bluuebunny/crossref_metadata_2025 huggingface dataset:
Health professionals’ perceptions of colorectal cancer patients’ treatment burden and their supportive work to ameliorate the burden
Authors: Husebø Anne Marie Lunde , Karlsen Bjørg , Husebø Sissel I. Eikeland
Published: April 2020

Background. Support is pivotal for patients in managing colorectal cancer treatment, as they might be overwhelmed by the burden of treatment. There is scarce knowledge regarding health professionals’ perceptions of colorectal cancer patients’ burdens and supportive needs. The study aims to describe health professionals’ perspectives on treatment burden among patients receiving curative surgical treatment for colorectal cancer during the hospital stay and how they support patients to ameliorate the burden.Methods: This study has a descriptive and explorative qualitative design, using semi-structured interviews with nine health professionals recruited from a gastrointestinal-surgery ward at a university hospital in Norway. Data were analysed by using systematic text condensation. Results: Data analysis identified the themes “capturing patients’ burdens of colorectal cancer treatment” and “health professionals’ support to ameliorate the burden”. Patients with colorectal cancer had to face burdens related to a challenging emotional situation, treatment complications and side effects, and an extensive need for information. A trusting patient-carer relationship was therefore perceived as the essence of health professionals’ support. Health professionals focused their support on safeguarding patients, motivating patients to self-manage, and involving family and peers as supporters. Patients’ journey characteristics and illness severity challenged health professionals’ supportive work. Conclusion: Support from health professionals includes providing patients emotional support and relevant treatment-related information and motivating patients for early post-surgical mobilisation. Health professionals should be aware of identifying colorectal cancer patients’ information needs according to the specific treatment stages, which may ameliorate the burden of colorectal cancer treatment and enable patients to self-manage.
Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study In Jos North And Mangu, Plateau State, North - Central Nigeria
Authors: Sariem Comfort Nanbam , Odumosu Patricia , Dapar Maxwell Patrick , Musa Jonah , Ibrahim Luka , Aguiyi John Chinyere
Published: April 2020

Background: Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos North and Mangu Local Government Areas of Plateau State Nigeria. Methods: The retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. Data were collected from 10156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariable and multivariable logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.Results: During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The Mean age ±SD was 35.5±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p=0.028) more likely to be associated with treatment success than having an unknown status. Treatment after loss to follow-up, relapse and treatment failure were less likely associated with treatment success than newly diagnosed TB patients.Conclusion: With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.
High expressions of the cytoglobin and PGC-1α genes during the tissue regeneration of house gecko (Hemidactylus platyurus) tails
Authors: Novianti Titta , Juniantito Vetnizah , Jusuf Ahmad Aulia , Arida Evy Ayu , Sadikin Mohamad , Jusman Sri Widia A.
Published: April 2020

Background The tissue regeneration process requires high oxygen and energy levels. Cytoglobin (Cygb) is a member of the globin family, which has the ability to bind oxygen, plays a role in dealing with oxidative stress, and carries oxygen into the mitochondria. Energy production for tissue regeneration is associated with mitochondria—especially mitochondrial biogenesis. The peroxisome proliferator-activated receptor-gamma coactivator (PGC)-1alpha protein helps to regulate mitochondrial biogenesis. House geckos ( Hemidactylus platyurus ) are reptiles that have the ability to regenerate the tissue in their tails. House geckos were selected as the animal models for this study in order to analyze the association of Cygb with oxygen supply and the association of PGC-1α with energy production for tissue regeneration. Results The growth of house gecko tails showed a slow growth at the wound healing phase, then followed by a fast growth after wound healing phase of the regeneration process. While Cygb mRNA expression reached its peak at the wound healing phase and slowly decreased until the end of the observation. PGC-1α mRNA was expressed and reached its peak earlier than Cygb. Conclusions The expressions of both the Cygb and PGC-1α genes were relatively high compared to the control group. We therefore suggest that Cygb and PGC-1α play an important role during the tissue regeneration process.
Acceptability and practicability of self-management for patients with Parkinson's disease based on smartphone applications in China
Authors: Hu Jie , Yuan Dezhi , Zhao Qiuye , Wang Xuefei , Zhang Xiaotian , Jiang Qihui , Luo Huirong , Li Jing , Ran Jianhua , Li Jinfang
Published: April 2020

Background: China has had about 1.2 billion mobile-phone users, and this number continues to grow. However, mobile-health services (mHealth) are currently in the initial stage, and have not yet prevailed in China. Additionally, the prevalence of Parkinson's disease (PD) in China is 1700/100,000 (≥65 years). Indeed, these PD patients would benefit from mHealth to manage their disease. Therefore, we designed a study to determine attitudes toward smartphone applications (apps) for chronic condition self-management, and to discover the practicality of these apps among PD patients in China.Methods: We selected 204 participants with PD between 52 and 87 years old and surveyed their attitudes concerning the use of smartphone apps for chronic condition management via questionnaires. Results: Among the participants, 65.19％ had smartphones. Among these smartphone users, 82.84％ expressed a preference for using apps for PD management. This group tended to be younger and more frequent web users with higher education and better medication compliance, and they tended to have a longer PD course and worse conditions (P < 0.001, P = 0.001, P < 0.001, P = 0.041, P < 0.001, P = 0.013) .Additionally, the willingness to apply apps for PD self-management was positively related to education (P < 0.001) and negatively related to age and PD course (P = 0.017, P < 0.001). Conclusion: In China, patients with PD have a generally positive attitude towards self-management through smartphone apps. Consequently, improving the coverage of smartphones with practical and handy apps is a promising strategy for PD self-management.
Submicromolar copper (II) ions stimulate transretinal signaling in the isolated retina from wild type but not from Cav2.3-deficient mice
Authors: Lüke Jan Niklas , Neumaier Felix , Alpdogan Serdar , Hescheler Jürgen , Schneider Toni , Albanna Walid , Akhtar-Schäfer Isha
Published: April 2020

Background: So far, only indirect evidence exists for the pharmacoresistant R-type voltage-gated Ca2+ channel (VGCC) to be involved in transretinal signaling by triggering GABA-release onto ON-bipolar neurons. This release of inhibitory neurotransmitters was deduced from the sensitivity of the b-wave to stimulation by Ni2+, Zn2+ and Cu2+. To further confirm the interpretation of these findings, we compared the effects of Cu2+ application and chelation (using kainic acid, KA) on the neural retina from wildtype and Cav2.3-deficient mice. Furthermore, the immediately effect of KA on the ERG b-wave modulation was assessed.Methods: Transretinal signaling was recorded as an ERG from the superfused murine retina isolated from wildtype and Cav2.3-deficient mice.Results: In mice, the stimulating effect of 100 nM CuCl2 is absent in the retinae from Cav2.3-deficient mice, but prominent in Cav2.3-competent mice. Application of up to 3 mM tricine does not affect the murine b-wave in both genotypes, most likely because of chelating amino acids present in the murine nutrient solution. Application of 27 µM KA significantly increased the b-wave amplitude in wild type and Cav2.3 (-|-) mice. This effect can most likely be explained by the stimulation of endogenous KA-receptors described in horizontal, OFF-bipolar, amacrine or ganglion cells, which could not be fully blocked in the present study.Conclusion: Cu2+-dependent modulation of transretinal signaling only occurs in the murine retina from Cav2.3 competent mice, supporting the ideas derived from previous work in the bovine retina that R-type Ca2+ channels are involved in shaping transretinal responses during light perception.
Clinical outcomes after mix-and-match implantation of diffractive multifocal intraocular lenses with +2.75 and +4.00 diopter add powers
Authors: Lee Jae Hyuck , Lee Hun , Lee Jin Ah , Yoo Aeri , Kim Jae Yong , Tchah Hungwon
Published: April 2020

Background: To evaluate the clinical outcomes of bilateral mix-and-match implantation of diffractive multifocal intraocular lenses (IOLs) with different add powers.Methods: We retrospectively reviewed the medical records of 18 patients who underwent bilateral mix-and-match implantation of diffractive multifocal IOLs with different add powers. Multifocal IOLs with add powers of +2.75 diopters (D) and +4.00 D were implanted into the patients’ dominant and nondominant eyes, respectively. At 1 and 3-month postoperatively, monocular and binocular visual acuity was measured using logMAR charts and manifest refraction was performed. Specifically, logMAR charts were used to measure uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and corrected distance visual acuity (CDVA). Defocus curves, contrast sensitivity, and patient satisfaction were assessed at 3-month postoperatively.Results: Binocular logMAR measurements (mean ± standard deviation) at 3-month postoperatively were 0.01±0.04 (UDVA), 0.16±0.05 (UIVA), and 0.11±0.07 (UNVA). Postoperative spherical equivalent was -0.43±0.35 D and -0.39±0.21 D in the dominant and nondominant eyes, respectively. Defocus curves showed significant differences between -1.50 and -4.00 D among binocular, dominant, and nondominant eye measurements, except between -2.50 and -3.00 D. Eyes implanted with +2.75 and +4.00 D IOLs showed good contrast sensitivity under photopic and mesopic conditions. Over 80% of patients reported high satisfaction with their near vision.Conclusions: Bilateral mix-and-match implantation of diffractive multifocal IOLs with add powers of +2.75 D and +4.00 D showed good near, intermediate, and far vision.Trial registration: Clinical Research Information Service[Internet]; Osong(Chungcheongbuk-do): Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare (Republic of Korea), KCT0003945, Registered 20 May 2019 – Retrospectively registered, https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=13946&sLeft=2<ype=my&rtype=my
Leishmania infection induces a limited differential gene expression in the sand fly midgut
Authors: Coutinho-Abreu Iliano V. , Serafim Tiago D. , Meneses Claudio , Kamhawi Shaden , Oliveira Fabiano , Valenzuela Jesus G.
Published: April 2020

Background: Phlebotomine sand flies are the vectors of Leishmania worldwide. To develop in the sand fly midgut, Leishmania multiplies and undergoes multiple stage differentiations leading to the infective form, the metacyclic promastigotes. To gain a better understanding of the influence of Leishmania infection on midgut gene expression, we performed RNA-Seq comparing uninfected and Leishmania infantum -infected Lutzomyia longipalpis midguts at seven time points which cover the various Leishmania developmental stages including early time points when blood digestion is taking place, and late time points when the parasites are undergoing metacyclogenesis. Results: Out of over 13,841 transcripts assembled de novo , only 113 sand fly transcripts, about 1%, were differentially expressed. Further, we observed a low overlap of differentially expressed sand fly transcripts across different time points suggesting that each Leishmania stage influences midgut gene expression in a specific manner. Two main patterns of sand fly gene expression modulation were noted. At early time points (days 1-4), more transcripts were down-regulated by Leishmania infection at large fold changes (> -32 fold). Among the down-regulated genes, the transcription factor Forkhead/HNF-3 and hormone degradation enzymes were differentially regulated on day 4 and appear to be the upstream regulators of nutrient transport, digestive enzymes, and peritrophic matrix proteins. Conversely, at later time points (days 6 onwards), most of the differentially expressed transcripts were up-regulated by small fold changes (< 32 fold). The molecular function of these genes has been associated with the metabolism of lipids and detoxification of xenobiotics. Conclusion: Overall, it appears that Leishmania modulates sand fly gene expression early on in order to overcome the barriers imposed by the midgut, yet it behaves like a commensal at later time points, where a massive number of parasites in the anterior midgut results only in modest changes in midgut gene expression.
Implementation of Sexual and Gender Minority Health Curricula in Health Care Professional Schools: A Qualitative Study
Authors: Pratt-Chapman Mandi L.
Published: April 2020

Background: Lesbian, gay, bisexual, transgender, queer, and intersex people—inclusively termed “sexual and gender minorities”—have unique health and health care needs that are not being met by most healthcare providers due to lack of training in health care professional schools. The purpose of this qualitative study was to examine implementation factors for advancing sexual and gender minority health professional student curricula in academic settings. Methods: Semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR) were conducted with sixteen curricular champions to identify factors relevant to curricular adoption, integration, and sustainment. Themes were coded using a hybrid of deductive and inductive approaches and reported using major CFIR domains. Results: Facilitators supporting implementation of sexual and gender minority health curricula included collaboration among multiple stakeholders, alignment of formal and hidden curricula, fostering an organizational culture that valued inclusion and diversity, engagement with external subject matter experts or faculty with content expertise, and thoughtful and inclusive planning. Conclusion: This study contributes to health care professional education research as well as to implementation science. Facilitators that were identified in this study can be used to increase the adoption, integration, and sustainment of sexual and gender minority health curricula in diverse academic settings.
Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea
Authors: Müller Sophie Alice , Diallo Alpha Oumar Karim , Wood Rebekah , Bayo Mouctar , Eckmanns Tim , Tounkara Ousmane , Arvand Mardjan , Diallo Mamadou , Borchert Matthias
Published: April 2020

Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea. Methods: In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison. Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption. Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.
IgE reactivity to fish allergens in Pacific cod (Gadus macrocephalus) in atopic dogs
Authors: Imanishi Ichiro , Uchiyama Jumpei , Mizukami Keijiro , Kamiie Junichi , Kurata Keigo , Fujimura Masato , Shimakura Kuniyoshi , Nishifuji Koji , Sakaguchi Masahiro
Published: April 2020

Background: IgE reactivity to fish allergens in atopic dogs, which are used as models for food allergy, has not been elucidated to date. We investigated IgE reactivity to crude extracts and purified Pacific cod (Gadus macrocephalus) allergens in atopic dogs to identify the allergenic proteins of cod.Methods: Specific IgE to crude cod extracts in the sera of 179 atopic dogs, including 27 dogs with cod allergy, were measured using enzyme-linked immunosorbent assay (ELISA). The allergens of crude cod extracts were analyzed by ELISA, immunoblotting, and liquid chromatography-tandem mass spectrometry (LC-MS/MS). IgE reactivity to parvalbumin, collagen, and tropomyosin was evaluated using the sera of atopic dogs that were positive for specific IgE to crude cod extracts.Results: Specific IgE to crude cod extracts were present in 36 (20%) of the 179 atopic dogs and 12 (44%) of the 27 dogs with cod allergy. In allergen component analysis, IgE reactivity to tropomyosin and enolase was observed in the sera of dogs with cod allergy. Among the 36 dogs with IgE reactivity to crude cod extracts, 9 (25%), 14 (39%), and 18 (50%) dogs had specific IgE to parvalbumin, collagen, and tropomyosin, respectively.Conclusions: The dogs exhibited IgE reactivity to the cod allergens which observed in humans, providing support for the use of atopic dogs with fish allergy as a model for fish allergy in humans.
Opinions of key stakeholders on alternative interventions for malaria control and elimination in Tanzania
Authors: Finda Marceline Francis , Christofides Nicola , Lezaun Javier , Tarimo Brian , Chaki Prosper , Kelly Ann H. , Kapologwe Ntuli , Kazyoba Paul , Emidi Basiliana , Okumu Fredros O.
Published: April 2020

Background: Malaria control in Tanzania currently relies primarily on long-lasting insecticidal nets and indoor residual spraying, alongside effective case management and behaviour change communication. This study explored opinions of key stakeholders on the national progress towards malaria elimination, the potential of currently available vector control interventions in helping achieve elimination by 2030, and the need for alternative interventions that could be used to supplement malaria elimination efforts in Tanzania.Methods: In this exploratory qualitative study, focus group discussions were held with policy-makers, regulators, research scientists and community members. Malaria control interventions discussed were: a) improved housing, b) larval source management, c) mass drug administration (MDA) with ivermectin to reduce vector densities, d) release of modified mosquitoes, including genetically modified or irradiated mosquitoes, e) targeted spraying of mosquito swarms, and f) spatial repellents. Results: Larval source management and spatial repellents were widely supported across all stakeholder groups, while insecticide-spraying of mosquito swarms was the least preferred. Support for MDA with ivermectin was high among policy makers, regulators and research scientists, but encountered opposition among community members, who instead expressed strong support for programmes to improve housing for poor people in high transmission areas. Policy makers, however, challenged the idea of government-supported housing improvement due to its perceived high costs. Techniques of mosquito modification, specifically those involving gene drives, were viewed positively by community members, policy makers and regulators, but encountered a high degree of scepticism among scientists. Overall, policy-makers, regulators and community members trusted scientists to provide appropriate advice for decision-making. Conclusion: Stakeholder opinions regarding alternative malaria interventions were divergent except for larval source management and spatial repellents, for which there was universal support. MDA with ivermectin, housing improvement and modified mosquitoes were also widely supported, though each faced concerns from at least one stakeholder group. While policy-makers, regulators and community members all noted their reliance on scientists to make informed decisions, their reasoning on the benefits and disadvantages of specific interventions included factors beyond technical efficiency. This study suggests the need to encourage and strengthen dialogue between research scientists, policy makers, regulators and communities regarding new interventions.
Phantom and clinical evaluation of bone SPECT/CT image reconstruction with xSPECT algorithm
Authors: Miyaji Noriaki , Miwa Kenta , Tokiwa Ayaka , Ichikawa Hajime , Terauchi Takashi , Koizumi Mitsuru , Onoguchi Masahisa
Published: April 2020

Background Two novel methods of image reconstruction, xSPECT Quant (xQ) and xSPECT Bone (xB) that use an ordered subset conjugate gradient minimizer (OSCGM) for bone SPECT/CT have been proposed. The present study compares the performance characteristics of xQ, xB and conventional Flash3D (F3D) reconstruction using images derived from phantoms and patients. Methods A custom-designed body phantom for bone SPECT was scanned using a Symbia Intevo (Siemens Healthineers) and reconstructed xSPECT images were evaluated. The phantom experiments proceeded twice in different activity concentrations and sphere sizes. A phantom with 28-mm spheres containing a 99mTc background and having tumor-to-normal bone ratios (TBR) of 1, 2, 4 and 10, were generated and its convergence property was evaluated across 96 iterations. A phantom with four spheres (13-, 17-, 22-, and 28-mm diameters), containing a 99mTc-background at TBR4, was also generated. The full width at half maximum of an imaged spinous process (10 mm), coefficients of variance (CV), contrast-to-noise ratio (CNR) and recovery coefficients (RC) of an imaged spine were evaluated with F3D, xQ and xB.Images from 20 patients with suspected bone metastases (male, n = 13) were acquired using 99mTc-(H)MDP SPECT/CT, then the CV and standardized uptake value (SUV) at the 4th vertebral body (L4) were compared with xQ and xB in a clinical setup. Results Mean activity concentrations with various TBR converged accordance to increasing numbers of iterations. Spatial resolution was improved in the order of xB, xQ and F3D regardless of the number of iterations during reconstruction. The CV and RC were better for xQ and xB than for F3D. The CNR peaked at 24 iterations for xQ and 48 iterations for F3D and xB, respectively. The RC significantly differed between xQ and xB at lower numbers of iterations, whereas those of xQ and xB became almost equivalent at higher numbers of iterations. Significant differences in the clinical patients’ SUVmax and SUVpeak were observed in the reconstructed xQ and xB images. Conclusions The reconstructed xQ and xB images were more accurate than those conventionally reconstructed using F3D. Bone SPECT xB imaging offered essentially unchanged spatial resolution even when the numbers of iterations did not converge. The xB further enhanced SPECT image quality using CT data. Our findings provide important evidence for understanding the performance characteristics of the novel xQ and xB algorithms.
Gut microbiome signatures of nursing home residents carrying Enterobacteria Producing Extended-spectrum β-lactamases
Authors: BASTARD Quentin LE , Chapelet Guillaume , Birgand Gabriel , Hillmann Benjamin M , Javaudin François , Hayatgheib Niki , Bourigault Céline , Bemer Pascale , De Decker Laure , Batard Eric , Lepelletier Didier , Montassier Emmanuel
Published: April 2020

BackgroundThe prevalence of extended beta-lactamase producing Enterobacteriaceae (ESBL-E) has been constantly increasing over the last few decades. These microorganisms that have acquired broad antibiotic resistance are now common human pathogens. Changes in the gut microbiome, induced by antibiotics or other drugs, enable expansion of these microorganisms, but the mechanisms are not yet fully understood. ObjectivesThe main objective was to identify specific bacteria and functional pathways and genes characterizing the gut microbiome of nursing home residents carrying ESBL-E, using metagenomics. Subjects and methodsWe included 144 residents living in two different nursing homes. All fecal samples were screened for ESBL-E and gut microbiome was characterized using shallow shotgun metagenomic DNA sequencing. ResultsTen nursing home residents were colonized by ESBL-E, namely Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae species, and were compared to non-carriers. We found that ESBL-E carriers had an alteration in within-sample diversity. Using a bootstrap algorithm, we found that the gut microbiome of ESBL-E carriers was depleted in butyrate-producing species, enriched in succinate-producing species and enriched in pathways involved in intracellular pH homeostasis compared to non-carriers individuals. Several energy metabolism pathways were overrepresented in ESBL-E carriers suggesting a greater ability to metabolize multiple microbiota and mucus layer-derived nutrients.ConclusionsThe gut microbiome of ESBL-E carriers in nursing homes harbors specific taxonomic and functional characteristics, conferring an environment that enables Enterobacteriaceae expansion. Here we describe new functional features associated with ESBL-E carriage that could help us to elucidate the complex interactions leading to colonization persistence in the human gut microbiota.
Proactive community case management in Senegal 2014-2016: a case study in maximizing the impact of community case management of malaria
Authors: Gaye Seynabou , Kibler Janelle , Ndiaye Jean Louis , Diouf Mame Birame , Linn Annē , Gueye Alioune Badara , Fall Fatou Ba , Ndiop Medoune , Diallo Ibrahima , Cisse Moustapha , Ba Mady , Thwing Julie
Published: April 2020

The Senegal National Malaria Control Programme (NMCP) introduced home-based malaria management for all ages, with diagnosis by rapid diagnostic test (RDT) and treatment with artemisinin-based combination therapy (ACT) in 2008, expanding to over 2,000 villages nationwide by 2014. With prise en charge à domicile (PECADOM), community health workers (CHWs) were available for community members to seek care, but did not actively visit households to find cases. A trial of a proactive model (PECADOM Plus), in which CHWs visited all households in their village weekly during transmission season to identify fever cases and offer case management, in addition to availability during the week for home-based management, found that CHWs detected and treated more cases in intervention villages, while the number of cases detected weekly decreased over the transmission season. The NMCP scaled PECADOM Plus to three districts in 2014 (132 villages), to a total of six districts in 2015 (246 villages), and to a total of 16 districts in 2016 (708 villages). A narrative case study with programmatic results is presented. During active sweeps over approximately 20 weeks, CHWs tested a mean of 77 patients per CHW in 2014, 89 patients per CHW in 2015, and 90 patients per CHW in 2016, and diagnosed a mean of 61, 61 and 43 patients with malaria per CHW in 2014, 2015 and 2016, respectively. The number of patients who sought care between sweeps increased, with a 104% increase in the number of RDTs performed and a 77% increase in the number of positive tests and patients treated with ACT during passive case detection. While the number of CHWs increased 7%, the number of patients receiving an RDT increased by 307% and the number of malaria cases detected and treated by CHWs increased 274%, from the year prior to PECADOM Plus introduction to its first year of implementation. Based on these results, approximately 700 additional CHWs in 24 new districts were added in 2017. This case study describes the process, results and lessons learned from Senegal’s implementation of PECADOM Plus, as well as guidance for other programmes considering introduction of this innovative strategy.
MYB44 competitively inhibits the formation of the MYB340-bHLH2-NAC56 complex to regulate anthocyanin biosynthesis inpurple-fleshed sweet potato
Authors: Wei Zeng-Zheng , Hu Kang-Di , Zhao Dong-Lan , Tang Jun , Huang Zhong-Qin , Jin Peng , Li Yan-Hong , Han Zhuo , Hu Lan-Ying , Yao Gai-Fang , Zhang Hua
Published: April 2020

Background: Anthocyanins, which have important biological functions and have a beneficial effect on human health, notably account for pigmentation in purple-fleshed sweet potato tuberous roots. Individual regulatory factors of anthocyanin biosynthesis have been identified; however, the regulatory network of anthocyanin biosynthesis in purple-fleshed sweet potato is unclear. Results: We functionally determined that IbMYB340 cotransformed with IbbHLH2 in tobacco and strawberry receptacles induced anthocyanin accumulation, and the addition of IbNAC56a or IbNAC56b caused increased pigmentation. Furthermore, we confirmed the interaction of IbMYB340 with IbbHLH2 and IbNAC56a or IbNAC56b via yeast two-hybrid and firefly luciferase complementation assays; these proteins could form a MYB340-bHLH2-NAC56a or MYB340-bHLH2-NAC56b transcriptional complex to regulate anthocyanin biosynthesis by binding to the IbANS promoter rather than the IbUFGT promoter. Furthermore, it was found by a transient expression system in tobacco leaves that IbMYB44 could decrease anthocyanin accumulation. Moreover, the interaction of IbMYB44 with IbMYB340 and IbNAC56a or IbNAC56b was verified. This result suggested that IbMYB44 acts as a repressor of anthocyanin in sweet potato.Conclusions: The repressor IbMYB44 affected anthocyanin biosynthesis by competitively inhibiting the IbMYB340-IbbHLH2-IbNAC56a or IbMYB340-IbbHLH2-IbNAC56b regulatory complex formation. Overall, the present study proposed a novel regulatory network whereby several vital TFs play key roles in regulating anthocyanin biosynthesis, and it provides strong insight into the potential mechanism underlying anthocyanin biosynthesis in sweet potato tuberous roots with purple color.
Risk Perception and Behavior in Egyptian Adolescent Pesticide Applicators: An Intervention Study
Authors: Rohlman Diane S , Davis Jonathan W , Ismail Ahmed , Rasoul Gaafar Abdel , Hendy Olfat , Olson James R , Bonner Matthew R
Published: April 2020

Background: Adolescents are engaged in agricultural work, including pesticide application, around the world. Adolescent pesticide applicators are more likely to be exposed to pesticides than their adult counterparts because of their application practice and hygiene habits surrounding pesticide use. There is a need for low-cost interventions to reduce pesticide exposure. We evaluated a theoretically-based educational intervention to change perceptions about the risk of pesticide use and hygiene habits during and after pesticide application for adolescent and young adult pesticide applicators in Egypt.Methods: Young adult and adolescent male pesticide applicators were given a one-hour educational intervention to inform them about the risk of pesticide use and how to reduce pesticide exposure. The median age of participants was 18 years old. Changes in perceived susceptibility and effectiveness were measured with a survey pre and post-intervention (n=119) on the same day. The same survey (n=95) was given 8-months post-intervention to identify sustained effects. Observational checklists of pesticide application practice were also completed during application seasons before and after the intervention.Results: There was an increase in the proportion of individuals who viewed pesticides as being a long-term health risk (74.7% pre-intervention to 97.9% post-intervention, McNemar test p<0.001). This change remained significant when surveyed at the 8-month follow-up (90.5%, p<0.001). There was also a sustained improvement regarding participants’ view of proper hygiene practice surrounding pesticide application. Applicators were observed wearing goggles, shoes, and masks more frequently post-intervention.Conclusion: This theoretically-based intervention is an example of a low-cost solution that can improve adolescent and young adult’s practices regarding pesticide application and personal hygiene practices during and after pesticide application. The intervention can be applied in other countries with similar safety culture surrounding pesticide application.
Schizophrenia patients with a metabolically abnormal obese phenotype have milder negative symptoms
Authors: Wang Juan , Zhang Yulong , Liu Zhiwei , Yang Yating , Zhong Yi , Ning Xiaoshuai , Zhang Yelei , Zhao Tongtong , Xia Lei , Geng Feng , Tao Rui , Fan Mei , Ren Zhenhua , Liu Huanzhong
Published: April 2020

Background: Schizophrenia patients with a metabolically abnormal obese (MAO) phenotype have been shown poor cardiovascular outcomes, but the characteristics of their current psychiatric symptoms have not been characterized. This study mainly explored the psychiatric symptoms of schizophrenia patients with the MAO phenotype. Methods: A total of 329 patients with schizophrenia and 175 sex- and age-matched people without schizophrenia from Anhui Province in China were enrolled. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate the mental symptoms of the schizophrenia patients. The MAO phenotype was defined as meeting 1-4 metabolic syndrome criteria (excluding waist circumference) and having a body mass index (BMI) ≥ 28 kg/m2. And, metabolically healthy normal-weight (MHNW) phenotype was defined as meeting 0 criteria for metabolic syndrome and 18.5 ≤ BMI < 24 kg/m2. Results: Overall, 15.8% of the schizophrenia patients and 9.1% of the control group were consistent with the MAO phenotype, and the prevalence of MAO in the schizophrenia group was higher than that in the control group. Among the patients with schizophrenia, the MAO group had lower negative factor, cognitive factor and total PANSS scores than the MHNW group. However, when confounding factors were controlled, only the negative factor remained lower. The correlation analysis showed that the MAO phenotype was strongly correlated with C-peptide and insulin levels.Conclusion: we found that schizophrenia patients with the MAO phenotype had reduced negative symptoms, which may indicate an internal mechanism linking metabolic disorders and negative symptoms.Trial registration: This study was registered in the China Clinical Trial Registration Center (No. chiCTR 1800017044)
QTL mapping of winter dormancy and associated traits in two switchgrass pseudo-F1 populations: lowland x lowland and lowland x upland
Authors: Razar Rasyidah Mohamad , Missaoui Ali
Published: April 2020

Background
Switchgrass (Panicum virgatum) undergoes seasonal growth changes based on the perception of photoperiod and temperature. It transitions to winter dormancy in early fall, breaks dormancy in the spring, and resume the cycle starting from flowering which is the cue for senescence. The length of growing season can impact the biomass accumulation and yield. In this study, we conducted QTL mapping of winter dormancy measured by fall regrowth height (FRH) and normalized difference vegetation index (NDVI), spring emergence (SE), and flowering date (FD) in two bi-parental pseudo-F1 populations derived from crosses between the lowland AP13 with the lowland B6 (AB) with 285 progenies, and the lowland B6 with the upland VS16 (BV) with 227 progenies.
Methods
Pearson correlation coefficient between phenotypic traits was calculated to determine if some traits can be as surrogates for other traits. Broad-sense heritabilities were calculated to determine the inheritance, and QTL mapping was conducted for two-years phenotypic data to identify QTLs associated with the trais.
Results
We identified 18 QTLs for FRH, 18 QTLs for NDVI, 21 QTLs for SE, and 30 QTLs for FD. The ranges of percent variance explained by these QTLs varied between 4.21–23.27% for FRH, 4.47–24.06% for NDVI, 4.35–32.77% for SE, and 4.61–29.74% for FD. A higher number of QTL was discovered in the BV population, suggesting more variants in the lowland x upland population contributing to the expression of seasonal dormancy underlying traits. We identified 9 regions of colocalized QTL with possible pleiotropic gene action. The positive correlation between FRH or NDVI with dry biomass weight suggests that winter dormancy level could affect switchgrass biomass yield. The medium to high heritability levels of FRH (0.55–0.64 H2) and NDVI (0.30–0.61 H2) support the possibility of using the traits for indirect selection for biomass yield.
Conclusion
Markers found within the significant QTL interval can serve as genomic resource for breeding non-dormant and semi-dormant switchgrass cultivars for the southern regions, where growers can benefit from the longer production season.
Distributed causality in resting-state network connectivity in the acute and remitting phases of RRMS
Authors: Wu Lin , Huang Muhua , Zhou Fuqing , Zeng Xianjun , Gong Honghan
Published: April 2020

Background
Although previous studies have shown that intranetwork abnormalities in brain functional networks are correlated with clinical/cognitive impairment in multiple sclerosis (MS), there is little information regarding the pattern of causal interactions among cognition-related resting-state networks (RSNs) in different disease stages of relapsing-remitting MS (RRMS) patients. We hypothesized that abnormalities of causal interactions among RSNs occurred in RRMS patients in the acute and remitting phases.
Patients and methods:
Seventeen patients in the acute phases of RRMS, 24 patients in the remitting phases of RRMS, and 23 appropriately matched healthy controls participated in this study. First, we first used group independent component analysis to extract the time courses of the spatially independent components from all the subjects. Then, the Granger causality test was used to investigate the causal relationships among RSNs in the spectral domain and to identify correlations with clinical indexes.
Results
Compared with the patients in the acute phase of RRMS, patients in the remitting phase of RRMS showed a significantly lower expanded disability status scale, modified fatigue impact scale scores, and significantly higher paced auditory serial addition test (PASAT) scores. Compared with healthy subjects, during the acute phase, RRMS patients had significantly increased driving connectivity from the right executive control network (rECN) to the anterior salience network (aSN), and the causal coefficient was negatively correlated with the PASAT score. During the remitting phase, RRMS patients had significantly increased driving connectivity from the rECN to the aSN and from the rECN to the visuospatial network.
Conclusion
Together with the disease duration (mean disease duration < 5 years) and relatively better clinical scores than those in the acute phase, abnormal connections, such as the information flow from the rECN to the aSN and the rECN to the visuospatial network, might provide adaptive compensation in the remitting phase of RRMS.
SEIR Model for COVID-19 Dynamics Incorporating the Environment and Social Distancing
Authors: Mwalili Samuel , Kimanthi Mark , Ojiambo Viona , Gathungu Duncan , Mbogo Rachel Waema
Published: April 2020

Objective: Coronavirus disease 2019 (COVID-19) is a pandemic of respiratory disease spreading from person-to-person caused by a novel coronavirus and poses a serious public health risk. The goal of this study is to apply SEIR compartmental mathematical model for prediction of COVID-19 epidemic dynamics incorporating pathogen in the environment and interventions. The next generation matrix approach was used to determine the basic reproduction number R0. The model equations are solved numerically using fourth and fifth order Runge–Kutta methods. Results: The value of basic reproduction number R0 was determined as 2.03, implying that the pandemic will persist in the human population. Results after simulating various scenarios indicate that disregarding social distancing, wearing of masks and frequent washing of hands can have devastating effects on the human population. The model shows that quarantine and isolation are key winners to this pandemic.
Identification of Potential Key Genes Associated with the Pathogenesis and Prognosis of Glioblastoma Based on Integrated Bioinformatics Analysis
Authors: Tu Youbing , Zhou Sijia , Zhang Hui , Lv Jing , Ding Dengfeng , Zhang Zhongjun
Published: April 2020

Background: Despite striking advances in multimodality management, the low survival rate of Glioblastoma (GBM) patients has not been significantly improved and identifying novel diagnostic and prognostic biomarkers is urgently demanded. The present study aimed to identify potential key genes associated with the pathogenesis and prognosis of GBM.Methods: Differentially expressed genes between GBM and normal brain tissue samples were screened by an integrated analysis of multiple gene expression profile datasets. Key genes related to the pathogenesis and prognosis of GBM were identified by employing protein–protein interaction network and Cox proportional hazards model analyses.Results: We identified nine hub genes (TP53, FN1, EGFR, MYC, RRM2, EZH2, FOXM1, CD44 and MMP2) which might be closely associated with the pathogenesis of GBM. A prognostic gene signature consisted of RAB33B, KIAA1199, TEK, EVC, SOD2, CXCR4, hCG_40738, CHD9, GCSH, SUHW1, RPS6KA5, PDCD4, ZG16, KCNG1, DECR1, PPCS, SERPINF1, TMSB10, NAT10, HIC2, PIR and OR2W1 was constructed with a good performance in predicting overall survivals (OS).Conclusions: The findings of present study would provide certain reference for further predicting the diagnostic and prognostic biomarkers to facilitate the molecular targeting therapy of GBM.
Prognostic Value of Circulating Tumour Cells detected with the CellSearch System in Esophageal Cancer Patients: A Systematic Review and Meta-Analysis
Authors: Li Yiding , Wu Guiling , Yang Wanli , Wang Xiaoqian , Duan Lili , Niu Liaoran , Zhang Yujie , Liu Jinqiang , Hong Liu , Fan Daiming
Published: April 2020

Background: Esophageal carcinoma (EC) is the seventh-most prevalent tumour in the world, which is still the primary cause of tumour-related death. Identifying noteworthy biomarkers for EC is particularly significant in guiding active and effective treatment. Recently, circulating tumour cells (CTCs) in peripheral blood (PB) were intensively discussed as prognostic markers in patients with EC. However, an ongoing controversy still exists regarding the prognostic significance of CTCs determined using the CellSearch System in EC sufferers. This meta-analysis was designed to approach this topic. Methods: We systematically conducted searches using PubMed, Medline, Web of Science and the Cochrane Library for relevant studies, which were published through February 20, 2020. Using the random-effects model, our study was performed in Review Manager software, with odds ratios (ORs), risk ratios (RRs), hazard ratios (HRs) and 95% confidence intervals (CIs) as effect values. Results: In total, 7 articles were finally included in this study. For clinicopathological characteristics, the pooled results on TNM stage indicated that the III/IV group had higher incidence of CTCs compared with the I/II group (OR=1.36, 95% CI (0.68,2.71), I2=0%). Incidence of CTCs was higher among patients on T3/T4 stage (OR=2.92, 95% CI (1.31,6.51), I2=0%) and distant metastasis group (OR=5.18, 95% CI (2.38,11.25), I2=0%) compared to patients on T1/T2 stage or non-metastatic group. The pooled analysis revealed that CTC positivity detected in EC patients was correlated with poor overall survival (OS) (HR =2.83, 95% CI (1.99,4.03), I2=0%) and relapse-free survival (RFS) (HR =4.71, 95% CI (2.73,8.13), I2=0%). When pooling the estimated RR, a poor therapeutic response to chemoradiotherapy was discovered in patients with CTC positivity (RR =1.99, 95% CI (1.73,2.29), I2=60%). Conclusions: In summary, our meta-analysis demonstrated that CTCs from PB of EC patients determined using the CellSearch System are correlated with the prognosis of EC patients and might indicate a poor therapeutic response to chemotherapy in EC patients.