bluuebunny/crossref_metadata_2025 huggingface dataset:
High Prevalence Of Alphaherpes Virus 2 (HSV-2) Positivity In Prisons From Midwest Brazil: A Cross-Sectional Study
Authors: Almeida Nathália Alves Araujo de , Lima Lyana Rodrigues Pinto , Puga Marco Antonio Moreira , Castro Ana Rita Coimbra Motta de , Horta Marco Aurelio , Paula Vanessa Salete de
Published: January 2020

Herpes virus 2 (HSV-2) is the main cause of genital herpes, one of the most prevalent sexually transmitted infections (STIs) in the world. STIs are major public health problems in prisons because of the behaviors of prisoners and the presence of other factors that increase the risk of transmission. The present study aimed to estimate the prevalence and risk factors associated with HSV-2 infection at 12 prisons in Mato Grosso do Sul, Brazil. We tested 872 serum samples (732 from males, 140 from females) for anti-HSV-2 IgG, and tested the positive samples (n = 184) for anti-HSV-2 IgM. Anti-HSV-2 IgG positivity (n = 85, 43.1%, 95% CI = 34.6 to 40.4). The prevalence of HSV-2 positivity was much greater than reported in the general population of Brazil and in other prison populations worldwide. There was a greater risk of HSV-2 positivity in prisoners who were older, female, unmarried, HIV positive, positive for other STIs, not previously incarcerated, in the same cell with more than 26 individuals, and in those who reported having had genital discharge in the past month, having had a homosexual relationship in recent months, and not using or occasionally not using condoms during sexual intercourse. Further analysis of prisoners with active HSV-2 infections (anti-HSV-2 IgM positivity) indicated that unmarried status and the presence of 26 or more prisoners in the same cell increased the risk for active HSV-2 infection. This study provides important data on HSV-2 seroprevalence in the prison population of Brazil, and identified risk factors associated with HSV-2 infection. These data provide important information needed to implement procedures that better prevent and control of STIs in prison populations.
Dehydroxymethylepoxyquinomicin, a novel nuclear factor-κB inhibitor, prevents the development of cyclosporine A nephrotoxicity in a rat model
Authors: Morita Shinya , Shinoda Kazunobu , Yoshida Tadashi , Shimoda Masayuki , Kanno Yoshihiko , Mizuno Ryuichi , Kono Hidaka , Asanuma Hiroshi , Nakagawa Ken , Umezawa Kazuo , Oya Mototsugu
Published: January 2020

Background Cyclosporine A (CsA) is an essential drug used for immunosuppression in the field of organ transplantation. However, especially in kidney transplantation, its chronic nephrotoxicity is considered an obstacle to long allograft survival that has not been overcome. Nuclear factor-κB (NF-κB) is activated in the renal tissue in CsA nephropathy. In this study, we aimed to investigate the effect of the specific NF-κB activation inhibitor, dehydroxymethylepoxyquinomicin (DHMEQ) in a rat model of CsA nephrotoxicity. Methods We administered high-dose CsA (15 mg/kg) daily for 28 days to Sprague-Dawley rats that underwent 5/6 nephrectomy under a low-salt diet. We administered DHMEQ (8 mg/kg) to the treatment group daily for 28 days and evaluated its effect on CsA nephrotoxicity. Results DHMEQ significantly inhibited NF-κB activation and nuclear translocation due to high-dose CsA treatment. Elevated serum urea nitrogen and creatinine levels due to repeated CsA administration were significantly decreased by DHMEQ treatment, and creatinine clearance was restored in the treatment group. However, DHMEQ treatment did not alter the inhibitory effect of CsA on urinary protein secretion. The development of renal fibrosis due to chronic CsA nephrotoxicity was significantly inhibited by DHMEQ treatment, and these results correlated with the results of renal functional assessment. DHMEQ treatment also had an inhibitory effect on the increased expression of chemokines, monocyte chemoattractant protein-1, and chemokine (c-c motif) ligand 5 due to repeated CsA administration, which inhibited the infiltration of macrophages and neutrophils into the renal tissue. Conclusions These findings suggest that DHMEQ treatment in combination therapy with CsA-based immunosuppression is beneficial to prevent the development of CsA-induced nephrotoxicity.
Retrograde Intrarenal Surgery versus Percutaneous Nephrolithotomy in the Treatment of Solitary Kidney Calculi: a Meta-Analysis
Authors: Qian LuJie , Jiang YuLi , Jiang ZePeng , Li YanJuan , Xiang JiaNan
Published: January 2020

Background: To assess the effectiveness and safety of retrograde intrarenal surgery(RIRS) and percutaneous nephrolithotomy(PCNL) as surgical management strategies for solitary kidney calculi. Methods: Our team searched the PubMed, Cochrane and Web of Science databases up to February 28, 2019, for relevant published studies. After data extraction and quality assessment, Review Manager 5.3.5.0 software was used to pool the data. Results: Four studies involving 314 patients were included in our meta-analysis. The pooled data showed that the stone-free rate(SFR) was higher in the PCNL group than in the RIRS group, and the difference was significant(OR:0.36, 95% CI: 0.20 to 0.67, P =0.001). No significant differences were found in minor complications or major complications between the RIRS and PCNL groups(P > 0.05, OR:0.79, 95% CI: 0.46 to 1.35;p > 0.05, OR:2.96, 95% CI: 0.67 to 12.96, respectively). Conclusions: Neither the minor nor the major complications of RIRS and PCNL showed any statistical differences. Additionally, PCNL provided a higher SFR than RIRS. There exists enormous heterogeneity in mean operation time. Overall, this meta-analysis may help urologists make decisions regarding interventions for solitary kidney calculi management. Keywords: Solitary kidney, Calculi, Retrograde Intrarenal surgery, Percutaneous Nephrolithotomy, Meta-analysis
Potential of the Japanese Version of PainDETECT questionnaire for Patients with Chronic Orofacial Pain and Psychiatric Comorbidities: A preliminary study
Authors: (Boku) Aiji Sato , Kimura Hiroyuki , Tokura Tatsuya , Nagashima Wataru , Kobayashi Yuka , Umemura Eri , Miyauchi Tomoya , Ito Mikiko , Kishi Shinichi , Ogi Nobumi , Tonoike Takashi , Ozaki Norio , Kurita Kenichi , Nakano Yumi , Okuda Masahiro
Published: January 2020

Background Various questionnaires have been introduced and validated as methods for screening of neuropathic pain, but none have been established for the orofacial region. Although chronic pain and depression are likely to comorbid, few studies have examined the relationship between chronic pain in the orofacial region and depression. Therefore, we evaluated the potential of the Japanese Version of PainDETECT as an assessment tool for neuropathic pain associated with burning mouth syndrome (BMS) and persistent idiopathic facial pain (PIFP).We also evaluated the depression scale such as Beck’s Depression Inventory (BDI: a subjective index) and Hamilton Depression Rating Scale (HDRS: an objective index) with BMS or PIFP. Methods We administered the Japanese version of the PainDETECT questionnaire to the patients with BMS (29 patients) and PIFP (17 patients). We performed BDI and HDRS with BMS or PIFP. We also evaluated the correlation between the PainDETECT final score and BDI or HDRS. The questionnaire was also used to evaluate post-extraction pain which is a typical nociceptive pain (EXT 16 patients). All subjects underwent a psychiatric evaluation by a trained psychiatrist. Results Although PainDETECT final score was significantly higher in the BMS [median: 10] compared with the PIFP [6] (p=0.016) and EXT [5] (p=0.005), both BMS and PIFP did not reach the cutoff value. HDRS was significantly higher in the BMS [7] than the PIFP [3.5] (p =0.04). There were no significant differences between the BMS [14] and PIFP [9] in BDI. There was little correction between the PainDETECT final score and BDI or HDRS. Conclusion We cloud not say that the Japanese version of the PainDETECT questionnaire have sufficient potential as a pain assessment tool for patients with BMS and PIFP. Although there was little correlation between depression and PainDETECT final score for patients with BMS or PIFP, BMS was comorbid with depression objectively than PIFP.
What Gait Features Influence the Amount and Intensity of Physical Activity in People with Multiple Sclerosis?
Authors: Pau Massimiliano , Porta Micaela , Pilloni Giuseppina , Coghe Giancarlo , Cocco Eleonora
Published: January 2020

Background: Although the mutual relationship between ambulation and Physical Activity (PA) in people with Multiple Sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.Methods: Thirty-one pwMS (17F, 14M, mean age 52.5, mean Expanded Disability Status Scale score 3.1) were requested to wear a tri-axial accelerometer 24h/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e. gait speed, stride length, cadence and duration of stance, swing and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman’s rank correlation coefficient rho.Results: Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, p<0.001), percentage of sedentary activity (rho = -0.44, p<0.001) and percentage of moderate-to-vigorous activity (rho = 0.48, p<0.001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.Conclusions: The data obtained suggest that the most relevant determinants associated with higher and more intense levels of physical activity in free-living conditions are gait speed and stride length.The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.
Primary carnitine deficiency – diagnosis after heart transplantation: Better late than never!
Authors: Grünert Sarah Catharina , Tucci Sara , Schumann Anke , Schwendt Meike , Gramer Gwendolyn , Hoffmann Georg F. , Erbel Michelle , Stiller Brigitte , Spiekerkoetter Ute
Published: January 2020

Background Primary carnitine deficiency due to mutations in the OCTN2 gene is a rare but well-treatable metabolic disorder that puts patients at risk for metabolic decompensations, skeletal and cardiac myopathy and sudden cardiac death. Results We report on a 7-year-old boy diagnosed with primary carnitine deficiency 2 years after successful heart transplantation thanks his younger sister’s having been identified via expanded newborn screening during a pilot study evaluating an extension of the German newborn screening panel. Conclusion As L-carnitine supplementation can prevent and mostly reverse clinical symptoms of primary carnitine deficiency, all patients with cardiomyopathy should be investigated for primary carnitine deficiency even if newborn screening results were unremarkable.
Influenza A virus antagonizes type I and type II interferon responses via SOCS1-dependent ubiquitination and degradation of JAK1
Authors: Du Yinping , Yang Fan , Wang Qiuxia , Xu Nuo , Xie Yizhang , Chen Sujuan , Qin Tao , Peng Da-Xin
Published: January 2020

BACKGROUND Although influenza A virus (IAV) employs diverse strategies to evade IFN responses by inhibiting the synthesis of IFN, how IAV regulates signaling downstream of IFN is incompletely understood. METHODS In this study, we used Western blot-based protein analysis coupled with RT-qPCR, overexpression and RNA interference to investigate the regulation of JAK1 by IAV infection in 293T cells. RESULTS The results indicated that JAK1 was ubiquitinated and degraded, resulting in inhibition of type I and type II IFN responses, demonstrating that IAV antagonizes the IFN-activated JAK/STAT signaling pathway by inducing the degradation of JAK1. Furthermore. IAV infection upregulated the suppressor of cytokine signaling (SOCS) protein SOCS1, and SOCS1 mediated the ubiquitination and degradation of JAK1.CONCLUSION Collectively, our findings suggest that IAV infection induced SOCS1 expression promotes JAK1 degradation, which in turn inhibits host innate immune responses.
Effectiveness of Glucocorticoids on acute respiratory distress syndrome: An umbrella review
Authors: Mekonnen Semagn , Kassim Haile Mariam Mulugeta , Basu Bivash , Nega Solomon
Published: January 2020

Background Management of Acute Respiratory Distress Syndrome is a very challenging critical illness in ICU with high morbidity and mortality worldwide.The review was intended to provide evidence on the effectiveness of Glucocorticoid treatment for acute respiratory distress syndrome Method A comprehensive search strategy was conducted on PubMed/Medline, Cochrane Library, Science direct, LILACS, and African Online Journal. Data extraction was carried out with two independent authors with customized checklist. The quality of each systemic review was assessed by two independent authors using AMSTAR tool and the overall quality of evidence was generated with online GRADEpro GDT software for primary and secondary outcomes. Result The umbrella review included nine systemic reviews and meta-analysis and one narrative review with eight thousand four hundred ninety one participants. The methodological quality of the included studies was moderate to high quality. The overall quality of evidence and recommendation varied form high to very low. Conclusion There is high to moderate quality evidence on the initiation of early low dose prolonged glucocorticoid for reduction of mortality for ARDS. However, randomized controlled trials with large sample sizes to address ventilator-free days, the incidence of infection and other glucocorticoid associated adverse events is required as the quality of evidence with these secondary outcomes were low to very low
Reduction of subacromial osteolysis by bending the hook arthroscopically in clavicle hook plate fixation for distal clavicle fractures
Authors: Okazaki Atsushi , Sakano Hiroaki , Takeuchi Tsuyoshi , Inaba Yutaka
Published: January 2020

Background: Subacromial osteolysis is a serious complication caused by clavicle hook plates. Incongruency between the hook and undersurface of the acromion has been reported as a cause of subacromial osteolysis. The aim of this study was to retrospectively examine the effectiveness of hook bending in reducing subacromial osteolysis. Methods: Twenty-two patients with unstable distal clavicle fractures were treated with clavicle hook plates. There were 19 males and 3 females, with a mean age of 55.0 years. They were followed for a mean period of 9.5 months. The patients were divided into two groups; there were 10 patients whose hook was bent (the bending group) and 12 patients whose hook was not bent (the nonbending group). In the bending group, the hook was bent using a dedicated bender such that the hook and the undersurface of the acromion were parallel, and the direction of the hook was confirmed arthroscopically. At plate removal, arthroscopy was performed in both groups to observe the subacromial bony defect and the rotator cuff injury. Results: One patient in the nonbending group had a fibrous union, but bone union was achieved in all other patients. In the bending group, the angle at which the hook was inclined downward with respect to the distal portion of the plate (hook inclination angle) was 9.3 ± 6.1˚ (range, 2-23˚). The subacromial bony defects were significantly smaller in the bending group (1.7 ± 2.4 mm) than in the nonbending group (4.7 ± 2.3 mm) (P<0.05). Partial-thickness rotator cuff tears localized around the hook were observed arthroscopically in 6 patients in the bending group (60%) and in 7 patients in the nonbending group (58%). Conclusions: When the hook was bent such that it was parallel to the undersurface of the acromion, the degree of subacromial osteolysis was reduced.
Self-rated health inequalities in the intersection of gender and social class in Spain: exploring contributions of material and psychosocial factors
Authors: Barnils Núria Pedrós , Eurenius Eva , Gustafsson Per E
Published: January 2020

Background Inequalities in health across social class, gender and regional context in Spain are well-known; however, there is a lack of research examining how these dimensions of inequality interact. This study explores self-rated health (SRH) inequalities across intersectional positions of gender, social class and region, and the contribution of material and psychosocial factors to these inequalities. Methods Participants were drawn from the cross-sectional 2015 National Living Conditions Survey of Spanish residents aged 19-88 years (N=27,215; 77% response rate). Eight intersectional positions were formed by combining dichotomous variables of gender, social class and regional development. Poisson regression was used to estimate intersectional inequalities in SRH as prevalence ratios, and the contributions of material and psychosocial factors. Results Women in manual social class from low development regions reported the worst SRH. Inequalities by the interaction of social class and regional development were best explained by the joint contributions of material and psychosocial factors, while gender inequalities among non-manual social class were better explained by material factors alone. Conclusions The results illustrate the complexity of interacting inequalities in health and their underpinnings in Spain. Local and national policies that take this complexity into account are needed to broadly improve equity in health in Spain.
Incidence, risk factors and consequences of preterm birth – findings from a multicentric observational study in Nepal
Authors: Gurung Abhishek , Wrammert Johan , Sunny Avinash K , Gurung Rejina , Rana Netra , Basaula Yuba Nidhi , Paudel Prajwal , Pokhrel Amrit , Kc Ashish
Published: January 2020

Background: Preterm birth is a worldwide epidemic and a leading cause of neonatal mortality. In this study, we aimed to evaluate the incidence, risk factors and consequences of preterm birth in Nepal. Methods: This was an observational study conducted in 12 public hospitals of Nepal. All the babies born during the study period were included in the study. Babies born <37 weeks of gestation were classified as preterm births. For the association and outcomes for preterm birth, univariate followed by multiple regression analysis was conducted. Results: The incidence of preterm was found to be 93 per 1000 live births. Mothers with age less than 20 years (aOR 1.21; 1.09-1.34) and 35 years and above (aOR 1.30; 1.05-1.63) had a high risk for preterm birth. Similarly, education of the mother was a significant predictor for preterm birth: illiterate mothers (aOR 1.90; 1.66-2.19), literate mothers (aOR 1.48; 1.33-1.65) and mothers having basic level of education (aOR 1.25; 1.14-1.38). Socio-demographic factors such as smoking (aOR 2.02; .84-2.22) and use of polluted fuel (aOR 1.38; 1.28-1.50); obstetric factors such as nulliparity (aOR 1.44; 1.28-1.61), multiple delivery (aOR 1.92; 1.33-2.76), severe anemia during pregnancy (aOR 2.43; 1.55-3.82), antenatal visit during second trimester (aOR 1.10; 1.02-1.19) and third trimester (aOR 1.44; 1.30-1.60) were found to be significant risk factors of preterm birth. Preterm has a risk for pre-discharge mortality (10.60; 9.28-12.10). Conclusion: In this study, we found high incidence of preterm birth. Various socio-demographic, obstetric and neonatal risk factors were associated with preterm birth. Risk factor modifications and timely interventions will help in the reduction of preterm births and associated mortalities.
Association between procalcitonin and acute kidney injury in patients with septic shock: A case-control study
Authors: Wu Ming , Fu Guang , Li Hao-li , Zhan Hai-chao , Lu Jun-fu , Chen Yan-hong , Wu Le-feng , Zhang Fan , Yang Zi-Long , Huang Jia-jia , Feng Yong-wen , Luan Ying-yi
Published: January 2020

Objective This study aims to assess the relationship between serum procalcitonin (PCT) and acute kidney injury (AKI) induced by sepsis shock.Methods A case-control study was designed which included patients that admitted in intensive care unit (ICU) between January 2015 and October 2018. The worst values of biochemical parameters in the first 48 hours from septic shock admission to ICU were evaluated. According to KDIGO guideline, these patients were divided into AKI and non-AKI groups.Results Of 1631 patients screened, 157 patients were included in the primary analysis in which 84 (53.5%) patients with AKI. Multiple logistic regression results showed that PCT (OR=1.017, 95% CI 1.009- 1.025, P<0.001) was associated with AKI induced by septic shock. The ROC analysis showed that the cutoff point for PCT to predict AKI development was 14 ng/ml, and with a sensitivity 63%, specificity 67%. Specifically, in multivariate piecewise linear regression, the occurrence of AKI decreased with the elevation of PCT when PCT was between 25mol/L and 120 mol/L (OR 0.963, 95% CI 0.929-0.999; P= 0.042). The AKI increased with the elevation of PCT when PCT was either less than 25mol/L (OR 1.077, 95% CI 1.022-1.136; P= 0.006) or more than 120mol/L (OR 1.042, 95% CI 1.009-1.076; P= 0.013). Moreover, the PCT level was significant higher in AKI group only in female patients with age under 75(P=0.001).Conclusions Our data revealed a nonlinear relationship between PCT in 48 hours admission to ICU and AKI in septic shock patients and PCT could be used as a biomarker of AKI only in female patients under 75 years with sepsis shock.
Prevalence of Microalbuminuria and associated factors among HIV−infected ART naïve patients at Mulago hospital, Kampala, Uganda.
Authors: KIGGUNDU THOMAS , Byakika-Kibwika Pauline , Biraro Irene Andia , Makanga Gyaviira , Kalyesubula Robert
Published: January 2020

Background The kidney is one of the common target organs for HIV infection. Early detection of microalbuminuria, the earliest marker of renal damage is critical to slowing down progression to end stage renal disease if appropriate intervention is made. The burden of microalbuminuria and its associated factors in HIV−infected ART naive patients has not been determined in Uganda.Methods A cross-sectional study was conducted in the Mulago Immune suppression syndrome (ISS) clinic on adult HIV−infected ART naïve outpatients. Data was collected on age, sex, level of education, marital status, religion, address, and history of alcohol intake, diabetes mellitus, hypertension, medications and smoking. Measurement of blood pressure, weight and height to determine body mass index (BMI) and investigations including complete blood count (CBC),serum urea and creatinine, Liver function tests(LFTs), CD4+ count, spot morning urine albumin and urine creatinine to determine microalbuminuria were conducted. Logistic regression was used to estimate the strength of association between variables.ResultsA total of 185 adult participants were consecutively enrolled into the study. The mean (SD) age was 34.2(±9.0) years and majority (63.8%) were female. The mean (SD) CD4+ count 466±357 cells/µL, and BMI 23.1 (±4.9) kg/m 2 . The prevalence of microalbuminuria was 18.9%. None of the participants had albuminuria. CD4+ count <350cells/µL and BM1<18.5kg/m 2 were associated increased risk of microalbuminuria OR 3.8 (95%CI 1.7-8.3) (p value=0.01) and OR 4.7 (95%CI 1.82-12.4) (p value=0.03) respectively. Diabetes mellitus, hypertension, smoking, alcohol intake were not found to be significantly associated with microalbuminuria.Conclusion Microalbuminuria was highly prevalent in adult HIV−infected ART patients especially those with low CD4+ count and low BMI. There is need to study the effect of ART on microalbuminuria in adult HIV−infected patients. Key words: HIV, microalbuminuria, Uganda, ART naïve
Efficacy of therapies in the treatment of Guillain-Barre Syndrome: a network meta-analysis
Authors: Lin Jingfeng , Gao Qiang , Xiao Kang , Tian Danfeng , Hu Wenyue , Han Zhenyun
Published: January 2020

Background Guillain-Barre syndrome (GBS) is an acute, paralyzing, inflammatory peripheral nerve disease. For treatments of the Guillain-Barre Syndrome, there are many kinds of therapies for this diseases. For comparing all of the therapies, such as immunoglobulin, plasma exchanging, etc. in the treatment of Guillain-Barre Syndrome(GBS) to better inform clinical practice, we use Network meta analysis to get the outcome of the Guillain-Barre Syndrome. The protocol has been submitted to PROSPERO:CRD: 42019119178. Methods Web of Science, PubMed, Embase, and the Cochrane library were searched for related articles. We identified citations of these and included 26 trials comprising 2434 patients and control group human beings. Network meta-analysis (NMA) was performed with two kinds of outcomes. We carried on R software with gemtc package and JAGS software to calculate results for different therapies. The consistency of direct and indirect evidence was also assessed by R software. Results Concerning for two outcomes, there were no improvement observed in MTP and Pred compared with placebo. PE and IVIg were illustrated to be effective over Placebo. There was no significant difference between different doses and times of PE and IVIg. On consistency examination between direct and indirect evidences, there were no obvious heterogeneity between all of therapies. Funnel plots indicates the possibility of publication bias in this study are small. Conclusion PE or IVIg had a significant efficency for GBS patients. The effects of some combination treatments should be further explored. Corticosteroids had no significant effects on GBS.
Genomic Characterization of an Emerging Enterobacteriaceae Species for the First Case of Human Infection in Cooperation with a Typical Pathogen
Authors: Zhang Zhao , Li Daixi , shi xing , Zhai Yao , Guo Yatao , Zheng Yali , Zhao Lili , He Yukun , Chen Yusheng , Wang Zhanwei , Su Jianrong , Kang Yu , Gao Zhancheng
Published: January 2020

Opportunistic pathogens are important for clinical practice as they often cause antibiotic resistant infections. However, little is documented for many emerging opportunistic pathogens and their biological characteristics. Here, we isolated a novel species of extended-spectrum β-lactamase-producing Enterobacteriaceae from a patient of biliary tract infection. The isolate grows very slowly but confers strong protection for the co-infected cephalosporin-sensitive Klebsiella pneumonia. As the initial laboratory testing failed to identify the taxonomy of the strain, great perplexity was caused in the etiological diagnosis, and anti-infection treatment for the patient. Rigorous sequencing efforts achieved the complete genome sequence of the isolate which we designated as AF18. AF18 is phylogenetically close to a few strains respectively isolated from soil, clinical sewage, and patients, forming a novel species together, while the taxonomic nomenclature of which is still under discussion. And this is the first report of human infection of this novel species. As its relatives, AF18 harbors many genes related to cell mobility, various genes adaptive to both wild environment and animal host, tens of genetic mobile elements, and a plasmid bearing blaCTX-M-3 gene, indicating its ability to disseminate antimicrobial resistant genes from wild to patients. Transcriptome sequencing identified two sRNAs that critically regulate the growth rate of AF18 which could serve as targets for novel antimicrobial strategies. These findings imply that AF18 and its species are not only infection-relevant but also potential disseminators in transferring antibiotic determinants, which highlights the need for continuous monitoring for this novel species and efforts to develop controlling strategies.
Uptake and willingness to use PrEP among Chinese men who have sex with men with experience of sexualized drug use
Authors: Wang Zixin , Mo Phoenix K.H. , Ip Mary , Fang Yuan , Lau Joseph T.F.
Published: January 2020

Background Sexualized drug use (SDU, use of any psychoactive substance before/during sexual intercourse) is prevalent among men who have sex with men (MSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among MSM with experience of SDU. Methods A total of 580 Hong Kong Chinese speaking MSM self-reported to be HIV negative/unknown sero-status completed a cross-sectional anonymous telephone interview. Results Of the participants, 107 (18.4%) and 56 (9.7%) had experience of SDU and chemsex in their lifetime. The prevalence of PrEP use was 4.0% among all participants and 12.1% among those with experience of SDU. Among MSM with experience of SDU who were not on PrEP (n=94), 59.6% were willing to use daily oral PrEP in the next six months. After adjustment for significant background variables (age group, HIV testing in the past year, and anal intercourse with non-regular male sex partners), having ≥3 episodes of SDU per month (adjusted odds ratios (AOR): 3.87, 95%CI: 1.01, 15.28), presence of condomless anal intercourse during SDU (AOR: 2.96, 95%CI: 1.03, 9.55), positive attitudes toward PrEP (AOR: 2.01, 95%CI: 1.37, 2.95), perceived support from significant others to use PrEP (AOR: 11.63, 95%CI: 3.93, 34.37)), and perceived behavioral control of using PrEP (AOR: 20.82, 95%CI: 6.51, 66.64) were significantly associated with higher willingness to use PrEP. Conclusion MSM with experience of SDU are potential good candidates of PrEP implementation. Effective strategies to increase PrEP coverage are needed even if affordable PrEP became available, future health promotion may make use of HIV testing and counseling settings and modify perception related to PrEP.
Geographical clustering of hantavirus isolates from Apodemus agrarius identified in the Republic of Korea indicate the emergence of a new hantavirus genotype
Authors: Jalal Sehrish , Kim Choon-Mee , Kim Dong-Min , Song Hyeon Je , Lee Jeong-Chi , Shin Mi Yeong , Lim Hyun Cheol
Published: January 2020

Background Several studies on hantavirus evolution have shown that genetic reassortment plays an important role in the evolution and epidemiology of this disease. Hantaan virus, a prototype hantavirus carried by Apodemus agrarius, is found throughout China, Russia, and Korea. The aim of this study was to investigate the distribution of hantaviruses in rodents in the Republic of Korea (ROK) and perform phylogenetic comparisons using the geographical distribution of their natural reservoir rodent hosts as a point of reference.Methodology To understand the genetic epidemiology of human pathogenic hantaviruses, we examined viral isolates from rodent reservoirs, captured at three different locations in the ROK, between 2017 and 2018. Each sample collected was subjected to reverse-transcription nested polymerase chain reaction (RT-N-PCR) targeting the L- and S-segments of the hantavirus genome. Positive isolates from Gwangju, Boseong-gun (Jeollanam-do Province), and Jeju Island were confirmed as Hantaan virus using DNA sequencing.Results Phylogenetic analysis showed that all isolates grouped together as Hantaan virus. The isolates from Jeju, Boseong-gun, and Gwangju tended to cluster together, but with each region forming a distinct cluster. In addition, these three clusters were distinct from other Hantaan isolates reported in previous studies from Korea and its neighboring countries China and Russia. This suggests the emergence of a new hantavirus genotype in southwestern ROK.Conclusion Hantaan viruses exhibit a considerable degree of geographical clustering, and there may be a novel Hantaan genotype in southwestern ROK. This study helps expand our knowledge regarding the emergence of new hantavirus strains and their degree of geographical variation.
Self-assessed competence and need for further training among registered nurses in somatic hospital wards: a cross-sectional survey
Authors: Allvin Renée , Bisholt Birgitta , Blomberg Karin , Bååth Carina , Wangensteen Sigrid
Published: January 2020

Background: Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses’ self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (≤ 0,5 year, >0,5-5 year, and ≥ 6 year). Methods: A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n=267) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51 %). Independent student t-test and analysis of variance were carried out. Results: Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility; and acting ethically. They assessed their need for further training most for statements related to assessing patients’ health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant. Conclusions: Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.
Usefulness of ultrasensitive anti-Müllerian hormone assay to predict follicle growth in patients with primary ovarian insufficiency
Authors: Kasahara Yukiyo , Osuka Satoko , Bayasula Bayasula , Nakanishi Natsuki , Murase Tomohiko , Nakamura Tomoko , Goto Maki , Kotani Tomomi , Iwase Akira , Kikkawa Fumitaka
Published: January 2020

Background: Patients with primary ovarian insufficiency (POI) present with follicle growth occasionally, however, it is difficult to predict the exact cycles with follicle growth. Serum anti-Müllerian hormone (AMH), a useful marker for ovarian reserve, is produced in early-stage follicles. Therefore, AMH levels should reflect the existence of small follicles which are difficult to detect using ultrasonography and may be useful for predicting follicle growth in patients with POI. Methods: Using an ultrasensitive enzyme-linked immunosorbent assay (ELISA) kit, we found very low serum AMH levels of patients with POI; we further assessed the follicle growth of each patient and their cycles to clarify the usefulness of measuring serum AMH levels for predicting the follicle growth in patients with POI. Results: A total of 91 cycles of 19 patients with POI were analyzed in this study. Five patients presented with positive serum AMH levels during the observational periods and all five experienced follicle growth. Only two of the 14 patients with negative serum AMH levels had follicle growth. Serum AMH and follicle-stimulating hormone (FSH) levels in cycles with follicle growth were significantly higher than in cycles without follicle growth. The median serum AMH level (2.77 pg/mL; 25th, 75th percentiles: 0.0, 9.64) in cycles with follicle growth were lower than the lower limit of detection of conventional AMH ELISA kits. The positive predictive value of positive serum AMH levels for follicle growth was higher than that of FSH (<10 mIU/mL).Conclusions: Measuring very low levels of serum AMH using picoAMH assays is useful for the prediction of follicle growth in patients with POI.
Three-dimensional morphometric analysis reveals time-dependent structural changes in microglia and astrocytes in the central amygdala and hypothalamic paraventricular nucleus of heart failure rats
Authors: Althammer Ferdinand , Ferreira-Neto Hildebrando Candido , Rubaharan Myurajan , Roy Ranjan Kumer , Stern Javier E
Published: January 2020

BackgroundCardiovascular diseases, including heart failure are the most common cause of death globally. Recent studies support a high degree of comorbidity between heart failure and cognitive and mood disorders resulting in memory loss, depression and anxiety. While neuroinflammation in the hypothalamic paraventricular nucleus has been shown to contribute to autonomic/cardiovascular dysregulation in heart failure, mechanisms underlying cognitive and mood disorders in this disease remain elusive. The goal of this study was to quantitatively asses several markers of neuroinflammation in the central amygdala, a critical forebrain region involved in emotion and cognition, and to compare the time course of neuroinflammation between the central amygdala and paraventricular nucleus during the progression of heart failure. MethodsWe developed and implemented a comprehensive microglial/astrocyte profiler for precise three-dimensional morphometric analysis of individual microglia and astrocytes in specific brain nuclei at different time points during the progression of heart failure. To this end, we used a well-established ischemic heart failure rat model. Morphometric studies were complemented with quantification of various proinflammatory cytokines and A1/A2 astrocyte markers via qPCR. ResultsWe report a drastic structural remodeling of central amygdala microglia and astrocytes during heart failure that affected cell volume, surface area, filament length, dendritic branches, resulting overall in somatic swelling and deramification, indicative of an activated microglial state. These changes occurred in a time-dependent manner and were delayed compared to changes in the hypothalamic paraventricular nucleus. Morphometric changes correlated with elevated mRNA levels of proinflammatory cytokines and markers of reactive neurotoxic astrocytes in the paraventricular nucleus and central amygdala during heart failure. ConclusionWe provide evidence that in addition to the previously described hypothalamic neuroinflammation implicated in sympathohumoral activation during heart failure, microglia and astrocytes within the central amygdala also undergo structural remodeling indicative of glial shifts towards an activated and neurotoxic phenotype, respectively. Thus, our studies suggest that neuroinflammation in the amygdala stands as a novel pathophysiological mechanism and therapeutic target for alleviating comorbid emotional and cognitive deficits commonly observed at later stages during the course of heart failure.
Exposure to varied cage-size habitats alters pain sensitivity and inflammation-related biomarkers
Authors: OYEWOLE Aboyeji Lukuman , OYAFEMI Kehinde Olumide , BADMUS Kolade Samson , OMOLEYE Janet Omotola , ABUBAKAR Midrar Folahanmi , ADENIYI-RAHEEM Omolade , AMEDU Abdul-hameed , LAWAL Dolapo Latifah , IJIYODE Aishat Oluwakemi , YUSSUF Ateeqah Oreoluwa , ISHOLA Solomon Sunday , SULAIMON Fatimo Ajoke , ALLI-OLUWAFUYI Abdulmusawwir O. , NAFIU Abdulrazaq Bidemi , AKINOLA Olugbenga , OLAJIDE Olayemi Joseph , AMIN Abdulbasit , ABDULMAJEED Wahab Imam , MICHAEL Olugbenga Samuel , ADEYANJU Oluwaseun Aremu , OGUNJIMI Gbowoloye Lanre
Published: January 2020

Background Nature and size of rodent cages vary from one laboratory or country to another. Little is however known about the physiological implications of exposure to diverse cage sizes in animal-based experiment. Here, we exposed male Swiss mice to various cage sizes used across laboratories in Nigeria, top-rated paradigms were used to profile changes in physiological behaviours, and this was followed by evaluation of modified biochemical metrics. Results The study showed a better systemic regulation of glucose metabolism in cage migrated mice compared to cage stationed. Strikingly, peripheral oxidative stress and pain sensitivity decreased significantly in cage-to-cage migrated mice despite increased pro-inflammation mediators (IL-6 and NF-κB) which contrast the norm reported in inflammatory conditions. Interestingly, emotion-linked behaviours, neurotransmitters (serotonin, noradrenaline and GABA) and body electrolytes were not altered by cage-to-cage migration. Conclusion Taken together, these results suggest that varied size cage-to-cage migration of experimental mice could affect targeted behavioural and biomolecular parameters of pain and inflammation, thus diminishing research reproducibility, precipitating false negative/positive results and leading to poor translational outcomes.
Sustainable high impact community health worker programs for low-income urban settings: Designing of ANCHUL (AnteNatal and Child Health Care in Urban sLums) intervention for Accredited Social Health Activist (ASHAs) in Delhi, India
Authors: Ghosh-Jerath Suparna , Devasenapathy Niveditha , Rana Monika , Zodpey Sanjay , Shankar Anuraj
Published: January 2020

Background: Urbanization in India has led to increasing economic disparities and health inequalities with worse maternal and child health indicators among the urban poor. Community health workers (CHW) within the urban community health systems (UCHS) can play important role in addressing the health needs of urban poor. We present here a 3-stage process of development of a remodelled program for the existing CHWs called Accredited Social Health Activists (ASHAs) working in urban poor settlements of Delhi, India, in collaboration with Delhi State Health Mission (DSHM); the implementers of the program. The intervention was called ANCHUL (Antenatal and Child Health in Urban sLums) intervention and was designed in three phases; formative phase, design phase and evaluation phase. In this paper we discuss the formative and design phase.Methods: We used a mixed methods approach including surveys, qualitative enquires, desk reviews and consultations with key stakeholders (program implementers, decision makers in the health system, ASHAs, clients and healthcare providers) during the formative and design phase. The goal was to create a dynamic adaptive model for the urban ASHA program based on current evidence yet bound within the decision space and options of program implementers. Principles of implementation research was applied to design the ANCHUL intervention. A pragmatic quasi experimental design was used to evaluate this complex intervention.Results: The formative phase identified the current maternal and child health needs of the urban poor, the programmatic challenges of the ASHA program and helped in creating a conceptual framework for the intervention. The design phase formalised the key components of the ANCHUL intervention namely selection, training, monitoring and supervision, and execution of ASHAs' day to day activities; identify the standardized components and flexible functions, and list the process indicators for evaluating this intervention.Conclusion: Principles of implementation research was used for designing a context specific intervention directed towards ASHAs while engaging with a wide range of stakeholders. Such an approach may prove to be time consuming yet is feasible to address implementation challenges of an ongoing program and remodel it with evidence based components planned within the decision space of implementers.
Prednisolone versus placebo addition in the treatment of patients with recent-onset psychotic disorder: A trial design
Authors: Nasib Lyliana G. , Sommer Iris E. , Rossum Inge Winter-van , de Vries Jacqueline , Gangadin Shiral S. , Oomen Priscilla P. , Judge Gurmeet , Blom Renske E. , Luykx Jurjen J. , Beveren Nico J.M. van , Veen Natalie D. , Kroken Rune A. , Johnsen Erik
Published: January 2020

Background: The symptom severity of a substantial group of schizophrenia patients (30-40%) does not improve through pharmacotherapy with antipsychotic medication, indicating a clear need for new treatment options to improve schizophrenia outcome. Meta-analyses, genetic studies, randomized controlled trials and post-mortem studies suggest that immune dysregulation plays a role in the pathophysiology of schizophrenia. Some anti-inflammatory drugs have shown beneficial effects on the symptom severity of schizophrenia patients. Corticosteroids are effective in various chronic inflammatory and autoimmune disorders. Prednisolone, a potent glucocortisteroid, has minor mineral-corticosteroid potencies, can adequately pass the blood-brain barrier and its side-effects and safety profile are well known. Therefore, the effect of prednisolone can be studied as a proof of concept for immune modulation as a treatment for schizophrenia.
Method: In total 90 subjects, aged 18-70 years, diagnosed with schizophrenia, schizoaffective or schizophreniform disorder (Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) 295.*) or psychosis NOS (not otherwise specified) (298.9) will be included. The time interval between the onset of psychosis and study entry should not exceed seven years. Patients will be randomized 1:1 to either prednisolone or placebo daily for a period of six weeks in addition to a stable dose of antipsychotic medication. Study medication will be initiated at 40 mg for three days, after which it will be tapered down within six weeks after initiation, following current treatment guidelines. Primary outcome is change in symptom severity, expressed as change in total score on the Positive and Negative Symptom Scale (PANSS) from baseline to end of treatment. Cognitive functioning (measured through the Brief Assessment of Cognition in Schizophrenia; BACS) and change in Global Assessment Functioning (GAF) will be assessed, in addition to various immunological biomarkers. Secondary outcomes are a 4- and 6-month follow-up assessment of PANSS, BACS, GAF scores and immunological biomarkers. Additionally, a subgroup of patients will be included in the magnetic resonance imaging (MRI) part of the study where MR spectroscopy, structural, functional and diffusion MRI will be conducted.
Discussion: It is expected that prednisolone addition to current antipsychotic medication use will reduce symptom severity and will improve cognition when compared to placebo.
Sparse sampling and tensor network representation of two-particle Green's functions
Authors: Shinaoka Hiroshi , Geffroy Dominique , Wallerberger Markus , Otsuki Junya , Yoshimi Kazuyoshi , Gull Emanuel , Kuneš Jan
Published: January 2020

Many-body calculations at the two-particle level require a compact
representation of two-particle Green’s functions. In this paper, we
introduce a sparse sampling scheme in the Matsubara frequency domain as
well as a tensor network representation for two-particle Green’s
functions. The sparse sampling is based on the intermediate
representation basis and allows an accurate extraction of the
generalized susceptibility from a reduced set of Matsubara frequencies.
The tensor network representation provides a system independent way to
compress the information carried by two-particle Green’s functions. We
demonstrate efficiency of the present scheme for calculations of static
and dynamic susceptibilities in single- and two-band Hubbard models in
the framework of dynamical mean-field theory.