bluuebunny/crossref_metadata_2025 huggingface dataset:
Broadening Diversity Through Creative Engagement in Research Prioritisation
Authors: Tierney Stephanie , Dawson Shoba , Boylan Anne-Marie , Richards Gillian , Park Sophie , Turk Amadea , Babatunde Opeyemi
Published: October 2020

Background: Patient and public involvement (PPI) can help with steering and shaping research prioritisation and execution. However, some groups of people may not be encouraged to take part and their voices may be seldom listened to in the production of research. This is important to consider because they may have poorer healthcare experiences. We wanted to try out using art as a vehicle for including individuals not necessarily invited to be part of research priority setting. Methods: We contacted existing groups and organisations to reach people who are not routinely supported to be part of PPI. We targeted individuals: a) with dementia, b) with mental health conditions, and c) from Black, Asian and Minority Ethnic backgrounds. We ran a workshop with each group at which individuals shared their experiences of healthcare. A young amateur artist also attended, who produced a piece of artwork afterwards that reflected the research priorities raised. We held a Twitter chat to discuss the final pieces of art that were created, and the processes involved in their generation.Results: From each workshop, we produced a list of research priorities. These included: a) improving coordination of care for people with dementia, b) supporting discussion of women’s health issues in South Asian communities, c) information needs, anxiety/guilt around accessing care and costs associated with this for people with a mixture of physical and mental health conditions. These priorities were reflected in three pieces of art, which can be viewed online. Feedback from those at workshops suggested that the artwork has helped them to feel their voice has been heard and triggered their interest in how research is developed. Those involved in the Twitter chat commented that art was one means through which researchers could connect with a range of groups in a PPI context when preparing and then producing a study. Conclusions: We found the medium of art to be an effective way of including a range of people in research prioritisation setting. This approach could be useful for future public involvement and engagement, building on what we have learnt from the project described in this paper.
Community Socioeconomic Disadvantage Drives Type of 30-Day Medical-Surgical Revisits Among Patients with Serious Mental Illness
Authors: Germack Hayley Drew , Cooper Mandy , Koller Krista , Mahmoud Khadejah , Vincent Heather , Martsolf Grant R.
Published: October 2020

Background: Patients with serious mental illness (SMI) are vulnerable to medical-surgical readmissions and emergency department visits. Community socioeconomic disadvantage has been associated with readmission risk in the general population, but its impact on other types of revisits (emergency department visits and observation stays), particularly in patients with SMI, is unknown. Methods: We used Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project discharge abstracts for 1,914,619 patients with SMI discharged after medical-surgical admissions in Florida and New York between 2012 and 2015 and their revisits to the hospital within 30 days of discharge. We linked this data to the Area Deprivation Index for the communities that patients returned to.Results: Patients with SMI returning to the most disadvantaged communities had greater adjusted 30-day revisit rates than patients from less disadvantaged communities. Among those that experienced a revisit, patients returning the most disadvantaged communities had 7.3% greater 30-day observation stay revisits. Conclusion: These results suggest that additional investments are needed to ensure that patients with SMI returning the most socioeconomically disadvantaged communities are receiving appropriate post-discharge care.
Cancer Patients’ Satisfaction with Virtual Clinics in Ireland During COVID-19.
Authors: Mullally William J , Greene John , Jordan Emmet , Horgan Anne , Calvert Paula , O'Connor Miriam
Published: October 2020

Background The COVID-19 pandemic has led to an unprecedented lockdown of Ireland and significant healthcare challenges including outpatient department clinics. As a result, these cancer clinics were conducted virtually by telephone. The aim of this study is to measure cancer patients’ satisfaction with telephone consultations.Methods Cancer patients on active treatment or surveillance in an Irish university hospital were invited to complete a questionnaire issued via “Survey Monkey”. It comprised ten questions and assessed whether patients concerns were adequately addressed and preference to continue with virtual consultations. Patients recorded what was absent from the current environment when compared with previous clinics.Results This survey was issued to 180 cancer patients including 65 (36%) men and 115 females (64%) with a median age of 65 (range 20 – 92) years. Fifty-four patients (30%) completed this anonymised questionnaire. Over 96% (n=52) of cancer patients agreed/strongly agreed their concerns were addressed satisfactorily and similarly 93% (n=50) felt reassured after this consultation. One-third of patients (n=18) would prefer for all out-patient consultations to revert to those in the pre COVID-19 era and 11% agreed all future consultations should continue virtually. The remaining, 30 patients (56%) agreed with the later though only in certain circumstances. Twenty-eight patients missed (56%) missed the face-to-face interaction and reassurance provided by a physical examination. Conclusion This is the first Irish oncology study which examined cancer patients perspective of Health Service Executive directed virtual outpatient clinics. Face-to-face consultations are crucial for optimal cancer patient care and cannot be eliminated completely.
High-grade Postoperative Complications Affect Survival Outcomes of Patients with Colorectal Cancer Peritoneal Metastases Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
Authors: Zhou Sicheng , Feng Qiang , Zhang Jing , Zhou Haitao , Jiang Zheng , Liu Zheng , Zheng Zhaoxu , Chen Haipeng , Wang Zheng , Liang Jianwei , Pei Wei , Liu Qian , Zhou Zhixiang , Wang Xishan
Published: October 2020

Objective This study aimed to evaluate the impact of postoperative complications on long-term survival in patients with peritoneal metastasis (PM) arising from colorectal cancer (CRC) treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).Methods Patients with PM arising from CRC treated with CRS and HIPEC were systematically reviewed at the China National Cancer Center and Huanxing Cancer Hospital from June 2017 to June 2019. High-grade complications that occurred within 30 days were defined as grade 3 to 4 events according to the Common Terminology Criteria for Adverse Events (CTCAE) classification. Univariate and multivariable Cox regression models for overall survival were created. Predictors of high-grade postoperative complications were evaluated with univariate and multivariate logistic regression analyses.Results In all, 86 consecutive cases were included in this study. Forty-one patients (47.7%) developed postoperative complications, while 22 patients (25.6%) experienced high-grade complications. No mortality occurred during the postoperative period. The median survival of all patients was 25 months, and the estimated 3-year overall survival (OS) rate was 35.0%. In the multivariable Cox regression analysis, a high peritoneal carcinomatosis index (PCI) score (HR, 1.07, 95% CI, 1.01-1.14; P=0.015) and grade 3-4 postoperative complications (HR, 1.86, 95% CI, 1.22-3.51; P=0.044) correlated with worse overall survival. High estimated blood loss (OR, 1.01, 95% CI, 1.01-1.02; P<0.001) was identified as an independent risk factor for developing high-grade complications.Conclusion Careful patient selection, high levels of technical skill and improved perioperative management are crucial to ensure patient survival benefits after CRS+HIPEC.
NSUN5 is Upregulated and Positively Correlated with Translation in Human Cancers: A Bioinformatics-based Study
Authors: Zhang Xiao-wen , Huang Yan , Wu Lu-yi , Qi Qin , Zhong Rui , Li Shan-shan , Zhao Ji-meng , Liu Hui-rong , Wu Huan-gan
Published: October 2020

The role of RNA m5C (5-methylcytosine) and RNA m5C methyltransferases (RCMTs, including NSUN1, NSUN2, NSUN3, NSUN4, NSUN5, NSUN6, NSUN7 and TRDMT1) in human cancers remains largely unknown. In this study, GEPIA2 was used to compare the expression of RCMTs in human cancers and that in associated normal tissues, and to analyze the prognosis value of NSUN5 expression. UALCAN was used to compare the methylation level of NSUN5 promoter in human cancers and that in associated normal tissues. LinkedOmics was used perform BPs (biological processes), CCs (cellular components), MFs (molecular functions) and KEGG pathways analyses of NSUN5-correlated genes in each cancer one by one. We found that six RCMTs (NSUN1-NSUN5 and TRDMT1), especially NSUN5, were generally upregulated in human cancers, that the hypomethylation of NSUN5 promoter may be responsible for its upregulation, and that overexpressed NSUN5 predicted poorer prognosis and was positively correlated with translation in human cancers. The function of NSUN5 in human cancers and its mechanism need to be validated by biological experiments.
WITHDRAWN: Effect of Elevated CO2 on Photosynthetic Accumulation and Sucrose Metabolism-related Enzyme Activity and Gene Expression Patterns in Goji Berry (Lycium Barbarum L.)
Authors: Ma Yaping , Xie Yun , Ha Rong , Cao Bing , Song Lihua
Published: October 2020

Background: Exposing goji berries to elevated CO2 (eCO2) for long periods reduces sugar and secondary metabolite contents. However, sugar accumulation in fruit depends on photosynthesis and photoassimilate partitioning. The objectives of this study were a) to explore photosynthesis, sugar content, and sucrose metabolism-related enzyme activity in goji berry leaves and fruits under ambient and elevated CO2, and b) to identify the genes encoding Lycium barbarum acid invertase (LBAI), L. barbarum sucrose synthase (LBSS), L. barbarum sucrose phosphate synthase (LBSPS), and L. barbarum neutral invertase (LBNI) based on transcriptome profiling and expression analyses in different tissues. Results: The results showed that the expression of the above genes changed significantly in plants grown under eCO2 for 90 and 120 days as photosynthetic rate increased, while leaf and fruit sugar content decreased and the activity of four sucrose metabolism-related enzymes increased in leaves, and acid and neutral invertase increased in fruits. Furthermore, a significant correlation was detected between sugar content and enzyme activity. The expression of LBAI, LBSPS, and LBNI were high in stems, whereas LBSS was predominantly expressed in fruits. Conclusions: eCO2 affects chlorophyll, photosynthesis, sugars, and related enzyme activities in goji berry leaves and fruits after 90 and 120 days of treatment. Our findings provide fundamental data on photosynthesis and sugar accumulation trends in goji berries under eCO2 exposure.
Helmet CPAP to Treat Hypoxic Pneumonia Outside the ICU: An Observational Study During the COVID-19 Outbreak
Authors: Coppadoro Andrea , Benini Annalisa , Fruscio Robert , Verga Luisa , Mazzola Paolo , Carbone Marco , Mulinacci Giacomo , Soria Alessandro , Noe' Beatrice , Beck Eduardo , Sciacca Riccardo Di , Ippolito Davide , Citerio Giuseppe , Valsecchi Grazia , Biondi Andrea , Pesci Alberto , Bonfanti Paolo , Gaudesi Davide , Bellani Giacomo , Foti Giuseppe
Published: October 2020

Background: Respiratory failure due to COVID-19 pneumonia is associated with high mortality and may threaten healthcare systems hold, due to the surge patients requiring advanced respiratory support. Shortage of intensive care unit (ICU) beds required many patients to be treated outside the ICU despite severe hypoxia. Helmet is as effective interface to provide Continuous Positive Airway Pressure (CPAP) non-invasively. We report data about the usefulness of helmet CPAP during pandemic, either as an effective treatment, a bridge to intubation or a rescue therapy for patients with care limitations (DNI).Methods: In this observational study we collected data regarding patients failing standard oxygen therapy (i.e. non-rebreathing mask) due to COVID-19 pneumonia treated with a free flow helmet CPAP system. Patients’ data were recorded before, at initiation of CPAP treatment and once a day, since. CPAP failure was defined as a composite outcome of intubation or death.Results: A total of 306 patients were included; 42% were deemed as DNI. Helmet CPAP treatment was successful in 69% of the full-treatment and 29% of the DNI patients (P<0.001). With helmet CPAP, PaO2/FiO2 ratio doubled from about 100 to 200 mmHg (P<0.001); respiratory rate decreased from 28 [22-32] to 24 [20-29] breaths per minute, P<0.001). CPAP failure was independently associated with CRP, time to oxygen mask failure, age, PaO2/FiO2 during CPAP, number of comorbidities. Helmet CPAP was maintained for 6 [3-9] days, almost continuously during the first two days. None of the full treatment patients died before intubation in the wardsConclusions: Helmet CPAP treatment is feasible for several days outside the ICU, despite persisting hypoxia. It is effective, avoiding intubation in the majority of full treatment patients when standard oxygen therapy fails. DNI patients could benefit from helmet CPAP as rescue therapy to improve survival.Trial Registration: NCT04424992
Assessment of Patient-Reported Outcomes After Polytrauma: A Systematic Review
Authors: Ritschel Michaela , Kuske Silke , Gnass Irmela , Andrich Silke , Moschinski Kai , Borgmann Sandra Olivia , Herrmann-Frank Annegret , Metzendorf Maria-Inti , Wittgens Charlotte , Flohé Sascha , Sturm Johannes , Windolf Joachim , Icks Andrea
Published: October 2020

Background: Tools assessing patient-reported outcomes (PROs) after polytrauma have not been systematically reviewed so far. Therefore, we sought to: (1) collect instruments that assess health-related quality of life (HRQoL), activities of daily living (ADL), and social participation during follow-up after polytrauma, (2) describe their use (e.g. frequency of application during follow-up), and (3) investigate other relevant PROs assessed in the included studies (e.g. pain, depression, anxiety).Methods: The search was conducted in MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, the trials registers ClinicalTrials.gov, and WHO ICTRP. All original empirical research published between January 2005 and April 2018 was included. Data extraction, narrative content analysis, and a critical appraisal were performed.Results: The search yielded 3496 hits and 54 publications were included in the review. Predominantly, HRQoL was assessed (in 48 of 54 publications), with Short Form-36 Health Survey (SF-36) applied most frequently. ADL and (social) participation were rarely assessed. The follow-up period lasted between 8 days and 17.5 years; assessments were performed between one and five times. Most used were a single assessment of PROs, a follow-up period of 1 to 1.5 years, and a postal survey. Other relevant PRO areas reported were function, mental disorders, and pain.Conclusions: There is a large variation in the assessment of PROs after polytrauma, impairing comparability of outcomes. First efforts to standardise the collection of PROs have been initiated, but further harmonisation between central players, such as trauma registers, is required. Definition and continuous collection of core outcome sets would improve comparability of study results, creating the basis for more targeted treatment. Additional knowledge on rarely reported PRO areas like (social) participation and social network may lead to their consideration in health services provision.Registration: PROSPERO (CRD42017060825)
Mechanical Ventilation in COVID-19 Patients Supported With ECMO in Wenzhou, China: A Retrospective Study
Authors: Cai Jiejie , Lu Yingru , Wang Xiaorong , Ye Yincai , Qian Songzan , Pan Jingye
Published: October 2020

BackgroundThe function of Extracorporeal membrane oxygenation (ECMO) is to maintain cardiopulmonary function in critical patients diagnosed with Coronavirus (COVID-19). Under the protection of ECMO, we recorded and analyzed the results of ventilator treatment following the adjustment of ventilator settings.MethodsThis retrospective study enrolled six patients who received ECMO treatment. Clinical, laboratory and radiological characteristics, time of spontaneous respiration, and static lung compliance (CLst) were all recorded. Positive end-expiratory pressure (PEEP) and oxygen concentration (FIO2) were adjusted to record changes in oxygen saturation (SpO2), tidal volume (TV), peak airway pressure, and blood gas analysis. ResultsDuring analysis, one patient died of COVID-19 within 28 days, and two patients were successfully weaned off mechanical ventilation and ECMO. Patients with an improved condition have a longer time of spontaneous respiration and better CLst than those who worsen. With an instantaneous increase in FIO2 alone or a combination of PEEP / FIO2, SpO2 and partial pressure of oxygen (PaO2) both increased, but no significant change was observed in PaCO2, PaO2/FIO2 and TV. With an instantaneous increase of PEEP alone, SpO2 , PaO2, PaCO2, PaO2/FIO2 and TV showed no significant change. ConclusionsECMO can save some patients’ lives, but some patients will still suffer multiple organ failure and even death. The time of spontaneous respiration, CLst and TV may be a good choice for evaluating patients' lung situations. Increased PEEP may not significantly reduce lung exudation in COVID-19 patients supported by ECMO but further expand the over-expanded alveoli.
Urban Living Environment and Mental Health of Older People: A Photovoice Study
Authors: Mysyuk Yuliya , Widdershoven Guy , Huisman Martijn
Published: October 2020

Background Living environment has long been considered an important determinant of health. The aim of this study was to explore older people’s experiences with their living environment, their definition of, and their view on its possible impact on mental health and well-being.MethodsThis qualitative study was conducted in Amsterdam among 20 participants, 11 males and 9 females aged 55 to 70 years. We used photovoice as a visual tool to explore older persons’ unique experiences with, and perceptions of their living environment.ResultsOur findings show that social environment plays an important role in defining and shaping the living environment of older people. Older people’s living environment is a place where they feel safe and comfortable, have social contact with others, and stay active and involved.ConclusionPhotovoice was an effective method for documenting visual representation of salient aspects of older people’s living environment and capturing their experiences.
Multiple-testing Correction in Metabolome-wide Association Studies
Authors: Peluso Alina , Glen Robert , Ebbels Timothy M D
Published: October 2020

The search for statistically signiﬁcant relationships between molecular markers and outcomes is challenging when dealing with high-dimensional, noisy and collinear multivariate omics data. Permutation procedures allow for the estimation of adjusted signiﬁcance levels without assuming independence among the metabolomic variables. Nevertheless, the complex non-normal structure of the metabolic proﬁles and outcomes may bias the permutation results leading to overly conservative threshold estimates i.e. lower than a Bonferroni or Sidak correction. Within a univariate permutation procedure we employ parametric simulation methods based on the multivariate (log-)Normal distribution to obtain adjusted signiﬁcance levels which are consistent across phenotypes while eﬀectively controlling the type I error rate at the α level. Next, we derive an alternative closed-form expression for the estimation of the number of non-redundant metabolic variates based on the spectral decomposition of their correlation matrix. The eﬃcacy of our methods is tested for diﬀerent model parametrizations and across a wide range of correlation levels of the variates using both synthetic and real data sets. Both the permutation-based formulation and the more practical closed form expression are found to give an eﬀective indication of the number of indipendent metabolic eﬀects exhibited by the system.
Surgery for Primary Tumor Benefits Survival for Breast Cancer Patients With Bone Metastases: A Large Cohort Retrospective Study
Authors: Huang Zhangheng , Zhou Xin , Tong Yuexin , Zhu Lujian , Zhao Ruhan , Zhao Chengliang
Published: October 2020

Background: The role of surgery for the primary tumor in breast cancer patients with bone metastases (BM) remains unclear. The purpose of this study was to determine the impact of surgery for the primary tumor in breast cancer patients with BM and to develop prognostic nomograms to predict the overall survival (OS) of breast cancer patients with BM.Methods: A total of 3,956 breast cancer patients with BM from the Surveillance, Epidemiology, and End Results database between 2010 and 2016 were included. Propensity score matching (PSM) was used to eliminate the bias between the surgery and non-surgery groups. The Kaplan-Meier analysis and the log-rank test were performed to compare the OS between two groups. Cox proportional risk regression models were used to identify independent prognostic factors. Two nomograms were constructed for predicting the OS of patients in the surgery and non-surgery groups, respectively. In addition, calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the performance of nomograms.Result: The survival analysis showed that the surgery of the primary tumor significantly improved the OS for breast cancer patients with BM. Based on independent prognostic factors, separate nomograms were constructed for the surgery and non-surgery groups. The calibration and ROC curves of these nomograms indicated that both two models have high predictive accuracy, with the area under the curve values ≥0.700 on both the training and validation cohorts. Moreover, DCA showed that nomograms have strong clinical utility. Based on the results of the X-tile analysis, all patients were classified in the low-risk-of-death subgroup had a better prognosis.Conclusion: The surgery of the primary tumor can provide survival benefits for breast cancer patients with BM. Furthermore, these prognostic nomograms we constructed can be used as a tool to accurately assess the long-term prognosis of patients and help clinicians to develop individualized treatment strategies.
Additive Value of Texture Analysis Based on Breast MRI for Distinguishing Between Benign and Malignant Non-mass Enhancement in Premenopausal Women
Authors: Tan Yu , Mai Hui , Huang Zhiqing , Zhang Li , Li Chengwei , Wu Songxin , Huang Huang , Tang Wen , Liu Yongxi , Jiang Kuiming
Published: October 2020

Background: Non-mass enhancement (NME) is a diagnostic dilemma. Texture analysis (TA) could serve as an objective method to quantify tumor characteristics and growth patterns. However, there are few reports about TA use in NME diagnosis. To our knowledge, NME diagnosis based on the combination of the features noted on routine MRI and TA has not been reported.. The purpose of this study was to explore the value of TA in distinguishing between benign and malignant NME in premenopausal women. Methods: Women in whom NME was histologically proven (n = 147) were enrolled (benign: 58; malignant: 89) was retrospective. Then, 102 and 45 patients were classified as the training and validation groups, respectively. Scanning sequences included Fat-suppressed T2-weighted and fat-suppressed contrast-enhanced T1-weighted which were acquired on a 1.5T MRI system. Clinical and routine MR characteristics (CRMC) were evaluated by two radiologists according to the Breast Imaging and Reporting and Data system (2013). Texture features were extracted from all post-contrast sequences in the training group. The combination model was built and then assessed in the validation group. Pearson’s chi-square test and Mann-Whitney U test were used to compare categorical variables and continuous variables, respectively. Logistic regression analysis and receiver operating characteristic curve were employed to assess the diagnostic performance of CRMC, TA, and their combination model in NME diagnosis.Results: The combination model showed a superior diagnostic performance in differentiating between benign and malignant NME compared to that of CRMC or TA alone (AUC, 0.887 vs 0.832 vs 0.74). Moreover, compared to CRMC, the model showed high specificity (72.5% vs 80%). The results obtained in the validation group confirmed the model was promising.Conclusion: The combined use of TA and CRMC could afford an improved diagnostic performance in differentiating between benign and malignant NME.
Alleviation of EGFR Tyrosine Kinase Inhibitor-induced Skin Toxicity by Modified Huang-Lian-Jie-Du Decoction Cream in Cancer Patients
Authors: Lee Ming-Yang , Lin Mei-Yi , Chang Yu-Ju , Tseng Yu-Ting , Huang I-An , Siao Ying-Yu , Liu Yi-Wen
Published: October 2020

Background: The EGFRIs and TKIs are effective for cancer target therapy, but the acneiform rashes or called inflammatory papulopustular exanthemas are common (50% to 100%). The conventional therapy for EGFRIs/TKIs-induced skin toxicity is steroids and antibiotics, but their effect is still limited. In this study, a modified Chinese herbal medicine Huang Lian Jie Du decoction cream with Yin-Cold (YC) medicine characteristic was investigated for the effect on patients suffering EGFRIs/TKIs-induced skin toxicity.Methods: The modified Huang Lian Jie Du (mHLJD) decoction cream was made from 10 herbal medicines including 4 major medicines (Huanglian, Huangqin, Huangbo, and Zhizi) in traditional HLJD decoction. Patients with EGFRIs/TKIs-induced skin toxicity were enrolled. Patients were excluded if they also used other cream for the skin toxicity. Skin conditions were follow up every 2 weeks. The patients’ characteristics, the skin toxicities and treatment response were recorded and analyzed after using mHLJD decoction cream for 1~2 months.Results: The mHLJD decoction cream and its subpackages were stored at 4℃ before use. Thirty-four patients who had grade 1-3 skin toxicities after receiving EGFRIs or TKIs were enrolled. Five patients were withdrawal or excluded, 2 patients with paronychia syndrome had no improvement and were excluded, too. Finally, data from 27 patients were analyzed. The mean grade of rash acneiform was decreased from 2.23 (ranged 1 to 3) to 0.38 (ranged 0 to 1) after mHLJD decoction cream treatment for 1~2 months. And the mean grade of dry skin was decreased from 1.57 (ranged 1 to 2) to 0.77 (ranged 0 to 1). The changes of skin toxicity were significant and no obvious adverse events.Conclusions: In summary, the mHLJD decoction cream is effective for alleviation of EGFRIs/TKIs-induced skin rash acneiform and dry skin. And mHLJD decoction cream has no effect in patients with paronychia syndrome.Trial registration: CYCH, CYCH-IRB No. 2019023. Registered 14 May 2019, http://www.cych.org.tw/irbweb/
Association of Risk Factors With Hepatitis B & C Infection Among Pregnant Women Visiting a Private Tertiary Care Hospitals- Peshawar (An Un Matched Pilot Case Control Study)
Authors: Farooqi Jalwa Javed , Malik Farhat Rehana , Farooqi Kanza Javed , Mudassar Owais
Published: October 2020

Background; Viral hepatitis causes devastating health issues to everyone globally and specifically the most vulnerable groups like pregnant ladies. The aim of this study was to identify risk factors for hepatitis B and C virus infection with univariate association of virus seropositivity among pregnant women and comparison of public with private hospital data.Study Design; An Unmatched Case Control Pilot Study.Place and Duration; Gynaecology wards of Two Public Tertiary Care Hospitals of Peshawar and equal number of Private clinics, from September- 2018 to February- 2019.Methods; This study enrolled 21 cases and controls as 1:1 ratio via consecutive sampling. A validated questionnaire was used. Cases included were HBsAg and ELISA positive HCV females, while anti HBsAg and Anti HCV ELISA negative were the controls. The collected data was entered and analysed in SPSS version- 19. Descriptive statistics were computed by frequency and percentages while inferential statistics through Odd ratio and 95% confidence interval. P value cut of limit was set at <0.05. Results; The mean age was 37±9 for the cases and 28±6 years for controls respectively. The risk factors with increase occurrence of disease were past history of abortion OR=1.23 (95% Cl=0.34-4.35), past hospitalization OR=2.90 (Cl=0.77-10.8), past surgical procedure OR=3.69 (Cl=0.81-16.6), dental extraction OR=1.25 (Cl=0.33-4.63), delivery in hospital OR=4.26 (Cl=1.13-16.05), injection in hospitals OR=1.47 (Cl=0.43-5.04), household contact with jaundice OR=5.66 (Cl=1.41-22.7). Normal vaginal delivery OR=1.96 (Cl=0.51-7.48) and history of sexually transmitted infections OR=2.23 (Cl=0.36-13.7) were independently associated with HBV, HCV.Conclusion; Iatrogenic exposures of injections, blood transfusions, tooth extractions, home deliveries with past history of sexually transmitted infections, abortion, hepatitis infection and hospital admissions were the risk factors among the pregnant women.
Changes in the Taxonomic and Functional Structure of Microbial Communities During Vegetable Waste Silage Fermentation
Authors: Zhang Juntao , Huang Xiying , Ma Menggen , Xiang Quanju , Zhao Ke , Penttinen Petri , Gu Yunfu
Published: October 2020

Background：Silage fermentation, a sustainable way to use vegetable waste resources, is a complex process driven by a variety of microorganisms. We used lettuce waste as the raw material for silage, analyzed changes in the physico-chemical characteristics and bacterial community composition of silage during a 60 day fermentation, identified differentially abundant taxa, predicted the functional profiles of bacterial communities, and determined the associated effects on the quality of silage. Results: The biggest changes occurred in the early stage of silage fermentation. Changes in the physico-chemical characteristics included a decrease in pH and increases in ammonia nitrogen to total nitrogen ratio and lactic acid content. The numbers of lactic acid bacteria increased and those of molds, yeasts and aerobic bacteria decreased. The bacterial communities and their predicted functions on day 0 were clearly different from those on day 7 to day 60. The relative abundances of phylum Firmicutes and genus Lactobacillus increased. Nitrite ammonification and nitrate ammonification were more prevalent after day 0. The differences in the predicted functions were associated with differences in pH and amino acid, protein, carbohydrate, NH3-N, ether extract and crude ash contents. Conclusion: Firmicutes and Lactobacillus were the dominant taxa during vegetable waste silage fermentation. The microbial communities and the predicted functions changed in different stages of silage fermentation, and the changes were accompanied with changes in the physico-chemical characteristics, especially with a decrease in pH and increases in ammonia nitrogen to total nitrogen ratio and lactic acid content.
LOCATE: A Prospective Evaluation of the Value of Leveraging Ongoing Citation Acquisition Techniques for Living Evidence Syntheses
Authors: Gates Michelle , Elliott Sarah A , Gates Allison , Sebastianski Meghan , Pillay Jennifer , Bialy Liza , Hartling Lisa
Published: October 2020

Background. Living systematic reviews (LSRs) can expedite evidence synthesis by incorporating new evidence in real time. However, the methods needed to identify new studies in a timely manner are not well established. Objectives. To explore the value of complementary search approaches in terms of search performance, impact on results and conclusions, screening workload and feasibility compared to the reference standard.Methods. We developed three complementary search approaches for a systematic review on treatments for bronchiolitis: Automated Full Search, Pubmed Similar Articles, and Scopus Citing References. These were automated to retrieve results monthly; pairs of reviewers screened the records and commented on feasibility. After one year, we conducted a full update search (reference standard). For each complementary approach, we compared search performance (proportion missed, number needed to read [NNR]) and reviewer workload (number of records screened, time required) to the reference standard. We investigated the impact of the new trials on the effect estimate and certainty of evidence for the primary outcomes. We summarized comments about feasibility. Results. Via the reference standard, reviewers screened 505 titles/abstracts, 24 full texts, and identified four new trials (NNR 126.6; 12.4 hours). Of the complementary approaches, only the Automated Full Search located all four trials; these were located six to 12 months sooner than via the reference standard but did not alter the results nor certainty in the evidence. The Automated Full Search was the most resource-intensive approach (816 records screened; NNR 204.1; 17.1 hours). The Pubmed Similar Articles and Scopus Citing References approaches located far fewer records (452 and 244, respectively), thereby requiring less screening time (9.4 and 5.2 hours); however, each approach located only one of the four new trials. Reviewers found it feasible and convenient to conduct monthly screening for searches of this yield (median 15-65 records/month). Conclusions. The Automated Full Search was the most resource-intensive approach, but also the only to locate all of the newly published trials. Although the monthly screening time for the Pubmed Similar Articles and Scopus Citing Articles was far less, most relevant records were missed. These approaches were feasible to integrate into reviewer work processes.Study Protocol. Posted 25 October 2018 on the Open Science Framework, https://osf.io/wxebg/ doi: 10.17605/OSF.IO/6M28H.
The Clinical Effects of Cerebral Near-Infrared Spectroscopy Monitoring (NIRS) Versus No Monitoring in Children and Adults: A Protocol for a Systematic Review With Meta-Analysis and Trial Sequential Analysis
Authors: Hansen Mathias Lühr , Hyttel-Sørensen Simon , Jakobsen Janus Christian , Gluud Christian , Kooi Elisabeth M.W. , Mintzer Jonathan , de Boode Willem P. , Fumagalli Monica , Allen Ana Alarcon , Alderliesten Thomas , Greisen Gorm
Published: October 2020

BackgroundMultiple clinical conditions are associated with cerebral hypoxia/ischaemia and thereby an increased risk of hypoxic-ischaemic brain injury. Cerebral near-infrared spectroscopy monitoring (NIRS) is a tool to monitor brain oxygenation and perfusion, and the clinical uptake of NIRS has expanded over recent years. Specifically, NIRS is used in the perioperative and neonatal, paediatric, and adult intensive care settings. However, the available literature suggests that clinical benefits and harms of cerebral NIRS monitoring are uncertain. As rates of clinically significant hypoxic-ischaemic brain injuries are typically low, it is difficult for randomised clinical trials to capture a sufficiently large number of events to evaluate the clinical effect of cerebral NIRS monitoring, when focusing on specific clinical settings. MethodsWe will conduct a systematic review with meta-analysis and Trial Sequential Analysis to evaluate the benefits and harms of clinical care with cerebral NIRS monitoring versus clinical care without cerebral NIRS monitoring in children and adults across all clinical settings. We will only include randomised clinical trials and the primary outcomes are all-cause mortality, moderate or severe persistent cognitive or neurological deficit, and proportion of participants with one or more serious adverse events. The review will be conducted according to the methodology described in The Cochrane Handbook for Systematic Reviews of Interventions, including GRADE. An eight-step procedure by Jakobsen et al. will be used to assess if thresholds for statistical and clinical significance are crossed.DiscussionAs we include trials across multiple clinical settings, there is an increased probability of reaching a sufficient information size. However, heterogeneity between the included trials may impair our ability to interpret results to specific clinical settings. In this situation, we may have to depend on subgroup analyses with inherent increased risks of type I and II errors. Systematic review registrationThis systematic review protocol has been submitted for registration in the International Prospective Register of Systematic Reviews (PROSPERO) (http://www.crd.york.ac.uk/prospero) (1,2) on 12th of October 2020.
Inflammation Scores as Prognostic Biomarkers in Small Cell Lung Cancer: A Systematic Review and Meta-Analysis
Authors: Winther-Larsen Anne , Aggerholm-Pedersen Ninna , Sandfeld-Paulsen Birgitte
Published: October 2020

Background: Inflammation scores based on general inflammation markers as leucocyte count or C-reactive protein have been evaluated as prognostic markers of inferior survival in several cancers. In small cell lung cancer (SCLC), however, inflammation scores are less studied. In the present study, we set out to perform a systematic review and meta-analysis investigating reported associations between inflammation scores and overall survival (OS) in SCLC. Methods: A literature search was performed in PubMed, Embase, Scopus, and Web of Science following the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) guidelines. Of the identified publications, only studies in English containing original data evaluating inflammation scores as a prognostic factor in SCLC patients were included. Hazard ratios (HRs) for OS were pooled in a random-effects model. Results: In total, 33 articles were included evaluating eight different inflammation scores in 7762 SCLC patients. Seven of the identified scores were based on leucocyte count. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio were the most frequently evaluated scores (NLR: n=23; PLR: n=22). For NLR, a meta-analysis including 16 studies demonstrated that patients with a high NLR had a significantly shorter OS compared to patients with a low NLR (pooled HR=1.39 (95 % CI, 1.23 – 1.56)). For PLR, an association with survival could not be confirmed in a meta-analysis performed based on eight studies (pooled HR=1.20 (95 % CI, 0.96 – 1.51)). Conclusions: This review identifies that inflammation scores based on general inflammation markers have some potential as prognostic biomarkers in SCLC. The meta-analyses indicated that NLR is associated with inferior OS, whereas an association between PLR and OS could not be confirmed. Thus, NLR could be a useful biomarker of OS in SCLC patients. Systematic Review Registrations: The protocol for the study was submitted to the PROSPERO database (registration number CRD42020188553).
Adverse Health Manifestations in the Hands of Vibration Exposed Carpenters - A Cross Sectional Study
Authors: Tekavec Eva , Löfqvist Lotta , Larsson Anna , Fisk Karin , Riddar Jakob , Nilsson Tohr , Nordander Catarina
Published: October 2020

BackgroundDespite EU regulatory standards, many workers suffer injury as a result of working with hand-held vibrating tools. Our aim of this study was to investigate whether carpenters, a highly exposed group, suffer more injuries to their hands than painters, a group assumed to be less exposed to vibration. Methods193 carpenters and 72 painters, all men, answered a questionnaire and underwent a clinical examination to identify manifestations of neural and vascular origin in hands. Neurosensory affection was defined as having at least one symptom in the fingers/hands (impaired perception of touch, warmth, or cold, impaired dexterity, increased sensation of cold, numbness or tingling, or pain in the fingers/hands when cold) and at least one clinical finding (impaired perception of touch, warmth, cold, vibration, or two-point discrimination). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). ResultsNeurosensory affection was fulfilled for 31% of the carpenters and 17% of the painters, age-adjusted OR 3.3 (CI 1.6–7.0). Among carpenters with neurosensory affection 18% reported interference with daily life activities, the most common symptoms being increased sensation of cold, numbness and pain in the fingers/hands when cold, the most common clinical findings were impaired perception of touch and vibration. Neurosensory affection was found in 12 % of young carpenters (≤ 30 years old). No difference was found in the prevalence of white fingers between carpenters and painters. ConclusionsCarpenters showed more symptoms and clinical findings of neurosensory affection than painters, probably due to vibration exposure. Also young carpenters showed signs of neurosensory affection, which indicates that workers at today´s working conditions are not protected against injury. This underlines the importance of reducing exposure to vibration, and conducting regular medical check-ups to detect early signs of neural and vascular manifestations indicating hand-arm vibration injuries. Special attention should be given to symptoms of increased sensation of cold, pain in the fingers when cold, and numbness, as these were the most common initiating ones, and should be addressed as early as possible in the preventive sentinel process. It is also important to test clinically for small- and large-fibre neuropathy, as the individual may be unaware of any pathology.
Genetic Testing of Leukodystrophies Unraveling Extensive Heterogeneity in a Large Cohort: The Role of Five Common Diseases and Report of 38 Novel Variants
Authors: Mahdieh Nejat , Soveizi Mahdieh , Tavasoli Alireza , Rabbani Ali , Ashrafi Mahmoudreza , Kohlschütter Alfried , Rabbani Bahareh
Published: October 2020

Background: This study evaluates the genetic spectrum of leukodystrophies and leukoencephalopathies in Iran. Methods: 152 children, aged from 1day to 15 years, were genetically tested for leukodystrophies and leukoencephalopathies based on clinical and neuroradiological findings from 2016 to 2019. Patients with a suggestive specific leukodystrophy, e. g. metachromatic leukodystrophy, Canavan disease, Tay-Sachs disease were tested for mutations in single genes (108; 71%) while patients with less suggestive findings were evaluated by NGS. Results: 108 of 152(71%) had MRI patterns and clinical findings suggestive of a known leukodystrophy. In total, 114(75%) affected individuals had (likely) pathogenic variants which included 38 novel variants. 35 different types of leukodystrophies and genetic leukoencephalopathies were identified. The more common identified disorders included metachromatic leukodystrophy (19 of 152; 13%), Canavan disease (12; 8%), Tay-Sachs disease (11; 7%), megalencephalic leukodystrophy with subcortical cysts (7; 5%), X-linked adrenoleukodystrophy (8; 5%), Pelizaeus-Merzbacher-like disease type 1 (8; 5%), Sandhoff disease (6; 4%), Krabbe disease (5; 3%), and vanishing white matter disease (4; 3%). Whole exome sequencing (WES) revealed 26% leukodystrophies and genetic leukoencephalopathies. The total diagnosis rate was 75%. Conclusions: This unique study presents a national genetic data of leukodystrophies; it may provide clues to the genetic pool of neighboring countries. Patients with clinical and neuroradiological evidence of a genetic leukoencephalopathy should undergo a genetic analysis to reach a definitive diagnosis. This will allow a diagnosis at earlier stages of the disease, reduce the burden of uncertainty and costs, and will provide the basis for genetic counseling and family planning.
Distribution and Exposure Risk Assessment of Perfluorinated Alkyl Substances in Aquatic Products Along the Coastal Region of the South China Sea
Authors: Wang Xu-Feng , Mo Meng-Song , Chen Hai-Gang , Wang Qiang , Yang Jin-Lan , Zhao Dong-Hao
Published: October 2020

ObjectiveThe purpose of this investigation was to monitor the contamination characters and spatial and temporal distributions of 23 Perfluorinated alkyl substances (PFASs) in seafood along South China Coastal Regions. The exposure risks of PFOA and PFOS to human health in marine aquatic products were also evaluated.MethodsA total of 844 samples including 359 fishes, 391 shellfishes and 94 crustaceans were collected from Guangdong, Guangxi and Hainan provinces. The samples were extracted and purified using a modified QuEChERS procedure and analyzed by UPLC-MS / MS. The statistical analysis was performed in view of the detection of different PFAS components in variety of fishes, shellfishes and crustaceans, respectively.ResultsSixteen PFASs were detected in the survived samples and the total detection rates reached to 99.21 %. The highest ∑PFASs in each sample was 28.27 μg/kg, and the average and medium values of ∑PFAS were 1.83 μg/kg and 1.18 μg/kg, respectively. PFOS and PFBA have been considered as predominant PFAS components with corresponding pollution contribution rates of 29.14% and 24.71%, respectively. However, it is noted that PFNA and PFBS were primarily enriched in the oyster and mussel. During the period of this investigation (2014-2016), ∑PFAS average concentrations turned out constantly rising trend and new pollution component PFHxS detected in 2016. ∑PFAS concentrations of Guangdong, Guangxi and Hainan provinces were approximately at similar level.ConclusionThe contamination status of PFASs were getting worse in South China Coastal Regions. Safety and risk exposure assessments of PFOA and PFOS via daily diet intakes showed relatively low to local residents.