bluuebunny/crossref_metadata_2025 huggingface dataset:
Lay therapist delivered low intensity psychosocial intervention for refugees and asylum seekers (PROSPER): protocol for a pilot randomised controlled trial.
Authors: Rawlinson Rebecca , Aslam Rabeea’h , Burnside Girvan , Chiumento Anna , Eriksson-Lee Malena , Humphreys Amy , Khan Naila , Lawrence Daniel , Mahzir Iqra , McCluskey Rachel , Mackinnon Annette , Orton Lois , Rahman Atif , Roberts Ewan , Rosala-Hallas Anna , Tudor-Edwards Rhiannon , Uwamaliya Philomene , White Ross , Winrow Eira , Dowrick Christopher
Published: February 2020

Background Asylum seekers and refugees (AS&Rs) experience impaired mental health and wellbeing, related to stresses in their country of origin, experiences in transit and reception on arrival, including significant barriers to accessing mainstream services. Their contact with healthcare is often crisis-driven and mediated through non-governmental organisations (NGOs). Problem Management Plus (PM+) is a psychosocial intervention recommended by the World Health Organization to address distress experienced by adults affected by humanitarian crises. We are investigating its application for the first time in a high income country. Methods In a pilot randomised controlled trial, PM+ will be delivered to AS&Rs in contact with NGOs in Liverpool City Region, UK, by lay therapists who have lived experience of forced migration. Following systematic review and stakeholder engagement, PM+ has been adapted to the local context, and lay therapists have been trained in its delivery. We will assess the feasibility of conducting a three-arm RCT of five 90-minute sessions of PM+, delivered individually or in groups by lay therapists to AS&Rs experiencing emotional distress and functional impairment, compared with each other and with usual support offered by local NGOs. Distress and impairment at baseline will be measured by Hospital Anxiety and Depression Scale (HADS) and WHO Disability Assessment Schedule (WHO-DAS). We aim to recruit 105 participants, 35 per arm. Primary health outcomes are anxiety and depressive symptoms at 3 months, measured by HADS. Secondary outcomes include subjective wellbeing, functional status, progress on identified problems, post-traumatic stress disorder, depressive disorder and service usage. Longer term impact will be assessed at 6-months post baseline, on the same parameters. We will assess the feasibility of conducting a full RCT in relation to the following elements: recruitment and retention of lay therapists and study participants; fidelity of delivery of PM+; and suitability of the study measures, including any linguistic or cultural barriers. Discussion We will use these findings to specify the parameters for a full randomised controlled trial to test the effectiveness and cost effectiveness of PM+ in reducing emotional distress and health inequalities, and improving functional ability and wellbeing, amongst asylum seekers and refugees.
Ellagic acid produces neuroprotection against LPS-induced dopamine neurotoxicity via the inhibition of microglial NLRP3 inflammasome activation
Authors: He Xuemei , Yang Qiuyu , He Jingyi , Sheng Shuo , Li Jingjie , Li Daidi , Wang Guoqing , Zhang Feng
Published: February 2020

Background: Neuroinflammation plays a crucial role in the pathological process of Parkinson's disease (PD). Nod-like receptor protein 3 (NLRP3) inflammasome was highly located in microglia and involved in the process of neuroinflammation. Activation of NLRP3 inflammasome has been confirmed to contribute to the progression of PD. Thus, inhibition of NLRP3 inflammasomes activation could be an important breakthrough point in PD drug therapy. Ellagic acid (EA) is a natural polyphenol that has been widely found in soft fruits, nuts and other plant tissues with various anti-inflammatory and anti-oxidant properties. However, the mechanisms underlying EA-mediated anti-inflammatory and neuroprotection have not been fully elucidated.Methods: In this study, lipopolysaccharide (LPS)-induced rat dopamine (DA) neuronal damage model was performed to determine the effects of EA on the protection of DA neurons. Furthermore, DA neuron MN9D cell line and microglia BV-2 cell line were employed to explore whether EA-mediated neuroprotection was through an NLRP3-dependent mechanism.Results: EA ameliorated LPS-induced DA neuronal loss in rat substantia nigra. Furtherly, inhibition of microglial NLRP3 inflammasome signaling activation was involved in EA-generated neuroprotection, as evidenced by the following observations. First, EA reduced NLRP3 inflammasome signaling activation in microglia and the subsequent pro-inflammatory cytokines excretion. In addition, EA-mediated anti-neuroinflammation and further DA neuroprotection from LPS-induced neurotoxicity was not shown upon microglial NLRP3 siRNA treatment.Conclusions: This study demonstrated EA has a profound effect on protecting DA neurons against LPS-induced neurotoxicity via the suppression of microglial NLRP3 inflammasome signaling activation.
The Potential Role of Very Small Embryonic-Like Stem Cells in the Neuroinflammation Induced by Social Isolation Stress: Introduction of a New Paradigm
Authors: Haj-Mirzaian Arvin , Khosravi Ayda , Haj-Mirzaian Arya , Rahbar Alireza , Ramezanzadeh Kiana , Nikbakhsh Rajan , Pirri Fardad , Talari Bhenam , Shakiba Saeed , Nikbakhsh Rambod , Badripour Abolfazl , Dehpour Ahmad Reza
Published: February 2020

Background: Lack of social contacts could induce psychiatric features and lead to various behavioral and neurochemical abnormalities in rodents. Social isolation stress (SIS) is a valid paradigm of depressive- and anxiety-like behaviors in animals. It has demonstrated that psychiatric disorder could affect the peripheral blood population of very small embryonic-like stem cells (VSELs). The aim of the current study is to evaluate the role of VSELs in behavioral impairments induced by SIS through neuroinflammation in mice. Methods: Behavioral experiments were evaluated by using forced swimming test (FST), open field test (OFT), and splash test in male NMRI mice. In addition, plasma and bone marrow samples, as well as hippocampus, were collected to evaluate the population of VSELs, nitrite level, and inflammatory cytokines by using flow cytometry and ELISA. Results: Behavioral tasks showed that SIS could induce depressive- and anxiety-like behaviors in mice. Data obtained from flow cytometry showed that VSELs significantly increased in socially isolated animals in bone marrow, peripheral blood, and hippocampus. Also, TNF-α, IL-1β, and IL-6 significantly increased in hippocampal and plasma samples in socially isolated animals. Correlation analysis indicated that mice with higher VSELs counts have better results in behavioral tasks, and lower pro-inflammatory cytokines as well as nitrite level in mice. Conclusion: VSELs could be used as a biological marker to enhance diagnostic accuracy as well as predicting the prognosis. Also, increment in the VSELs counts might decrease the neuro-inflammation and subsequently improve the behavioral impairments induced by SIS.
Transcriptome and proteome profiling reveal complementary scavenger and immune features of rat liver sinusoidal endothelial cells and liver macrophages
Authors: Bhandari Sabin , Li Ruomei , Simón-Santamaría Jaione , McCourt Peter , Johansen Steinar Daae , Smedsrød Bård , Martinez-Zubiaurre Inigo , Sørensen Karen Kristine
Published: February 2020

Background: Liver sinusoidal endothelial cells (LSECs) and Kupffer cells (KCs; liver resident macrophages) form the body´s most effective scavenger cell system for removal of harmful blood-borne substances, ranging from modified own proteins to pathogens and xenobiotics. Controversies in the literature regarding the LSEC phenotype pose a challenge when determining distinct functionalities of KCs and LSECs. This may be due to overlapping functions of the two cells, insufficient purification and/or identification of the cells, rapid dedifferentiation of LSECs in vitro, or species differences. We therefore characterized and quantitatively compared expressed gene products of freshly isolated, highly pure LSECs (fenestrated SE-1/FcγRIIb2 + ) and KCs (CD11b/c + ) from Sprague Dawley, Crl:CD(SD), male rats using high throughput mRNA-sequencing and label-free proteomics. Results: We observed a robust correlation between the proteomes and transcriptomes of the two cell types. Integrative analysis of the global molecular profile demonstrated the immunological aspects of LSEC. The constitutive expression of several immune genes and corresponding proteins of LSECs bore resemblance with the expression in macrophages. LSECs and KCs both expressed high levels of scavenger receptors (SR) and C-type lectins. Equivalent expression of SR-A1 (Msr1), mannose receptor (Mrc1), SR-B1 (Scarb1), and SR-B3 (Scarb2) suggested functional similarity between the two cell types, while functional distinction between the cells was evidenced by LSEC-specific expression of the SRs stabilin-1 (Stab1) and stabilin-2 (Stab2), and the C-type lectins LSECtin (Clec4g) and DC-SIGNR (Clec4m). Many immune regulatory factors were differentially expressed between LSECs and KCs, with one cell predominantly expressing a specific cytokine/chemokine and the other cell the cognate receptor, illustrating the complex cytokine milieu of the sinusoids. Both cells expressed genes and proteins involved in antigen processing and presentation, and lymphocyte co-stimulation. Conclusions: Our findings support complementary and partly overlapping scavenging and immune functions of LSECs and KCs. This highlights the importance of including LSECs in studies of liver immunity, and liver clearance and toxicity of large molecule drugs and nano-formulations.
Acetabular defects reconstruction with tantalum constructions.
Authors: Galstyan Artak , Wu Yulin , Fu Peiliang
Published: February 2020

Background Total hip replacement (THR) is a common procedure that is performed increasingly often. Al­though most patients have satisfactory long-term stability, approximately 17% of prosthetic hips fail, thus requiring revision. Frequently, when hip prosthesis revision is undertaken, there is significant ace­tabular bone deficiency present; this clinical setting presents one of the most challenging circu­m­stances in hip surgery. There is a variety of surgical hardware and strategies available to address this problem. Preoperative planning is a critical aspect of any reconstructive hip surgery but is particularly im­por­tant in revision surgery. The surgeon must anticipate instrument, bone graft, and implant requi­re­ments for the surgery, as well as which reconstructive options may be needed, based on what may be found intraoperatively. The purpose of this study was to evaluate early functional results of hip arthroplasty with acetabular defects, pelvic bone loss revised with porous tantalum acetabular components.Methods 56 patients were operated during research period with different kind of acetabular defects. W.G. Paprosky classification was used to classify existing acetabular defect. From 56 patients 26 was primary hip replacement and 30 – revision.Results Different kind of tantalum constructions were used to reconstruct acetabular defects during replacement surgery. During research period three patient had complications: two cases of dislocation after revision replacement (3,6%) and one – after primary replacement (1,8%), one suppuration case (1,8%).Conclusions According research results possible to make conclusion: using tantalum augments during acetabular region reconstruction allow to avoid non-biological fixators – support rings and structural grafts; tantalum augments are successfully applicable during all kinds of acetabular defects reconstruction, in primary and revision replacement; using tantalum augments during acetabular region reconstruction allow to achieve components stable primary fixation.
Effect of ulinastatin on post-operative blood loss and allogeneic transfusion in patients receiving cardiac surgery with cardiopulmonary bypass: a prospective randomized controlled study with 10-year follow-up
Authors: Zhang Peng , Lv Hong , Qi Xia , Xiao Wenjing , Xue Qinghua , Zhang Lei , Li Lihuan , Shi Jia
Published: February 2020

Background: Major bleeding and allogeneic transfusion leads to negative outcomes in patients receiving cardiac surgery with cardiopulmonary bypass (CPB). Ulinastatin, a urine trypsin inhibitor, relieves systemic inflammation and improves coagulation profiles with however sparse evidence of its effects on blood loss and allogeneic transfusion in this specific population.Methods: In this prospective randomized controlled trial, 426 consecutive patients receiving open heart surgery with CPB were randomly assigned into three groups to receive ulinastatin (group U, n=142), tranexamic acid (group T, n=143) or normal saline (group C, n=141). The primary outcome was the total volume of post-operative bleeding and the secondary outcome included the volume and exposure of allogeneic transfusion, the incidence of stroke, post-operative myocardial infarction, renal failure, respiratory failure and all-cause mortality. A ten-year follow-up was carried on to evaluate long-term outcomes.Results: Compared with placebo, ulinastatin significantly reduced the total volume of post-operative blood loss (801.7±460.14ml vs 1016.67±529.08ml, MD -214.98ml, p<0.001) and the volume of allogeneic erythrocyte transfusion (2.57±3.15 unit vs 3.73±4.21 unit, MD-1.16 unit, p=0.002). The bleeding and transfusion outcomes were comparable between the ulinastatin group and the tranexamic acid group. In-hospital outcomes and 10-year follow-up showed no statistical difference in mortality and major morbidity among groups.Conclusion: Ulinastatin reduced post-operative blood loss and allogeneic erythrocyte transfusion in open heart surgery with CPB. The mortality and major morbidity was comparable among the groups shown by the 10-year follow-up.Trial registration: The trial was retrospectively registered on February 2, 2010. Trial registration number: https://www.clinicaltrials.gov. Identifier: NCT01060189.
The value of clinical examination in preterm newborns after neonatal sepsis: a case control study.
Authors: Golin Marina Ortega , Souza Fabíola Isabel Suano , Paiva Laércio da Silva , Sarni Roseli Oselka Sacardo
Published: February 2020

Background Neonatal sepsis is an important risk factor for lesions in the white matter of the brain of preterm newborns (PTNB) and the most effective strategies to minimize its deleterious effects are early detection and intervention. However, no studies were found to analyze the neurological behavior of PTNBs with neonatal sepsis. Thus, the objective of the present study was to investigate the presence of neurological abnormalities in PTNBs, after neonatal sepsis, by neonatal clinical evaluation. Methods This is a prospective cross-sectional study with 100 PTNBs selected at random, 50 of the study group (sepsis) and 50 of the control group (non-sepsis) of the university municipal hospital. PTNBs were evaluated at adjusted gestational age (37 to 42 weeks). The neurological evaluation protocol adopted was the Hammersmith Neonatal Neurological Examination (HNNE), which consists of 34 items grouped into six categories. Statistical analysis: Statistical analysis was performed using the Chi-square, Mann-Whitney and Binary Logistic Regression tests using the assumption of each statistical test. The statistical program used was Stata version 11.0. Results The PTNBs of the sepsis group had total HNNE scores lower than expected for normality in 86% of the cases, and the non-sepsis group in 26% (p<0.001). Higher prevalence levels of altered scores in tone category (p<0.001), tone patterns (p=0.026), reflexes (p=0.002), movements (p<0.001), abnormal signs (p<0.001) and behavior (p<0.001), were also found in the sepsis group, as well as in 26 of the 34 evaluation items. Conclusion The preterm neonatal sepsis showed significant frequency of neurological alterations. Thus, it is concluded that neurological dysfunctions in preterm newborns after neonatal sepsis can be identified by clinical neonatal neurological evaluation.
Bone Mineral Density and Bone Microarchitecture in a Cohort of Patients with Erdheim-Chester Disease
Authors: He Tianhua , Cui Lijia , Niu Na , Wang Fengdan , Miao Huilei , Zhao Hao , Gao Xuemin , Liu Chang , Yu Fan , Jiang Yan , Wang Ou , Li Mei , Xing Xiaoping , Zhou Daobin , Li Jian , Cao Xin-Xin , Xia Weibo
Published: February 2020

Background: Erdheim-Chester Disease (ECD) is a rare type of non-Langerhans histiocytosis. Skeletal structures are affected in over 95% ECD patients. Due to the lack of proper imaging assessment tools, the alteration of bone microarchitecture in ECD has not been well studied. High-resolution peripheral quantitative computed tomography (HR-pQCT) is a newly developed assessment of bone mineral density and bone microarchitecture.Methods: We performed a cross-sectional study with thirteen patients diagnosed with ECD in Peking Union Medical College Hospital between October 2018 and June 2019. The diagnosis of ECD was based on typical pathological findings in the context of appropriate clinical and radiological manifestations. Bone geometry, volumetric bone mineral density and bone microarchitecture of those ECD patients were assessed using HR-pQCT at the non-dominant distal radius and distal tibia. Those HR-pQCT parameters were then compared to an ongoing population-based database of HR-pQCT for Mainland Chinese.Results: As a result, remarkable heterogeneity of osteosclerosis in HR-pQCT images was found in ECD patients, ranging from apparently normal structure, scattered thickening of trabecula, to homogenous consolidation. On quantitative measurements, total volumetric BMD (383.50mg/cm3, 1.352 times of normal mean, p=0.023) of the tibia differed significantly in ECD patients, attributing to the increased trabecular volumetric BMD (291 mg/cm3, 2.058 times of normal mean, p=0.003). The increased trabecular volumetric BMD of tibia was associated with remarkably increased number of trabecula (1.7/mm, 1.455 times of normal mean, p=0.002) and increased thickness of trabecula (0.37mm, 1.466 times of normal mean, p=0.003). These differences could be due to the existence of dense bone interposed in the trabecula.Conclusion: This study is the first to assess the volumetric bone mineral density and bone microstructure with HR-pQCT in a cohort of ECD patients, and indicated that the application of HR-pQCT may help to reveal the nature of bone lesions in the disease.
Optic neuritis at the nexus of peripheral autoimmunity and central nervous system demyelination: a nationwide cohort study
Authors: Lin Wei-Sheng , Chen Ho-Min , Yang Chih-Chao , Chen Ta-Ching , Lin Jou-Wei , Lee Wang-Tso
Published: February 2020

Background

Long-term course of optic neuritis is heterogeneous and varies across populations. We aim to investigate immune-related determinants that predict conversion of optic neuritis (ON) to multiple sclerosis (MS) or neuromyelitis optica (NMO) in a nationwide cohort.

Methods

We conducted the population-based cohort study using data from Taiwan’s National Health Insurance Research Database. Incident ON cases during 2003~2014 were followed until the end of 2015. Pediatric and adult sub-cohorts were examined separately. The associations between immune-related comorbidities or treatment and outcomes were analyzed using Cox proportional hazards models.

Results

A total of 11923 adult and 1365 pediatric ON patients were enrolled. The rates of conversion to MS were 2.7% for adult and 3.1% for pediatric ON with median follow-up duration of 6.3 and 7.3 years respectively, while 1.2% of pediatric and adult ON evolved to NMO. Comorbid systemic lupus erythematosus was associated with increased risks of subsequent development of MS in adult (adjusted hazard ratio [aHR], 2.80; 95% CI, 1.04-7.49) and pediatric ON patients (aHR, 21.65; 95% CI, 1.29-363.4). Adult ON patients were at increased risks of NMO if comorbid with myasthenia gravis (aHR, 9.13; 95% CI, 1.20-69.45) or Sjogren’s syndrome (aHR, 4.71; 95% CI, 1.74-12.76).

Conclusion

ON could be the sentinel event linking several peripheral autoimmune comorbidities to distinct forms of central nervous system demyelination. The clinical context in which ON occurs should be taken into account in the care and counseling of these patients.
Clinical outcomes and prognostic factors in bloodstream infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae among patients with malignancy: a meta-analysis
Authors: Jiang Ai-Min , Liu Na , Zhao Rui , Zheng Hao-Ran , Chen Xue , Fan Chao-Xin , Zhang Rui , Zheng Xiao-Qiang , Fu Xiao , Yao Yu , Tian Tao
Published: February 2020

Background The colonization of Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) in bloodstream infections (BSIs) has been increased dramatically worldwide, and it was associated with worse clinical outcomes in patients with malignancy. We performed the meta-analysis to investigate the prognosis and risk factors in BSIs caused by ESBL-PE in oncological patients. Methods PubMed and EMBASE were searched for related studies. All-cause mortality was considered as the primary outcome. Subgroup analyses, meta-regression analyses, and sensitivity analysis were used to investigate heterogeneity and reliability in results. Results 6729 patients from 25 studies were eligible. Six studies enrolled oncological patients with BSIs caused by ESBL-PE only, while 19 studies both enrolled ESBL-PE and non-ESBL-PE infections. The results showed that BSIs caused by ESBL-PE in patients with malignancy was associated with higher mortality than non-ESBL-PE infections (RR = 2.21, 95% CI: 1.60–3.06, P < 0.001), with a significant between-study heterogeneity (I2 = 78.3%, P < 0.001). Subgroup analyses showed that children (RR = 2.80, 95% CI: 2.29–3.43, P < 0.001) and hematological malignancy (RR =3.20, 95% CI: 2.54–4.03, P < 0.001) were associated with a higher mortality. Severe sepsis/ septic shock, pneumonia, and ICU admission were the most common predictors of mortality. Conclusions Our study identified that BSIs caused by ESBL-PE in patients with malignancy was associated with worse clinical outcomes compared with non-ESBL-PE infections. Furthermore, children and hematological malignancy were associated with higher mortality. Severe sepsis/ septic shock, pneumonia, and ICU admission were the most common predictors of mortality.
Placenta-Specific Protein 1 Enhances Metastatic Potential and is Associated with the PI3K/AKT/NF-κB Signaling Pathway in Colorectal Cancer
Authors: Ma Jiachi , Li Lei , Du Jun , Pan Chengwu , Zhang Chensong , Chen Yuzhong
Published: February 2020

Background To better explore the underlying mechanism of liver metastatic formation by placenta-specific protein 1 (PLAC1) in human colorectal cancer, we investigated the proliferation, invasion and angiogenic capabilities of human colorectal cancer cell lines with different liver metastatic potentials as well as the mechanism of action of PLAC1 in the metastatic process. Methods The expression of PLAC1 was detected by reverse transcriptase PCR, western blot and real-time PCR. The effect of PLAC1 on metastatic potential was determined by proliferation, invasion, and angiogenesis assays, including an in vitro coculture system consisting of cancer cells and vascular endothelial cells that were used to detect the relationship between cancer cells and angiogenesis. In addition, we also determined PLAC1 downstream targets that preferentially contribute to the metastatic process. Results PLAC1 was expressed in HT-29, WiDr and CaCo-2 colorectal cancer cells but not in Colo320 colorectal cancer cells. PLAC1 could not only significantly enhance the proliferation of CoLo320 and human umbilical vein endothelial cells (HUVECs) but could also promote the invasion of CoLo320 cells. The angiogenesis of HUVECs was enhanced by PLAC1 in a dose-dependent manner. In cocultured systems, angiogenesis was significantly increased by coculture with HT-29 cells. In addition, PLAC1 could promote angiogenesis in coculture with HT-29 cells. Furthermore, PLAC1-enhanced metastatic potential of colorectal cancer cells was dependent on activation of the PI3K/Akt/NF-κB pathway. Conclusions The activation of PI3K/Akt/NF-κB signaling by PLAC1 may be critical for the metastasis of colorectal cancer cells. According to our results, we suggest that modification of PLAC1 function might be a promising new therapeutic approach to inhibit the aggressive spread of colorectal cancer.
Epitome mapping of E6 and E7 proteins from high-risk oncogenic HPV types 16, 18 and 45
Authors: Xu Wan-Xiang , Tang Hai-Ping , Wang Jian , Zhan Jian-Min , Lian Wen-Bo , He Ya-Ping , Xue Feng , Wang Li , Xu Chen , Li Yijie , Zhang Ailian , Zhang Fuchun , Li Jinyao
Published: February 2020

Background It is crucial to reveal entire epitomes of more target homologous proteins and specificity of each mapped B cell epitope (BCE) within them for the development of high-risk (hr-) human papillomavirus (HPV) type-specific diagnostic reagents. Methods Recombinant E6 and -E7 oncoproteins from HPV16/18/45 were immunized mice to prepare Rabbit antisera. Overlapping 16mer/8mer-peptides for two rounds of antigenic peptide and fine BCE motif mapping were expressed as GST188 fusion proteins. Fine BCEs were delineated by Western blot and sequence alignment. Results In this work, we decoded six epitomes of E6 and E7 oncoproteins from three HPV types 16, 18 and 45 that are the most common hr-HPVs in cervical cancer patients worldwide, in which total 35 fine BCEs (8, 6 and 4 for E6; 7, 6 and 4 for E7) were mapped using rabbit antisera to respective recombinant proteins. The specificity of each mapped BCE among 20 defined or possible hr-HPVs was delineated by sequence alignment based on BCE minimal motif. According to similarities of immune responses to E6/E7 existed among rabbit and humans, 7 human-recognizing (HR) BCE motifs in HR-peptides of HPV16/18-E6 and E7 proteins were delimitated by comparing with corresponding rabbit-recognizing BCEs. Also, the unique BCE distribution within three delineated E7 epitomes was confirmed, in which almost mapped BCEs were clustered at the first half of the molecules, suggesting that it may be a common characteristic of hr-HPV E7 proteins. Conclusions The results would form the basis for identifying HR-BCEs and developing serodiagnostic reagents used in HPV-based cervical cancer screening and HPV-positive women managing.
Somatically derived Yolk Sac tumor of the urinary bladder: A case report and differential diagnosis
Authors: Espejo-Herrera Nadia , Mundó Enric Condom
Published: February 2020

Background: Yolk sac tumor is a germ cell neoplasm that arises predominantly in the gonads, but can also derive from somatic neoplasms in extragonadal locations. These cases have been denominated recently as “somatically derived Yolk sac tumors”, and have been documented in several locations, although reports from the urinary tract are scarce. To our knowledge, this is the first report of a Yolk sac tumor derived from urothelial carcinoma. Case presentation: We present a unique case of a 76-year-old man with a recurrent urinary bladder tumor, initially interpreted as a high grade urothelial carcinoma with glandular differentiation. In the recurrent tumor, diverse histological patterns were identified, including glandular, hepatoid and sarcomatoid. This tumor showed positivity for AFP, GLP3 and SALL4, and negativity for CK7 and EMA. Fluorescent in situ hybridization study showed a polysomic pattern of chromosome 12. All these findings led to the final diagnosis of a Yolk sac tumor derived from urothelial carcinoma. Conclusions: Somatically derived Yolk Sac tumors should be considered in the differential diagnosis of a high grade urothelial carcinoma, particularly when glandular and other unusual patterns are observed. Key words: Yolk sac tumor, somatically derived, urothelial carcinoma, urinary bladder, case report.
A longitudinal cohort of stress cardiomyopathy screening with speckle-tracking echocardiography after moderate to severe traumatic brain injury
Authors: Cinotti Raphael , Tourneau Thierry Le , Bach-Ngohou Kalyane , Manoir Maxime Le Courtois du , Masson Damien , Bouras Marwan , Mahé Pierre-Joachim , Roquilly Antoine , Rozec Bertrand , Asehnoune Karim
Published: February 2020

Background. Stress cardiomyopathy is common after subarachnoid haemorrhage but has been scarcely described after traumatic brain injury. Methods. Mono-centric longitudinal study in moderate to severe traumatic brain injury (Glasgow coma score ≤ 12). Evaluation of global longitudinal strain and 2-dimension trans-thoracic echography at day-1, day-3 and day-7. The primary outcome was the incidence of stress cardiomyopathy assessed with global longitudinal strain. Secondary outcomes were the relationship between global longitudinal strain and mortality, plasma levels of metanephrine and normetanephrine in patients with traumatic brain injury and subarachnoid haemorrhage to explore the mechanisms of stress cardiomyopathy. Results. We included 100 patients from March 2014 to August 2017. Twenty (20%) patients died in the intensive care unit. At day 1, global longitudinal strain (-20.3(±3.6)%) and left ventricular ejection fraction (65.9 (±10.8)%) were preserved. Nine (9%) patients displayed impaired global longitudinal strain (-13.3[-14.5/-11.6]%) at baseline, with significant improvement at day-3 and day-7 (p<0.0001), compatible with stress cardiomyopathy. There was a slight global longitudinal strain improvement at day-3 in the overall population ((-22.2 (± 3.6)%, p=0.004), but was similar to baseline at day-7 (-20.7(± 3.3)%). Global longitudinal strain was not related to mortality (p=1). In 15 subarachnoid haemorrhage and 15 traumatic brain injury patients matched with age and severity, there were no differences in baseline normetanephrine or metanephrine plasma levels. Conclusions. Stress cardiomyopathy could occur after traumatic brain injury, but global longitudinal strain remains preserved. The raised baseline metanephrine and normetanephrine is comparable in traumatic brain injury and subarachnoid haemorrhage patients. Thus, sympathetic hyperactivation is probably not the only mechanism involved in stress cardiomyopathy.
A novel and simple risk model predicts the prognosis for patients with paraquat poisoning
Authors: Gao Yanxia , Liu Liwen , Li Tiegang , Yuan Ding , Wang Yibo , Xu Zhigao , Cui Guangying , Hou Linlin , Zhang Yan , Duan Guoyu , Sun Changhua , Zhou Heqi , Che Lu , Li Sujuan , Li Yi , Ren Zhigang
Published: February 2020

Background: Acute paraquat (PQ) poisoning is characterized by multi-organ failure and lacking effective therapies. Therefore, identifying risk factors and developing model that could predict early prognosis for patients with PQ poisoning is of great importance. Methods: This was a retrospective cohort study employed with patients suffered from acute PQ poisoning (n=1199). Patients (n=913) with PQ poisoning from 2011 to 2018 were randomly divided into 2 mutually exclusive groups: training (609 patients) and test (304 patients). Another 2 external cohorts containing 207 cases from Zhengzhou 2019 were used as validation from different time and 79 from Shenyang as validation from different site. Risk factors were identified by a logistic model with Markov Chain Monte Carlo (MCMC) simulation and further evaluated by a latent class analysis. The prediction score of this model was developed based on the training sample and was further evaluated using the testing and validation samples. Results: Eight risk factors including age, ingestion volume, CK-MB, platelet (PLT), white blood cell (WBC), neutrophil counts (N), gamma-glutamyl transferase (GGT) and serum creatinine (Cr) were identified as in dependent risk indicators of in-hospital death events. The risk model had a C statistic of 0.895 (95% CI 0.855-0.928), 0.891 (95% CI 0.848-0.932) and 0.829 (95% CI 0.455-1.000) and a predictive range of 4.6%-98.2%, 2.3%-94.9% and 0%-12.5% for the test, validation_time and validation_site group, respectively. In the training group, the risk model classified 18.4%, 59.9% and 21.7% of patients into the high, average and low-risk groups, with corresponding probabilities of 0.985, 0.365, and 0.03 for in-hospital death events. Conclusion: Eight risk factors were identified in this study. And we developed and evaluated a simple risk model to predict the prognosis of patients with acute PQ poisoning. This simple and reliable risk score system could be helpful in recognizing high-risk patients and reducing in-hospital death rate due to PQ poisoning.
Molecular Characterization of Virulence Factors and Microbial Resistance of Different Bacterial Isolates in some Dairy Products
Authors: Alkhafaje Waleed K. , Ali Safaa Mohamed , Olama Zakia A.
Published: February 2020

Background: Bacterial contamination of milk and dairy products is a common problem. Foodborne microbial diseases reason for 20 million cases annually in the world. In the last two years, foodborne diseases caused by the intake of dairy products have been mostly disturbed with Salmonella entertica, Listeria monocytogenes Escherichia coli 0157:H7 and Campylobacter jejune. Aim of the study is to isolate MDR bacteria in dairy product and study of molecular characterization of that isolates.Results: A total 30 out of 131 bacterial isolates were MDR and distributed as 50 % from white cheese, 36.7% from industrial white cheese, 13.3 from old cheese and 6.6 % roomy cheese. The incidence of MDR bacterial isolates revealed the abundance of Staphylococcus sp. with 43.3% among all the tested bacterial isolates, while the other tested isolates showed Bacillus sp 16.7%, Salmonella 13.3%, E.coli 10 %, Enterococcus 6.7 % Psedoumonas 3.3 %, Shegella 3.3 % and Proteous 3.3 %. Molecular studies of genes presence or absence for class A (TEM, CTX and BSHV), class B (VIM, IMP, KPC and NDM), class C (FOX) and class D (OXA-10, OXA-24 and OXA-58) were tested. NDM, TEM, CITM and (OXA -10) genes were the most abundant the selected bacterial isolates.Conclusions: The results of this study indicate that cheese made from unpasteurized milk can pose a significant risk to consumers. Product manufacturing processes should be subject to health control-to-control pathogens. Reducing the surface area exposed to air reduces harmful microbial growth in dairy products.
The evaluation of juvenile ocular hypertension by optical coherence tomography angiography
Authors: Chen Xiaoxiao , Wang Xiaolei , Hu Xinxin , Sun Xinghuai
Published: February 2020

Background: We wish to evaluate the vessel density using optical coherence tomography angiography (OCTA) in juvenile ocular hypertension (JOHT). In addition, we investigate the potential risk parameters of intraocular pressure (IOP) and vertical cup/disc ratio (CDR) with OCTA for observing the development of JOHT. Methods: We examined 86 eyes in 45 healthy subjects and 65 eyes in 34 patients with JOHT using OCTA at the glaucoma clinic of the Eye, Nose, and Throat Hospital of Fudan University. The vessel density (VD) of radial peripapillary capillaries (RPC) and perifoveal superficial vascular plexus (SVP) was compared between healthy and JOHT group. Other basic study factors such as: age, sex, blood pressure, best-corrected visual acuity, central corneal thickness, IOP, CDR, the thickness of retinal nerve fiber layer, ganglion cell complex, visual field mean deviation, and pattern standard deviation were also recorded. Results: Temporal RPC-VD was negatively associated with IOP (p=0.043). Additional five sections of nasal, inferior-nasal, inferior-temporal, superior-temporal and superior-nasal of RPC-VD showed positive correlation with CDR. SVP-VD in superior and nasal regions were affected by high IOP (p=0.023 and p=0.049). No other difference was uncovered between healthy and JOHT subjects. Conclusions: Peripapillary temporal perfusion had negative correlation with IOP in JOHT subjects. And regions were positively correlated with large CDR. Perfusion of perifoveal regions were only affected by IOP. We conclude that OCTA could be used as an effective technique to monitor the development of JOHT.
Ferulic acid attenuates microglia-mediated neuroinflammation in retinal degeneration
Authors: Sun Xiaowei , Sun Peng , Liu Limei , Jiang Pengfei , LI YUANBIN
Published: February 2020

Background: To use a rd10 mouse model as a means of exploring the impact of Ferulic acid(FA) on microglia-mediated neuroinflammation as well as associated retinal degeneration.

Methods: Rd10 mice received different concentrations of FA treatment every day from postnatal day (P)4 to P24. At P25, mice visual function were detected by electroretinogram, then retinae were collected for further investigation. Retinal microglia activation state and relevant cytokines were evaluated by qPCR, Western blot and immunofluorescent staining. The retinal structure was assessed by HE Staining.

Results:50mg/Kg FA supplement exhibited optimal protection against retinal degeneration, with treated mice exhibiting more photoreceptor nuclei as well as significant wave amplitude amplification in electroretinograms. FA suppressed microglia activation both in vivo and in vitro, inhibited pro-inflammatory factors Tnfα, IL1β, Ccl2 expression in rd10 retinae. Furthermore, FA suppressed the activation of STAT1 and subsequently IRF8 expression, potentially highlighting a role for these pathways in FA-mediated immunomodulatory activity.

Conclusions: Attenuating neuroinflammation by FA may be beneficial to retard retinal degeneration.
Psychiatric sequelae in women who experience life-threatening complications during pregnancy in a low-and-middle income country (LMIC)
Authors: Khamker Nadira , Roos Johannes Lodewikus
Published: February 2020

Purpose: Researchers compared psychiatric sequelae in women with life threatening complications during pregnancy (LT), and uncomplicated pregnancies (UP) in a low- and middle-income country (LMIC) over a 6-month follow-up period.Method: The study design was a mixed method and quantitative data was collected in a parallel convergent manner at two university hospitals in Gauteng, South Africa. Women from two groups, namely those with uncomplicated pregnancies and those with life threatening complications were followed up over a six-month period postnatally. Results: Eighty-nine women participated in the study of whom 46 experienced a life-threatening pregnancy complication. At six-week follow-up, 65.5% (n=19) of women in the LT-group and 29.2% (n=7) of the UP-group experienced symptoms of depression (p=0.08). In the LT-group, 30.4% (n=14) had anxiety symptoms compared to 7% (n=3) of UP-group (p=0.011). Compared to the UP-group, more women in the LT-group experienced somatic symptoms (28.3%, n=13, p=0.003) and sleep disturbances (28.3%, n=13, p=0.0009). More women in the LT-group reported memory disturbance 15.2% (n=7, p=0.034) compared to women in the UP-group. Psychotic symptoms were not prominent in either group.Conclusions: Women who experienced life-threatening complications at birth experienced significant distress including depression, anxiety, somatic complaints, sleep disturbances and memory deficits compared to women with uncomplicated pregnancies and deliveries. Maternal services for women with complicated deliveries should include a comprehensive package of obstetric, paediatric and psychiatric care that involves a multi-professional team.
Antiresorptive Therapy and the Bone Turnover Markers—Assessed Fracture Risk in Postmenopausal Women
Authors: Smilic Ljiljana , Smilic Tanja , Jovanovic Aleksandar N. , Jovanovic Snezana R. Markovic - , Mirkovic Zlatica , Mirkovic Jana , Jaksic Bojan S. , Bisevac Boban , Filimonovic Jelena
Published: February 2020

Purpose/Introduction: The aim of this study was to determine relationship of the bone markers levels with the fracture risk and treatment monitoring in patients with osteoporosis. Bone markers may point out to on specific aspects of bone quality, detecting changes of bone mineral density, thus providing prognostic perspective and accounting for a substantial proportion of fracture risk reduction.Methods: The case-control study comprised data from 55 patients undergoing evaluation for osteoporosis at Medicus Universalis Polyclinic in Krusevac. Densitometric findings, P1NP, CTX and osteocalcin levels were determined in all patients twice – at the first assessment and 6 months after. While 30 patients took no medical therapy, 25 of them were treated with ibandronate. Results: No convincing difference in densitometric measurements between patients with and without prevalent fractures were noted, while mean osteocalcin and P1NP levels were significantly lower (p<0.05) in osteoporotic patients who suffered fractures. A significant correlation between those bone turnover markers and T-score was established, especially in the second measurement and in patients treated with ibandronate.Conclusion: In postmenopausal women and individuals with low BMD, the presence of increased bone turnover markers suggests an increased risk of fractures. Furthermore, these metabolic markers are useful in the monitoring of patients receiving antiresorptive therapy, wherein fast decline of their levels indicate favorable course. Their determination after 6 months offers the remarkable advantage in assessing the effectiveness of medical treatment comparing to 12–24 months required to document changes by BMD.
Long-term Transmission Patterns and Public Health Policies Leading to Malaria Elimination in Panamá
Authors: Hurtado Lisbeth , Cumbreras Alberto , Rigg Chystrie , Perea Milixa , Santamaría Ana María , Chaves Luis Fernando , Moreno Dianik , Romero Luis , Lasso Jose , Caceres Lorenzo , Saldaña Azael , Calzada Jose Eduardo
Published: February 2020

Background: The present study provides a countrywide perspective of the malaria situation in Panama over a long-term framework, with the purpose of identifying historical malaria resurgence events and their potential causes.Methods: A descriptive-ecological study was conducted by analyzing demographic and epidemiological annual malaria time series data in Panamá (1884 – 2019) using several data sources. Malaria intensity indicators were calculated during the study period. We also analyze the effects of El Niño Southern Oscillation on malaria transmission using a retrospective analysis of malaria cases between 1957 and 2019.Results: Several factors were identified responsible for malaria resurgence in Panama, mostly related with Malaria Control Programme weakening. During the past 20 years (2000 – 2019) malaria has progressively increased its prevalence within indigenous settlements, with a predominance of male cases and a high proportion (15% of total cases) in children less than 5 years old. During this period a significant and increasing proportion of the P. falciparum total cases were imported. Our retrospective analysis (1957 - 2019) evidenced that ENSO has a significant impact on malaria transmission dynamics in Panama.Conclusions: Data analysis confirmed that although authorities have been successful in focalizing malaria transmission in the country, there are still neglected issues to be solved and important intercultural barriers that need to be addressed in order to achieve elimination of the disease by 2022. This information will be useful for targeting strategies by the National Malaria Control Programme.
Coverage of Community Case Management for Malaria through CHWs: A Quantitative Assessment using Primary Household Surveys of High-burden Areas in Chhattisgarh state of India
Authors: Garg Samir , Gurung Preeti , Dewangan Mukesh , Nanda Prabodh
Published: February 2020

Background: Community Case Management of Malaria (CCMM) has been implemented through Community Health Workers (CHWs) in many countries. Existing studies have shown that CHWs can be viable means of implementing CCMM. However, not many studies have examined the coverage under large-scale CCMM programmes.India is a big contributor to global malaria burden. Chhattisgarh is a leading state in India in malaria incidence and mortality. CCMM was implemented on a large scale through the ‘Mitanin’ CHWs in rural Chhattisgarh from 2015. Under CCMM, 37696 CHWs in 84 high-burden administrative blocks of the state were trained and equipped with Rapid Diagnostic Tests (RDT), Artemisinin Combination Therapy (ACT) and Chloroquine.Methods: This descriptive quantitative study assesses coverage of CCMM in detection and treatment of Malaria over three rounds of household surveys - 2015, 2016 and 2018. Household-interviews covered more than 15000 individuals in each round, using multi-stage random sampling across the 84 blocks. The main objectives were to find out the coverage in identification and treatment of malaria and the share of CHWs in them. A 15-days recall was used to find out cases of fever and healthcare sought by them.Results: In 2018, 62% of febrile cases in rural population contacted CHWs. RDT, ACT and Chloroquine were available with 96%, 80% and 95% of CHWs respectively. From 2015 to 2018, the share of CHWs increased from 34% to 70% in testing of febrile cases and 28% to 69% in treatment of malaria cases. CHWs performed better than other providers in three-day treatment-completion and administered medication under direct observation to 72% of cases they treated.Conclusion: This study adds to one of the most crucial but relatively less reported area of CCMM programmes, i.e. the extent of coverage of the total febrile population by CHWs which subsequently determines the actual coverage of case-management in malaria. Mitanin-CHWs achieved high coverage and treatment-completion rates that were rarely reported in context of large-scale CCMM elsewhere. Close to community, well-trained CHWs with sufficient supplies of rapid tests and anti-malarial drugs can play a key role in achieving the desired coverage in malaria-management.
An unlabeled probe based real time PCR and modified semi nested PCR as molecular tools for analysis of chloroquine resistant in Plasmodium vivax isolates from Afghanistan
Authors: Mosawi Sayed Hussain , Dalimi Abdolhossein , Safi Najibullah , Fotouhi-Ardakani Reza , Ghaffarifar Fatemeh , Sadraei Javid
Published: February 2020

Background: Chloroquine (CQ) resistance Plasmodium vivax isolates have been reported from many endemic regions in the world. P. vivax has been reported to be about 95% of the whole malaria in Afghanistan and CQ is prescribing in the first-line treatment of vivax malaria. The pvmdr-1 and pvcrt-o (K10 insertion) genes are the possible markers of CQ-resistance P. vivax isolates. There have been no studies done on the prevalence of molecular markers of CQ-resistance P. vivax in Afghanistan. In the present work, we aimed to evaluate the prevalence of mutations in the pvmdr-1 and K10 insertion in the pvcrt-o genes of P. vivax.Methods: P. vivax isolates were collected from Laghman, Baghlan and Khost provinces. For investigation of polymorphisms of desired regions in pvmdr-1 and pvcrt-o genes, sequencing was applied on the PCR products. We developed a new asymmetric qPCR and melting analysis assay based on unlabeled probe for scanning of K10 insertion in pvcrt-o gene.Results: The analysis of sequencing data of the pvmdr-1 gene showed wild type Y976 and K997 and mutant M958 and L1076 in 33 isolates from three provinces and submitted in GenBank (accession number MK419882-MK419914)Of 36 samples that evaluated for K10 insertion in pvcrt-o, 2/18(11%), 0/10(0%) and 0/8(0%) isolates from Laghman, Baghlan and Khost province possessed K10 insertion, respectively, that confirmed by either sequencing and unlabeled probes and submitted in GenBank (accession number MK292011-MK292046).Conclusion: The existence of 2 samples with K10 insertion and 33 samples with pvmdr1 polymorphism indicating on CQ resistance P. vivax populations in Afghanistan. This can lead to spreading of resistant strains in the society. Furthermore, unlabeled probes are simple and inexpensive alternative tools for screening of P. vivax mutations.