bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibiotic resistance and typing of the methicillin-resistant Staphylococcus aureus clones in Kuwait hospitals, 2016–2017
Authors: Boswihi Samar S. , Udo Edet E. , AlFouzan Wadha
Published: October 2020

Background

Methicillin-resistant Staphylococcus aureus (MRSA) belong to diverse genetic backgrounds that differ in antibiotic resistance. Knowledge of the local clonal composition of MRSA strains is important for patients’ management and for designing effective control and eradication methods. The aim of this study was to compare the antibiotic resistance patterns and genotypic characteristics of MRSA isolates obtained in public hospitals in Kuwait in 2016 and 2017 for changes in their resistance patterns and clonal composition.

Methods

A total of 4726 MRSA isolates obtained in 2016–2017 from clinical specimens in Kuwait public hospitals were characterized using antibiogram, SCCmec typing, spa typing and DNA microarray.

Results

The isolates expressed resistance to fusidic acid (52.9%), kanamycin (41.6%), gentamicin (32.5%) and erythromycin (36.2%). The prevalence of high-level mupirocin resistance decreased from 3.7% in 2016 to 2.4% in 2017, while the proportion of resistance to other antibiotics remained relatively stable. A total of 382 spa types were detected with eight spa types, t688 (N = 547), t304 (N = 428), t860 (N = 394), t127 (N = 306), t044 (N = 230), t311 (N = 243), t223 (N = 184) and t002 (N = 181) constituting 53.1% of the MRSA isolates in 2016–2017. Of the 3004 MRSA isolates obtained in 2016 (N = 1327) and 2017 (N = 1677) selected for DNA microarray analysis, 26 clonal complexes (CCs) were identified. Most of the isolates belonged to CC1 (N = 248), CC5 (N = 833), CC6 (N = 241), CC8 (N = 292), CC22 (N = 421), CC30 (N = 177), CC80 (N = 177) and CC97 (N = 171). The prevalence of CC5 isolates has significantly (p ≤ 0.05) increased from 294 isolates in 2016 to 539 isolates in 2017. Although CC22 increased from 196 isolates in 2016 to 225 isolates in 2017, CC1 increased from 112 isolates in 2016 to 136 isolates in 2017, CC6 increased from 103 isolates in 2016 to 138 isolates in 2017, these changes were not significant (p ≥ 0.05).

Conclusion

These results revealed the diversity in the genetic backgrounds of MRSA isolates and the stable maintenance of the dominant MRSA clones in Kuwait hospitals in 2016 and 2017 suggesting an on-going transmission of these clones. Novel and creative infection prevention and control measures are required to curtail further transmission.
Transcriptomic and metabolomic profiling reveals the effect of LED light quality on morphological traits, and phenylpropanoid-derived compounds accumulation in Sarcandra glabra seedlings
Authors: Xie Dejin , Chen Lingyan , Zhou Chengcheng , Tarin Muhammad Waqqas Khan , Yang Deming , Ren Ke , He Tianyou , Rong Jundong , Zheng Yushan
Published: October 2020

Background

Sarcandra glabra is an evergreen and traditional Chinese herb with anti-oxidant, anti-bacterial, anti-inflammatory, and anti-tumor effects. Light is one of the most influential factor affecting the growth and quality of herbs. In recent times, the introduction of Light Emission Diode (LED) technology has been widely used for plants in greenhouse. However, the impact of such lights on plant growth and the regulatory mechanism of phenylpropanoid-derived compounds in S. glabra remain unclear.

Results

The red LED light (RL) substantially increased the plant height and decreased the stem diameter and leaf area relative to the white LED light (WL), while the blue LED light (BL) significantly reduced the height and leaf area of S. glabra. According to transcriptomic profiling, 861, 378, 47, 10,033, 7917, and 6379 differentially expressed genes (DEGs) were identified among the groups of leaf tissue under BL (BY) vs. leaf tissue under RL (RY), BY vs. leaf tissue under WL (WY), RY vs. WY, root tissue under WL (WG) vs. WY, stem tissue under WL (WJ) vs. WG, and WJ vs. WY, respectively. We identified 46 genes encoding for almost all known enzymes involved in phenylpropanoid biosynthesis, e.g., phenylalanine ammonia lyase (PAL), chalcone synthase (CHS), and flavonol synthase (FLS). We found 53 genes encoding R2R3-MYB proteins and bHLH proteins, respectively, where several were related to flavonoids biosynthesis. A total of 454 metabolites were identified based on metabolomic profiling, of which 44, 87, and 296 compounds were differentially produced in WY vs. RY, WY vs. BY, and WY vs. WG. In BY there was a substantial reduction in the production of esculetin, caffeic acid, isofraxidin, and fraxidin, while the yields of quercitrin and kaempferol were significantly up-regulated. In RY, the contents of cryptochlorogenic acid, cinnamic acid, and kaempferol decreased significantly. Besides, in WG, the production of metabolites (e.g. chlorogenic acid, cryptochlorogenic acid, and scopolin) declined, while their yields increased significantly (e.g. esculetin, fraxetin, isofraxidin, and fraxidin).

Conclusion

These results provide further insight into the regulatory mechanism of accumulation patterns of phenylpropanoid-derived compounds in S. glabra under various light conditions, allowing optimum breeding conditions to be developed for this plant.
The clinical efficacy and adverse effects of Entecavir plus Thymosin alpha-1 combination therapy versus Entecavir Monotherapy in HBV-related cirrhosis: a systematic review and meta-analysis
Authors: Peng Dan , Xing Hai-Yan , Li Chen , Wang Xian-Feng , Hou Min , Li Bin , Chen Jian-Hong
Published: October 2020

Background

Previous studies have demonstrated the benefits of thymosin alpha-1 (Tα1) in anti-virus, immunological enhancement and anti-inflammation. However, it is controversial about the efficacy and safety of entecavir (ETV) plus Tα1 combination therapy versus ETV monotherapy in cirrhotic patients with hepatitis B virus (HBV) infection.

Methods

The systematic review and meta-analysis of randomized clinical trials (RCTs) were performed to evaluate the efficacy and safety of ETV plus Tα1 combination therapy versus ETV monotherapy in HBV-related patients with cirrhosis. We performed a systematic literature search via PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journals Database (VIP), and Chinese Biological Medicine database (CBM). Relative risk (RR) and standardized mean difference (SMD) with a fixed- or random- effect model were calculated. Heterogeneity was assessed through a Cochrane Q-test and I2 values.

Results

Seven RCTs involving 1144 subjects were included in the systematic review and meta-analysis. Compared with ETV monotherapy, ETV plus Tα1 combination therapy led to a higher complete response (RR = 1.18; 95% CI, 1.07–1.30). In post treatment for 24 weeks, the HBV DNA undetectable rate and HBeAg loss rate were higher in ETV plus Tα1 group than in ETV alone group (RR = 1.91; 95% CI, 1.56–2.35; RR = 2.05; 95% CI, 1.62–2.60). However, after 48 and 52 weeks of treatment, there was no significant difference between the combination therapy and ETV monotherapy (RR = 1.07; 95% CI, 0.96–1.18; RR = 1.17; 95% CI, 0.89–1.55). At week 52 of treatment, the HBsAg loss rate of ETV plus Tα1 group was no significance with that of ETV alone group (RR = 1.03; 95% CI, 0.15–7.26). In comparison with ETV alone, the some biochemical parameters and liver fibrosis were obviously improved by ETV plus Tα1, and there was significant heterogeneity. In addition, the number of adverse events was significantly reduced by ETV plus Tα1, compared to ETV alone (RR = 0.48; 95% CI, 0.24–0.95).

Conclusions

ETV plus Tα1 might lead to a higher clinical response and a lower comprehensive adverse reaction rate in HBV-related patients with cirrhosis, compared to ETV alone. However, the whole patients included in this meta-analysis were from Chinese mainland, so that more worldwide RCTs with a larger sample size are needed to verify the current findings.
Supporting the mobilization of health assets among older community dwellers residing in senior-only households in Singapore: a qualitative study
Authors: Seah Betsy , Espnes Geir Arild , Ang Emily Neo Kim , Lim Jian Yang , Kowitlawakul Yanika , Wang Wenru
Published: October 2020

Background

Care activities provided by community health practitioners for older adults primarily focused on disease prevention and management. However, healthy longevity can go beyond disease prevention and management and promote greater well-being by tapping into the accrual of resources that older adults possess using the salutogenic approach. This study explored how health resources are used among older adults who are residing in senior-only households to promote and maintain health, with the intent of providing insights into how community health practitioners can support these older adults via asset-based strategies.

Methods

We adopted a descriptive qualitative study design using focus group discussions. Twenty-seven older adults who either lived alone or with their spouses were purposively sampled from an elderly populated residential estate in Singapore. Six focus group discussions, conducted from December 2016 to May 2017, were audio-recorded, transcribed, and analyzed using thematic analysis.

Results

The themes that emerged were ‘tapping on internal self-care repository’, ‘maintaining and preserving informal social support’, and ‘enabling self by using environmental aids’, and an eco-map of aging assets was used to capture an overview of internal and external resources. With the repository of personal strengths, knowledge, and experiences, these older adults were generally resourceful in navigating around their resource-rich environments to cope with everyday life stressors and promote health. However, they were occasionally limited by individual factors that affected their comprehension, access, maintenance, and utilization of resources.

Conclusion

The eco-map of aging assets can be used as an assessment framework by community health practitioners to recognize, consider, and build a repertoire of resources among these older adults. It serves as a gentle reminder to adopt an ecological approach in considering and tapping into older adults’ wide-ranging personal, social, and environmental resources. Community health practitioners can support resource integration as resource facilitators via cognitive, behavioral, and motivational salutogenic pathways to overcome resource mobilization barriers faced by older adults. Such an approach helps older adults to find their internal capabilities and abilities to know who, where, what, and how to seek external resources to identify solutions, creating the intrinsic value to sustain their actions on resource utility.
The use of antibiotics in the intensive care unit of a tertiary hospital in Malawi
Authors: Kayambankadzanja Raphael Kazidule , Lihaka Moses , Barratt-Due Andreas , Kachingwe Mtisunge , Kumwenda Wezzie , Lester Rebecca , Bilima Sithembile , Eriksen Jaran , Baker Tim
Published: October 2020

Background

Antibiotic resistance is on the rise. A contributing factor to antibiotic resistance is the misuse of antibiotics in hospitals. The current use of antibiotics in ICUs in Malawi is not well documented and there are no national guidelines for the use of antibiotics in ICUs. The aim of the study was to describe the use of antibiotics in a Malawian ICU.

Methods

A retrospective review of medical records of all admissions to the main ICU in Queen Elizabeth Central Hospital in Blantyre, Malawi, between January 2017 and April 2019. Data were extracted from the ICU patient register on clinical parameters on admission, diagnoses, demographics and antibiotics both prescribed and given for all patients admitted to the ICU. Usage of antibiotics in the ICU and bacterial culture results from samples taken in the ICU and in the peri-ICU period, (from 5 days before ICU admission to 5 days after ICU discharge), were described.

Results

Six hundred-and-forty patients had data available on prescribed and received medications and were included in the analyses. Of these, 577 (90.2%) were prescribed, and 522 (81.6%) received an antibiotic in ICU. The most commonly used antibiotics were ceftriaxone, given to 470 (73.4%) of the patients and metronidazole to 354 (55.3%). Three-hundred-and-thirty-three (52.0%) of the patients received more than one type of antibiotic concurrently – ceftriaxone and metronidazole was the most common combination, given to 317 patients. Forty five patients (7.0%) were given different antibiotics sequentially. One-hundred-and-thirty-seven patients (21.4%) had a blood culture done in the peri-ICU period, of which 70 (11.0% of the patients) were done in the ICU. Twenty-five (18.3%) of the peri-ICU cultures were positive and eleven different types of bacteria were grown in the cultures, of which 17.2% were sensitive to ceftriaxone.

Conclusion

We have found a substantial usage of antibiotics in an ICU in Malawi. Ceftriaxone, the last-line antibiotic in the national treatment guidelines, is commonly used, and bacteria appear to show high levels of resistance to it, although blood culture testing is infrequently used. Structured antibiotic stewardship programs may be useful in all ICUs.
Determinants of early initiation of breastfeeding in Ghana: a population-based cross-sectional study using the 2014 Demographic and Health Survey data
Authors: Seidu Abdul-Aziz , Ameyaw Edward Kwabena , Ahinkorah Bright Opoku , Bonsu Freda
Published: October 2020

Background

The World Health Organisation (WHO) recommends that breastfeeding should be initiated within the first hour of delivery followed by exclusive breastfeeding up to 6 months. This study examined the determinants of early initiation of breastfeeding in Ghana using data from the 2014 Ghana Demographic and Health Survey.

Methods

A sample size of 4219 was used for the study. Descriptive statistics was conducted to ascertain the proportion of children who had early initiation of breastfeeding after which binary logistic regression analysis was carried out. Results were presented using frequencies, percentages, unadjusted and adjusted odds ratios. Statistical significance was pegged at p<0.05.

Results

Children of first birth order [AOR = 0.71, CI = 0.61–0.84], those who were delivered by non-professionals [AOR = 0.51, CI = 0.30–0.88] and those whose mothers were Traditionalists [AOR = 0.65, CI = 0.46–0.92] and Mole-Dagbanis [AOR = 0.69, CI = 0.54–0.89] were less likely to go through early initiation of breastfeeding compared to those of 2–4 birth order, those who were delivered by health professionals, those whose mothers were Christians and Akan, respectively. Conversely, children born to mothers who read newspaper/magazine at least once a week were more likely to go through early initiation of breastfeeding, compared to those who never read newspaper/magazine [AOR = 1.40, CI = 1.01–1.95]. Children born to mothers who watched television less than once a week were more likely to go through early initiation of breastfeeding compared to those who watched television at least once a week [AOR = 1.40, CI = 1.01–1.95]. Finally, women from the Northern [AOR = 2.40, CI = [1.77–3.26] and Upper East regions [AOR = 2.57, CI = [1.86–3.56] practiced early initiation of breastfeeding compared to those from the Ashanti region.

Conclusions

Empowering healthcare providers to be consistent in early breastfeeding initiation advocacy and effective community engagement on the need to embrace and practice early initiation of breastfeeding can improve the situation.
Association of Schistosoma haematobium infection morbidity and severity on co-infections in pre-school age children living in a rural endemic area in Zimbabwe
Authors: Mduluza-Jokonya Tariro L. , Naicker Thajasvarie , Jokonya Luxwell , Midzi Herald , Vengesai Arthur , Kasambala Maritha , Choto Emilia , Rusakaniko Simbarashe , Sibanda Elopy , Mutapi Francisca , Mduluza Takafira
Published: October 2020

Background

Individuals living in Schistosoma haematobium endemic areas are often at risk of having other communicable diseases simultaneously. This usually creates diagnostic difficulties leading to misdiagnosis and overlooking of schistosomiasis infection. In this study we investigated the prevalence and severity of coinfections in pre-school age children and further investigated associations between S. haematobium prevalence and under 5 mortality.

Methods

A community based cross-sectional survey was conducted in Shamva District, Zimbabwe. Using random selection, 465 preschool age children (1–5 years of age) were enrolled through clinical examination by two independent clinicians for the following top morbidity causing conditions: respiratory tract infections, dermatophytosis, malaria and fever of unknown origin. The conditions and their severe sequels were diagnosed as per approved WHO standards. S. haematobium infection was diagnosed by urine filtration and the children were screened for conditions common in the study area which included HIV, tuberculosis, malnutrition and typhoid. Data was analysed using univariate and multinomial regression analysis and relative risk (RR) calculated.

Results

Prevalence of S. haematobium was 35% (145). The clinical conditions assessed had the following prevalence in the study population: upper respiratory tract infection 40% (229), fever of unknown origin 45% (189), dermatophytosis 18% and malaria 18% (75). The odds of co-infections observed with S. haematobium infection were: upper respiratory tract infection aOR = 1.22 (95% CI 0.80 to 1.87), dermatophytosis aOR = 4.79 (95% CI 2.78 to 8.25), fever of unknown origin aOR = 10.63 (95% CI 6.48–17.45) and malaria aOR = 0.91 (95% CI 0.51 to1.58). Effect of schistosomiasis coinfection on disease progression based on the odds of the diseases progressing to severe sequalae were: Severe pneumonia aOR = 8.41 (95% CI 3.09–22.93), p < 0.0001, complicated malaria aOR = 7.09 (95% CI 1.51–33.39), p = 0.02, severe dermatophytosis aOR = 20.3 (95% CI 4.78–83.20):p = 0.03, and fever of unknown origin aOR = 1.62 (95%CI 1.56–4.73), p = 0.02.

Conclusion

This study revealed an association between schistosomiasis and the comorbidity conditions of URTI, dermatophytosis, malaria and FUO in PSAC living in a schistosomiasis endemic area. A possible detrimental effect where coinfection led to severe sequels of the comorbidity conditions was demonstrated. Appropriate clinical diagnostic methods are required to identify associated infectious diseases and initiate early treatment of schistosomiasis and co-infections in PSAC.
Risk perception related to COVID-19 among the Iranian general population: an application of the extended parallel process model
Authors: Jahangiry Leila , Bakhtari Fatemeh , Sohrabi Zahara , Reihani Parvin , Samei Sirous , Ponnet Koen , Montazeri Ali
Published: October 2020

Background

The novel coronavirus disease 2019 (COVID-19) has emerged as a major global public health challenge. This study aimed to investigate on how people perceive the COVID-19 outbreak using the components of the Extended Parallel Process Model (EPPM) and to find out how this might contribute to possible behavioral responses to the prevention and control of the disease.

Methods

This cross-sectional study was conducted in Iran during March and April 2020. Participants were recruited via online applications using a number of platforms such as Telegram, WhatsApp, and Instagram asking people to take part in the study. To collect data an electronic self-designed questionnaire based on the EPPM was used in order to measure the risk perception (efficacy, defensive responses, perceived threat) related to the COVID-19. Descriptive statistics, chi-square, t-test and analysis of variance (ANOVA), were used to explore the data.

Results

A total of 3727 individuals with a mean age (SD) of 37.0 (11.1) years participated in the study. The results revealed significant differences in efficacy, defensive responses and perceived threat among different population groups particularly among those aged 60 and over. Women had significantly higher scores than men on some aspects such as self-efficacy, reactance, and avoidance but men had higher perceived susceptibility scores compared to women. Overall 56.4% of participants were engaged in danger control (preventive behavior) while the remaining 43.6% were engaged in fear control (non-preventive behavior) process.

Conclusion

More than half of all participants motivated by danger control. This indicated that more than half of participants had high perceived efficacy (i.e., self-efficacy and response efficacy). Self-efficacy scores were significantly higher among participants who were older, female, single, lived in rural areas, and had good economic status. The results suggest that socioeconomic and demographic factors are the main determinants of the COVID-19 risk perception. Indeed, targeted interventions are essential for controlling the pandemic.
Analysis of low-dose estrogen on callus BMD as measured by pQCT in postmenopausal women
Authors: Jäckle K. , Kolb J. P. , Schilling A. F. , Schlickewei C. , Amling M. , Rueger J. M. , Lehmann W.
Published: October 2020

Background

Osteoporosis affects elderly patients of both sexes. It is characterized by an increased fracture risk due to defective remodeling of the bone microarchitecture. It affects in particular postmenopausal women due to their decreased levels of estrogen. Preclinical studies with animals demonstrated that loss of estrogen had a negative effect on bone healing and that increasing the estrogen level led to a better bone healing. We asked whether increasing the estrogen level in menopausal patients has a beneficial effect on bone mineral density (BMD) during callus formation after a bone fracture.

Methods

To investigate whether estrogen has a beneficial effect on callus BMD of postmenopausal patients, we performed a prospective double-blinded randomized study with 76 patients suffering from distal radius fractures. A total of 31 patients (71.13 years ±11.99) were treated with estrogen and 45 patients (75.62 years ±10.47) served as untreated controls. Calculated bone density as well as cortical bone density were determined by peripheral quantitative computed tomography (pQCT) prior to and 6 weeks after the surgery. Comparative measurements were performed at the fractured site and at the corresponding position of the non-fractured arm.

Results

We found that unlike with preclinical models, bone fracture healing of human patients was not improved in response to estrogen treatment. Furthermore, we observed no dependence between age-dependent bone tissue loss and constant callus formation in the patients.

Conclusions

Transdermally applied estrogen to postmenopausal women, which results in estrogen levels similar to the systemic level of premenopausal women, has no significant beneficial effect on callus BMD as measured by pQCT, as recently shown in preclinical animal models.

Trial registration

Low dose estrogen has no significant effect on bone fracture healing measured by pQCT in postmenopausal women, DRKS00019858. Registered 25th November 2019 - Retrospectively registered. Trial registration number DRKS00019858.
In vitro osteogenesis of rat bone marrow mesenchymal cells on PEEK disks with heat-fixed apatite by CO2 laser bonding
Authors: Kawasaki Sachiko , Inagaki Yusuke , Akahane Manabu , Furukawa Akira , Shigematsu Hideki , Tanaka Yasuhito
Published: October 2020

Background

Polyether-ether-ketone (PEEK) is increasingly being used for spinal applications. However, because of its biologically inactive nature, there are risks of false joint loosening and sinking. PEEK materials are coated with apatite to enhance the osteoconductive properties. In this study, we aimed to evaluate whether strontium apatite stimulate osteogenesis on the surface of PEEK by using the CO2 laser technique.

Methods

We prepared non-coated disks, laser-exposed disks without apatite, and four types of apatite-coated by laser PEEK disks (hydroxyapatite (HAP), strontium hydroxyapatite (SrHAP), silicate-substituted strontium apatite (SrSiP), and silicate-zinc-substituted strontium apatite (SrZnSiP)). A part of the study objective was testing various types of apatite coatings. Bone marrow mesenchymal cells (BMSCs) of rats were seeded at a density of 2 × 104/cm2 onto each apatite-coated, non-coated, and laser-irradiated PEEK disks. The disks were then placed in osteogenic medium, and alkaline phosphatase (ALP) staining and Alizarin red staining of BMSCs grown on PEEK disks were performed after 14 days of culture. The concentrations of osteocalcin (OC) and calcium in the culture medium were measured on days 8 and 14 of cell culture. Furthermore, mRNA expression of osteocalcin, ALP, runt-related transcription factor 2 (Runx2), collagen type 1a1 (Col1a1), and collagen type 4a1 (Col4a1) was evaluated by qPCR.

Results

The staining for ALP and Alizarin red S was more strongly positive on the apatite-coated PEEK disks compared to that on non-coated or laser-exposed without coating PEEK disks. The concentration of osteocalcin secreted into the medium was also significantly higher in case of the SrHAP, SrSiP, and SrZnSiP disks than that in the case of the non-coated on day14. The calcium concentration in the PEEK disk was significantly lower in all apatite-coated disks than that in the pure PEEK disks on day 14. In qPCR, OC and ALP mRNA expression was significantly higher in the SrZnSiP disks than that in the pure PEEK disks.

Conclusions

Our findings demonstrate that laser bonding of apatite—along with trace elements—on the PEEK disk surfaces might provide the material with surface property that enable better osteogenesis.
Periodic injections of adipose-derived stem cell sheets attenuate osteoarthritis progression in an experimental rabbit model
Authors: Takagi Tomoharu , Kabata Tamon , Hayashi Katsuhiro , Fang Xiang , Kajino Yoshitomo , Inoue Daisuke , Ohmori Takaaki , Ueno Takuro , Yoshitani Junya , Ueoka Ken , Yamamuro Yuki , Tsuchiya Hiroyuki
Published: October 2020

Background

Subcutaneous adipose tissue represents an abundant source of multipotent adult stem cells named as Adipose-derived stem cells (ADSCs). With a cell sheet approach, ADSCs survive longer, and can be delivered in large quantities. We investigated whether intra-articular ADSC sheets attenuated osteoarthritis (OA) progression in a rabbit anterior cruciate ligament transection (ACLT) model.

Methods

Fabricating medium containing ascorbate-2-phosphate was used to enhance collagen protein secretion by the ADSCs to make ADSC sheets. At 4 weeks after ACLT, autologous ADSC sheets were injected intra-articularly into the right knee (ADSC sheets group), and autologous cell death sheets treated by liquid nitrogen were injected into the left knee (control group). Subsequent injections were administered once weekly. Femoral condyles were compared macroscopically and histologically.

Results

Macroscopically, OA progression was significantly milder in the ADSC sheets than in the control groups. Histologically, control knees showed obvious erosions in the medial and lateral condyles, while cartilage was retained predominantly in the ADSC sheets group. Immunohistochemically, MMP-1, MMP-13, ADAMTS-4 were less expressive in the ADSC sheets than in the control groups.

Conclusions

Periodic ADSC sheets injections inhibited articular cartilage degeneration without inducing any adverse effects. A large quantity of autologous ADSCs delivered by cell sheets homed to the synovium and protected chondrocytes.
Automated identification of the mouse brain’s spatial compartments from in situ sequencing data
Authors: Partel Gabriele , Hilscher Markus M. , Milli Giorgia , Solorzano Leslie , Klemm Anna H. , Nilsson Mats , Wählby Carolina
Published: October 2020

Background

Neuroanatomical compartments of the mouse brain are identified and outlined mainly based on manual annotations of samples using features related to tissue and cellular morphology, taking advantage of publicly available reference atlases. However, this task is challenging since sliced tissue sections are rarely perfectly parallel or angled with respect to sections in the reference atlas and organs from different individuals may vary in size and shape and requires manual annotation. With the advent of in situ sequencing technologies and automated approaches, it is now possible to profile the gene expression of targeted genes inside preserved tissue samples and thus spatially map biological processes across anatomical compartments.

Results

Here, we show how in situ sequencing data combined with dimensionality reduction and clustering can be used to identify spatial compartments that correspond to known anatomical compartments of the brain. We also visualize gradients in gene expression and sharp as well as smooth transitions between different compartments. We apply our method on mouse brain sections and show that a fully unsupervised approach can computationally define anatomical compartments, which are highly reproducible across individuals, using as few as 18 gene markers. We also show that morphological variation does not always follow gene expression, and different spatial compartments can be defined by various cell types with common morphological features but distinct gene expression profiles.

Conclusion

We show that spatial gene expression data can be used for unsupervised and unbiased annotations of mouse brain spatial compartments based only on molecular markers, without the need of subjective manual annotations based on tissue and cell morphology or matching reference atlases.
Pregnant women with COVID-19 and risk of adverse birth outcomes and maternal-fetal vertical transmission: a population-based cohort study in Wuhan, China
Authors: Yang Rong , Mei Hui , Zheng Tongzhang , Fu Qiang , Zhang Yiming , Buka Stephen , Yao Xinan , Tang Zezhong , Zhang Xichi , Qiu Lin , Zhang Yaqi , Zhou Jieqiong , Cao Jiangxia , Wang Youjie , Zhou Aifen
Published: October 2020

Background

The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. However, little is known about the association between pregnant women with COVID-19 and the risk of adverse birth outcomes.

Method

We conducted a retrospective cohort study based on the Maternal and Child Health Information System (MCHIMS) of Wuhan, China. All pregnant women with singleton live birth recorded by the system between January 13 and March 18, 2020, were included. The adverse birth outcomes were preterm birth, low birth weight, neonatal asphyxia, premature rupture of membrane (PROM), and cesarean section delivery. Multivariate logistic regression was used to evaluate the associations between maternal COVID-19 diagnosis and adverse birth outcomes.

Results

Out of 11,078 pregnant women, 65 were confirmed with coronavirus disease 2019 (COVID-19). No deaths occurred from these confirmed cases or their newborns. Compared to pregnant women without COVID-19, pregnant women with a confirmed COVID-19 diagnosis had an increased risk of preterm birth (OR 3.34, 95% CI 1.60–7.00) and cesarean section (OR 3.63, 95% CI 1.95–6.76). There was no statistical difference in low birth weight, neonatal asphyxia, and PROM between the mothers with and without COVID-19. Among these newborns that were born to mothers with confirmed COVID-19, none was tested severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive or had abnormal CT results. Only one had diarrhea and three had a fever.

Conclusions

This population-based cohort study suggests that COVID-19 during the later pregnancy is associated with an increased risk of adverse birth outcomes, including iatrogenic preterm birth and cesarean section delivery. Our data provide little evidence for maternal-fetal vertical transmission of SARS-CoV-2. It is important to monitor the long-term health effects of SARS-CoV-2 infection on pregnant women and their children.
Blood pressure levels and cardiovascular risk according to age in patients with diabetes mellitus: a nationwide population-based cohort study
Authors: Kim Hack-Lyoung , Kim Hyue Mee , Kwon Chang Hee , Shin Jeong-Hun , Jung Mi-Hyang , Lee Chan Joo , Kim Dae-Hee , Kim Woo-Hyeun , Kang Si-Hyuck , Lee Ju-Hee , Cho In Jeong , Cho Iksung , Lee Jun Hyeok , Kang Dae Ryong , Lee Hae-Young , Chung Wook-Jin , Ihm Sang-Hyun , Kim Kwang Il , Cho Eun Joo , Sohn Il-Suk , Kim Hyeon-Chang , Shin Jinho , Kim Ju Han , Ryu Sung Kee , Kang Seok-Min , Pyun Wook Bum , Cho Myeong-Chan , Park Sungha , Sung Ki-Chul
Published: October 2020

Background

Little is known about age-specific target blood pressure (BP) in hypertensive patients with diabetes mellitus (DM). The aim of this study was to determine the BP level at the lowest cardiovascular risk of hypertensive patients with DM according to age.

Methods

Using the Korean National Health Insurance Service database, we analyzed patients without cardiovascular disease diagnosed with both hypertension and DM from January 2002 to December 2011. Primary end-point was composite cardiovascular events including cardiovascular death, myocardial infarction and stroke.

Results

Of 241,148 study patients, 35,396 had cardiovascular events during a median follow-up period of 10 years. At the age of < 70 years, the risk of cardiovascular events was lower in patients with BP < 120/70 mmHg than in those with BP 130–139/80–89 mmHg. At the age of ≥ 70, however, there were no significant differences in the risk of cardiovascular events between patients with BP 130–139/80–89 mmHg and BP < 120/70 mmHg. The risk of cardiovascular events was similar between patients with BP 130–139/80–89 mmHg and BP 120–129/70–79 mmHg, and it was significantly higher in those with BP ≥ 140/90 mmHg than in those with BP 130–139/80–89 mmHg at all ages.

Conclusions

In a cohort of hypertensive patients who had DM but no history of cardiovascular disease, lower BP was associated with lower risk of cardiovascular events especially at the age of < 70. However, low BP < 130–139/80–89 mmHg was not associated with decreased cardiovascular risk, it may be better to keep the BP of 130–139/80–89 mmHg at the age of ≥ 70.
Protective effects of Olyset® Net on Plasmodium falciparum infection after three years of distribution in western Kenya
Authors: Tamari Noriko , Minakawa Noboru , Sonye George O. , Awuor Beatrice , Kongere James O. , Hashimoto Muneaki , Kataoka Masatoshi , Munga Stephen
Published: October 2020

Background

Several types of insecticides, treating technologies and materials are available for long-lasting insecticide-treated nets (LLINs). The variations may result in different efficacies against mosquitoes and correspondingly infection risks for thePlasmodium falciparummalaria parasite. This cross-sectional study investigated whether infection risk varied among children who slept under different LLIN brands in rural villages of western Kenya.

Methods

Children sleeping under various types of LLINs were tested forP. falciparuminfection using a diagnostic polymerase chain reaction (PCR) assay. Data were collected for other potential factors associated with infection risk: sleeping location (with bed/without bed), number of persons sharing the same net, dwelling wall material, gap of eaves (open/close), proportional hole index, socio-economic status, and density of indoor resting anophelines. Bed-net efficacy against theAnopheles gambiaesusceptible strain was estimated using the WHO cone test and the tunnel test. The residual insecticide content on nets was measured.

Results

Seven LLIN brands were identified, and deltamethrin-based DawaPlus® 2.0 was the most popular (48%) followed by permethrin-based Olyset® Net (28%). The former LLIN was distributed in the area about six months before the present study was conducted, and the latter net was distributed at least three years before. Of 254 children analysed,P. falciparumPCR-positive prevalence was 58% for DawaPlus® 2.0 users and 38% for Olyset® users. The multiple regression analysis revealed that the difference was statistically significant (adjusted OR: 0.67, 95% credible interval: 0.45–0.97), whereas the confounders were not statistically important. Among randomly selected net samples, all DawaPlus® 2.0 (n = 20) and 95% of Olyset® (n = 19) passed either the cone test or the tunnel test.

Conclusions

Olyset® was more effective in reducing infection risk compared with DawaPlus® 2.0. Although the data from the present study were too limited to explain the mechanism clearly, the results suggest that the characteristics of the former brand are more suitable for the conditions, such as vector species composition, of the study area.
The microneedles carrying cisplatin and IR820 to perform synergistic chemo-photodynamic therapy against breast cancer
Authors: Fu Ji-jun , Li Chu-wen , Liu Yang , Chen Ming-yue , Zhang Qiang , Yu Xi-yong , Wu Bo , Li Jie-xia , Du Ling-ran , Dang Yuan-ye , Wu Dan , Wei Min-yan , Lin Zhi-qiang , Lei Xue-ping
Published: October 2020

Backgrounds

Surgical resection and adjunct chemotherapy or radio-therapy has been applied for the therapy of superficial malignant tumor in clinics. Whereas, there are still some problems limit its clinical use, such as severe pains and side effect. Thus, it is urgent need to develop effective, minimally invasive and low toxicity therapy stagey for superficial malignant tumor. Topical drug administration such as microneedle patches shows the advantages of reduced systemic toxicity and nimble application and, as a result, a great potential to treat superficial tumors.

Methods

In this study, microneedle (MN) patches were fabricated to deliver photosensitizer IR820 and chemotherapy agent cisplatin (CDDP) for synergistic chemo-photodynamic therapy against breast cancer.

Results

The MN could be completely inserted into the skin and the compounds carrying tips could be embedded within the target issue for locoregional cancer treatment. The photodynamic therapeutic effects can be precisely controlled and switched on and off on demand simply by adjusting laser. The used base material vinylpyrrolidone—vinyl acetate copolymer (PVPVA) is soluble in both ethanol and water, facilitating the load of both water-soluble and water-insoluble drugs.

Conclusions

Thus, the developed MN patch offers an effective, user-friendly, controllable and low-toxicity option for patients requiring long-term and repeated cancer treatments.
Novel drug delivery systems targeting oxidative stress in chronic obstructive pulmonary disease: a review
Authors: Xu You , Liu Hongmei , Song Lei
Published: October 2020

Oxidative stress is significantly involved in the pathogenesis and progression of chronic obstructive pulmonary disease (COPD). Combining antioxidant drugs or nutrients results in a noteworthy therapeutic value in animal models of COPD. However, the benefits have not been reproduced in clinical applications, this may be attributed to the limited absorption, concentration, and half-life of exogenous antioxidants. Therefore, novel drug delivery systems to combat oxidative stress in COPD are needed. This review presents a brief insight into the current knowledge on the role of oxidative stress and highlights the recent trends in novel drug delivery carriers that could aid in combating oxidative stress in COPD. The introduction of nanotechnology has enabled researchers to overcome several problems and improve the pharmacokinetics and bioavailability of drugs. Large porous microparticles, and porous nanoparticle-encapsulated microparticles are the most promising carriers for achieving effective pulmonary deposition of inhaled medication and obtaining controlled drug release. However, translating drug delivery systems for administration in pulmonary clinical settings is still in its initial phases.
Toward a human-centered use of technology: a stakeholder analysis of harm reduction and CBO staff
Authors: Aronson Ian David , Bennett Alex S. , Freeman Robert
Published: October 2020

Background

Technology can enable syringe service programs (SSPs) and other community-based organizations (CBOs) operating under a harm reduction framework to work with an increased number of clients and can also enable organizations to offer services more effectively (e.g., offering HIV testing in ways participants may be more likely to accept). In the current time of COVID-19 social distancing, technology can also help organizations more safely provide services to people with compromised immune systems and to clients who might otherwise not be reached. However, technology projects implemented in harm reduction settings are frequently conceptualized and developed by researchers or technology specialists rather than by SSP staff or clients.

Methods

To more effectively meet the needs of SSPs and other CBOs across the USA, our team conducted qualitative interviews with 16 individuals who have extensive backgrounds working in the field of harm reduction. Interviews were digitally recorded and professionally transcribed, and the transcripts were checked for accuracy by the interviewers. The resulting transcripts were coded and analyzed to determine emerging themes.

Results

Interviewees mentioned the ability of technology to deliver consistent quality messaging to multiple clients at the same time and the potential to customize or tailor technology-based messaging to specific client populations as positive benefits. Clear barriers to technology use also emerged, in particular regarding privacy, data security, and the need to maintain client trust when discussing sensitive issues (e.g., illicit drug use).

Conclusions

Technology offers the potential to deliver consistently high-quality health communication and maintain contact with clients who may have no other access to care. If designed and managed effectively, technology can also address issues related to providing services during times when physical contact is limited due to COVID-19 social distancing measures.
Women and barriers to harm reduction services: a literature review and initial findings from a qualitative study in Barcelona, Spain
Authors: Shirley-Beavan Sam , Roig Aura , Burke-Shyne Naomi , Daniels Colleen , Csak Robert
Published: October 2020

Background

There are an estimated 3.2 million women who inject drugs worldwide, constituting 20% of all people who inject drugs. The limited data that are available suggest that women who inject drugs are at greater risk of HIV and viral hepatitis acquisition than men who inject drugs. This increased vulnerability is a product of a range of environmental, social and individual factors affecting women, which also affect their ability to engage in health promoting services such as harm reduction.

Methods

The researchers undertook a narrative literature review examining access to harm reduction services for women who use drugs in Europe and conducted semi-structured focus groups with women who use drugs and harm reduction and prison health workers in Barcelona, Spain.

Results

Women who use drugs face multiple barriers to accessing harm reduction services. These include stigma, both in society in general and from health and harm reduction workers in prisons and in the community; gender-based violence and a lack of services that are equipped to address the interaction between drug use and experiences of violence; criminalisation in the form of legal barriers to access, arrest and harassment from law enforcement, and incarceration; and a lack of services focused on the specific needs of women, notably sexual and reproductive health services and childcare. In Barcelona, participants reported experiencing all these barriers, and that their engagement with the Metzineres harm reduction centre had to some extent mitigated them. However, women continued to experience structural barriers to harm reduction service access.

Conclusions

Women and gender non-conforming people who use drugs face unique barriers to accessing harm reduction services. While services such as Metzineres can be life changing and life affirming for its members, it is incumbent on states to act to address the structural barriers to health faced by women who use drugs.
Hepatitis C in Israeli prisons: status report
Authors: Michaeli Niv , Litvin Anat , Davidovitch Nadav
Published: October 2020

The article discusses and analyzes the changes that have taken place since 2016 in Israeli policy with regard to the treatment, diagnosis and detection of hepatitis C (HCV) in prison settings. The article finds indications of promising changes to official procedure, such as the statement by authorities that they plan to begin screening new inmates for HCV, and the increase in the number of inmates provided antiviral drugs. These measures, however, only came about after a prolonged campaign and legal battle by human rights organizations, patient advocacy groups and the medical community. Despite these encouraging changes, it appears that a significant portion of inmates in need of treatment are still not getting it due both to bureaucratic delays and to inmates’ reluctance. In addition, in the absence of a suitable screening program, the extant figures of morbidity—high in themselves—may reflect underdiagnosis. The flaws in the policymaking process and in its implementation may be attributed, at least in part, to the fact that the prison healthcare system is under the aegis of the Israel Prison Service and not that of a medical body. This reality places the medical staff in prisons in a state of dual loyalty, and also means the prison healthcare system is excluded from national health plans and major sources of budgeting, leaving it without sufficient means to provide the necessary level of care. These problems plague the prison healthcare system in general and are not limited to its handling of HCV. These challenges are not unique to Israel, and many other Western countries must also face the obstacles that are the result of prison healthcare services being subject to the authority of the correctional establishment. As this test case demonstrates, extended active involvement by civil organizations and the medical community are essential to promoting and ensuring inmates’ right to health.
The validity of the diabetes self-management questionnaire (DSMQ) in Hungarian patients with type 2 diabetes
Authors: Vincze Agnes , Losonczi Antonia , Stauder Adrienne
Published: October 2020

Background

A wide range of measuring instruments are available for diabetes self-management. According to several studies, a relatively new instrument, the diabetes self-management questionnaire (DSMQ), shows a consistent relationship with outcomes of diabetes treatment as well, such as glycated hemoglobin (HbA1c). Furthermore, the questionnaire is short, but covers the main aspects of diabetes management. Given the increasing prevalence of diabetes in Hungary, our goal was to adapt this user-friendly questionnaire and analyze its validity.

Methods

After the standard translation process, we analyzed a sample of 221 people. The construct validity of the questionnaire was tested with HbA1c and body mass index. Morisky Medication Adherence Scale-8 values were tested via Pearson correlations. Known-groups validity of the DSMQ in relation to groups based on glycemic control levels was investigated using one-way ANOVA.

Results

The “sum scale” of the questionnaire and the HbA1c values show an inverse relationship (r = − 0.253, p < 0.01). Body mass index was related to the “sum scale” (r = − 0.214, p < 0.01) and to the “physical activity” (r = − 0.219, p < 0.01), while questionnaire results reflecting medication adherence correlated with the “glucose management” (r = − 0.291, p < 0.01), “health-care use” subscale (r = 0.236, p < 0.01) and the “sum scale” (r = 0.281, p < 0.01). A significant difference (F = 6.225, p = 0.002) was found between the DSMQ mean scores of the three groups, defined by good, medium, and poor glycemic control levels.

Conclusions

The Hungarian version of the DSMQ was considered a valid tool for the measurement of diabetes self-management. With its help, problematic areas of self-management could be uncovered, and interventions can be improved.