bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of age on pharmacokinetics, efficacy, and safety of galcanezumab treatment in adult patients with migraine: results from six phase 2 and phase 3 randomized clinical trials
Authors: Stauffer Virginia L. , Turner Ira , Kemmer Phebe , Kielbasa William , Day Kathleen , Port Martha , Quinlan Tonya , Camporeale Angelo
Published: June 2020

Background

Migraine clinical profile may change with age, making it necessary to verify that migraine treatments are equally safe and effective in older patients. These analyses evaluated the effects of patient age on the pharmacokinetics (PK), efficacy, and safety of galcanezumab for prevention of migraine.

Methods

Analyses included efficacy data from three double-blind phase 3 clinical trials: two 6-month studies in episodic migraine (EVOLVE-1, EVOLVE-2: N = 1773) and one 3-month study in chronic migraine (REGAIN:N = 1113). Patients were randomized 2:1:1 to placebo, galcanezumab 120 mg, or galcanezumab 240 mg. Safety and PK data included additional phase 2 and phase 3 trials for a larger sample size of patients > 60 years (range = 18–65 for all studies). Subgroup analyses assessed efficacy measures, adverse event (AE) occurrence, and cardiovascular measurement changes by patient age group. Galcanezumab PK were evaluated using a population analysis approach, where age was examined as a potential covariate on apparent clearance (CL/F) and apparent volume of distribution (V/F) of galcanezumab.

Results

Numbers of baseline monthly migraine headache days were similar across age groups. There were no statistically significant treatment-by-age group interactions for any efficacy measures, except in episodic migraine studies where older patients appeared to have a larger reduction than younger patients in the number of monthly migraine headache days with acute medication use. Age (18–65) had a minimal effect on CL/F, and no effect on V/F. Galcanezumab-treated patients ≥60 years experienced no clinically meaningful increases in blood pressure and no increased frequency in treatment-emergent AEs, discontinuations due to AEs, serious adverse events (SAEs) overall, or cardiovascular SAEs, compared to age-matched placebo-treated patients.

Conclusions

Age (up to 65 years) does not affect efficacy in migraine prevention and has no clinically meaningful influence on galcanezumab PK to warrant dose adjustment. Furthermore, older galcanezumab-treated patients experienced no increases in frequency of AEs or increases in blood pressure compared with age-matched placebo-treated patients.

Trial registrations

EVOLVE-1 (NCT02614183, registered 23 November 2015), EVOLVE-2 (NCT02614196, 23 November 2015), REGAIN (NCT02614261, 23 November 2015), ART-01 (NCT01625988, 20 June 2012, ), I5Q-MC-CGAB (NCT02163993, 12 June 2014, ), I5Q-MC-CGAJ (NCT02614287, 23 November 2015, ), all retrospectively registered.
Modulation of Magnetoresistance Polarity in BLG/SL-MoSe2 Heterostacks
Authors: Khan Muhammad Farooq , Rehman Shania , Rehman Malik Abdul , Basit Muhammad Abdul , Kim Deok-kee , Ahmed Faisal , Khalil H. M. Waseem , Akhtar Imtisal , Jun Seong Chan
Published: June 2020

Two-dimensional (2D) layered materials have an atomically thin and flat nature which makes it an ultimate candidate for spintronic devices. The spin-valve junctions (SVJs), composed of 2D materials, have been recognized as unique features of spin transport polarization. However, the magnetotransport properties of SVJs are highly influenced by the type of intervening layer (spacer) inserted between the ferromagnetic materials (FMs). In this situation, the spin filtering effect at the interfaces plays a critical role in the observation of the magnetoresistance (MR) of such magnetic structures, which can be improved by using promising hybrid structure. Here, we report MR of bilayer graphene (BLG), single-layer MoSe2 (SL-MoSe2), and BLG/SL-MoSe2 heterostack SVJs. However, before annealing, BLG and SL-MoSe2 SVJs demonstrate positive MR, but after annealing, BLG reverses its polarity while the SL-MoSe2 maintains its polarity and demonstrated stable positive spin polarizations at both interfaces due to meager doping effect of ferromagnetic (FM) contacts. Further, Co/BLG/SL-MoSe2/NiFe determines positive MR, i.e., ~ 1.71% and ~ 1.86% at T = 4 K before and after annealing, respectively. On the contrary, NiFe/BLG/SL-MoSe2/Co SVJs showed positive MR before annealing and subsequently reversed its MR sign after annealing due to the proximity-induced effect of metals doping with graphene. The obtained results can be useful to comprehend the origin of polarity and the selection of non-magnetic material (spacer) for magnetotransport properties. Thus, this study established a new paragon for novel spintronic applications.
Ecological, genetic and evolutionary drivers of regional genetic differentiation in Arabidopsis thaliana
Authors: Castilla Antonio R. , Méndez-Vigo Belén , Marcer Arnald , Martínez-Minaya Joaquín , Conesa David , Picó F. Xavier , Alonso-Blanco Carlos
Published: June 2020

Background

Disentangling the drivers of genetic differentiation is one of the cornerstones in evolution. This is because genetic diversity, and the way in which it is partitioned within and among populations across space, is an important asset for the ability of populations to adapt and persist in changing environments. We tested three major hypotheses accounting for genetic differentiation—isolation-by-distance (IBD), isolation-by-environment (IBE) and isolation-by-resistance (IBR)—in the annual plantArabidopsis thalianaacross the Iberian Peninsula, the region with the largest genomic diversity. To that end, we sampled, genotyped with genome-wide SNPs, and analyzed 1772 individuals from 278 populations distributed across the Iberian Peninsula.

Results

IBD, and to a lesser extent IBE, were the most important drivers of genetic differentiation inA. thaliana. In other words, dispersal limitation, genetic drift, and to a lesser extent local adaptation to environmental gradients, accounted for the within- and among-population distribution of genetic diversity. Analyses applied to the four Iberian genetic clusters, which represent the joint outcome of the long demographic and adaptive history of the species in the region, showed similar results except for one cluster, in which IBR (a function of landscape heterogeneity) was the most important driver of genetic differentiation. Using spatial hierarchical Bayesian models, we found that precipitation seasonality and topsoil pH chiefly accounted for the geographic distribution of genetic diversity in IberianA. thaliana.

Conclusions

Overall, the interplay between the influence of precipitation seasonality on genetic diversity and the effect of restricted dispersal and genetic drift on genetic differentiation emerges as the major forces underlying the evolutionary trajectory of IberianA. thaliana.
Replication origin location might contribute to genetic variability in Trypanosoma cruzi
Authors: de Araujo Christiane Bezerra , da Cunha Julia Pinheiro Chagas , Inada Davi Toshio , Damasceno Jeziel , Lima Alex Ranieri Jerônimo , Hiraiwa Priscila , Marques Catarina , Gonçalves Evonnildo , Nishiyama-Junior Milton Yutaka , McCulloch Richard , Elias Maria Carolina
Published: June 2020

Background

DNA replication in trypanosomatids operates in a uniquely challenging environment, since most of their genomes are constitutively transcribed.Trypanosoma cruzi, the etiological agent of Chagas disease, presents high variability in both chromosomes size and copy number among strains, though the underlying mechanisms are unknown.

Results

Here we have mapped sites of DNA replication initiation across theT. cruzigenome using Marker Frequency Analysis, which has previously only been deployed in two related trypanosomatids. The putative origins identified inT. cruzishow a notable enrichment of GC content, a preferential position at subtelomeric regions, coinciding with genes transcribed towards the telomeres, and a pronounced enrichment within coding DNA sequences, most notably in genes from the Dispersed Gene Family 1 (DGF-1).

Conclusions

These findings suggest a scenario where collisions between DNA replication and transcription are frequent, leading to increased genetic variability, as seen by the increase SNP levels at chromosome subtelomeres and in DGF-1 genes containing putative origins.
Biochar addition alleviate the negative effects of drought and salinity stress on soybean productivity and water use efficiency
Authors: Zhang Yaojun , Ding Jiaqi , Wang Hong , Su Lei , Zhao Cancan
Published: June 2020

Background

Environmental stress is a crucial factor restricting plant growth as well as crop productivity, thus influencing the agricultural sustainability. Biochar addition is proposed as an effective management to improve crop performance. However, there were few studies focused on the effect of biochar addition on crop growth and productivity under interactive effect of abiotic stress (e.g., drought and salinity). This study was conducted with a pot experiment to investigate the interaction effects of drought and salinity stress on soybean yield, leaf gaseous exchange and water use efficiency (WUE) under biochar addition.

Results

Drought and salinity stress significantly depressed soybean phenology (e.g. flowering time) and all the leaf gas exchange parameters, but had inconsistent effects on soybean root growth and WUE at leaf and yield levels. Salinity stress significantly decreased photosynthetic rate, stomatal conductance, intercellular CO2 concentration and transpiration rate by 20.7, 26.3, 10.5 and 27.2%, respectively. Lower biomass production and grain yield were probably due to the restrained photosynthesis under drought and salinity stress. Biochar addition significantly enhanced soybean grain yield by 3.1–14.8%. Drought stress and biochar addition significantly increased WUE-yield by 27.5 and 15.6%, respectively, while salinity stress significantly decreased WUE-yield by 24.2%. Drought and salinity stress showed some negative interactions on soybean productivity and leaf gaseous exchange. But biochar addition alleviate the negative effects on soybean productivity and water use efficiency under drought and salinity stress.

Conclusions

The results of the present study indicated that drought and salinity stress could significantly depress soybean growth and productivity. There exist interactive effects of drought and salinity stress on soybean productivity and water use efficiency, while we could employ biochar to alleviate the negative effects. We should consider the interactive effects of different abiotic restriction factors on crop growth thus for sustainable agriculture in the future.
Genome-wide association analysis reveals loci and candidate genes involved in fiber quality traits in sea island cotton (Gossypium barbadense)
Authors: Su Xiujuan , Zhu Guozhong , Song Xiaohui , Xu Haijiang , Li Weixi , Ning Xinzhu , Chen Quanjia , Guo Wangzhen
Published: June 2020

Background

Sea island cotton (Gossypium barbadense) has markedly superior high quality fibers, which plays an important role in the textile industry and acts as a donor for upland cotton (G. hirsutum) fiber quality improvement. The genetic characteristics analysis and the identification of key genes will be helpful to understand the mechanism of fiber development and breeding utilization in sea island cotton.

Results

In this study, 279 sea island cotton accessions were collected from different origins for genotyping and phenotyping fiber quality traits. A set of 6303 high quality single nucleotide polymorphisms (SNPs) were obtained by high-density CottonSNP80K array. The population characteristics showed that the sea island cotton accessions had wide genetic diversity and were clustered into three groups, with Group1 closely related to Menoufi, an original sea island cotton landrace, and Group2 and Group3 related to widely introduced accessions from Egypt, USA and Former Soviet Union. Further, we used 249 accessions and evaluated five fiber quality traits under normal and salt environments over 2 years. Except for fiber uniformity (FU), fiber length (FL) and fiber elongation (FE) were significantly decreased in salt conditions, while fiber strength (FS) and fiber micronaire (MIC) were increased. Based on 6303 SNPs and genome-wide association study (GWAS) analysis, a total of 34 stable quantitative trait loci (QTLs) were identified for the five fiber quality traits with 25 detected simultaneously under normal and salt environments. Gene Ontology (GO) analysis indicated that candidate genes in the 25 overlapped QTLs were enriched mostly in “cellular and biological process”. In addition, “xylem development” and “response to hormone” pathways were also found. Haplotype analyses found that GB_A03G0335 encoding an E3 ubiquitin-protein ligase in QTL TM6004 had SNP variation (A/C) in gene region, was significantly correlated with FL, FS, FU, and FE, implying a crucial role in fiber quality.

Conclusions

The present study provides a foundation for genetic diversity of sea island cotton accessions and will contribute to fiber quality improvement in breeding practice.
Late discovery of left atrial appendage occluder device embolization: a case report
Authors: Mansour Mohamad Jihad , Bénic Clément , Didier Romain , Noel Antoine , Gilard Martine , Mansourati Jacques
Published: June 2020

Background

Left atrial appendage (LAA) closure has been well evaluated in the prevention of stroke in patients with atrial fibrillation. Device embolization remains one of the most common complications. To the best of our knowledge, there have been no reports of late discovery of LAA occluder device embolization at 1.5 years after implantation.

Case presentation

We describe the case of a 77-year-old man who underwent uneventful LAA closure. Echocardiography performed the next day showed the device in place. The patient was discharged but was then lost to follow-up. 1.5 years later, he was admitted for ischemic stroke. Transesophageal echocardiography showed the absence of the occluder device in the LAA. Computed tomography scan of the abdomen showed the device in the abdominal aorta. Due to the high cardiovascular risk, the device was kept in place and the patient was treated medically.

Conclusions

Per-procedural and late device embolization are not uncommon. Review of the literature however showed no report of late discovery of device embolization at 1.5 years. Follow-up echocardiography is mandatory for the detection of endothelialization or embolization.
Predicting non-elective hospital readmission or death using a composite assessment of cognitive and physical frailty in elderly inpatients with cardiovascular disease
Authors: Yao Si-Min , Zheng Pei-Pei , Liang Yao-Dan , Wan Yu-Hao , Sun Ning , Luo Yao , Yang Jie-Fu , Wang Hua
Published: June 2020

Background

We aimed to assess the utility of the combination of the mini-mental state examination (MMSE) + clock drawing test (CDT) and the Fried phenotype for predicting non-elective hospital readmission or death within 6 months in elderly inpatients with cardiovascular disease (CVD).

Methods

A single-center prospective cohort was conducted from September 2018 to February 2019. Inpatients ≥65 years old were recruited. Predictive validity was tested using a Cox proportional hazards regression model analysis, and the discriminative ability was evaluated by the receiver operating characteristic (ROC) curve.

Results

A total of 542 patients were included. Overall, 12% (64/542) screened positive for cognitive impairment, 16% (86/542) were physically frail and 8% (44/542) had cognitive impairment combined with physical frailty, showing an older age (P < 0.001) and a lower education level (P < 0.001) than physically frail patients. A total of 113 patients (20.9%) died or were readmitted at 6 months. Frail participants with a normal (hazard ratio [HR]: 1.73, 95% confidence interval [CI]: 1.06–2.82, P = 0.028) or impaired cognition (HR: 2.50, 95% CI: 1.27–4.91, P = 0.008) had a higher risk of non-elective hospital readmission or death than robust patients after adjusting for the age, sex, education level, marital status, the presence of diabetes mellitus, heart failure, and history of stroke. The area under the ROC curve (AUC) showed that the discriminative ability in relation to 6 months readmission and death for the MMSE + CDT + Fried phenotype was 0.65 (95% CI: 0.60–0.71), and the AUC for men was 0.71 (95% CI: 0.63–0.78), while that for women was 0.60 (95% CI: 0.51–0.69).

Conclusions

Accounting for cognitive impairment in the frailty phenotype may allow for the better prediction of non-elective hospital readmission or death in elderly inpatients with CVD in the short term.

Trial registration

ChiCTR1800017204; date of registration: 07/18/2018.
Physical activity in people with dementia attending farm-based dementia day care – a comparative actigraphy study
Authors: Finnanger Garshol B. , Ellingsen-Dalskau L. H. , Pedersen I.
Published: June 2020

Background

Despite public focus on the importance of physical activity and findings showing the benefits of such activity, research has shown that people with dementia are less physically active and have more sedentary behaviour compared to others in similar age groups. In Norway, there is a focus on day care services as a means to allow people with dementia to experience social, physical and cultural activities. Farm based services have been highlighted as an innovative and customized day care service, but little research has been done on physical activity and such services. This study therefor aims to investigate the potential of farm-based day care services as services that can promote physical activity for people with dementia.

Methods

Actigraphy data from people with dementia attending farm-based day care services (n = 29) and people with dementia attending regular day care services (n = 107) was used to assess levels of physical activity in each group and to compare the two groups.

Results

People attending farm-based day care had significantly higher levels of moderate activity, approximately 23 min each day, compared with persons attending ordinary day care (p = 0.048). Time spent in sedentary or light activity were similar for both groups. For the group attending farm-based day care services, days at the service, were significantly associated with less time spent in sedentary activity (p = 0.012) and more time spent in light (p < 0.001) and moderate activity (p = 0.032), and in taking more steps (p = 0.005) compared to days not at the service.

Conclusion

The findings indicate that participants in farm-based day care for people with dementia have higher levels of physical activity compared to ordinary day care and that farm-based day care increases levels of physical activity for its attendees. Farm based day care services has the potential to help their participants reach or maintain recommended levels of physical activity. Further research is needed to investigate what facilitates this increase in activity and how such knowledge could be used in all types of day care services.
Iodine adequacy in reproductive age and pregnant women living in the Western region of Saudi Arabia
Authors: Azzeh Firas , Refaat Bassem
Published: June 2020

Background

Despite the serious maternal and foetal complications associated with iodine deficiency during pregnancy, surveys related to pregnant women in the Kingdom of Saudi Arabia (KSA) are lacking. This study, therefore, measured urine iodine concentrations (UIC) alongside the potential socioeconomic factors contributing towards iodine inadequacy in reproductive age and pregnant Saudi women from the Western province of KSA.

Methods

Spot urine samples were collected from 1222 pregnant and 400 age-matched non-pregnant/non-lactating reproductive age women. The socioeconomic characteristics were obtained through a structured questionnaire. The WHO criteria for iodine sufficiency in non-pregnant (100–199 μg/L) and pregnant (150–249 μg/L) women were applied.

Results

The median UIC in the non-pregnant women (101.64 μg/L; IQR: 69.83–143.55) was at the lowermost WHO recommended cut-off, whereas the pregnant group was iodine deficient (112.99 μg/L; IQR: 81.01–185.57). Moreover, the median UIC was below adequacy across the different trimesters. The use of non-iodised salt significantly increased the risk of iodine deficiency in the non-pregnant (OR = 2.052; 95%CI: 1.118–3.766) and pregnant women (OR = 3.813; 95%CI: 1.992–7.297), whereas taking iodine supplements significantly lowered the risk in both groups (OR = 0.364; 95%CI: 0.172–0.771 and OR = 0.002; 95%CI: 0.001–0.005, respectively). Passive smoking was also an independent risk factor for iodine deficiency in the non-pregnant (OR = 1.818; 95%CI: 1.097–3.014) and pregnant (OR = 1.653; 95%CI: 1.043–2.618) groups. Additionally, BMI correlated independently and significantly with median UIC in the non-pregnant and pregnant populations. However, multiparity (OR = 3.091; 95%CI: 1.707–5.598) and earning below the minimum wage (2.520; 95%CI: 1.038–6.119) significantly increased the risk of iodine deficiency only in the non-pregnant women.

Conclusions

This study is the first to show borderline iodine sufficiency in reproductive age Saudi women from the Western province, whereas mild iodine deficiency was observed in the pregnant population and could represent a serious public health problem. This study also advocates the necessity to establish routine iodine dietary advice services by the health authorities to foster adequate iodine intake in pregnant women to avoid the perilous consequences of iodine deficiency on maternal-foetal health.
Sophoridine exerts tumor-suppressive activities via promoting ESRRG-mediated β-catenin degradation in gastric cancer
Authors: Peng Zhiyang , Guan Qing , Luo Jianfei , Deng Wenhong , Liu Jiasheng , Yan Ruicheng , Wang Weixing
Published: June 2020

Background

As a natural alkaloid product isolated from Sophora alopecuroides. L, Sophoridine reshapes gastric cancer immune microenvironment via inhibiting chemotaxis and M2 polarization of tumor-associated macrophages (TAMs). However, the exact effects and underlying mechanism of Sophoridine on gastric cancer cells remains poorly known.

Methods

The potential anti-tumor effects of Sophoridine on gastric cancer cell lines, including AGS and SGC7901 cells, were detected by CCK-8, EDU and colony forming assay, immunofluorescence, transwell assay, and flow cytometry. Molecular mechanisms of Sophoridine were investigated by siRNA transfection, nuclear/cytoplasmic extraction and western blot. The synergistic effects of Sophoridine with cisplatin on gastric cancer cells were further investigated in in vitro functional studies.

Results

Sophoridine exhibited potent tumor-suppressive activities in gastric cancer cells, including inhibition of proliferation, colony formulation, migration and invasion, as well as induction of apoptosis. In addition, we further showed that Sophoridine induced G2/M cell cycle arrest via inhibiting double-stranded DNA breaks repair and enhanced the efficacy of cisplatin in gastric cancer cells. Molecular studies further revealed that Sophoridine promoted β-catenin degradation by enhancing Estrogen-related receptor gamma (ESRRG) expression, but not depended on ubiquitination-proteasome pathway, either TRIM33-mediated (GSK3β-independent) or altered GSK3β activity, and thus exerted potent tumor-suppressive activities.

Conclusion

Sophoridine depends on targeting ESRRG/β-catenin pathway to exert tumor-suppressive activities in gastric cancer cells and enhances the anti-tumor effect of cisplatin. Our study provided the promising preclinical anti-tumor evidence for the potential application of Sophoridine against gastric cancer.
Prognostic significance of branched-chain amino acid transferase 1 and CD133 in triple-negative breast cancer
Authors: Song Yu , Zhao Bin , Xu Yali , Ren Xinyu , Lin Yan , Zhou Liangrui , Sun Qiang
Published: June 2020

Background

Previous studies have shown that branched-chain amino acid transferase 1 (BCAT1) is associated with tumour progression in triple-negative breast cancer (TNBC). Furthermore, CD133 has emerged as a novel cancer stem cell marker for indicating tumour progression. However, the prognostic significance of these two markers remains to be verified. This study was conducted to investigate the correlation between BCAT1 and CD133 expression and clinicopathological features, as well as the prognosis of patients with TNBC.

Methods

The study cohort included 291 patients with TNBC. Tissue microarrays were constructed for both cancer and normal tissues. The expression of BCAT1 and CD133 was detected by immunohistochemical staining, and the levels were evaluated using an H-scoring system. Cut-off points for BCAT1 and CD133 expression were determined using receiver operating characteristic curves.

Results

The median follow-up time for the study participants was 68.73 months (range: 1.37–103.6 months). The 5-year disease-free survival (DFS) and overall survival (OS) rates of the 291 patients with TNBC were 72.51 and 82.47%, respectively. Higher levels of BCAT1 and CD133 expression independently indicated shorter DFS and OS. High levels of both BCAT1 and CD133 expression were detected in 36 (12.37%) patients, who had significantly shorter DFS and OS (both P < 0.001) compared to other patients.

Conclusion

BCAT1 and CD133 can be considered as biomarkers with prognostic significance for TNBC.
Eiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation
Authors: Guo Tao , Qin Xiuhong , Wang Hongwei , Lu Yang , Xu Li , Ji Jiali , Xiao Caiwen , Zhang Zhenzhen
Published: June 2020

Background

To evaluate the etiology of lacrimal canalicular laceration and explore the possible risk factors influencing prognosis.

Methods

The data of 142 patients (142 eyes) with lacrimal canalicular lacerations who were surgically treated using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018 were reviewed. The analyzed data contained demographic information, types of trauma, injury locations, associated additional ocular injuries, and surgical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and complications of surgery.

Results

The mean patient age was 42.07 years (ranging from 1 to 75 years). Among the 142 patients, 112 (78.87%) were males. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 (78.87%) patients, respectively. Meanwhile, both upper and lower canalicular lacerations were found in 16 (11.27%) patients. Electric bike accidents comprised the leading cause of injury, accounting for 76 (53.52%) cases. There were 100 (70.42%) patients who had lid lacerations without tarsal plate fracture and 42 (29.58%) patients who had lid lacerations with tarsal plate fractures. The anatomic success rate was 98.59% and the functional success rate was 83.8%. The functional reconstruction failure rates were higher in patients with indirect injuries, lid lacerations with tarsal plate fractures, and those with punctum splitting (P < 0.05). Surgical complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, and stent extrusion and loss in 2 (1.41%) patients.

Conclusions

Electric bike accidents have become the leading cause of injury instead of motor vehicle accidents because of the changes in the lifestyles of people. Indirect injuries, lid lacerations with tarsal plate fractures, and those with punctum splitting were significantly more likely to lead to poor prognosis, as confirmed by the lower functional success rate of surgery.
Bacteriological profiles and drug susceptibility of Streptococcus isolated from conjunctival sac of healthy children
Authors: Ke Ruili , Zhang Min , Zhou Qin , Yang Yunfei , Shen Ruifen , Huang Huipin , Zhang Xiangrong
Published: June 2020

Background

To investigate bacterial flora and antibiotics susceptibility of Streptococcus pneumoniae isolated from the conjunctival sac of heathy children.

Methods

Bacteria were isolated from the secretions of conjunctival sac of healthy children between 2015 and 2018. Antimicrobial susceptibility of isolated S. pneumoniae strains were determined using microbroth dilution method.

Results

The sac secretions were collected from a total of 6440 children. 1409 samples presented bacterial growth, accounting for 21.8% of the samples. Among the 22 bacterial species isolated, 528 samples presented Gram-positive Staphylococcus spp. growth, accounting for 37.4% of the isolates, followed by Corynebacterium spp., counting for 30% of the isolates and Streptococcus pneumoniae, counting for 21.4% of the isolates. Antibiotics susceptibility tests showed that the majority of S. pneumoniae isolates were sensitive to most antibiotics tested. However, 72.8 and 81.2% of the isolates were resistant to erythromycin and tetracycline, respectively, and over 10% of them were resistant to gentamicin, tobramycin and rifampicin.

Conclusions

The bacterial flora of healthy children is mainly consisted of Gram-positive bacteria belonging to Corynebacterium spp. and Streptococcus spp.; most of S. pneumoniae isolates were sensitive to antibiotics except erythromycin and tetracycline.
Assessing the effects of maternal HIV infection on pregnancy outcomes using cross-sectional data in Malawi
Authors: Twabi Halima S. , Manda Samuel O. , Small Dylan S.
Published: June 2020

Background

Several studies have shown that maternal HIV infection is associated with adverse pregnancy outcomes such as low birth weight and perinatal mortality. However, the association is conflicted with the effect of antiretroviral therapy (ART) on the pregnancy outcomes and it remains unexamined. If the association is confirmed then it would guide policy makers towards more effective prevention of mother to child HIV transmission interventions. Using methods for matching possible confounders, the objectives of the study were to assess the effect of maternal HIV infection on birth weight and perinatal mortality and to investigate the effect of ART on these two pregnancy outcomes in HIV-infected women.

Methods

Data on 4111 and 4759 children, born within five years of the 2010 and 2015-16 Malawi Demographic and Health Surveys (MDHS) respectively, whose mothers had an HIV test result, were analysed. A best balancing method was chosen from a set of covariate balance methods namely, the 1:1 nearest neighbour (NN) matching, matching on the propensity score (PS) and inverse weighting on the PS. HIV and ART data were only available in the MDHS 2010, permitting an assessment of the moderating effect of ART on the association between maternal HIV infection and birth weight and perinatal mortality.

Results

The overall average birth weight was 3227.9g (95% CI: 3206.4, 3249.5) in 2010 and 3226.4g (95%: 3205.6, 3247.2) in 2015-16 and perinatal mortality was 3.8% (95%: 3.2, 4.3) in 2010 and 3.5% (95%: 2.8, 3.8) in 2015-16. The prevalence of HIV among the mothers was 11.1% (95%: 10.1, 12.0) and 9.2% (95% CI: 8.4, 10.1) in 2010 and 2015-16, respectively. In 2010, maternal HIV infection was negatively associated with birth weight (mean= -25.3g, 95% CI:(-95.5, -7.4)) and in 2015-16 it was positively associated with birth weight (mean= 116.3g, 95% CI:(27.8, 204.7)). Perinatal mortality was higher in infants of HIV-infected mothers compared to infants of HIV-uninfected mothers (OR = 1.5, 95% CI:(1.1 - 3.1)) in 2010, while there was no difference in the rate in 2015-16 (OR = 1.0, 95% CI:(0.4, 1.6)). ART was not associated with birth weight, however, it was associated with perinatal mortality (OR=3.9, 95% CI:(1.1, 14.8)).

Conclusion

The study has found that maternal HIV infection had an adverse effect on birth weight and perinatal mortality in 2010. Birth weight was not dependent on ART uptake but perinatal mortality was higher among infants of HIV-infected mothers who were not on ART. The higher birth weight among HIV-infected mothers and similarity in perinatal mortality with HIV-uninfected mothers in 2015-16 may be indicative of successes of interventions within the PMTCT program in Malawi.
Six-minute walking distance in healthy Chinese people older than 60 years
Authors: Zou He , Zhang Jia , Zou Yingying , Chen Xiaoshu , Wang Yi , Chen Hao , Ye Fanhao , Yu Haizhu
Published: June 2020

Background

The six-minute walking test (6MWT) is a tool that plays a key role in evaluating the functional exercise capacity, prognosis and evaluation of treatment response of patients with various cardiopulmonary diseases. However, standard reference equations are currently unavailable for the six-minute walking distance (6MWD) for people aged 60–85 years in China. The purpose of this study was to 1) measure the 6MWD of healthy Chinese people aged 60–85 years, 2) establish reference equations for predicting the 6MWD, and 3) compare our reference equations with equations reported in previously published studies.

Method

We obtained informed consent from each participant prior to the test, and the research design was approved by the Ethics Committee of Wenzhou People’s Hospital. The demographic and anthropometric data and the 6MWD of healthy Chinese subjects aged 60–85 years old were measured using a standardized protocol. Every subject completed two 6MWTs, and the longest 6MWD further analyzed.

Results

Two hundred sixty-six subjects (128 males and 138 females) completed the 6MWT, and the mean walking distance was 518 ± 72 m. Males achieved a longer walking distance than females (518 ± 72 m vs. 487 ± 70 m; p < 0.0001), and active subjects achieved a longer walking distance than nonactive subjects (512 ± 76 m vs. 485 ± 63 m; p < 0.0001). According to the univariate analysis, the 6MWD was significantly associated with age, height, body mass index (BMI), heart rate and blood pressure after exercise and changes in heart rate before and after exercise. The stepwise multivariate regression analysis identified age, height and BMI as independent predictors of the 6MWD. The reference equations for Caucasians and South Americans tended to overestimate the 6MWD of our subjects, while the equations for Asian and African populations tended to underestimate the 6MWD.

Conclusions

This study is the first to describe the 6MWD of healthy Chinese people aged 60–85 years, and reference prediction equations were proposed. These findings will help to improve the evaluation of Chinese patients with diseases that affect exercise capacity.
Loop-mediated isothermal amplification (LAMP) reaction as viable PCR substitute for diagnostic applications: a comparative analysis study of LAMP, conventional PCR, nested PCR (nPCR) and real-time PCR (qPCR) based on Entamoeba histolytica DNA derived from faecal sample
Authors: Foo Phiaw Chong , Nurul Najian A. B. , Muhamad Nuramin A. , Ahamad Mariana , Mohamed Maizan , Yean Yean Chan , Lim Boon Huat
Published: June 2020

Background

This study reports the analytical sensitivity and specificity of a Loop-mediated isothermal amplification (LAMP) and compares its amplification performance with conventional PCR, nested PCR (nPCR) and real-time PCR (qPCR). All the assays demonstrated in this study were developed based on Serine-rich Entamoeba histolytica protein (SREHP) gene as study model.

Results

A set of SREHP gene specific LAMP primers were designed for the specific detection of Entamoeba histolytica. This set of primers recorded 100% specificity when it was evaluated against 3 medically important Entamoeba species and 75 other pathogenic microorganisms. These primers were later modified for conventional PCR, nPCR and qPCR applications. Besides, 3 different post-LAMP analyses including agarose gel electrophoresis, nucleic acid lateral flow immunoassay and calcein-manganese dye techniques were used to compare their limit of detection (LoD). One E. histolytica trophozoite was recorded as the LoD for all the 3 post-LAMP analysis methods when tested with E. histolytica DNA extracted from spiked stool samples. In contrast, none of the PCR method outperformed LAMP as both qPCR and nPCR recorded LoD of 100 trophozoites while the LoD of conventional PCR was 1000 trophozoites.

Conclusions

The analytical sensitivity comparison among the conventional PCR, nPCR, qPCR and LAMP reveals that the LAMP outperformed the others in terms of LoD and amplification time. Hence, LAMP is a relevant alternative DNA-based amplification platform for sensitive and specific detection of pathogens.
Relationships between menstrual status and obesity phenotypes in women: a cross-sectional study in northern China
Authors: Chen Xueyu , Xi Hui , Ji Long , Liu Weihua , Shi Fengxue , Chen Yanru , Wang Xiaohui , Zhang Wenran , Sui Xinxia , Wang Xiaojun , Zhang Haitao , Liu Huamin , Li Dong
Published: June 2020

Background

One of most important concerns of postmenopausal women is obesity. The relationships between menstruation status and obesity phenotypes are unclear. This study aimed to assess the associations between menstrual status and different obesity phenotypes in women.

Methods

In total, 5373 women aged ≥40 years were recruited from the Jidong and Kailuan communities. Basic information was collected via clinical examination, laboratory testing and standardized questionnaires. The women were stratified into the following three groups: menstrual period, menopausal transition period and postmenopausal period. General obesity was defined as a body mass index (BMI) of ≥28 kg/m2. Central obesity was defined as a waist-to-hip ratio (WHR) of > 0.85. Visceral obesity was defined as the presence of nonalcoholic fatty liver disease (NAFLD) and increased pericardial fat volume (PFV).

Results

The numbers of women in the menstrual, menopausal transition, and postmenopausal periods were 2807 (52.2%), 675 (12.6%) and 1891 (35.2%), respectively. The adjusted odds ratio (OR) and 95% confidence interval (CI) for central obesity among women in the menopausal transition and postmenopausal periods compared with women in the menstrual period were 0.99 (0.82–1.19) and 1.52 (1.26–1.84), respectively. The OR for NAFLD among postmenopausal women was 1.78 (1.44–2.20). The adjusted β-coefficient (standard error, SE) for PFV among postmenopausal women was 41.25 (7.49). The adjusted OR for general obesity among postmenopausal women was 1.01 (0.77–1.34).

Conclusions

This study demonstrated that menopause is an independent risk factor for central and visceral obesity but not general obesity.
Evaluation of a midwifery network to guarantee outpatient postpartum care: a mixed methods study
Authors: Grylka-Baeschlin Susanne , Iglesias Carolina , Erdin Rebekka , Pehlke-Milde Jessica
Published: June 2020

Background

The necessity of outpatient postpartum care has increased due to shorter hospital stays. In a health care system, where postpartum care after hospital discharge must be arranged by families themselves, this can be challenging for those experiencing psychosocial disadvantages. Therefore, we compared characteristics of users of a midwifery network which referred women to outpatient postpartum care providers with those of women organising care themselves. Additionally, we investigated benefits of the network for women and health professionals.

Methods

Evaluation of the services of a midwifery network in Switzerland. We combined quantitative secondary analysis of routine data of independent midwives with qualitative telephone interviews with users and a focus group with midwives and nurses. Descriptive statistics and logistic regression modelling were done using Stata 13. Content analysis was applied for qualitative data.

Results

Users of the network were more likely to be: primiparas (OR 1.52, 95% CI [1.31–1.75, p < 0.001]); of foreign nationality (OR 2.36, 95% CI [2.04–2.73], p < 0.001); without professional education (OR 1.89, 95% CI [1.56–2.29] p < 0.001); unemployed (OR 1.28, 95% CI [1.09–1.51], p = 0.002) and have given birth by caesarean section (OR 1.38, 95% CI [1.20–1.59], p < 0.001) compared to women organising care themselves. Furthermore, users had cumulative risk factors for vulnerable transition into parenthood more often (≥ three risk factors: 4.2% vs. 1.5%, p < 0.001). Women appreciate the services provided. The collaboration within the network facilitated work scheduling and the better use of resources for health professionals.

Conclusions

The network enabled midwives and nurses to reach families who might have struggled to organise postpartum care themselves. It also facilitated the work organisation of health professionals. Networks therefore provide benefits for families and health professionals.
The potential role of patent and proprietary medicine vendors’ associations in improving the quality of services in Nigeria’s drug shops
Authors: Oyeyemi Abisoye S. , Oladepo Oladimeji , Adeyemi Adedayo O. , Titiloye Musibau A. , Burnett Sarah M. , Apera Iorwakwagh
Published: June 2020

Background

Patent and Proprietary Medicine Vendors (PPMVs) play a major role in Nigeria’s health care delivery but regulation and monitoring of their practice needs appreciable improvement to ensure they deliver quality services. Most PPMVs belong to associations which may be useful in improving their regulation. However, little is known about how the PPMV associations function and how they can partner with relevant regulatory agencies to ensure members’ compliance and observance of good practice. This study sought to describe the PPMV associations’ structure and operations and the regulatory environment in which PPMVs function. With this information we explore ways in which the associations could help improve the coverage of Nigeria’s population with basic quality health care services.

Methods

A mixed methods study was conducted across four rural local government areas (LGAs) (districts) in two Nigerian states of Bayelsa and Oyo. The study comprises a quantitative data collection of 160 randomly selected PPMVs and their shops, eight PPMV focus group discussions, in-depth interviews with 26 PPMV association executives and eight regulatory agency representatives overseeing PPMVs’ practice.

Results

The majority of the PPMVs in the four LGAs belonged to the local chapters of National Association of Patent and Proprietary Medicine Dealers (NAPPMED). The associations were led by executive members and had regular monthly meetings. NAPPMED monitored members’ activities, provided professional and social support, and offered protection from regulatory agencies. More than 80% of PPMVs received at least one monitoring visit in the previous 6 months and local NAPPMED was the organization that monitored PPMVs the most, having visited 68.8% of respondents. The three major regulators, who reached 30.0–36.3% of PPMVs reported lack of human and financial resources as the main challenge they faced in regulation.

Conclusions

Quality services at drug shops would benefit from stronger monitoring and regulation. The PPMV associations already play a role in monitoring their members. Regulatory agencies and other organizations could partner with the PPMV associations to strengthen the regulatory environment and expand access to basic quality health services at PPMV shops in Nigeria.
A strategic approach to social accountability: Bwalo forums within the reproductive maternal and child health accountability ecosystem in Malawi
Authors: Butler Nadia , Johnson Ginger , Chiweza Asiyati , Aung Kyaw Myint , Quinley John , Rogers Katherine , Bedford Juliet
Published: June 2020

Background

The majority of documented social accountability initiatives to date have been ‘tactical’ in nature, employing single-tool, mostly community-based approaches. This article provides lessons from a ‘strategic’, multi-tool, multi-level social accountability project: UNICEF’s ‘Social Accountability for Every Woman Every Child’ intervention in Malawi.

Methods

The project targeted the national, district and community levels. Three Civil Society Organisations (CSOs) were engaged to carry out interventions using various tools to generate evidence and political advocacy at one or more levels. This article focuses on one of the social accountability methods – thebwaloforum (a meeting based on a traditional Malawian method of dialogue). A detailed political economy analysis was conducted by one of the co-authors using qualitative methods including interviews and group discussions. The authors conducted in-country consultations and analysed secondary data provided by the CSOs.

Results

The political economy analysis highlighted several ways in which CSO partners should modify their work plans to be more compatible with the project context. This included shifting the advocacy and support focus, as well as significantly expanding thebwaloforums.Bwaloswere found to be an important platform for allowing citizens to engage with duty bearers at the community and district levels, and enabled a number of reproductive, maternal, newborn, child and adolescent health issues to be resolved at those levels. The project also enabled learning around participant responses as intermediate project outcomes.

Conclusions

The project utilised various tools to gather data, elevate community voices, and facilitate engagement between citizen and state actors at the community, district and national levels. This provided the scaffolding for numerous issues to be resolved at the community or district levels, or referred to the national level.Bwaloforums were found to be highly effective as a space for inter-level engagement between citizens and state; however, as they were not embedded in existing local structures, their potential for sustainability and scalability was tenuous. A key strength of the project was the political economy analysis, which provided direction for partners to shape their interventions according to local and national realities and be sensitive to the barriers and drivers to positive action.
Assessment of completeness and legibility of handwritten prescriptions in six community chain pharmacies of Asmara, Eritrea: a cross-sectional study
Authors: Weldemariam Dawit G. , Amaha Nebyu Daniel , Abdu Nuru , Tesfamariam Eyasu H.
Published: June 2020

Background

Incompleteness and illegibility of prescriptions are prescription errors that account for a high proportion of medication errors that could potentially result in serious adverse effects. Thus, the objective of this study was to assess the completeness and legibility of prescriptions filled in the community chain pharmacies.

Methods

An analytical and cross-sectional study was conducted in the six government owned community chain pharmacies of Asmara, Eritrea from June 3rd to 10th, 2019 using a stratified random sampling technique. A total of 385 prescriptions were analyzed for completeness and legibility by three pharmacists (two experienced and one intern pharmacist). Descriptive statistics and multinomial logistic regression were employed using IBM SPSS® (Version 22).

Results

A total of 710 drugs were prescribed from the 385 prescriptions assessed. On average, a prescription was found to have 78.63% overall completeness. In the majority of the prescriptions, patient’s information such as name, age, sex, and prescriber’s identity were present. Prescribed drugs’ information such as dose, frequency and quantity and/or duration were present in 83.7, 87.7, and 95.1% respectively. Moreover, generic names were used in 83.3% of the drugs prescribed. About half (54.3%) of the prescriptions’ legibility were classified in grade four (clearly legible) and 30.6% in grade three (moderately legible). It was observed that legibility significantly increased with an increase in percentage completeness (rs = 0.14, p = 0.006). However, as the number of drugs written in brand name increased, legibility decreased (rs = − 0.193, p < 0.001). Similarly, as the number of drugs prescribed increased, legibility decreased (rs = − 0.226, p < 0.006).

Conclusion

Majority of the handwritten prescriptions received in the community pharmacies of Asmara are complete and clearly legible.