bluuebunny/crossref_metadata_2025 huggingface dataset:
Contribution of Pondok Pesantren Tahfiz Al-Qur’an in Responding to the Digital Era in South Borneo
Authors: Setiawan Agus , Rasyidi Ahyar
Published: June 2020

Negative exposure to children's dependence on devices, mobile phones, laptops and online games can indirectly damage children's education in the digital age. The digital age is accompanied by a disruptive era that permeates the life of Education, not only in schools but even in their respective homes. Of course this is troubling parents for the educational life of children. Faced with these problems, some parents began to equip their children's education with the education of the Koran from an early age. Currently, the parents' choice is in Islamic boarding schools that teach the values of Islamic education or more specifically in the education of tahfizh al-Qur'an. This study aims to analyze and map contributionsIslamic Boarding School Tahfizh Al-Qur'an Al-Ihsan Bentok and public perception of the existence of Islamic Boarding School Tahfizh Al-Qur'an Al-Ihsan Bentokin the alpha generation in the digital age. This research design uses qualitative research with approach phenomenological and sociological. Sources of data from a number of respondents randomly sampled. The results in this study describe thatIslamic Education Center Tahfizh Al-Qur'an Al-Ihsan Bentokhas carried out an important role in the form of al-Qura'n education and Islamic education which concentrated on the field of tahfizh al-Qur'an especially children who entered the alpha generation. In the aspect of education, thatIslamic Education Center Tahfizh Al-Qur'an Al-Ihsan Bentokwhich is taught contributes to personality and character, so that it is able to realize it in everyday life. The contribution to the religious aspect is to print memorization of the Koran, while the social aspect of the community is to contribute to the implementation of Islamic education, as well as to protect poor students in the form of education and guidance.
Description of the sagittal jaw relation in cephalometric analysis – a review of literature
Authors: Jedliński Maciej , Janiszewska-Olszowska Joanna , Grocholewicz Katarzyna
Published: June 2020

Introductionː Lateral cephalometry is commonly used to analyse craniofacial morphology, soft tissue profile and the direction of facial growth in an attempt to predict the possibilities and limits of orthodontic therapy.

The aim of the study was to present the most frequently used cephalometric measurements to assess the skeletal class on a lateral cephalometric headfilm.

Materials and methods: A Pubmed search was undertaken to systematize information on ANB angle, WITS appraisal, APDI and Harvold measurements. The keywords used were “cephalometry AND evaluation of sagittal malocclusion AND reference lines AND accuracy OR ANB angle OR WITS appraisal OR APDI”. A manual search was performed from the reference lists of studies found in order to identify and include pioneer studies.

Results: A total number of 1258 records were found and finally 23 studies were included in the review. Four of them were descriptive, the other 19 were randomized control trials.

Conclusionsː 1. ANB angle cannot be used as the only indicator of sagittal skeletal discrepancy. 2. WITS appraisal is independent of the variability of cranial base structures, thus may be an important supplement to the diagnosis, although it depends on the variability of the occlusal plane. 3. APDI can reliably distinguish between class I, II and III malocclusions.
CEDIA method in amphetamine and cannabinoid analysis – potential applications in forensic toxicology blood tests
Authors: Semeniuk Urszula , Potocka-Banaś Barbara , Jasionowicz Ewa , Borowiak Krzysztof , Janus Tomasz
Published: June 2020

Introduction: Immunoassays are the 1st stage of clinical and forensic toxicology examinations.

The aim of the research was to evaluate the suitability of CEDIA (cloned enzyme donor immmunoassay) for the detection of selected drugs such as amphetamine, tetrahydrocannabinol (THC) metabolite: tetrahydrocanabinolic acid (11-nor-9-carboxy-Δ9-tetrahydrocannabinol – THC-COOH).

Materials and methods: Blood samples were examined for the presence of the selected psychoactive drugs, similar in effect to alcohol. Whole blood samples were centrifuged, and the obtained plasma was analysed using CEDIA and LC-MS/MS.

Results: We observed a strong correlation between amphetamine levels measured with CEDIA and the reference technique (LC-MS/MS), and a lack correlation for THC-COOH levels. Cloned enzyme donor immmunoassay did not provide false positive results – positive samples in CEDIA were also positive in LC-MS/ MS, which demonstrated the high specificity of CEDIA.

Conclusions: Considering the high specificity in tests for amphetamine and cannabinoids, CEDIA can be used as a qualitative method in forensic and clinical analysis. This study demonstrates a linearity only for amphetamine detection, which may suggest the need for further verification of the results of other assays offered by the manufacturer. Only serum/plasma can be analysed with CEDIA, which makes this technique unsuitable for highly degraded samples.
Enhanced tolerance to Phytophthora root and stem rot by over-expression of the plant antimicrobial peptide CaAMP1 gene in soybean
Authors: Niu Lu , Zhong Xiaofang , Zhang Yuanyu , Yang Jing , Xing Guojie , Li Haiyun , Liu Dongbo , Ma Rui , Dong Yingshan , Yang Xiangdong
Published: June 2020

Background: Antimicrobial peptides play important roles in both plant and animal defense systems. Moreover, over-expression of CaAMP1 (Capsicum annuum antimicrobial protein 1), an antimicrobial protein gene isolated from C. annuum leaves infected with Xanthomonas campestris pv. vesicatoria, confers broad-spectrum resistance to hemibiotrophic bacterial and necrotrophic fungal pathogens in Arabidopsis. Phytophthora root and stem rot (PRR), caused by the fungus Phytophthora sojae, is one of the most devastating diseases affecting soybean (Glycine max) production worldwide.Results: In this study, CaAMP1 was transformed into soybean by Agrobacterium-mediated genetic transformation. Integration of the foreign gene in the genome of transgenic soybean plants and its expression at the translation level were verified by Southern and western blot analyses, respectively. CaAMP1 over-expression (CaAMP1-OX) lines inoculated with P. sojae race 1 exhibited enhanced and stable PRR tolerance through T2–T4 generations compared with the wild-type Williams 82 plants. Gene expression analyses in the transgenic plants revealed that the expression of salicylic acid-dependent, jasmonic acid-dependent, and plant disease resistance (R-genes) genes were significantly up-regulated after P. sojae inoculation.Conclusions: These results indicate that CaAMP1 over-expression can significantly enhance PRR tolerance in soybean by eliciting resistance responses mediated by multiple defense signaling pathways. This provides an alternative approach for developing soybean varieties with improved tolerance against soil-borne pathogenic PRR.
Can we walk away from cardiovascular disease risk or do we have to ‘huff and puff’? A cross-sectional compositional accelerometer data analysis among adults and older adults in the Copenhagen City Heart Study
Authors: Johansson Melker Staffan , Søgaard Karen , Prescott Eva , Marott Jacob Louis , Schnohr Peter , Holtermann Andreas , Korshøj Mette
Published: June 2020

Background: It is unclear whether walking can decrease cardiovascular disease (CVD) risk or if high intensity physical activity (HIPA) is needed, and whether the association is modified by age. We investigated how sedentary behaviour, walking, and HIPA, were associated with systolic blood pressure (SBP), waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) among adults and older adults in a general population sample using compositional data analysis. Specifically, the measure of association was quantified by reallocating time between sedentary behaviour and 1) walking, and 2) HIPA.Methods: Cross-sectional data from the fifth examination of the Copenhagen City Heart Study was used. Using the software Acti4, we estimated daily time spent in physical behaviours from accelerometer data worn 24 h/day for 7 days (i.e., right frontal thigh and iliac crest; median wear time: 6 days, 23.8 h/day). SBP, WC, and LDL-C were measured during a physical examination. Inclusion criteria were ≥5 days with ≥16 h of accelerometer recordings per day, and no use of antihypertensives, diuretics or cholesterol lowering medicine. The 24-hour physical behaviour composition consisted of sedentary behaviour, standing, moving, walking, HIPA (i.e., sum of climbing stairs, running, cycling and rowing), and time in bed. We used fitted values from linear regression models to predict the difference in outcome given the investigated time reallocations relative to the group-specific mean composition.Results: Among 1053 eligible participants, we found an interaction between the physical behaviour composition and age. Age-stratified analyses (i.e., </≥65 years; 773 adults, 280 older adults) indicated that less sedentary behaviour and more walking was associated with lower SBP among older adults only. For less sedentary behaviour and more HIPA, the resultsi)indicated an association with lower SBP irrespective of age,ii)showed an association with a smaller WC among adults, andiii)showed an association with a lower LDL-C in both age groups.Conclusions: Less sedentary behaviour and more walking seems to be associated with lower CVD risk among older adults, while HIPA types are associated with lower risk among adults. Therefore, to reduce CVD risk, the modifying effect of age should be considered in future physical activity-promoting initiatives.
Discriminative Pattern of Reduced Cerebral Blood Flow in Parkinson's Disease and Parkinsonism-Plus Syndrome: an ASL-MRI study
Authors: Cheng Lina , Wu Xiaoyan , Guo Ruomi , Wang Yuzhou , Wang Wensheng , He Peng , Lin Hanbo , Shen Jun
Published: June 2020

Background: Accurate identification of Parkinson's disease (PD) and Parkinsonism-Plus syndrome (PPS), especially in the early stage of the disease, is very important. The purpose of this study was to investigate the discriminative spatial pattern of cerebral blood flow (CBF) between patients with PD and PPS. Methods: Arterial spin labeling (ASL) perfusion-weighted imaging was performed in 20 patients with PD (mean age 56.35±7.56 years), 16 patients with PPS (mean age 59.62±6.89 years), and 17 healthy controls (HCs, mean age 54.17±6.58 years). Voxel-wise comparison of the CBF was performed among PD, PPS, and HC groups. The receiver operating characteristic (ROC) curve was used to evaluate the performance of CBF in discriminating between PD and PPS. The relationship between CBF and non-motor neuropsychological scores was assessed by correlation analysis. Results: PD group showed a significantly decreased CBF in the right cerebelum_crus2, the left middle frontal gyrus (MFG), the triangle inferior frontal gyrus (IFG_Tri), the left frontal medial orbital gyrus (FG_Med_Orb) and the left caudate nucleus (CN) compared with the HC group (P < 0.05). Besides the above regions, the left supplementary motor area (SMA), the right thalamus had decreased CBF in the PPS group compared with the HC group (P < 0.05). PPS group had lower CBF value in the left MFG, the left IFG_Tri, the left CN, the left SMA, and the right thalamus compared with the PD group (P < 0.05). CBFs in left IFG_Tri, the left CN, the left SMA, and the right thalamus had moderate to high capacity in discriminating between PD and PPS patients (AUC 0.719-0.831). The CBF was positively correlated with MMSE and Montreal cognitive assessment (MoCA) scores in PD patients, while positively correlated with the Mini-mental State Examination (MMSE), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD) scores in PPS patients (P < 0.05). Conclusion: PD and PPS patients have certain discriminative patterns of reduced CBFs, which can be used as a surrogate marker for differential diagnosis.
Rapid Detection of Babesia motasi Responsible for Human Babesiosis by Cross-priming Amplification Combined with a Vertical Flow
Authors: Wang Jinming , Gao Shandian , Zhang Shangdi , He Xin , Liu Junlong , Liu Aihong , Li Youquan , Liu Guangyuan , Luo Jianxun , Guan Guiquan , Yin Hong
Published: June 2020

Background: Babesia motasi is known as an etiological agent of human and ovine babesiosis. Diagnosis of babesiosis is traditionally performed by microscopy, examining Giemsa-stained thin peripheral blood smears. Rapid detection and accurate identification of species are desirable for clinical care and epidemiological studies. Methods: An easy to operate molecular method, which requires less capital equipment and incorporates cross priming amplification combined with a vertical flow (CPA-VF) visualization strip for rapid detection and identification of B. motasi. Results: The CPA-VF targets the 18S rRNA gene and has a detection limit of 50 fg per reaction; no cross reaction was observed with other piroplasms infective to sheep or Babesia infective to humans. CPA-VF and real-time (RT)-PCR had sensitivities of 95.2% (95% confidence interval [CI], 78.1-99.4%) and 90.5% (72-97.6%) and specificities of 95.8 (80.5-99.5%) and 97.9 (83.5-99.9%), respectively, versus microscopy and nested (n) PCR combined with gene sequencing. The clinical performance of the CPA-VF assay was evaluated with field blood samples from sheep (n = 340) in Jintai county, Gansu Province, and clinical specimens (n = 492) obtained from patients bitten by ticks. Conclusions: Our results indicate that the CPA-VF is a rapid, accurate, nearly instrument-free molecular diagnostic approach for identification of B. motasi. Therefore, it could be an alternative technique for epidemiological investigations and diagnoses of ovine and/or human babesiosis caused by B. motasi, especially in resource-limited regions.
Long-term survival of elderly patients after intensive care unit admission for acute respiratory infection: a population-based, propensity-score matched cohort study.
Authors: Guillon Antoine , Hermetet C. , Barker K. A. , Jouan Y. , Gaborit C. , Ehrmann S. , Manach Y. Le , Dequin P F , Grammatico-Guillon L.
Published: June 2020

Background Intensive care unit (ICU) hospitalisations of elderly patients with acute respiratory infection have increased, yet the long-term effects of ICU admission among elderly individuals remain unknown. We examined differences over the two years after discharge in mortality, healthcare utilization and frailty score between elderly survivors of ARI in the ICU and an elderly control population.Methods We used 2009-2017 data from 39 hospital discharge databases. Patients ≥80 years old discharged alive from ICU-hospitalisation for acute respiratory infection were propensity-score matched with controls (cataract surgery) discharged from the hospital at the same time and adjusted for age, sex and comorbidities present before hospitalisation. We reported 2-year mortality and compared healthcare utilization and frailty scores in the 2-year periods before and after ICU-hospitalisation.Results 1,220 elderly survivors of acute respiratory infection in the ICU were discharged, and 988 were successfully matched with controls. After discharge, patients had a 10.1-fold [95%CI, 6.1-17.3] higher risk of death at 6 months and 3.6-fold [95%CI, 2.9-4.6] higher risk of death at 2 years compared with controls. They also had a 2-fold increase in both healthcare utilization and frailty score in the 2 years after hospital discharge, whereas healthcare utilization and frailty scores among controls were stable before and after hospitalisation.Conclusions We observed a substantially increased rate of death in the years following ICU-hospitalisation for elderly patients along with elevated healthcare resource use and accelerated age-associated decline as assessed by frailty score. These findings provide data for better informed goals-of-care discussions and may help target post-ICU discharge services.Funding: None
Metapristone (RU486 derivative) inhibits endometrial cancer cell progress through regulating miR-492/Klf5/Nrf1 axis
Authors: Chang Yue , Hao Min , Jia Ru , Zhao Yihui , Cai Yixuan , Liu Yun
Published: June 2020

Background: Endometrial cancer is the prevalent invasive gynecological cancer in the world. The pathogenesis of endometrial cancer involves many signaling pathways which are related with transcription factors or microRNAs. Metapristone is a hormone related drug and widely used in endometrial cancer clinical therapeutics. However, the deep regulatory mechanism of metapristone is not clear. In this research, we aimed to figure out the specific molecular mechanism during the treatment of endometrial cancer with metapristone.Methods: In this study, RL95-2 cells and Ishikawa cells were used as the endometrial cancer cell models. miR-492 was transfected into RL95-2 cells and Ishikawa cells. The miRNA expression was measured by qRT-PCR. Moreover, the mice tumor model was used to confirm the function of metapristone and the regulating process by miR-492/Klf5/Nrf1 axis in vivo. The protein expression was measured by western blot. Cell proliferation and apoptosis was monitored using the MTT assay, cell colony formation assay and EdU assay.Results: Firstly, the results indicated that metapristone as a kind of hormone-related drugs could significantly inhibit the endometrial cancer cell growth through regulating cell apoptosis-related gene expression. Meanwhile, miR-492 was detected to be highly expressed in the endometrial cancer cell lines. Overexpression of miR-492 could promote the cell proliferation and inhibit the cell apoptosis. Furthermore, the results demonstrated that the downstream target genes of miR-492 were Klf5 and Nrf1, which were inhibited by metapristone. At the animal level, metapristone also inhibited the endometrial cancer cell growth through down-regulating the expression of miR-492 and decreasing the protein level of Klf5 and Nrf1. Conclusion: Taken together, this study indicated that metapristone inhibited the endometrial cancer cell growth through regulating the cell apoptosis related signaling pathway and the expression of miR-492 and its downstream target genes (Klf5 and Nrf1), which provided the theoretical basis of endometrial cancer in clinical treatment.
Understanding access to professional healthcare among asylum seekers facing gender-based violence: a qualitative study from a stakeholder perspective
Authors: Sapia Mirjam Rodella , Wangmo Tenzin , Dagron Stéphanie , Elger Bernice S.
Published: June 2020

Background: When it comes to gender-based violence (GBV), migrant women and girls represent the most vulnerable group. GBV can happen at any stage of migrants’ flight and/or during the asylum process. It has severe consequences on their life and health. Victims therefore need timely access to healthcare. This study explores the context GBV victims face when they seek refuge in Switzerland. Methods: Qualitative methodology was used where we conducted five semi-structured focus groups and three interviews. A total of sixteen stakeholders participated in the study. They were either involved in the asylum process or provided healthcare to asylum seekers. We analyzed the data using framework analysis.Results: Study participants noted lack of confidence of the GBV victims in the legal and in the healthcare systems as major barriers to disclosure of GBV. Since only GBV exerted before fleeing the home country gives the right to asylum, they pointed out that victims do not disclose GBV that took place after they left their home country. Language was identified as a barrier to disclosure of GBV as well as to healthcare access. Continuity of care at the moment of transfer from federal to cantonal (i.e. state) accommodations is another issue that was deemed critical. Study participants felt that health professionals must be trained to identify GBV victims. The first-contact caregiver available to these victims was deemed as the most competent professional that could act as a “GBV coordinator”.Conclusion: In Switzerland, access to healthcare is guaranteed to all asylum seekers on a legal and structural level. Yet, health seeking by GBV survivors is hindered by factors such as lack of confidence in the legal system, trust in health providers, and continuity of care during the asylum process. Building trust in legal institutions, health structures, and professionals should be enhanced to facilitate disclosure and to strengthen resilience. This includes a healthcare system with competent professionals, support with language and cultural needs, as well as seamless continuity of care beyond cantonal borders.
Enrichment differentiation of human induced pluripotent stem cells into sinoatrial node-like cells by combined modulation of BMP, FGF and RA signaling pathways
Authors: Liu Feng , Fang YiBing , Hou XiaoJie , Yan Ying , Xiao HaiYing , Zuo DongChuan , Wen Jing , Wang LinLi , Zhou Zhichao , Dang XiTong , Zhou Rui , Liao Bin
Published: June 2020

Background: Biological pacemakers derived from pluripotent stem cell (PSC) have been considered as a potential therapeutic surrogate for sick sinus syndrome. So it’s essential to develop high efficient strategies for enrichment of sinoatrial node-like cells (SANLC) as seed cells for biological pacemakers. It has been reported that BMP, FGF and RA signaling pathways are involved in specification of different cardiomyocyte subtypes, pacemaker, ventricular, and atrial cells. We aimed to investigate whether combined modulation of BMP, FGF and RA signaling pathways could enrich the differentiation of SANLC from human pluripotent stem cell (hiPSC).Methods: During the differentiation process from human-induced pluripotent stem cell to cardiomyocyte through small molecule based temporal modulation of the Wnt signaling pathway, signaling of BMP, FGF and RA was manipulated at cardiac mesoderm stage. qRT-PCR, immunofluorescence, flow cytometry and whole cell patch clamp were used to identify the SANLC. Results: qRT-PCR results showed that manipulating each one of bone morphogenetic protein (BMP), fibroblast growth factor (FGF) and retinoid acid (RA) signaling was effective for the upregulation of SANLC markers. Moreover, combined modulation of these three pathways displayed the best efficiency for the expression of SANLC markers, which was further confirmed at protein level using immunofluorescence and flow cytometry. Finally, the electrophysiological characteristics of upregulated SANLC were verified by patch clamp method.Conclusion: An efficient transgene-independent differentiation protocol for generating SANLC from hiPSC was developed, in which combined modulating BMP, FGF and RA signaling at cardiac mesoderm stage generates SANLC at high efficiency. This may serve as a potential approach for biological pacemaker construction.
Juvenile Spondyloarthritis: focus on uveitis.
Authors: Marino Achille , Weiss Pamela F. , Brandon Timothy G. , Lerman Melissa Ann
Published: June 2020

Background Juvenile spondyloarthritis (JSpA) represents a group of inflammatory arthritides with several distinctive features (enthesitis, involvement of spine and sacroiliac joint, HLA-B27 association and development of uveitis). There are limited data on the course of uveitis in children with JSpA. This study aims to estimate the prevalence of uveitis and to look at the presence of HLA-B27 in relation to uveitis occurrence and ocular symptoms in a cohort of JSpA patients.Findings This is a cross sectional/retrospective study involving patients with JSpA followed in a tertiary referral hospital. Two hundred twenty-three patients were enrolled in the study. The prevalent diagnosis was enthesitis-related arthritis (ERA) (62%) followed by juvenile psoriatic arthritis (PsA), undifferentiated arthritis (UA), and the arthropathies associated with inflammatory bowel disease (IBD-A) (18%, 14%, 6%, respectively). Uveitis was reported in twenty-four patients (11%) of the JSpA cohort (JSpA-U). ERA patients had the highest uveitis prevalence (ERA-U) (13%) with similar prevalences in UA, PsA and in IBD-A (7% each). The prevalence of HLA-B27 positivity was similar amongst the entire JSpA-U cohort (N=22, 45%) and those with ERA-U (N=8, 44%). The overall prevalence of symptomatic uveitis was 79%. Neither the likelihood of uveitis, nor of symptomatic uveitis, varied by HLA-B27 status either in the entire cohort nor in those with ERA.Conclusions About one-tenth of patients developed uveitis, the majority of which was symptomatic. Fewer than half of the patients with uveitis were HLA-B27 positive. HLA-B27 status was not statistically associated with either the development of uveitis or symptomaticity of uveitis.
Validation of an e-health readiness assessment framework for developing countries
Authors: Mauco Kabelo Leonard , Scott Richard E , Mars Maurice
Published: June 2020

Background: Studies document e-health as having potential to improve quality of healthcare services, resulting in both developed and developing countries demonstrating continued interest in e-health uptake and use. e-Health implementations are not always successful as high failure rates have been reported in both developed and developing countries. These failures are often a result of lack of e-health readiness. e-Health readiness has been defined as the preparedness of healthcare institutions or communities for the anticipated change brought by programs related to information and communication technologies. As such it is critical to conduct an e-health readiness assessment prior to implementation of e-health innovations so as to reduce chances of project failure. Noting the absence of an adequate e-health readiness assessment framework (eHRAF) suitable for use in developing countries, the authors conceptualised, designed, and created a developing country specific eHRAF to aid in e-health policy planning. The aim of this study was to validate the developed eHRAF and to determine if it required further refinement before empirical testing. Methods: Published options for a framework validation process were adopted, and fifteen globally located e-health experts engaged. Botswana experts were engaged using saturation sampling, while international experts were purposively selected. Responses were collated in an Excel spreadsheet, and NVivo 11 software used to aid thematic analysis of the open ended questions.Results: Analysis of responses showed overall support for the content and format of the proposed eHRAF. Equivocal responses to some open ended questions were recorded, most of which suggested modifications to terms within the framework. One expert from the developed world had alternate views.Conclusions: The proposed eHRAF provides guidance for e-health policy development and planning by identifying, in an evidence based manner, the major areas to be considered when preparing for an e-health readiness assessment in the context of developing countries.
Neurological outcome after extracorporeal cardiopulmonary resuscitation for in-hospital cardiac arrest: a systematic review and meta-analysis
Authors: Gravesteijn Benjamin , Schluep Marc , Disli Maksud , Garkhail Prakriti , Miranda Dinis Dos Reis , Stolker Robert-Jan , Endeman Henrik , Hoeks Sanne Elisabeth
Published: June 2020

Background In hospital cardiac arrest (IHCA) is a major adverse event with a high mortality rate if not treated appropriately. Extracorporeal cardiopulmonary resuscitation (ECPR), as adjunct to conventional cardiopulmonary resuscitation (CCPR) is a promising technique for IHCA treatment. Evidence pertaining to neurological outcomes after ECPR is still scarce. Methods We performed a comprehensive systematic search of all studies up to December 20 th 2019. Our primary outcome was neurological outcome after ECPR at any moment after hospital discharge, defined by the Cerebral Performance Category (CPC) score. A score of 1 or 2 was defined as favourable outcome. Our secondary outcome was post-discharge mortality. A fixed-effects meta-analysis was performed. Results Our search yielded 1215 results, of which 19 studies were included in this systematic review. The average survival rate was 32% (95% CI: 29-34%, I2=0%, p=0.16). In the surviving patients, the pooled percentage of favourable neurological outcome was 82% (95% CI: 77- 85%, I2=60%, p=0.12). Conclusion ECPR as treatment for in-hospital cardiac arrest is associated with a large proportion of patients with good neurological outcome. The large proportion of favourable outcome could potentially be explained by the selection of patients for treatment using ECPR. Moreover, survival is higher than described in the conventional CPR literature. As indications for ECPR might extend to older or more fragile patient populations in the future, research should focus on increasing survival, while maintaining optimal neurological outcome.
”Side effects--part of the package”: A mixed methods approach to adverse events among patients being programmatically treated for DR-TB in Gujarat, India
Authors: Jakasania Arjunkumar Hardas , shringarpure Kalpita , Kapadia Dixit , Sharma Radhika , Mehta Kedar , Prajapati Arpit , Soundappan Kathirvel
Published: June 2020

Background Unsuccessful treatment outcomes among patients with drug resistant tuberculosis (DR-TB) are due to high rates of adverse events (AEs). However, information related to AEs is not systematically collected and managed under programmatic setting. The present study assessed the a) incidence and pattern of adverse events in first three months of DR-TB treatment initiation; b) treatment seeking behaviour for AE management; and c) explore the challenges in seeking treatment and reporting AEs.Methods This mixed methods study included all patients diagnosed and initiated on treatment under RNTCP during July-September 2018 at Ahmedabad DR-TB centre. The patients were interviewed telephonically and assessed for all AEs experienced by them. In-depth interviews and key-informant interviews were conducted among patients, DOTS supervisors and programme staffs (treatment supervisors, medical officer and district program manager). Results Total 207 AEs were reported by the 74 DR-TB patients. All patients experienced at least one AE during initial treatment period. Incidence rate of AEs (experienced) was 3.11 (1st month-4.6, 2nd month-2.7, 3rd month-2.02) per 100 person days. Of the 207 AEs, gastro-intestinal (59, 28.3%), ophthalmic (32, 15.4%) and otolaryngology (25, 11.9%) system related AEs were commonly experienced. Treatment was not sought in two-fifths of the AEs. Themes and sub-themes related to challenges in treatment seeking or reporting of AEs were 1) Patient related-Misconceptions, accessibility and affordability of management, lack of counselling support, stigma and discrimination, and past treatment experience; 2) Health system related- lack of guidelines and training for AE management, 3) Poor coordination between hospital and tuberculosis centre. Conclusion The incidence of AEs was high among patients with DR-TB in the first three months of treatment and treatment seeking/reporting was low. Adequate health education and counselling of the patient and orientation of the health systems are the need of the hour. An efficient real-time reporting and management of AE can be developed and tested for effective DR-TB control.
Symptoms of ocular surface disease in construction workers: comparative study with office workers
Authors: Hernandez-Llamas Sergio , Paz-Ramos Ana Karen , Marcos-González Patricio , Amparo Francisco , Garza-Leon Manuel
Published: June 2020

Background: To investigate and contrast the prevalence of dry eye symptoms in construction workers and office workers using the OSDI questionnaire.Methods: A cross-sectional, observational study was conducted using the OSDI questionnaire to evaluate dry eye symptoms and associated risk factors. Sampled size calculation with a power of 80% and a 95% degree of confidence suggested the inclusion of 298 participants. Results: We studied 304 subjects (149 construction workers and 155 office workers). More than half (55%) of the participants presented dry eye symptoms (OSDI > 12). The average OSDI score was 21.30 ± 22.20 points, being lower in the group of construction workers (12.45±17.50) than in-office workers (28.51±22.99) (p <0.001). Considering participants who had moderate and severe symptoms (23 to 100 points in OSDI), office workers presented dry eye symptoms 4.15 times more frequently than construction workers (OR 4.15, 95% CI 2.52, 6.85). Women presented statistical evidence of higher OSDI scores than men (32.47 ± 23.72 vs. 14.87 ± 18.48, respectively). Conclusions: construction workers have four times less risk of presenting dry eye symptoms than people working in the average office space. This highlights the pernicious effects on the ocular surface of the office environment, which poses a significant risk for the development or worsening of dry eye symptoms.
DLBCL with amplification of JAK2/PD-L2 exhibits PMBCL-like CNA pattern and worse clinical outcome resembling those with MYD88 L265P mutation
Authors: Xue Xuemin , Huang Wenting , Qiu Tian , Guo Lei , Ying Jianming , Lv Ning
Published: June 2020

Background: Recently, copy number alteration (CNA) of 9p24.1 were demonstrated in 10% of diffuse large b-cell lymphoma (DLBCL), with gene expression and mutation profiles that were similar to those of primary mediastinal large B-cell lymphoma(PMBCL). However, their CNA-based profile and clinical impact still remain unclear. Methods: Multiplex ligation-dependent probe amplification were employed to investigate the prevalence of JAK2/PD-L2 amplification in DLBCL and their CNA-based pattern of driver genes. The clinical outcome and characteristics were also analyzed. Results: Using unsupervised hierarchical clustering, a small group of DLBCL (10.5%, 8/76) was clustered together with PMBCL as Cluster_2, demonstrating amplification of JAK2 (100%,8/8) and PD-L2 (75.0%,6/8). This subgroups of DLBCL demonstrated significant higher expression of PD-L1 than those with MYD88 L265P mutation(p=0.024). And they exhibited dismal OS and PFS as compared with DLBCL_others(p=0.003 and 0.001, respectively), which is similar to DLBCL with MYD88 L265P mutation. Conclusions: DLBCL with amplification of JAK2/PD-L2 exhibits CNA pattern that is similar to PMBCL, and demonstrates unfavorable clinical outcome that resembles those with MYD88 L265P mutation. It is essential to identify this subgroup of DLBCL who may acquire more benefits from the JAK2 and PD-L1 signaling inhibition.
Prevalence of heavy episodic drinking and associated factors among adults residing in Arba Minch health and demographic surveillance site: a cross sectional study
Authors: Gutema Befikadu Tariku , Chuka Adefris , Ayele Gistane , Tariku Eshetu Zerhun , Aschalew Zeleke , Baharu Alazar , Degefa Nega , Gurara Mekdes Kondale
Published: June 2020

Background: Alcohol consumption is associated with different types of illness, particularly heavy episodic drinking is one of the risk factors for the disease burden of alcohol intake. The aim of the study was to assess the prevalence of heavy episodic drinking and associated factors in Arba Minch Health and Demographic Surveillance Site (HDSS).Methods: A community-based cross-sectional study was conducted in 2017 among adult residents of Arba Minch HDSS. Using Arba Minch HDSS database, 3368 individuals were selected by simple random sampling techniques. From WHO STEPS instruments, step one was applied for this study. Variables with a p-value of less than 0.10 for bivariate analysis entered into a multivariable logistic regression model to outline the independent predictors of the heavy episodic drinking. To assess the presence of an association between dependent and independent variables, a p-value of less than 0.05 was considered.Results: The prevalence of heavy episodic drinking was 13.7% (95% CI: 12.6–14.9). The study has shown that heavy episodic drinking was significantly associated with occupation (daily laborer [AOR=0.49; 95% C.I: 0.29–0.85] and housewives [AOR=0.63; 95% C.I: 0.45–0.88] compared with farmers), wealth index (2nd quintiles [AOR =0.55; 95% C.I: 0.41–0.74) and 3rd quintiles [AOR = 0.66; 95% C.I: 0.46–0.93] compared with 1st quintiles), and climatic zone (midland [AOR=1.80;95% CI: 1.11–2.93), highland [AOR=1.95;95% CI: 1.19–3.18] compared with lowland). In addition, tobacco use [AOR=4.28;95% CI: 3.38–5.43], and khat use [AOR=4.75; 95% CI: 2.66–8.50) were also associated with heavy episodic drinking among the study participants. Conclusions: More than one in ten adults reported heavy episodic drinking in the study area. Intervention programs that aim to prevent heavy episodic drinking should be designed appropriately for individuals from lower wealth status, and for highlander.
Establishing seasonal and alert influenza thresholds in Morocco
Authors: Rguig Ahmed , Cherkaoui Imad , McCarron Margaret , Oumzil Hicham , Triki Soumia , Elmbarki Houria , Bimouhen Abderrahman , Falaki Fatima El , Regragui Zakia , Ihazmad Hassan , Nejjari Chakib , Youbi Mohammed
Published: June 2020

Background: Several statistical methods of variable complexity have been developed to establish thresholds for influenza activity that may be used to inform public health guidance. We compared the results of two methods and explored how they worked to characterize the 2017-2018 season.Methods: Historical data from the 2005/2006 to 2016/2017 seasons were provided by a network of 412 primary health centers in charge of influenza like illness (ILI) sentinel surveillance. We used the WHO averages and the moving epidemic method (MEM) to evaluate the proportion of ILI visits among all outpatient consultations (ILI%) as a proxy for influenza activity. We also used the MEM method to evaluate three seasons of composite data (ILI% multiplied by percent of ILI with laboratory-confirmed influenza) as recommended by WHO. Results: The WHO method estimated the seasonal ILI% threshold at 0.9%. The annual epidemic period began on average at week 46 and lasted an average of 18 weeks. The MEM model estimated the epidemic threshold (corresponding to the WHO seasonal threshold) at 1.5% of ILI visits among all outpatient consultations. The annual epidemic period began on week 49 and lasted on average 14 weeks. Intensity thresholds were similar using both methods. When using the composite measure, the MEM method showed a clearer estimate of the beginning of the influenza epidemic, which was coincident with a sharp increase in confirmed ILI cases. Conclusions: We found that the threshold methodology presented in the WHO manual is simple to implement and easy to adopt for use by the Moroccan influenza surveillance system. The MEM method is more statistically sophisticated and may allow a better detection of the start of seasonal epidemics. Incorporation of virologic data into the composite parameter as recommended by WHO has the potential to increase the accuracy of seasonal threshold estimation.
Predictability and controlling factors of overpressure in the North Alpine Foreland Basin, SE Germany: An interdisciplinary post-drill analysis of the Geretsried GEN-1 Deep Geothermal Well
Authors: Drews Michael Christian , Hofstetter Peter , Zosseder Kai , Shipilin Vladimir , Stollhofen Harald
Published: June 2020

The North Alpine Foreland Basin in SE Germany Germany’s most active deep geothermal province. However, in its southern and eastern part the basin is considerably overpressured, which is a significant challenge for drilling deep geothermal wells. In this study, combine drilling data and velocity-based pore pressure analyses with 3D basin modelling to assess the predictability and controlling factors of overpressure in the sub-regional context (area of 80 km x 50 km) around the Geretsried GEN-1 well, a deep geothermal exploration well in the southern part of the North Alpine Foreland Basin in SE Germany. Drilling data and velocity-based pore pressure analyses indicate overpressure maxima in the Lower Oligocene (Rupelian and Schoeneck Formation) and up to mild overpressure in the Upper Oligocene (Chattian) and Upper Cretaceous, except for the hydrostatically pressured northwestern part of the study area. 3D basin modelling calibrated to four hydrocarbon wells surrounding the Geretsried GEN-1 well demonstrates the dominating role of disequilibrium compaction and low permeability units related to overpressure generation in the North Alpine Foreland Basin. However, secondary overpressure generation mechanisms are likely contributing. Also, the impact of Upper Cretaceous shales, which are eroded in the northwestern part of the study area, on overpressure maintenance is investigated. The calibrated basin model is tested against the drilling history and velocity (VSP) data-based pore pressure estimate of the Geretsried GEN-1 well and reveals that pore pressure prediction is generally possible using 3D basin modelling in the North Alpine Foreland Basin, but should be improved with more detailed analysis of lateral drainage systems and facies variations in the future. The results of the study are of relevance to future well planning and drilling as well as to geomechanical modelling of subsurface stresses and deep geothermal production in the North Alpine Foreland Basin.
Efficacy of a High-Dose Proton Pump Inhibitor in Patients with Gastroesophageal Reflux Disease: A Single Center, Randomized, Open-Label Trial
Authors: Cho Jae Ho , Shin Cheol Min , Yoon Hyuk , Park Young Soo , Kim Nayoung , Lee Dong Ho
Published: June 2020

Background: The extraesophageal manifestations of gastroesophageal reflux disease (GERD) are more difficult to manage than the typical symptoms. The efficacy of high-dose and standard-dose proton pump inhibitors against these atypical symptoms is not yet established.Methods: In this single center, randomized, open-label study, patients with GERD received rabeprazole for 8 weeks, either 20 mg once daily (standard-dose group) or 20 mg twice daily (high-dose group). Patients were assessed before treatment and at weeks 4 and 8 with a 5-graded scale questionnaire consisting of 2 typical symptoms (heartburn and acid regurgitation) and 8 atypical symptoms (chest pain, cough, globus, wheezing, laryngopharyngitis, hoarseness, belching, and dysphagia). Sufficient improvement of reflux symptoms was defined as ≥ 50% reduction from the initial questionnaire score.Results: Final analyses included 35 patients in the standard-dose group and 38 patients in the high-dose group. The rate of sufficient improvement for typical symptoms was significantly higher in the high-dose group than in the standard-dose group (100.0% vs. 84.0%, P = 0.040). For atypical symptoms, the rate of sufficient improvement tended to be higher in the high-dose group than in the standard-dose group (82.4% vs. 63.0%, P = 0.087). Scores of typical and some atypical symptoms (cough and globus) improved after treatment, with significant inter-group differences in time-course changes.Conclusions: High-dose rabeprazole is more effective for relieving typical GERD symptoms and some atypical symptoms such as cough and globus than a standard-dose regimen.Trial registration: This research was enrolled in a registry of clinical trials run by United States National Library of Medicine at the National Institutes of Health (ClinicalTrials.gov Protocol Registration and Results system ID: NCT04001400). This study was registered on June 26, 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04001400.
Albumin-bound paclitaxel and gemcitabine combination therapy in soft tissue sarcoma
Authors: Tian Zhichao , Zhang Fan , Li Po , Wang Jiaqiang , Yang Jinpo , Zhang Peng , Yao Weitao , Wang Xin
Published: June 2020

Background: The evidence that albumin-bound paclitaxel (nab-paclitaxel) is safe and efficacious for the treatment of many types of malignant tumors is continuously increasing. However, the clinical data and evidence of nab-paclitaxel and gemcitabine in metastatic soft tissue sarcoma (STS) treatment are rare.Methods: The data of 17 patients with metastatic STS who received nab-paclitaxel/ gemcitabine chemotherapy between January 2019 and February 2020 were retrospectively reviewed. All patients were treated with nab-paclitaxel/ gemcitabine only after doxorubicin-based chemotherapy had failed. We evaluated the median progression-free survival (m-PFS), disease control rate (DCR), objective response rate (ORR) and adverse events (AEs) in these patients. Results: The m-PFS was 6 months (95% CI, 2–9 months), ORR was 41.2% and DCR was 70.6%. The average change in target lesion diameter from baseline was -19.06±45.74%. While the majority of the treatment patients experienced grade 1 or 2 AEs, grade 3 or 4 AEs were not common, but included neutropenia (17.6%), fatigue (11.8%), anemia (11.8%), leukopenia (11.8%), nausea (5.9%), peripheral neuropathy (5.9%), diarrhea (5.9%), and thrombocytopenia (5.9%). No treatment-related deaths occurred. Conclusion: Nab-paclitaxel/ gemcitabine combination chemotherapy is comparatively effective in the treatment of STS, demonstrates low toxicity, and is worthy of further study.
Anopheles arabiensis and Anopheles funestus biting patterns in Dielmo, an area of low level exposure to malaria vectors
Authors: Doucoure Souleymane , Thiaw Omar , Wotodjo Amélé N. , Bouganali Charles , Diagne Nafissatou , Parola Philippe , Sokhna Cheikh
Published: June 2020

Background In Dielmo, Senegal, the widespread use of long-lasting insecticidal nets has decreased both the incidence of malaria and the density of the Anopheles population. However, persistent low-level malaria transmission may hamper efforts to eliminate the disease. Therefore, continuous monitoring of the vector population is needed in order to improve knowledge of Anopheles biting behaviour and to readjust control interventions.Methods In 2015, Anopheles were collected every month for a whole year and each specimen was identified using morphological and molecular techniques. The biting pattern of each species was analysed according to night (7pm–7am) and morning (7am–11am) periods, the place of biting and the season. The ELISA CSP technique was used to assess the Plasmodium falciparum sporozoite rate to evaluate the entomological inoculation rate (EIR).Results Anopheles arabiensis and Anopheles funestus sensu stricto were found to be the main vectors biting humans. Overall, the biting rate was low, at 3.84bites per night (bpn) and 1.27 bites per morning (bpm), respectively (IRR =3.04, CI = [1.84-5.00], p<0.001). The EIR was 2.51 and 5.03 infectious bites per year during the night and morning, respectively. During the night, the An. arabiensis and An. funestus biting rate was 1.81 bpn and 1.71 bpn, respectively (IRR=0.95, CI= [0.46-1.92], p=0.88). During the morning, their density decreased to 0.51 bpm and 0.73 bpm for An. arabiensis and An. funestus, respectively (IRR=1.47, CI= [0.58-3.71], p=0.41). During the night and the morning, no specific trend of indoor or outdoor biting was observed in the dry and rainy season for both vectors. Conclusion This study highlighted low level Anopheles nocturnal and diurnal biting and the associated risk of malaria transmission. It showed also the influence of the season on the indoor and outdoor biting pattern, indicating that the human population could be exposed all year round to a low level of Anopheles bites. Control programmes should increase awareness of the use of bed nets throughout the year and promote the development and implementation of complimentary tools to target Anopheles biting shortly after dawn when people are still indoors.