bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with the practice of exclusive breastfeeding for six months among mothers on antiretroviral therapy in the Eastern Cape, South Africa
Authors: GOON PROF DANIEL TER , Ajayi Anthony Idowu , ADENIYI OLADELE VINCENT
Published: September 2020

Background: Exclusive breast feeding (EBF) is associated with reduction of post-natal HIV transmission and optimal infant growth. Given that the factors influencing EBF are multi-factorial and context-specific, we examined the prevalence and factors associated with EBF practice in the first six months among mothers on antiretroviral therapy (ART) in the Eastern Cape, South Africa. Methods: This was a prospective cross-sectional study conducted between January – May 2018 on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. EBF was defined as infant feeding with breast milk only. We collected relevant socio-demographic, lifestyle and maternal information by interview. Bivariate and multivariate logistic regression analyses were fitted to determine the factors associated with EBF practice.Results: EBF for six months was practised by a few women (32.0%). The prevalence of EBF was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%) and those who never drank alcohol (37.0%). Unemployed women (AOR = 1.66, 95% CI: 1.08-2.56) and those with grade 12 or less level of education (AOR =2.76, 95% CI: 1.02-7.49) had a higher likelihood of practising EBF for six months while mothers who consumed alcohol (AOR = 0.54, 95% CI: 0.34-0.85) were less likely to practice EBF for six months. Conclusions: Sub-optimal rate of EBF in this study is comparable with the national (31.6%), sub-Saharan Africa (36%) and WHO global (35%) rates. Advocacy campaign on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.
Psychometric Properties of Persian Version of Autism-Spectrum Quotient (AQP-28): Evidence from Iranian Non-clinical Sample
Authors: Ashouri Ahmad , Asgharzade Ali , Ebrahimi Ali , Ghojazadeh Morteza , Akbarzadeh Abolfazl
Published: September 2020

Background: Recent evidence suggests that the autism spectrum is widespread among the general population. research has dimensionally moved towards the development of measurement tools with the introduction of autism spectrum disorder (ASD).Methods: The short-form of the autistic spectrum quotient questionnaire (AQ-28) developed by Hoekstra et al is a valuable and friendly alternative to the full 50-item version of autism spectrum disorder (AQ-50) consider as a widely used tool for screening and epidemiological studies of autistic traits. The present study aimed at investigating the psychometric properties of the Persian version of the short-form of the autistic spectrum quotient questionnaire (AQP-28) in the Iranian population. A total of 560 individuals participated in this study and they were asked to fill out The Persian version of the autistic spectrum quotient questionnaire (AQ-28). Results: confirmatory factor analysis (CFA) supported two higher-order factors models including ‘social behavior’ and numbers/patterns. Furthermore internal consistency of AQ-28-Persian indicate acceptable for social behavioral (α= .78), questionable for numbers/patterns (α= .65) and total (α= .62). Conclusions: in summary, the AQ-28-Persian is a useful tool to assess social behavior parts of the autistic spectrum quotient.
Whole-genome Resequencing Provides Insights into the Population Structure and Domestication Signatures of Ducks in Eastern China
Authors: Feng Peishi , Zeng Tao , Hua Yang , Chen Guohong , Du Jinping , Chen Li , Shen Junda , Tao Zhongrong , Wang Ping , Yang Lin , Lu Lizhi
Published: September 2020

Background: Ducks are an ancient domesticated animal with high economic value, uesd for its meat, eggs, and feathers. However, the origin of indigenous Chines ducks remains elusive. To address this question, we performed whole-genome resequencing to explore the genetic relationships among the domestic ducks and wild ducks in eastern China and to identify the genomic differences shaped by artificial selections. Results: The whole genomes of 60 ducks from eastern China were sequenced, with an average effective sequencing depth of ~6× per individual. The results of population and demographic analysis indicate that all individuals from the same breed gather together, and domestic ducks form a cluster separating from wild ducks. By applying selective sweep analysis, we identified that several candidate genes, important pathways and GO categories associated with artificial selection were functionally related to cellular adhesion, type 2 diabetes, lipid metabolism, the cell cycle, liver cell proliferation, and muscle functioning in domestic ducks.Conclusion: Genetic structure analysis showed that the domesticated ducks were not direct descendants of the mallard or Spot-billed duck and probably originated from an unknown population. During the long history of artificial selection, domesticated ducks have developed a complex biological adaptation to captivity.
Identification of a Gene Set Correlated with Immune Status in Ovarian Cancer by Transcriptome-Wide Data Mining
Authors: Fan Lili , Lei Han , Lin Ying , Zhang Tianxiang , Zhou Zhengwei , Shu Guang , Yan Zhipeng , Chen Haotian , Yin Gang
Published: September 2020

Background: Immune checkpoint blocking (ICB) immunotherapy has achieved great success in the treatment of various malignancies. Although not have been approved for the treatment of ovarian cancer (OC), it has been actively tested for the treatment of OC. Response to immunotherapy closely relies on the immune profile of tumors. However, biomarkers that could indicate the immune status of OC and predict the response to ICB are rare.Method: We downloaded RNAseq and clinical data of ovarian cancer from The Cancer Genome Atlas (TCGA). Up-regulated differentially expressed genes (Up-DEGs) were identified by analyzing the gene expression levels using the “limma, version=3.8” package in R software. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed in the “GSVA” and “limma” package in R software. Furthermore, gene set enrichment analysis (GSEA) and investigation of protein-protein interaction (PPI) networks were performed to clarify the function of Up-DEGs in both TMBhigh group and immunityhigh group. The correlation of genes with overall survival was also analyzed by conducted Kaplan-Meier survival analysis. Finally, TIMER and TIDE were used to predict gene immune function and its association with immunotherapy.Results: Data analysis revealed both TMBhigh and immunityhigh were significantly related to better survival of OC. Four genes, CXCL13, FCRLA, MS4A1, and PLA2G2D were found positively correlated with better prognosis of OC and mainly involved in immune response-related pathways. We also found that these four genes were positively correlated with better response to immune checkpoint blockade-based immunotherapy according to available data of a melanoma cohort.Conclusion: CXCL13, FCRLA, MS4A1, and PLA2G2D may be used as potential therapeutic biomarkers for reflecting OC immune status and predicting response to immunotherapy.
Social Justice in Health System; a Neglected Component of Academic Nursing Education: A Qualitative Study
Authors: Habibzadeh Hosein , Jasemi Madineh , Hosseinzadegan Fariba
Published: September 2020

Background: In recent decades, increasing social and health inequalities all over the world has highlighted the importance of social justice as a core nursing value. Therefore, proper education of nursing students is necessary for preparing them to comply with social justice in health systems. This study is aimed to identify the effective factors in teaching the concept of social justice in the nursing curriculum.Method: This is a qualitative study, in which the conventional content analysis approach was employed to analyze a sample of 13 participants selected using purposive sampling method. Semi-structured interviews were conducted to collect and analyze the data.Results: Analysis of the interviews indicated that insufficient education content, incompetency of educators, and inappropriate education approaches made social justice a neglected component in the academic nursing education. These factors were the main themes of the study and showed the negligence of social justice in academic nursing education.Conclusion: Research findings revealed the weaknesses in teaching the concept of social justice in the nursing education. Accordingly, it is necessary to modify the content of nursing curriculum and education approaches in order to convey this core value. Since nursing educators act as role models for students, especially in practical and ethical areas, more attention should be paid to competency of nursing educators.
Gastrointestinal Manifestations of Synthetic Cannabinoids: A retrospective Cohort Study
Authors: Hakimian David , Benson Ariel , Khoury Tawfik , Masarawa muhaamad , Israel Sara , Salameh Shaden , Gershinsky Yoni , Muszkat Mordechai
Published: September 2020

Introduction: Synthetic cannabinoids (SCs) are chemical substances similar to tetrahydrocannabinol that are used as illicit drugs and often smoked as recreational herbal mixtures. The usage of SCs is rapidly increasing worldwide. The adverse effects of SCs are wide ranging, and span from mild behavioral changes to death. The knowledge regarding gastrointestinal (GI) manifestations of SCs use is sparse. Methods: Medical records of patients with presentations to the hospital due to SCs use between January 2014 and February 2018 were retrieved from Hadassah Mount Scopus Hospital’s computerized database. The records were reviewed for clinical outcomes and laboratory tests. Results: Fifty-five patients were identified with hospital presentations due to SCs use. Twenty-one out of 55 patients (38%) reported GI complaints, with the most common being abdominal pain and vomiting. 28% had recurrent emergency department presentations due to abdominal pain and 66% presented with leukocytosis. Serum lactate was elevated in 66% of patients with GI manifestations. One patient had an abnormal computerized tomography (CT) abdominal angiography scan, which was compatible with intestinal ischemia. Discussion and conclusions: The clinical spectrum of GI manifestations in SCs intoxication ranges from mild symptoms including abdominal pain and vomiting to intestinal ischemia. Clinicians should be aware that abdominal pain and other GI complaints can be associated with SCs usage.
Non-pharmacological Interventions a Feasible Option for Addressing Dementia-related Sleep Problems in the Context of Family Care
Authors: Gibson Rosemary , Dowell Anthony , Jones Linda , Gander Philippa
Published: September 2020

Background: Sleep disturbances are challenging symptoms associated with mild cognitive impairment or dementia (MCIoD). This study assessed the feasibility of sleep monitoring and non-pharmacological interventions to improve the sleep of New Zealanders with MCIoD and their family carers. Methods: A five-week multi-modal intervention consisting of timed bright light therapy, physical activity, and sleep education was piloted. Sleep was monitored for a week at baseline and conclusion of the trial using actigraphy, diaries, and questionnaires alongside additional health and wellbeing information concerning both care recipients and carers. Results: Fifteen pairs participated, 9 completed the trial. Patterns of attrition and participant feedback are discussed. Case studies showed that six of the care recipients had minor improvements to sleep efficiency. Some also had improved subjective sleep ratings and quality of life. Changes did not clearly translate to family carers. However, five of them also showed some improvements in sleep status and mental health. Health deterioration of care recipients may mask the effects of the intervention. Conclusions: It is feasible to use non-pharmacological sleep interventions for people with MCIoD and their family carers. Given the limited treatment options, further consideration of such interventions in future research and clinical practice is warranted. Trial registration: As this study was to assess the feasibility of proposed methods, it was an observational study without case-control groups and therefore did not require registration. A future full version of the trial would be registered with the Australian New Zealand Clinical Trails Registry.
Leveraging hybrid biomarkers in clinical endpoint prediction
Authors: Saad Maliazurina , Lee Ik Hyun
Published: September 2020

Background: Clinical endpoint prediction remains challenging for health providers. Although predictors such as age, gender, and disease staging are of considerable predictive value, the accuracy often ranges between 60% and 80%. An accurate prognosis assessment is required for making effective clinical decisions.Methods: We proposed an extended prognostic model based on clinical covariates with adjustment for additional variables that were radio-graphically induced, termed imaging biomarkers. Eight imaging biomarkers were introduced and investigated in a cohort of 68 non-small cell lung cancer subjects with tumor internal characteristic. The subjects comprised of 40 males and 28 females with mean age at 68.7 years. The imaging biomarkers used to quantify the solid component and non-solid component of a tumor. The extended model comprises of additional frameworks that correlate these markers to the survival ends through uni- and multi-variable analysis to determine the most informative predictors, before combining them with existing clinical predictors. Performance was compared between traditional and extended approaches using Receiver Operating Characteristic (ROC) curves, Area under the ROC curves (AUC), Kaplan-Meier (KM) curves, Cox Proportional Hazard, and log-rank tests (p-value). Results: The proposed hybrid model exhibited an impressive boosting pattern over the traditional approach of prognostic modelling in the survival prediction (AUC ranging from 77– 97%). Four developed imaging markers were found to be significant in distinguishing between subjects having more and less dense components: (P=0.002-0.006). The correlation to survival analysis revealed that patients with denser composition of tumor (solid dominant) lived 1.6–2.2 years longer (mean survival) and 0.5–2.0 years longer (median survival), than those with less dense composition (non-solid dominant). Conclusion: The present study provides crucial evidence that there is an added value for incorporating additional image-based predictors while predicting clinical endpoints. Though the hypotheses were confirmed in a customized case study, we believe the proposed model is easily adapted to various clinical cases, such as predictions of complications, treatment response, and disease evolution.
Population-Based Screening and Eradication of Helicobacter pylori in a Resource-Limited Population of Sub-Saharan Africa
Authors: Lee Yang Jae , Ssekalo Ibrahim , Kazungu Rauben , Blackwell Timothy S. , Muwereza Peter , Wu Yuefeng , Saenz Jose Bernardo
Published: September 2020

Background: Helicobacter pylori (H. pylori) infection is a common cause of chronic dyspepsia worldwide. Its prevalence in the developing world remains understudied, however. Given that H. pylori is the most significant risk factor for developing gastric cancer, an accurate assessment of the effectiveness of population-based screening and eradication of H. pylori is warranted. The objectives of this study were to determine the prevalence of H. pylori, to identify risk factors associated with H. pylori colonization, and to assess the efficacy of triple therapy on H. pylori eradication within a region of sub-Saharan Africa.Methods: We administered a dyspepsia questionnaire to 376 randomly selected adult residents of the Namutumba District in Uganda. Participants submitted a stool sample for H. pylori fecal antigen testing. H. pylori-positive participants were given standard triple therapy. The efficacy of triple therapy on H. pylori eradication was established by fecal H. pylori antigen testing and improvement in dyspepsia scores after treatment. Dyspeptic, H. pylori-negative participants were administered daily omeprazole for one month. Logistic regression analyses were used to identify factors associated with H. pylori positivity, chronic dyspepsia, and H. pylori eradication failure.Results: The prevalence of H. pylori within the study population was 48%. A higher level of education was significantly associated with H. pylori positivity. 87% of study participants reported at least one symptom of dyspepsia, with 43% reporting moderate or severe dyspepsia. Dyspepsia severity was independent of H. pylori status. Standard triple therapy resulted in ~90% eradication. Missing four or more doses of the triple therapy regimen was significantly associated with H. pylori eradication failure.Conclusions: Chronic dyspepsia is a common complaint in this sub-Saharan population but is not by itself a defining feature of H. pylori positivity. Clinical suspicion for H. pylori within this population should nonetheless remain high, given the high prevalence of positivity among all those with dyspepsia, including many with relatively mild dyspeptic symptoms. Population-based screening and adherence to standard triple therapy are effective at eradicating H. pylori within this region. Trial Registration: This study was registered in ClinicalTrials.gov (TRN: NCT04525664, registered 24 August 2020 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04525664). This study adheres to CONSORT guidelines.
Modulation of visceral sensitivity by faecal microbiota transplantation (FMT): the active role of gut microbiota in the persistence of abdominal pain
Authors: Lucarini Elena , Pilato Vincenzo Di , Parisio Carmen , Micheli Laura , Toti Alessandra , Pacini Alessandra , Bartolucci Gianluca , Baldi Simone , Niccolai Elena , Amedei Amedeo , Rossolini Gian M. , Nicoletti Claudio , Cryan John F. , O'Mahony Siobhain M. , Ghelardini Carla , Mannelli Lorenzo Di Cesare
Published: September 2020

Background. Recent findings linked gastrointestinal disorders characterized by abdominal pain to gut microbiota composition. The present work aimed to evaluate the power of gut microbiota as a visceral pain modulator and, consequently, the relevance of its manipulation as a therapeutic option in reversing the persistence of visceral hypersensitivity consequent to colitis induced by the intra-rectal injection of 2,4-dinitrobezenesulfonic acid (DNBS) in rats. Results: The effect of faecal microbiota transfer (FMT) from viscerally hypersensitive DNBS and naïve donors was evaluated in control rats after an antibiotic-mediated microbiota depletion. FMT from DNBS donors induced a long-lasting visceral hypersensitivity in control rats. Pain threshold trend correlated with major modifications in the composition and structure of the gut microbiota at phylum (Proteobacteria and Firmicutes to Bacteroides ratio) and family levels (Enterobacteriaceae, Akkermansiaceae and Lachnospiraceae). Acetic acid was significantly increased in the recipients FMT from DNBS donors. Gut cytokine profile, as well as tryptophan metabolism were similarly altered after FMT from both DNBS and naïve donors. By contrast, no significant alterations of colon histology, permeability and monoamines levels were detected. Finally, following FMT from healthy donors to DNBS-treated animals, a counteraction of persistent visceral pain was achieved. Conclusions: The present results provide novel insights into the relationship between intestinal microbiota and visceral hypersensitivity, highlighting the therapeutic potential of microbiota modulation on persistent abdominal pain.
Validation of the Nanostring of the Banff Human Organ Transplant Gene Panel in Archival Data from Human Kidney Transplants and its Modelling Complexity
Authors: Smith Rex
Published: September 2020

Background
RNA gene expression of renal transplantation biopsies is commonly used to identify rejection. Mostly done with microarrays, seminal findings describe and define the patterns of genes associated with types of rejection and non-rejection kidney allograft diagnoses. To make gene expression more accessible for pathology laboratories, the Molecular Diagnostics Working Group of the Banff Foundation for Allograft Pathology and NanoString Technologies partnered to create the Banff Human Organ Transplant Panel (BHOT), a gene panel set of 770 genes as a substitute for microarrays (~ 50,000 genes). The advantage of this platform is that gene expressions are quantifiable on formalin fixed and paraffin embedded archival tissue samples. This new technology, thus, makes gene expressions cheaper and accessible to more laboratories and investigators. The purpose of this report is to validate the BHOT panel as a surrogate for microarrays and test the accuracy of the modelled BHOT data.
Results
This limited NanoString gene set readily identifies renal rejection and non-rejection diagnostic patterns using in silico statistical analyses of seminal archival databases derived from renal transplant RNA expression arrays. Multiple modelling algorithms show a highly variable pattern within the error matrices per sample. The discrepancies within the error matrices are most likely related to the gene expression heterogeneity of samples within a given pathological diagnosis. This was confirmed by clustering the data into 8 groups, which modelled with fewer misclassifications.
Conclusion
This report validates gene expression of human renal allografts using the Banff Human Organ Transplant Panel as a surrogate for microarrays and confirms the its modelling complexity.
Introducing Cross-Cultural Education in Palliative Care: Focus Groups With Experts on Practical Strategies
Authors: Semlali Imane , Tamches Emmanuel , Singy Pascal , Weber Orest
Published: September 2020

Background: The linguistic and cultural diversity found in European societies creates specific challenges to palliative care clinicians. Patients’ heterogeneous habits, beliefs and social situations, and in many cases language barriers, add complexity to clinicians’ work. Cross-cultural teaching helps palliative care specialists deal with issues that arise from such diversity. This study aimed to provide interested educators and decision makers with ideas for how to implement cross-cultural training in palliative care. Methods: We conducted four focus groups in French- and Italian-speaking Switzerland. All groups consisted of a mix of experts in palliative care and/or cross-cultural teaching. The interdisciplinary research team submitted the data for thematic content analysis.Results: Focus-group participants saw a clear need for courses addressing cross-cultural issues in end-of-life care, including in medical disciplines outside of palliative care (e.g. geriatrics, oncology, intensive care). We found that these courses should be embedded in existing training offerings and should appear at all stages of curricula for end-of-life specialists. Two trends emerged related to course content. One focuses on clinicians’ acquisition of cultural expertise and tools allowing them to deal with complex situations on their own; the other stresses the importance of clinicians’ reflections and learning to collaborate with other professionals in complex situations. These trends evoke recent debates in the literature: the quest for expertise and tools is related to traditional 20th century work on cross-cultural competence, whereas reflection and collaboration are central to more recent research that promotes cultural sensitivity and humility in clinicians.Conclusion: This study offers new insights into cross-cultural courses in palliative and end-of-life care. Basic knowledge on culture in medicine, variable practices related to death and dying, communication techniques, self-reflection on cultural references and aptitude for interprofessional collaboration are central to preparing clinicians in end-of-life settings to work with linguistically and culturally diverse patients.
A Randomized Controlled Trial on the Comparative Effectiveness of Mindfulness-Based Cognitive Therapy and Health Qigong-Based Cognitive Therapy Among Chinese People With Mood Disorders
Authors: Chan Sunny H.W. , Chan Wendy W.K. , Chao June Y.W. , Chan Phyllis K.L.
Published: September 2020

Background: The goal of this study was to investigate treatment outcome and related intervention processes of mindfulness-based cognitive therapy (MBCT) versus health qigong-based cognitive therapy (HQCT) versus waitlist control (WC) among individuals with mood disorders.Methods: A total of 187 individuals with mood disorders were randomized and allocated into MBCT, HQCT, or WC groups. All participants were assessed at three time points with regard to mood symptoms, physical and mental health status, perceived stress, sleep quality, and self-efficacy. Linear mixed models analysis was used to test the individual growth model by studying the longitudinal data.Results: MBCT and HQCT both produced greater improvements on most outcome measures as compared with WC. Relatively, more reductions of mood symptoms were observed in the HQCT group as compared with the MBCT group. HQCT is more conducive to physical health status whereas MBCT has more favorable mental health outcomes. Individual growth curve models indicated that alternations in perceived stress was the common predictor of mood changes in both intervention groups. Conclusions: The predominant emphasis on physical health in HQCT makes it more acceptable and effective than MBCT as applied in Chinese individuals with mood disorders. The influence of Chinese culture is discussed. Trial registration: HKU Clinical Trials Registry. Identifier: HKUCTR-2558. Registered 21st Nov 2018.
Social Determinants of Health and COVID-19 Among Patients in New York City
Authors: Woo Baidal Jennifer , Wang Amanda Y. , Zumwalt Katarina , Gary Dahsan , Greenberg Yael , Cormack Ben , Lovinsky-Desir Stephanie , Nichols Kelsey , Pasco Neil , Nieto Andres , Ancker Jessica S. , Goldsmith Jeff , Meyer Dodi
Published: September 2020

Background: Covid-19 testing and disease outcomes according to demographic and neighborhood characteristics must be understood.Methods: Using aggregate administrative data from a multi-site academic healthcare system in New York from March 1 – May 14, 2020, we examined patient demographic and neighborhood characteristics according to Covid-19 testing and disease outcomes.Results: Among the 23,918 patients, higher proportions of those over 65 years old, male sex, Hispanic ethnicity, Medicare, or Medicaid insurance had positive tests, were hospitalized, or died than those with younger age, non-Hispanic ethnicity, or private insurance. Patients living in census tracts with more non-White individuals, Hispanic individuals, individuals in poverty, or housing crowding had higher proportions of Covid-19 positive tests, hospitalizations, and deaths than counterparts.Discussion: Variation exists in Covid-19 testing and disease outcomes according to patient and neighborhood characteristics. There is a need to monitor Covid-19 testing access and disease outcomes and resolve racist policies and practices.
Gut microbiota Signatures in Schistosoma japonicum Infection-Induced Liver Cirrhosis Patients
Authors: Gui Qifeng , Zhu Feng , Xiao Chi , Lu Haifeng , Zhang Qin , Xu Jia , Jin Huilin , Yang Yunmei
Published: September 2020

BackgroundOne of the serious complications induced by Schistosoma japonicum infection is the development of liver cirrhosis. Several studies have assessed the role of gut microbiota in cirrhosis of different etiologies, but none has done so in the context of S. japonicum infection in humans. Here, to explore the possible role of gut microbiota in S. japonicum infection-induced liver cirrhosis, we conducted an observational clinical study.MethodsTwenty-four patients with S. japonicum infection-induced liver cirrhosis and 25 age- and gender-matched controls from Zhejiang Province, China, were enrolled in the study. Fecal samples were collected and used for 16S rRNA gene hypervariable V4 region Illumina MiSeq sequencing.ResultsEight hundred seven operational taxonomic units (OTUs) were detected, of which 491 were common in the two groups, while 123 and 193 were unique for the control and cirrhosis groups, respectively. Overall, no significant differences in both alpha and beta diversities and overall microbiota structure were found in the two groups. However, Bacilli (Class) and Lactobacillales (Order) were significantly higher in patients with S. japonicum infection-induced liver cirrhosis than in healthy individuals.ConclusionsAltogether, our results suggest that the gut microbiota of S. japonicum infection-induced liver cirrhosis patients is similar to that of healthy individuals.
Pneumocystis Pneumonia in Liver Transplant Recipients: Clinical Course, Epidemiological Analysis and Risk Factors
Authors: Li Xian-Liang , Liu Zhen-Jia , Li Han , Wilde Benjamin , Witzke Oliver , Qi Man , Xu Wen-Li , Liu Zi-Xi , He Qiang , Zhu Ji-Qiao
Published: September 2020

Background: We aimed to investigate the clinical course, possible transmission routes and the potential risk factors of Pneumocystis pneumonia in liver transplant recipients.Methods: The study was performed by collecting and analyzing the clinical, epidemiological, and molecular data from patients with Pneumocystis pneumonia as well as from matched controls.Results: There were a total of ten patients diagnosed with Pneumocystis pneumonia containing prospectively included six patients and retrospectively collected four patients, of which seven were transferred to the surgical intensive care unit and four died. The transmission map revealed inter-patient transmission of Pneumocystis jirovecii was impossible. Pneumocystis jirovecii detection was negative in all air samples. It was positive only in one sample from the twelve healthcare workers with close contact to diseased patients. Five out of 79 liver transplant recipients during the outbreak were colonized with Pneumocystis jirovecii compared to two out of 94 after the outbreak upon admission (P > 0.05). Liver transplant recipients with Pneumocystis pneumonia had totally different genotypes based on multilocus sequence typing. Additionally, we found an unreported mutation at the cytochrome b gene (566 C/T and C838C/T). The absolute CD19+ B-cell counts (odds ratio: 1.028; 95% confidence interval: 1.000-1.057; P = 0.049) was defined to be the only significant independent risk factor using multivariable conditional logistic regression. Conclusions: Pneumocystis pneumonia is a severe complication following liver transplantation. The outbreak may not be caused by nosocomial transmission. A decrease in absolute CD19+ B-cell counts may play an important role in the development of Pneumocystis pneumonia.
Pesticide use and COVID-19: An Indictment of Global Agriculture and An Advocacy of the Mediterranean Food Culture
Authors: Othmani Wadie
Published: September 2020

As an exploratory and theoretical reflection for future articles discussing the perceived green/health qualities of tunisian food as a tourist promotion argument, the article is based on the assumption that the COVID-19 pandemic would have more impact in countries whose population has an immune system weakened by food overtreated with pesticides, and that the Mediterranean food culture, which offers foods with little or no pesticide treatment, is the best diet to develop the necessary immunity to resist COVID-19 and, by extension, resist other pandemics. To demonstrate this, the thematic map technique was used to cross-reference several masses of official statistical data. The results suggest four main categories of countries in relation to the link between deaths from COVID-19 and the use of pesticides in agriculture. This study demonstrates, therefore, the weakness, if not the inaccuracy, of certain hypotheses which are circulating or have circulated in recent months and that attempt to explain each country's response to the COVID-19 pandemic. Thus, assumptions such as the role of quarantine in containing the pandemic, the role of the BCG vaccine and the role of heat will prove unreliable. On the other hand, the hypothesis the paper will defend is that of the role of a healthy Mediterranean and flexitarian diet in strengthening the human immune system, which in turn counteracts the SARS-CoV-2 virus. This sanitary suitability would therefore be an argument for promoting and disseminating this culinary heritage throughout the world and thus contribute to its development as a tourist attraction.
Three hematologic/immune system-specific expressed genes are considered as the potential biomarkers for the diagnosis of early rheumatoid arthritis through bioinformatics analysis
Authors: Cheng Qi , Wu Huaxiang , Du Yan
Published: September 2020

Background Rheumatoid arthritis (RA) is the most common chronic autoimmune connective tissue disease. However, early RA is difficult to diagnose due to the lack of effective biomarkers. This study aimed to identify new biomarkers and mechanisms for RA disease progression at the transcriptome level through a combination of microarray and bioinformatics analyses.Methods Microarray datasets for synovial tissue in RA or osteoarthritis (OA) were downloaded from the Gene Expression Omnibus (GEO) database, and differentially expressed genes (DEGs) were identified by R software. Tissue/organ-specific genes were recognized by BioGPS. Enrichment analyses were performed and protein-protein interaction (PPI) networks were constructed to understand the functions and enriched pathways of DEGs and to identify hub genes. Cytoscape was used to construct the co-expressed network and competitive endogenous RNA (ceRNA) networks. Biomarkers with high diagnostic value for the early diagnosis of RA were validated by GEO datasets. The ggpubr package was used to perform statistical analyses with Student’s t-test.Results A total of 275 DEGs, including 197 downregulated genes and 78 upregulated genes, were identified between the samples from RA and OA. Among these DEGs, 71 tissue/organ-specific expressed genes were recognized. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis indicated that DEGs are mostly enriched in immune response, immune-related biological process, immune system, and cytokine signal pathways. Fifteen hub genes and 4 gene cluster modules were identified by Cytoscape. Eight haematologic/immune system-specific expressed hub genes were verified by GEO datasets, and three genes (granzyme A (GZMA), protein regulator of cytokinesis 1 (PRC1), and threonine/tyrosine kinase protein kinase (TTK)) that have a high diagnostic value for early RA were identified. NEAT1-miR-212-3p/miR-132-3p/miR-129-5p-TTK, XIST-miR-25-3p/miR-129-5p-GZMA, and TTK_hsa_circ_0077158- miR-212-3p/miR-132-3p/miR-129-5p-TTK might be potential RNA regulatory pathways to regulate the disease progression of early RA.Conclusions This work identified three haematologic/immune system-specific expressed genes, namely, GZMA, PRC1, and TTK, as potential biomarkers for the early diagnosis and treatment of RA and provided insight into the mechanisms of disease development in RA at the transcriptome level. In addition, we proposed that NEAT1-miR-212-3p/miR-132-3p/miR-129-5p-TTK, XIST-miR-25-3p/miR-129-5p-GZMA, and TTK_hsa_circ_0077158-miR-212-3p/miR-132-3p/miR-129-5p-TTK are potential RNA regulatory pathways that control disease progression in early RA.
Predicting and interpreting COVID-19 transmission rates from the ensemble of government policies
Authors: Prakash Meher , Sr C. K. , Biswal Malay , Saraswat Brijesh , Joshi Himanshu
Published: September 2020

Several questions resonate as the governments relax their COVID-19 mitigation policies - is it too early to relax them, were the policies as effective as they could have been. Answering these questions about the past or crafting newer policy decisions in the future requires a quantification of how policy choices affect the spread of the infection. Policy landscape as well as the infection trajectories from different states and countries diverged so fast that comparing and learning from them has not been easy. In this work, we standardize and pool together the ensemble of lockdown and graded re-opening policies adopted by the 50 states of USA in any given week between 9th March and 9th August. Using artificial intelligence (AI) on this pooled data, we build a predictive model (R2training=0.79, R2test=0.76) for the weekly-averaged transmission rate of infections. Predictability conceptually raises the possibility of an evidence-based or data-driven mitigation policy-making by evaluating the relative merits of the different policy scenarios. Probing the predictions with interpretable AI highlights how factors such as the closing of bars or the use of masks influence transmission, effects which have been hard to decouple from the ensemble of policy instrument combinations. While acknowledging the limitations of our predictions as well as of the infection testing, we ask the theoretical question if the observed transmission rates in the states were as efficient as they could have been under various levels of restrictions, and if the mitigation policies of the states are ‘overdesigned’ for the success they have. The model can be further refined with a more detailed inclusion of geographies and policy compliances, as well as expanded as newer policies emerge.
The Role of Prophylactic Vertebroplasty at UIV+1 and Cement-augmented Fenestrated Pedicle Screw for Prevention of PJK/PJF  in Patients With Osteoporosis: A Propensity Score–matched Analysis
Authors: Wang Qi , Wang Chi , Hu Wenhao , Hu Fanqi , Liu Weibo , Li Teng , Cao Shiqi , Zhang Xuesong
Published: September 2020

Objective: To elucidate the role of prophylactic vertebroplasty (PV) at UIV+1 and cement-augmented fenestrated pedicle screw (CAFPS) in prevention of PJK and PJF.Background: Cement augmentation at UIV and UIV+1 was found to prevent PJK and PJF. But most studies are retrospective and have a selection bias due to multifactorial etiology of PJF, making it difficult to identify the efficacy of prophylactic cement augmentation. Methods: We enrolled 208 surgically treated adult spinal deformity (ASD) patients who were followed for at least 2 years, to elucidate whether prophylactic cement augmentation was truly minimizing the risk of PJK and PJF in a uniform population from one center database. Patients were classified into two groups. Two comparable groups were propensity-matched with one to one nearest neighbor matching. The main outcome variables including PJK, PJF, pedicle screw loosening and cement leakage were compared.Results：After propensity score matching, there were 58 propensity-matched patients in group A and B (n=29 in each group) whose parameters including age, BMI, BMD, number of instrumented vertebrae, SVA, spinal-pelvic parameters and the frequency of UIV and LIV were similar. The incidence of PJK showed no significantly statistical difference between group A and B (10.3% vs 13.8%, p >0.99). Compared to group A, group B had a higher proportion of patients developing PJF (24.1% vs 0%, p=0.01). Pedicle screw loosening at UIV and (or) LIV showed no difference (24.1% vs 3.4%, p=0.052) between two groups. In group A, cement leakage was detected in 5 cases via fluoroscopy, but none of them had neurological deficit or pulmonary cement embolism.Conclusion: Combined application of CAFPS and PV could reduce the incidence of PJF, but it could not prevent the development of PJK in the surgical management of ASD with low BMD or osteoporosis.
Childhood Trauma Associated With Abnormal Resting-State Brain Network Connectivity in First-Episode Schizophrenia Patients
Authors: Long Xiangyun , Wu Jiaxin , Liu Fei , Qi Ansi , Huang Nan , Guan Xiaofeng , Liu Na , Lu Zheng
Published: September 2020

Childhood trauma is a central risk factor for schizophrenia. We explored the correlation between early traumatic experiences and the functional connectivity of resting-state networks. This fMRI study included 28 first-episode schizophrenia patients and 27 healthy controls. In first-episode schizophrenia patients, higher levels of childhood trauma associated with abnormal connections of resting-state networks, and these anomalies distributed among task-positive networks (i.e., ventral attention network, dorsal-ventral attention network and frontal-parietal network), and sensory networks (i.e., visual network and auditory network). These findings mentioned that childhood traumatic experiences may impact resting-state network connectivity in adulthood, mainly involving systems related to attention and execution control.
Sociodemographic Correlates of Perceived Psychosocial Health in Times of the COVID-19 Pandemic: A Community-Based Online Study in China
Authors: Wang Ganyi , Tang Shangfeng
Published: September 2020

The coronavirus (COVID-19) pandemic and the ensuing sociopolitical measures to control and curb its spread have been affecting people's psychosocial health and well-being through various complex pathways and in unprecedented ways. The present study aims to assess the sociodemographic correlates of psychosocial health situation of Chinese community-dwelling residents. Methods: This was a cross-sectional survey that was carried out online and using a structured questionnaire during April 2020. In total, 4788 men and women with the age range of 11-98 years were included in the analysis. Outcome variables were the change in the experience of hopelessness, loneliness and depression before and during the pandemic, and the explanatory variables included demographic and social capital related variables.Results: Respectively 34.80%, 32.50% and 44.84% of the participants expressed feeling more hopeless, lonely, and depressed during the pandemic. The percentage of all three indicators was comparatively higher among women than among men: hopelessness (50.67% vs 49.33%), loneliness (52.44% vs 47.56%), and depression (56.22% vs 43.78%). Being married was associated lower odds of loneliness among men [Odds ratio= 0.63, 95% CI=0.45,0.90]. Loneliness was negatively associated with smoking [Odds ratio= 0.67, 95% CI=0.45,0.99] and positively with drinking [Odds ratio= 1.45, 95% CI=1.04,2.02]. Compared with those in the lowest income bracket (<10K), men [Odds ratio= 0.34, 95% CI=0.21,0.55] and women [Odds ratio= 0.36, 95% CI=0.23,0.56] in the highest (>40K) had the lowest odds of reporting perceived hopelessness [Odds ratio= 0.35, 95% CI=0.25,0.48]. Smoking also showed negative association with depression only among men [Odds ratio=0.63, 95% CI=0.43,0.91]. Conclusion: More about one-third of the participants reported worsening in the experience of hopelessness and loneliness, with more than two-fifth of worsening depression during the pandemic compared with the time before. Several socioeconomic and lifestyle factors were found to be associated with the outcome variables, most notably participants marital status, household income, smoking, alcohol drinking, existing chronic conditions, and urbanicity.
Evaluation and Analysis of Incidence and Risk Factors of Lower Extremity Venous Thrombosis After Urologic Surgeries: A Prospective Two-Center Study Using LASSO-Logistics Regression.
Authors: Tang Guyu , Qi Lin , Sun Zepeng , Liu Jing , Lv Zhengtong , Chen Lingxiao , Huang Bin , Zhu Shuai , Liu Yao , Li Yuan
Published: September 2020

Purpose: To analyze the incidence and risk factors of lower extremity venous thrombosis after urologic surgeries. Methods: A prospective two-center study was conducted from August 2019 to January 2020. 1122 consecutive patients who underwent urologic procedures were enrolled. The study primary end point was the detection of asymptomatic or symptomatic deep vein thrombosis (DVT) of lower extremity within 7 days after the surgeries. Univariate and LASSO-logistics regression analysis were performed.Results: We excluded 111 patients who met exclusion criteria. Totally, 56 (5.54%) out of 1011 patients had developed DVT. In the univariate analysis, Barthel Index ≤40, D-dimer levels ≥0.5mg/L and age≥ 60 yrs (p <0.001) were the most significant risk factors. The LASSO-logistics regression model identified 9 factors including age, history of DVT, lymph nodes dissection, perioperative steroid use, Caprini Score, Barthel Index, D-dimer levels, cystectomy and prostatectomy.Conclusion: Our study used the LASSO-logistic regression model to provide reliable data on risk factors of DVT after comprehensive urologic surgeries. It might facilitate individualized anticoagulant management of patients undergoing urologic procedures.Trial registration: ChiCTR1900024784
The Role of Chitosan Oligosaccharides in Regulating the Function of Ovarian Reproductive Stem Cells and Protecting Against Premature Ovarian Failure
Authors: Huang Yaoqi , Ye Haifeng , Zhu Feiyin , Hu Chuan , Zheng Yuehui
Published: September 2020

In recent years, the discovery of ovarian germ stem cells (OGSCs) has provided a new research direction for the treatment of ovarian failure. The ovarian microenvironment affects the proliferation and differentiation of OGSCs, and immune cells and related cytokines are important components of the microenvironment. However, whether improving the ovarian microenvironment can regulate the proliferation of OGSCs and remodel ovarian function has not been reported. In this study, we linked chitosan oligosaccharide(COS) with fluorescein isothiocyanate (FITC) to select the best route of administration. COS was given to mice through the best route of administration, and the changes in ovarian and immune function were observed using assays of organ index, follicular growth, serum estrogen (E 2 ) and anti-Mullerian hormone (AMH) levels, and the expression of IL-2 and TNF-α in the ovaries. COS significantly increased the weight of the ovary and immune organs, reduced the rate of follicular atresia, increased the levels of E 2 and AMH hormones, and increased the protein expression of IL-2 and TNF-α in the ovary. Then, COS and OGSCs were cocultured to observe the entry of COS into OGSCs and to measure the survival rate of OGSCs. With increasing time, COS gradually entered the cell, and the cytokines IL-2 and TNF-α significantly promoted OGSCs promotion. In conclusion, COS significantly improved the ovarian and immune function of mice with pathological ovarian aging, and improved the survival rate of OGSCs, which provided a preliminary blueprint for further exploring the mechanism of COS in anti ovarian aging.