact:

Our findings suggest that high blood n-3 PUFA levels may be associated with reduced colorectal cancer risk, but further studies are needed.
Evaluation of the Relationship of Dimensions of Maxillary Sinus Drainage System with Anatomical Variations and Sinusopathy: Cone-Beam Computed Tomography Findings
Authors: Akay Gülsün , Yaman Deniz , Karadağ Özge , Güngör Kahraman
Published: November 2019

Objective: The aim of this study was to evaluate the correlation between the length of the infundibulum and ostium height with the anatomic variations of osteomeatal complex (OMC) and sinus pathology using cone-beam computed tomography (CBCT). Methods: CBCT images of 204 patients (408 maxillary sinuses) were evaluated retrospectively. The height of the ostium and the length of the infundibulum were measured. The presence of maxillary sinus pathology, nasal septal deviation, Haller cells, concha bullosa, and sinus septa were analyzed. The correlation between the size of the maxillary sinus drainage system and anatomic variations was compared using the t test, Fisher’s exact test, and χ2 test. The effect of tooth loss on the length of the infundibulum and ostium height was also analyzed using ANOVA. Results: The height of the ostium and the maximal septal deviation angle were found to be significantly greater in males (p < 0.05). As ostium height increased, the presence of maxillary sinus septa increased (p < 0.05). No statistically significant association was detected between other variations and the length of infundibulum or ostium height. The relationship between tooth loss and both the length of the infundibulum and ostium height were found to be insignificant (p > 0.05). Conclusions: Radiographic examination, especially on CBCT images, is important for an evaluation of maxillary sinuses. here, we demonstrated a significant relationship between ostium height and the presence of maxillary sinus septa. However, it was found that nasal septal deviation, concha bullosa, Haller cells, and other sinusopathies did not have a major effect on the size of the maxillary sinus drainage system.
ВИВЧЕННЯ ФАКТОРІВ, ЯКІ ВПЛИВАЮТЬ НА ЗРОСТАННЯ РІВНЯ КЕСАРЕВОГО РОЗТИНУ, ЗА ПЕРІОД 2017–2018 рр.
Authors: Moskviak-Lesniak D. Ye. , Krasivska A. V. , Zhygaliak I. T.
Published: November 2019

Мета: дослідити та проаналізувати фактори, які впливають на збільшення частоти проведення кесаревого розтину, в пологових будинках м. Львова (2017–2018 рр.).

Матеріали і методи. Об’єктами дослідження були породіллі та лікарі акушер-гінекологи пологових будинків міста Львова: Комунального некомерційного підприємства «Пологовий клінічний будинок № 1 м. Львова», Пологового відділення комунального некомерційного підприємства «3-тя міська клінічна лікарня м. Львова», Комунального закладу Львівського обласного перинатального центру.

Проведено одномоментне, когортне дослідження з використанням методів: анонімного індивідуального анкетування; ретроспективного аналізу статистичного звіту структури показань до кесаревого розтину в Комунальному некомерційному підприємстві «Пологовий клінічний будинок № 1 м. Львова» у 2018 (1180 операцій) та 2017 рр. (1006 операцій); статистичного; аналітичного. Виконано розрахунок середніх (М±SE) та відносних показників.

Результати. У 2018 р. метод розродження шляхом кесаревого розтину був обраний у 25,7 % від загальної кількості пологів, що зросло в 1,2 раза порівняно з 2017 р. – 20,8 %. Серед опитаних жінок близько 86 % породіль, які повторно народжували, з яких 10 % – з багатоплідною вагітністю. Проаналізувавши частку фізіологічних пологів при першій вагітності – 52 %, повторній вагітності – 34 % та кесаревого розтину – 48 і 66 % відповідно в опитаних породіль, отримали, що кількість повторних пологів шляхом кесаревого розтину (КР) зросла у 1,26 раза. Встановлено, що на збільшення частоти загальної кількості розроджень шляхом кесаревого розтину впливає наявність медичних показань (90,58 %), зокрема: рубець на матці після операції кесаревого розтину – 27,12 %, дистрес плода – 14,16 %, тазове та ніжне передлежання – 9,7 %; збільшення кількості повторних пологів після попереднього КР; зростання частоти хронічних захворювань в анамнезі: варикозне розширення вен нижніх кінцівок, зниження гостроти зору, артеріальна гіпертензія, цукровий діабет; психологічний фактор (емоційне напруження з боку родичів і породіллі; страх спровокований громадою, страх болю, страх перед пологами); бажання жінки (після попередньої операції кесаревого розтину).

Висновки. На збільшення частоти загальної кількості розроджень шляхом КР у пологових будинках м. Львова впливають: медичні показання; збільшення кількості повторних пологів, після попереднього КР; зростання частоти хронічних захворювань в анамнезі; психологічний фактор; бажання жінки.
МЕДИКО-ДЕМОГРАФІЧНА СИТУАЦІЯ ЯК ГЛОБАЛЬНА ПРОБЛЕМА ГРОМАДСЬКОГО ЗДОРОВ’Я УКРАЇНИ
Authors: Slabkiy G. O. , Mironyuk I. S. , Koshelia I. I. , Dudnyk S. V.
Published: November 2019

Мета: визначити основні медико-демографічні проблеми України, які підлягають рішенню в межах діяльності системи громадського здоров’я країни.

Матеріали і методи. Матеріалами дослідження слугували дані державної і галузевої статистичної звітності та оперативні дані Центру громадського здоров’я МОЗ України з питань медико-демографічної ситуації в країні. Використано статистичний метод та метод структурно-логічного аналізу.

Результати. Демографічна ситуація в Україні характеризується зниженням рівня народжуваності за період 2014–2019 рр. на 19,4 % з перевищенням показника смертності населення на 6,16 на 100 тис. населення. При цьому частка випадків смерті чоловіків працездатного віку в загальній кількості смертей складає 20,3 %. Частка сільського населення має тенденцію до скорочення і становить 30,99 % в його загальній кількості. Відзначають високі рівні зареєстрованих випадків поширеності хвороб як серед всього, так і серед дитячого населення. Спостерігають тенденцію до зниження вказаних показників, що є чинником зменшення звертань населення до закладів охорони здоров’я. Встановлено різке погіршення епідемічної ситуації в країні та високі рівні саморуйнівної поведінки населення. При цьому більшість населення безвідповідально ставиться до власного здоров’я.

Висновки. В Україні реєструють складну медико-демографічну ситуацію, яка потребує від системи громадського здоров’я комплексних, цілеспрямованих та ефективних дій, спрямованих на зниження рівня смертності дітей та осіб працездатного віку, профілактику, раннє виявлення та ефективне лікування неінфекційних хвороб, подолання епідемій вакцинокерованих інфекцій, забезпечення доступу населення до здоров’язберігальних технологій та формування у населення відповідального ставлення до власного здоров’я.
ІНВЕСТУВАННЯ В УНІВЕРСИТЕТСЬКІ КЛІНІКИ НА ОСНОВІ МЕХАНІЗМУ ДЕРЖАВНО-ПРИВАТНОГО ПАРТНЕРСТВА
Authors: Chopchik V. D.
Published: November 2019

Мета: розглянути можливість інвестування в університетські клініки на основі використання механізму державно-приватного партнерства (ДПП).

Матеріали і методи. Для досягнення поставленої мети у роботі використано загальнонаукові методи аналізу, синтезу, узагальнення, інтерпретації наукових даних, а також системний і структурно-функціональний підходи. Інформаційною базою дослідження є наукові праці вітчизняних і зарубіжних спеціалістів із державно-приватного партнерства та менеджменту.

Результати. Обмеження фінансових ресурсів в охороні здоров’я зумовило потребу інвестувань в університетські клініки та необхідність пошуку нових, ефективних форм реалізації інвестиційної діяльності.

У статті розглянуто можливість інвестування в університетські клініки на основі використання механізму держав­но-приватного партнерства. При переході університетської клініки на роботу на принципах державно-приватного партнерства змінюється статус клініки, вона стає юридично і господарсько самостійним закладом, у якому управління переходить до приватного інвестора, але сама клініка залишається у державній власності. Інвестування реалізується на основі договору і програм із визначенням прав та обов’язків партнерів. Запропоновано алгоритм реалізації проекту державно-приватного партнерства, який забезпечує інвестування і формування сучасних клінічних баз університетів, розвиває бізнес-процеси, що залучають ресурси приватного інвестора і підвищують ефективність роботи університетської клініки.

Висновки. У статті визначені вектори інвестування в університетські клініки через механізми державно-приватного партнерства, а також основні умови реалізації ДПП в університетських клініках.
7. Theme
Authors: Ribó Ignasi
Published: November 2019

In this final chapter, we will first examine in some detail the concept of theme and will try to locate its expression in prose fiction. Then we will discuss how narratives often explore themes relating to identity and alterity, particularly in connection with gender and ethnicity. An important notion in the analysis of meaning in narrative is ideology, which encompasses the ideas, values, and beliefs that structure a worldview. As we will see, every narrative is ideological, but ideology can be expressed in different ways in each text. This will lead us to some final considerations regarding the moral and political significance of prose fiction, particularly in the modern world. We will see that some narratives attempt to persuade readers of a moral truth, while others provide a more ambiguous or complex representation of human morality. The function of short stories and novels, as well as other literary texts, has often been the object of passionate discussions. As a conclusion to this textbook, we will consider whether writers should use prose fiction to intervene in society or confine themselves to purely artistic pursuits.
Identifying Alzheimer’s disease-related proteins by LRRGD
Authors: Zhao Tianyi , Hu Yang , Zang Tianyi , Cheng Liang
Published: November 2019

Background

Alzheimer’s disease (AD) imposes a heavy burden on society and every family. Therefore, diagnosing AD in advance and discovering new drug targets are crucial, while these could be achieved by identifying AD-related proteins. The time-consuming and money-costing biological experiment makes researchers turn to develop more advanced algorithms to identify AD-related proteins.

Results

Firstly, we proposed a hypothesis “similar diseases share similar related proteins”. Therefore, five similarity calculation methods are introduced to find out others diseases which are similar to AD. Then, these diseases’ related proteins could be obtained by public data set. Finally, these proteins are features of each disease and could be used to map their similarity to AD. We developed a novel method ‘LRRGD’ which combines Logistic Regression (LR) and Gradient Descent (GD) and borrows the idea of Random Forest (RF). LR is introduced to regress features to similarities. Borrowing the idea of RF, hundreds of LR models have been built by randomly selecting 40 features (proteins) each time. Here, GD is introduced to find out the optimal result. To avoid the drawback of local optimal solution, a good initial value is selected by some known AD-related proteins. Finally, 376 proteins are found to be related to AD.

Conclusion

Three hundred eight of three hundred seventy-six proteins are the novel proteins. Three case studies are done to prove our method’s effectiveness. These 308 proteins could give researchers a basis to do biological experiments to help treatment and diagnostic AD.
A novel algorithm based on bi-random walks to identify disease-related lncRNAs
Authors: Hu Jialu , Gao Yiqun , Li Jing , Zheng Yan , Wang Jingru , Shang Xuequn
Published: November 2019

Backgrounds

There is evidence to suggest that lncRNAs are associated with distinct and diverse biological processes. The dysfunction or mutation of lncRNAs are implicated in a wide range of diseases. An accurate computational model can benefit the diagnosis of diseases and help us to gain a better understanding of the molecular mechanism. Although many related algorithms have been proposed, there is still much room to improve the accuracy of the algorithm.

Results

We developed a novel algorithm, BiWalkLDA, to predict disease-related lncRNAs in three real datasets, which have 528 lncRNAs, 545 diseases and 1216 interactions in total. To compare performance with other algorithms, the leave-one-out validation test was performed for BiWalkLDA and three other existing algorithms, SIMCLDA, LDAP and LRLSLDA. Additional tests were carefully designed to analyze the parameter effects such asα,β,landr, which could help user to select the best choice of these parameters in their own application. In a case study of prostate cancer, eight out of the top-ten disease-related lncRNAs reported by BiWalkLDA were previously confirmed in literatures.

Conclusions

In this paper, we develop an algorithm, BiWalkLDA, to predict lncRNA-disease association by using bi-random walks. It constructs a lncRNA-disease network by integrating interaction profile and gene ontology information. Solving cold-start problem by using neighbors’ interaction profile information. Then, bi-random walks was applied to three real biological datasets. Results show that our method outperforms other algorithms in predicting lncRNA-disease association in terms of both accuracy and specificity.

Availability

https://github.com/screamer/BiwalkLDA
Associations of serum low-density lipoprotein and systolic blood pressure levels with type 2 diabetic patients with and without peripheral neuropathy: systemic review, meta-analysis and meta-regression analysis of observational studies
Authors: Naqvi Syed Shah Zaman Haider , Imani Saber , Hosseinifard Hossein , Wen Qing-Lian , Shahzad M. Naveed , Ijaz Iqra , Deng Youcai , Guo Man , Xu Yong
Published: November 2019

Background

Compositional abnormalities in lipoproteins and cardiovascular risk factors play an important role in the progression of diabetic peripheral neuropathy (DPN). This systematic review aimed to estimate the predicting value of low-density lipoprotein (LDL) and systolic blood pressure (SBP) level in type-2 diabetes mellitus (T2DM) patients with and without peripheral neuropathy. We also tried to determine whether LDL and SBP are associated with an increased collision risk of DPN.

Methods

A systematic search was conducted for eligible publications which explored the LDL and SBP level in T2DM patients with and without peripheral neuropathy. The quality of the included studies was assessed by the QUADAS-2 tool. The standardized mean difference (SMD) with 95% CI of LDL and SBP level were pooled to assess the correlation between LDL and SBP level with DPN. We performed random effects meta-regression analyses to investigate factors associated with an increased collision risk of DPN.

Results

There was a significant association between LDL and SBP with poor prognosis of DPN in those included studies (I2 = 88.1% and I2 = 84.9%, respectively, BothP < 0.001). European T2DM patients have higher serum level of LDL in compare with the European DPN patients (SMD = 0.16, 95% CI: − 0.06 - 0.38;P < 0.001). SBP level was associated with a 2.6-fold decrease in non-DPN patients of T2DM (SMD = − 2.63, 95% CI: − 4.00 - -1.27,P < 0.001). Old age European T2DM patients have significantly high risk for diabetes drivers. Furthermore, the results of the case-control study design model are more precise to show the accuracy of SBP in Asian T2DM patients.

Conclusion

Our finding supports the LDL and SBP status could be associated with increased risk of peripheral neuropathy in T2DM patients.
Determinants of linear growth faltering among children with moderate-to-severe diarrhea in the Global Enteric Multicenter Study
Authors: Brander Rebecca L. , Pavlinac Patricia B. , Walson Judd L. , John-Stewart Grace C. , Weaver Marcia R. , Faruque Abu S. G. , Zaidi Anita K. M. , Sur Dipika , Sow Samba O. , Hossain M. Jahangir , Alonso Pedro L. , Breiman Robert F. , Nasrin Dilruba , Nataro James P. , Levine Myron M. , Kotloff Karen L.
Published: November 2019

Background

Moderate-to-severe diarrhea (MSD) in the first 2 years of life can impair linear growth. We sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of MSD.

Methods

Using data from the Global Enteric Multicenter Study of children 0–23 months old presenting with MSD in Africa and Asia, we performed log-binomial regression to determine clinical and sociodemographic factors associated with severe linear growth faltering (loss of ≥ 0.5 length-for-agez-score [LAZ]). Linear regression was used to estimate associations with ΔLAZ. A clinical prediction tool was developed using backward elimination of potential variables, and Akaike Information Criterion to select the best fit model.

Results

Of the 5902 included children, mean age was 10 months and 43.2% were female. Over the 50–90-day follow-up period, 24.2% of children had severe linear growth faltering and the mean ΔLAZ over follow-up was − 0.17 (standard deviation [SD] 0.54). After adjustment for age, baseline LAZ, and site, several factors were associated with decline in LAZ: young age, acute malnutrition, hospitalization at presentation, non-dysenteric diarrhea, unimproved sanitation, lower wealth, fever, co-morbidity, or an IMCI danger sign. Compared to children 12–23 months old, those 0–6 months were more likely to experience severe linear growth faltering (adjusted prevalence ratio [aPR] 1.97 [95% CI 1.70, 2.28]), as were children 6–12 months of age (aPR 1.72 [95% CI 1.51, 1.95]). A prediction model that included age, wasting, stunting, presentation with fever, and presentation with an IMCI danger sign had an area under the ROC (AUC) of 0.67 (95% CI 0.64, 0.69). Risk scores ranged from 0 to 37, and a cut-off of 21 maximized sensitivity (60.7%) and specificity (63.5%).

Conclusion

Younger age, acute malnutrition, MSD severity, and sociodemographic factors were associated with short-term linear growth deterioration following MSD. Data routinely obtained at MSD may be useful to predict children at risk for growth deterioration who would benefit from interventions.
Anopheles cinereus implicated as a vector of malaria transmission in the highlands of north-west Ethiopia
Authors: Lemma Wossenseged , Alemu Kassahune , Birhanie Meserete , Worku Ligabaw , Niedbalski Julie , McDowell Mary Ann , Lobo Neil F.
Published: November 2019

Background

Transmission of malaria in the highlands of Ethiopia is poorly understood and usually attributed to importation by mobile populations or local transmission by Anopheles arabiensis. To characterize and identify Anopheles species present in a highland area of northern Ethiopia, adult and larval collections were performed in Gondar town and the neighboring Senbet Debir village (Dembia district, > 2000 meters above sea level, masl), in addition to Bahir Dar town (capital of Amhara region) and Kumer Aftit village (Metema district, < 2000 masl).

Methods

CDC-light traps were used to collect adult mosquitoes and larval collections were performed from rain pools for rearing into adults for species identification. Collections were made September-March 2016–2018. Adult mosquitoes were identified morphologically and a subset of randomly chosen specimens were identified to species by sequencing the ribosomal DNA internal transcribed spacer region 2 (ITS2) and mitochondrial DNA cytochrome c oxidase subunit 1 (cox1).

Results

The primary species of Anopheles identified at elevations higher than 2000 masl was An. cinereus, which was confirmed molecularly by ITS2 and cox1 sequencing. Interestingly, two unknown species were also sequenced, in addition to two specimens of An. pretoriensis. The species collected at sites with elevations less than 2000 masl (Bahir Dar town and Kumer Aftit village) was An. arabiensis. Three Plasmodium falciparum-positive specimens were identified molecularly as An. cinereus.

Conclusions

The presence of Plasmodium-positive An. cinereus in areas greater than 2000 masl incriminates this species as a potential vector contributing to non-peak malaria transmission in Ethiopian highland areas.
Potential of Pseudomonas putida, Bacillus subtilis, and their mixture on the management of Meloidogyne incognita, Pectobacterium betavasculorum, and Rhizoctonia solani disease complex of beetroot (Beta vulgaris L.)
Authors: Khan Manzoor R. , Siddiqui Zaki A.
Published: November 2019

Effects of Pseudomonas putida and Bacillus subtilis alone, and in combinations for the management of Meloidogyne incognita, Pectobacterium betavasculorum, and Rhizoctonia solani disease complex of beetroot (Beta vulgaris L.), were studied. Application of P. putida or B. subtilis to plants with M. incognita or P. betavasculorum or R. solani singly or in combinations caused a significant increase in plant growth parameters and the activities of defense enzymes. A significant increase in chlorophyll fluorescence attributes, viz., Fv/Fm, ɸPSII, qP, NPQ, and ETR were recorded in plants treated with P. putida or B. subtilis over pathogen-inoculated plants. Inoculation of P. putida results in a higher reduction in galling and nematode multiplication than B. subtilis. Maximum reduction in nematode multiplication and galling occurred when a mixture of P. putida and B. subtilis was used. Soft rot and root rot indices were 3 when Pectobacterium betavasculorum and Rhizoctonia solani were inoculated alone. The disease indices were rated 5 when these pathogens and M. incognita were inoculated in combinations. Inoculation of P. putida/B. subtilis with P. betavasculorum or R. solani reduced soft rot and root rot indices to 2 out of 3, while the use of P. putida + B. subtilis reduced indices to 1. Disease indices were reduced to 2–3 out of 5, when P. putida + B. subtilis were used to plants inoculated with two or three pathogens. The principal component analysis showed significant correlations among the various studied attributes. Two principal components explained a total of 86.1 and 93.4% of the overall data variability. Therefore, the use of P. putida together with B. subtilis had the potential for successful management of disease complex of beetroot.
Effect of certain organic amendments and Trichoderma species on the root-knot nematode, Meloidogyne incognita, infecting pea (Pisum sativum L.) plants
Authors: El-Nagdi Wafaa M. A. , Youssef Mahmoud M. A. , El-Khair Hassan Abd , Abd-Elgawad Mahfouz M. M.
Published: November 2019

This study was conducted to evaluate the effects of three fungal species, Trichoderma harzianum (Th), T. viride (Tv), and T. vierns (Tvi), and ground seeds of fennel (Foeniculum vierns) and caraway (Carum carvi), and powdered leaves of basil (Ocimum basilicum) as soil amendments against the root-knot nematode, Meloidogyne incognita on pea root, Pisum sativum under screen house conditions. The treatments were compared to a nematicide, carbofuran 10G, and untreated check. The tested materials significantly (P ≤ 0.05) reduced M. incognita on pea as indicated by the numbers of galls, egg masses, and J2 per root system in pots, either as single or combined treatments. The combined treatments caused higher average total percentages of nematode reduction than those achieved by single ones. The single treatments recorded the averages total percentages of nematode reduction ranged from 72.4 to 82.0%. Basil waste as single was superior in reducing nematode numbers of J2 and egg masses in root system per plant, as it achieved the highest average total percentages of nematode reduction (77.9%) than 73. 9 and 72.4% caused by fennel and caraway, respectively. In combined treatments, the average total percentages of nematode reduction ranged from 72.4 to 86.4%. Basil + (Th) caused the highest reduction (86.4%), followed by caraway+Tvi (86.3%) and caraway+Th (86.2%). The nematicide, carbofuran was as effective as most as the treatments in reducing nematode parameters. Also, the treatments highly increased growth and yield criteria of pea infected with M. incognita as indicated by shoot length and fresh and dry weights and root fresh weight, number and fresh and dry weights of pods.
Understanding barriers to oral medication adherence in adults with acute myeloid leukemia (AML).
Authors: Bryant Ashley Leak , Chan Ya-Ning , Richardson Jaime , Foster Matthew Charles , Wujcik Debra
Published: November 2019

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Background: AML is a disease of older adults (median age 67 years). Although standard AML treatment is intravenous (IV) chemotherapy, availability of oral anti-cancer medications has increased , providing benefits and risks to patients. Patients prefer their convenience, absence of IV infusions, potential for fewer clinic visits, and increased subjective feeling of control over their disease. Poor adherence can increase toxicity risk and compromise treatment effectiveness. We aim to identify barriers to adherence to oral medications in patients with AML and proposed solutions for improvements. Methods: Following IRB approval, patients with AML and their caregivers were recruited to participate in focus groups. An experienced moderator conducted the groups using an interview guide developed by AML experts. Participants received gift cards for their participation. Sessions were digitally recorded, transcribed verbatim, and analyzed for thematic content using Dedoose qualitative software. Results: 11 patients (5 <65 years; 6 >65 years) and 4 caregivers participated in sessions lasting 60-75 minutes. Three central themes emerged: medication adherence challenges, managing an oral adherence plan, and strategies to improve oral adherence. Adherence challenges: number and size of pills, different directions, cost, availability, and side effects. An adherence plan was recommended: written schedules, take medications around meals, and use of pillboxes and alarms. Main sources of information: health care team and bottle directions. Recommendations for providing adherence assistance included better instructions, assistance with scheduling, making pills smaller, and consistency in packaging. Conclusions: Patients are an important source of insight into barriers and solutions to oral medication adherence. These responses were used to develop a survey to be administered to 100 patients with AML. Results will inform development of an intervention to improve oral medication adherence in the AML population.
Two-year review of the electronic Patient Reported Outcome (ePRO) system in the Prostate Clinic at the Vancouver Prostate Centre (VPC).
Authors: Wu Eugenia , Arsovska Olga , Hedden Lindsay , Spillane Maria , Vivar Michaela , Gleave Martin , Black Peter C. , So Alan , Goldenberg Larry , Higano Celestia S.
Published: November 2019

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Background: The Vancouver Prostate Centre (VPC) implemented an electronic patient reported outcomes (ePRO) system in April 2017 to collect data on a research protocol in collaboration with University Health Network of Toronto, funded by Prostate Cancer Canada. Responses to ePRO questionnaires collected on iPads were entered into the national PC360 registry initially and a global TrueNorth registry thereafter funded by Movember Foundation. Herein we describe our experience implementing the ePRO system over the last two years. Methods: All patients (pts) with a new diagnosis of localized prostate cancer, either before or just after therapy, were identified using the electronic medical record and were consented in person in clinic. After signing consent, pts were asked to complete ePROs, including EPIC-26, EQ-5D-5L, WHODAS 2.0, and Distress Thermometer, on iPads at designated clinic appointment. Results: Between April 3, 2017-March 31, 2019, 1027 pts were identified as being eligible to complete ePRO: 878 pts (85.5%) consented and completed ePRO at least once. In Year 1 (Apr 2017-Mar 2018), 76.7% of the 1075 planned ePRO questionnaires were completed vs 75% completed of 1258 planned in year 2. Most pts (82.3%,723/878) agreed to be contacted for future research. Of those, 424/723 were recruited to at least one additional registry study. Data for consented pts was missing for 155/878 (17.7%) each year, usually due to difficulty locating the pt to give him the iPad before he left the clinic. In a small percentage of cases, ePRO reports were incomplete due to fluctuating WiFi connectivity, inadequate time to complete the questions before the clinic appointment, refusal, or no show. Conclusions: ePROs for research were successfully implemented into clinical practice in the PCSC program as evidenced by high completion and low refusal rates but required significant manpower due to ethics board requirements. Challenges encountered included: training clinic staff and coordinators to direct pts to the iPad system to minimize missing ePRO assessments, technical difficulties with WiFi connectivity, requirement of ethics board mandating that staff interact with each pt individually to ensure the ePRO assessments are completed. The next step is to incorporate ePROs into clinical practice, in which case consent will not be required.
Whole-brain radiation practice pattern at a tertiary hospital with high-volume radiosurgery practice.
Authors: Boreta Lauren , Yee Emily , Wu Susan Y. , Braunstein Steve E.
Published: November 2019

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Background: Whole brain radiation (WBRT) is standard therapy used for palliation of brain metastases (BM). SRS is also used as primary treatment in patients with multiple BM, with WBRT reserved for salvage. We sought to describe WBRT practice patterns at a tertiary cancer center with a high-volume radiosurgical practice, and hypothesized that patients treated with WBRT at our institution had limited survival. Methods: Retrospective chart review was performed for patients treated with WBRT for BM from January 2013-Jan 2019. Patients with complete records were included in the analysis. Mann-Whitney U and chi-squared tests were for comparison of clinical factors. Results: Data for 100 patients receiving WBRT were available for analysis. Patients had NSCLC (32%) breast cancer (30%) and melanoma (9%). Median age was 52 (IQR 23). 43% of patients had SRS prior to WBRT, and 41% had 2+ SRS treatments prior to WBRT. 44% of patients had WBRT only. Median survival from diagnosis of BM was 9.3 months (IQR 17.9) and median survival from WBRT was 2.7 months (IQR 11.3). 35% of patients died within 30 days of WBRT, and 3% of patients died on treatment. 77% of patients had uncontrolled extracranial metastases and 43% of patients had imaging evidence of leptomeningeal disease (LMD). Of those with documented cause of death, 65% of patients with LMD died of neurologic causes, compared with 22% of those without LMD (p < 0.001). Patients with KPS < 70 had median survival of 2 months after WBRT, compared with 3.7 months in those with KPS > 70. Patients treated with WBRT alone and those treated with salvage WBRT after SRS had median survival after WBRT of 2.1 months, however median survival from time of brain met diagnosis was 3.3 months in those treated with WBRT alone, versus 12.8 months in those treated with salvage WBRT (p < 0.0001). Conclusions: This study reveals the poor prognosis of patients requiring WBRT at a tertiary cancer center. 35% patients died within 30 days of WBRT, in contrast to a prior study demonstrating 10% 30-day mortality after SRS, owing to differences in patient selection. The potential for poor outcome should be discussed with patients during shared-decision making, balancing toxicity or futility with potential benefits of treatment.
Patterns of storage, use, and disposal of prescription opioids by parents of children with cancer.
Authors: Madden Kevin , Reddy Akhila Sunkepally , De la Cruz Maxine Grace , Bruera Eduardo
Published: November 2019

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Background: Multiple studies have demonstrated that adults do not store prescription opioids safely. Increased prescription opioid rates have led to an increased incidence of opioid poisonings in children and adolescents. We investigated whether parents of children with cancer that were prescribed opioids practiced safe storage, use, and disposal techniques. Methods: We conducted a prospective cross-sectional survey of parents whose children were prescribed opioids and asked them about their patterns of storage, use, and disposal of prescription opioids. Results: Virtually all parents (106/109, 97%) completed the survey. Most parents (95/106, 90%) did not store opioids safely. Six of 106 parents (6%) gave their child's opioid pain medication to someone else with pain, and 3 of 106 parents (3%) personally took some of their child’s opioid. Parents who personally took their child’s opioid ( P = .01) or gave it to another person ( P < .001) were more likely to use opioids unsafely with their child. A minority of parents (22/106, 21%) did not use opioids safely in their child. A small number of parents (3/22, 14%) did not dispose of opioids safely. Conclusions: Universal education about the safe, use, and disposal of opioids should be adopted when prescribing opioids. Pediatricians need to maintain vigilance about the nonmedical use of prescription opioid use by parents of children.
Palliative medical management of inoperable malignant bowel obstruction with “triple therapy”: Dexamethasone, octreotide, and metoclopramide at a comprehensive cancer center.
Authors: Wey Winston , Mian Moeena , Calabrese Rebecca , Hansen Eric , Walter Michelle , Wang Chong , Case Amy Allen
Published: November 2019

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Background: Malignant bowel obstruction (MBO) is a complication of advanced malignancy. For inoperable patients, symptoms are often treated using analgesics, anticholinergics, and anti-emetics. There are, however, few published guidelines or algorithms for the medical management of MBO. Therefore, the objective was to measure the effect of the combination of dexamethasone, octreotide, and metoclopramide (“triple therapy”) in patients with MBO, compared to patients who received none of the three medications (“no drug therapy”). Methods: A retrospective cohort study was done of patients with malignant bowel obstruction admitted between 1/1/2015 to 12/31/2018. The outcome measures were a patient having de-obstruction (defined as toleration of oral intake and resolution of nausea and vomiting), as well as time to de-obstruction. Results: Medical staff identified 34 patients who received triple therapy and 34 patients who received no drug therapy. Patients who received triple therapy were more likely to reach de-obstruction, compared to patients who had no drug therapy (OR: 9.02 [1.43, 56.99], p=0.0194), after adjusting for related covariates (i.e. length of stay and percutaneous endoscopic gastrostomy [PEG] placement). Patients who reached de-obstruction in the triple therapy arm, however, took longer to reach de-obstruction than those in the no drug therapy arm (5.4 days versus 3.4 days, p=0.045). Conclusions: Triple drug therapy with dexamethasone, octreotide, and metoclopramide leads to higher rates of de-obstruction in patients with inoperable MBO, compared to patients who received none of the three drugs, though time to de-obstruction is longer.
Systemic inflammatory markers may predict survival in advanced cancer patients admitted to an acute palliative care unit.
Authors: Lee Si Won , Kim Yu Jung
Published: November 2019

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Background: The Acute Palliative Care Unit (APCU) is an inpatient palliative care program that provides intensive symptom management and facilitates the transition from hospital discharge to hospice. Often patients are admitted to the APCU very late at the end of their disease trajectory. The purpose of this study was to investigate whether systemic inflammatory markers can predict remaining survival in these patients. Methods: Advanced cancer patients admitted to the APCU at a tertiary cancer center in Korea between April 2015 and March 2016 were included in this retrospective study. Of the 405 consecutive APCU admissions during this time period, there were 312 individual patients. Within this cohort, 267 patients were eligible for this study. Systemic inflammatory markers including albumin level, neutrophil to lymphocyte ratio (NLR), and Advanced Lung cancer Inflammation index (ALI = BMI x Albumin / NLR) were analyzed. Results: Of the 267 patients analyzed, the median age of patients was 66 (range, 23-97), and 45% were female. Primary cancer types were lung cancer (21%), gastric cancer (17%), colorectal cancer (15%), and pancreatobiliary cancer (14%). Overall survival after admission to the APCU was 21 days. Patients with low albumin level ( < 3.3g/dL) showed shorter survival compared with those with normal albumin level (16 days vs 32 days, hazard ratio [HR] 1.79, 95% CI 1.37-2.33, P < 0.001). Median NLR was 8.7, and patients with high NLR (≥8.7) exhibited poorer survival (HR 1.32, 95% CI 1.03-1.68, P = 0.028). Patients with low ALI ( < 18) had poor prognosis compared with those with high ALI (≥18) (HR 1.54, 95% CI 1.15-2.08, P = 0.004). Conclusions: Low albumin level ( < 3.3), high NLR (≥8.7), and low ALI ( < 18) may indicate poor prognosis in advanced cancer patients admitted to the APCU. A prospective cohort studies are necessary to validate these results.