bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of macrophage related gene in colorectal cancer patients and their functional roles
Authors: Chen Yingxiang , Zhang Cui , Zou Xiang , Yu Miao , Yang Bo , Ji Chen-Feng , Gao Shi-Yong , Li Jun , Liu Bin
Published: June 2021

Background

Recent scientific research has enabled the identification of macrophages related-genes (MaRG), which play a key role in the control of the immune microenvironment in many human cancers. However, the functional role of MaRGs in human tumors is ill-defined. Herein, we aimed at bioinformatically exploring the molecular signatures of MaRGs in colorectal cancer.

Methods

A list of MaRGs was generated and their differential expression was analyzed across multiple datasets downloaded from the publicly available functional genomics database Gene Expression Omnibus. The weighted gene co-expression network analysis (WGCNA) was also applied to identify the partner genes of these MaRGs in colorectal cancer.

Results

After integration of the results from analyses of different datasets, we found that 29 differentially expressed MaRGs (DE-MaRGs) could be considered as CRC-related genes as obtained from the WGCNA analysis. These genes were functionally involved in positive regulation of DNA biosynthetic process and glutathione metabolism. Protein–protein interaction network analysis indicated that PDIA6, PSMA1, PRC1, RRM2, HSP90AB1, CDK4, MCM7, RFC4, and CCT5 were the hub MaRGs. The LASSO approach was used for validating the 29 MaRGs in TCGA-COAD and TCGA-READ data and the results showed that ten among the 29 genes could be considered as MaRGs significantly involved in CRC. The maftools analysis showed that MaRGs were mutated at varying degrees. The nomogram analysis indicated the correlation of these MaRGs with diverse clinical features of CRC patients.

Conclusions

Conclusively, the present disclosed a signature of MaRGs as potential key regulators involved in CRC pathogenesis and progression. These findings contribute not only to the understanding of the molecular mechanism of CRC pathogenesis but also to the development of adequate immunotherapies for CRC patients.
Enzyme-catalyzed biodegradation of penicillin fermentation residues by β-lactamase OtLac from Ochrobactrum tritici
Authors: Wang Peng , Shen Chen , Cong Qinqin , Xu Kaili , Lu Jialin
Published: June 2021

Background

Biodegradation of antibiotics is a promising method for the large-scale removal of antibiotic residues in the environment. However, the enzyme that is involved in the biodegradation process is the key information to be revealed.

Results

In this study, the beta-lactamase from Ochrobactrumtritici that mediates the biodegradation of penicillin V was identified and characterized. When searching the proteins of Ochrobactrumtritici, the β-lactamase (OtLac) was identified. OtLac consists of 347 amino acids, and predicted isoelectric point is 7.0. It is a class C β-lactamase according to BLAST analysis. The coding gene of OtLac was amplified from the genomic DNA of Ochrobactrumtritici. The OtLac was overexpressed in E. coli BL21 (DE3) and purified with Ni2+ column affinity chromatography. The biodegradation ability of penicillin V by OtLac was identified in an in vitro study and analyzed by HPLC. The optimal temperature for OtLac is 32 ℃ and the optimal pH is 7.0. Steady-state kinetics showed that OtLac was highly active against penicillin V with a Km value of 17.86 μM and a kcat value of 25.28 s−1 respectively.

Conclusions

OtLac demonstrated biodegradation activity towards penicillin V potassium, indicating that OtLac is expected to degrade penicillin V in the future.
Exosomal circRNA as a novel potential therapeutic target for multiple myeloma-related myocardial damage
Authors: Sun Runjie , Liu Wei , Zhao Yangang , Chen Haoyu , Wang Zhenzhen , Zhang Yanyu , Sun Xiaoqi , Cui Xing
Published: June 2021

Introduction

Myocardial damage is a mostly incurable complication of multiple myeloma (MM) that seriously affects the treatment outcome and quality of life of patients. Exosomal circular RNAs (exo-circRNAs) play an important role in tumor occurrence and development and are considered key factors in MM pathogenesis. However, the role and mechanism of action of exo-circRNAs in MM-related myocardial damage are still unclear. This study aimed to investigate correlations between exo-circRNAs and MM and to preliminarily explore the role of exo-circRNAs in MM-related myocardial damage.

Methods

Six MM patients and five healthy controls (HCs) were included in the study. High-throughput sequencing and qRT-PCR verification were used to obtain a profile of abnormally expressed exo-circRNAs. GO, KEGG, miRanda, TargetScan and Metascape were used for bioinformatics analyses. H9C2 cells treated with exosomes from U266 cells were used in cell experiments. CCK-8, PCR, immunofluorescence and western blotting assays were used to detect cell proliferation and expression of autophagy-related indicators. Electron microscopy was used to observe the number of autophagic vesicles.

Results

Bioinformatics analysis showed that circRNAs with upregulated expression had the potential to promote MM-related myocardial damage. In addition, PCR results confirmed that circ-G042080 was abundantly expressed in the serum exosomes of 20 MM patients. Correlation analysis showed that the expression level of circ-G042080 was positively correlated with the clinical level of MM and MM-related myocardial damage and that circ-G042080 might interfere with MM-related myocardial damage through a downstream miRNA/TLR4 axis. Cell experiments demonstrated that the circ-G042080/hsa-miR-4268/TLR4 axis might exist in H9C2 cells incubated with exosomes and cause abnormal autophagy.

Conclusion

Abnormal expression of serum exo-circRNAs was found to be associated with MM-related myocardial damage, suggesting that exo-circRNAs might become a new diagnostic marker of MM-related myocardial damage and a therapeutic target.
Evaluation of the effect of supervised anti-malarial treatment on recurrences of Plasmodium vivax malaria
Authors: Dinelly Kelry Mazurega Oliveira , Vitor-Silva Sheila , Brito-Sousa Jose Diego , Sampaio Vanderson Souza , Silva Milena Gabriela Oliveira , Siqueira André Machado , Peterka Cássio , Rodovalho Sheila , Omena Aretha Gomes , Monteiro Wuelton Marcelo , Lacerda Marcus Vinícius Guimarães , Melo Gisely Cardoso
Published: June 2021

Background

Relapses in vivax malaria have posed great challenges for malaria control, and they also account for a great proportion of reported cases. Knowing the real effectiveness of a 7-day primaquine (PQ) scheme is crucial in order to evaluate not only the cost-effectiveness of implementing new anti-hypnozoite drugs, but also how health education strategies can guarantee better compliance and be reinforced. This study aimed to evaluate the effect of daily treatment with chloroquine and PQ supervised by health workers versus prescription without supervision.

Methods

The outcome was the passive detection of new positive thick blood smears up to 180 days, based on the official data records from the National Malaria Control Programme. The recurrences seen in the real life were, therefore, used as a surrogate for true relapses.

Results

Patients under supervised treatment had a lower risk of recurrence up to day 180 when compared to the unsupervised treatment (17.9% vs. 36.1%; p = 0.027).

Conclusions

The lack of supervision in the non-supervised group (which followed standard of care in the real life) enabled proper comparison, as consent itself would have lead to greater compliance in this group. Future studies should scale such an analysis to different settings in the Brazilian Amazon.
Use of the creating opportunities for parent empowerment programme to decrease mental health problems in Ugandan children surviving severe malaria: a randomized controlled trial
Authors: Bangirana Paul , Birabwa Annet , Nyakato Mary , Nakitende Ann J. , Kroupina Maria , Ssenkusu John M. , Nakasujja Noeline , Musisi Seggane , John Chandy C. , Idro Richard
Published: June 2021

Background

Severe malaria is associated with long-term mental health problems in Ugandan children. This study investigated the effect of a behavioural intervention for caregivers of children admitted with severe malaria, on the children’s mental health outcomes 6 months after discharge.

Methods

This randomized controlled trial was conducted at Naguru Hospital in Kampala, Uganda from January 2018 to July 2019. Caregiver and child dyads were randomly assigned to either a psycho-educational arm providing information about hospital procedures during admission (control group), or to a behavioural arm providing information about the child’s possible emotions and behaviour during and after admission, and providing age appropriate games for the caregiver and child (intervention group). Pre- and post-intervention assessments for caregiver anxiety and depression (Hopkins Symptom Checklist) and child mental health problems (Strength and Difficulties Questionnaire and the Child Behaviour Checklist) were done during admission and 6 months after discharge, respectively. T-tests, analysis of covariance, Chi-Square, and generalized estimating equations were used to compare outcomes between the two treatment arms.

Results

There were 120 caregiver-child dyads recruited at baseline with children aged 1.45 to 4.89 years (mean age 2.85 years, SD = 1.01). The intervention and control groups had similar sociodemographic, clinical and behavioural characteristics at baseline. Caregiver depression at baseline, mother’s education and female child were associated with behavioural problems in the child at baseline (p < 0.05). At 6 months follow-up, there was no difference in the frequency of behavioural problems between the groups (6.8% vs. 10% in intervention vs control groups, respectively, p = 0.72). Caregiver depression and anxiety scores between the treatment arms did not differ at 6 months follow-up.

Conclusion

This behavioural intervention for caregivers and their children admitted with severe malaria had no effect on the child’s mental health outcomes at 6 months. Further studies need to develop interventions for mental health problems after severe malaria in children with longer follow-up time.

Trail registration ClinicalTrials.gov Identifier: NCT03432039
Spatial prediction of malaria prevalence in Papua New Guinea: a comparison of Bayesian decision network and multivariate regression modelling approaches for improved accuracy in prevalence prediction
Authors: Cleary Eimear , Hetzel Manuel W. , Siba Peter M. , Lau Colleen L. , Clements Archie C. A.
Published: June 2021

Background

Considerable progress towards controlling malaria has been made in Papua New Guinea through the national malaria control programme’s free distribution of long-lasting insecticidal nets, improved diagnosis with rapid diagnostic tests and improved access to artemisinin combination therapy. Predictive prevalence maps can help to inform targeted interventions and monitor changes in malaria epidemiology over time as control efforts continue. This study aims to compare the predictive performance of prevalence maps generated using Bayesian decision network (BDN) models and multilevel logistic regression models (a type of generalized linear model, GLM) in terms of malaria spatial risk prediction accuracy.

Methods

Multilevel logistic regression models and BDN models were developed using 2010/2011 malaria prevalence survey data collected from 77 randomly selected villages to determine associations of Plasmodium falciparum and Plasmodium vivax prevalence with precipitation, temperature, elevation, slope (terrain aspect), enhanced vegetation index and distance to the coast. Predictive performance of multilevel logistic regression and BDN models were compared by cross-validation methods.

Results

Prevalence of P. falciparum, based on results obtained from GLMs was significantly associated with precipitation during the 3 driest months of the year, June to August (β = 0.015; 95% CI = 0.01–0.03), whereas P. vivax infection was associated with elevation (β = − 0.26; 95% CI = − 0.38 to − 3.04), precipitation during the 3 driest months of the year (β = 0.01; 95% CI = − 0.01–0.02) and slope (β = 0.12; 95% CI = 0.05–0.19). Compared with GLM model performance, BDNs showed improved accuracy in prediction of the prevalence of P. falciparum (AUC = 0.49 versus 0.75, respectively) and P. vivax (AUC = 0.56 versus 0.74, respectively) on cross-validation.

Conclusions

BDNs provide a more flexible modelling framework than GLMs and may have a better predictive performance when developing malaria prevalence maps due to the multiple interacting factors that drive malaria prevalence in different geographical areas. When developing malaria prevalence maps, BDNs may be particularly useful in predicting prevalence where spatial variation in climate and environmental drivers of malaria transmission exists, as is the case in Papua New Guinea.
Inequitable access to healthcare in Africa: reconceptualising the “accountability for reasonableness framework” to reflect indigenous principles
Authors: Ujewe Samuel J. , van Staden Werdie C.
Published: June 2021

Background

The “Accountability for Reasonableness” (A4R) framework has been widely adopted in working towards equity in health for sub-Saharan Africa (SAA). Its suitability for equitable health policy in Africa hinges, at least in part, on its considerable successes in the United States and it being among the most comprehensive ethical approaches in addressing inequitable access to healthcare. Yet, the conceptual match is yet to be examined between A4R and communal responsibility as a common fundamental ethic in SAA.

Methodology

A4R and its applications toward health equity in sub-Saharan Africa were conceptually examined by considering the WHO’s “3-by-5” and the REACT projects for their accounting for the communal responsibility ethic in pursuit of health equity.

Results

Some of the challenges that these projects encountered may be ascribed to an incongruity between the underpinning ethical principle of A4R and the communitarian ethical principle dominant in sub-Saharan Africa. These are respectively the fair equality of opportunity principle derived from John Rawls’ theory, and the African communal responsibility principle.

Conclusion

A health equity framework informed by the African communal responsibility principle should enhance suitability for SAA contexts, generating impetus from within Africa alongside the affordances of A4R.
Remote sensing of environmental risk factors for malaria in different geographic contexts
Authors: McMahon Andrea , Mihretie Abere , Ahmed Adem Agmas , Lake Mastewal , Awoke Worku , Wimberly Michael Charles
Published: June 2021

Background

Despite global intervention efforts, malaria remains a major public health concern in many parts of the world. Understanding geographic variation in malaria patterns and their environmental determinants can support targeting of malaria control and development of elimination strategies.

Methods

We used remotely sensed environmental data to analyze the influences of environmental risk factors on malaria cases caused by Plasmodium falciparum and Plasmodium vivax from 2014 to 2017 in two geographic settings in Ethiopia. Geospatial datasets were derived from multiple sources and characterized climate, vegetation, land use, topography, and surface water. All data were summarized annually at the sub-district (kebele) level for each of the two study areas. We analyzed the associations between environmental data and malaria cases with Boosted Regression Tree (BRT) models.

Results

We found considerable spatial variation in malaria occurrence. Spectral indices related to land cover greenness (NDVI) and moisture (NDWI) showed negative associations with malaria, as the highest malaria rates were found in landscapes with low vegetation cover and moisture during the months that follow the rainy season. Climatic factors, including precipitation and land surface temperature, had positive associations with malaria. Settlement structure also played an important role, with different effects in the two study areas. Variables related to surface water, such as irrigated agriculture, wetlands, seasonally flooded waterbodies, and height above nearest drainage did not have strong influences on malaria.

Conclusion

We found different relationships between malaria and environmental conditions in two geographically distinctive areas. These results emphasize that studies of malaria-environmental relationships and predictive models of malaria occurrence should be context specific to account for such differences.
Calycosin-loaded nanoliposomes as potential nanoplatforms for treatment of diabetic nephropathy through regulation of mitochondrial respiratory function
Authors: Huang Chunrong , Xue Lian-Fang , Hu Bo , Liu Huan-Huan , Huang Si-Bo , Khan Suliman , Meng Yu
Published: June 2021

Backgrounds

One of the most common complications in diabetic nephropathy is generation of high levels of ROS which can be regulated by herbal antioxidants. However, polyphenols like calycosin, the bioactive compound of Radix astragali suffer from low solubility and poor bioavailability.

Methods

Therefore, in the present study, calycosin-loaded nanoliposomes were fabricated and characterized by TEM, DLS and FTIR techniques. Afterwards, the drug loading (DL) and entrapment efficiency (EE), drug release, solubility, stability, and pharmacodynamic assays were performed. Finally, the antinephropathic effects of calycosin-loaded-nanoliposomes on mitochondria of kidney cells were explored by MTT, ROS, MDA, mitochondrial respiratory function assays.

Results

The result showed that the size, hydrodynamic radius, zeta potential, EE, and DL were, 80 nm, 133.99 ± 21.44 nm, − 20.53 ± 3.57, 88.37 ± 2.28%, and 7.48 ± 1.19%, respectively. The outcomes of in vitro release assay showed that calycosin-loaded nanoliposomes were significantly slow-release in dialysis media with pH 1.2, pH 6.9 and pH 7.4, at about 30 min, the dissolution of calycosin from nanoliposome became almost complete, and after 2 months, the calycosin-loaded nanoliposomes were still stable. Pharmacokinetic assay revealed that the AUC0−t of calycosin in calycosin-loaded nanoliposome group was 927.39 ± 124.91 μg/L*h, which was 2.26 times than that of the free calycosin group (**P < 0.01). Additionally, the MRT0−t and t1/2 of calycosin in the calycosin-loaded nanoliposome group were prolonged by 1.54 times and 1.33 times than that of free calycosin group, respectively (*P < 0.05). Finally, it was shown that calycosin-loaded nanoliposomes regulated the viability, ROS production, lipid peroxidation and function of mitochondria in kidney cells of diabetic rats as a model of diabetic nephropathy.

Conclusion

In conclusion it may be suggested that new therapies based on nano-formulated calycosin can restore mitochondrial function which can improve diabetic nephropathy.

Graphic abstract
Biomimetic nanotherapy: core–shell structured nanocomplexes based on the neutrophil membrane for targeted therapy of lymphoma
Authors: Zhao Qiangqiang , Jiang Duanfeng , Sun Xiaoying , Mo Qiuyu , Chen Shaobin , Chen Wansong , Gui Rong , Ma Xianjun
Published: June 2021

Background

Non-Hodgkin’s lymphoma (NHL) is a malignant disease of lymphoid tissue. At present, chemotherapy is still the main method for the treatment of NHL. R-CHOP can significantly improve the survival rate of patients. Unfortunately, DOX is the main cytotoxic drug in R-CHOP and it can lead to adverse reactions. Therefore, it is particularly important to uncover new treatment options for NHL.

Results

In this study, a novel anti-tumor nanoparticle complex Nm@MSNs-DOX/SM was designed and constructed in this study. Mesoporous silica nanoparticles (MSNs) loaded with Doxorubicin (DOX) and anti-inflammatory drugs Shanzhiside methylester (SM) were used as the core of nanoparticles. Neutrophil membrane (Nm) can be coated with multiple nanonuclei as a shell. DOX combined with SM can enhance the anti-tumor effect, and induce apoptosis of lymphoma cells and inhibit the expression of inflammatory factors related to tumorigenesis depending on the regulation of Bcl-2 family-mediated mitochondrial pathways, such as TNF-α and IL-1β. Consequently, the tumor microenvironment (TME) was reshaped, and the anti-tumor effect of DOX was amplified. Besides, Nm has good biocompatibility and can enhance the EPR effect of Nm@MSNs-DOX/SM and increase the effect of active targeting tumors.

Conclusions

This suggests that the Nm-modified drug delivery system Nm@MSNs-DOX/SM is a promising targeted chemotherapy and anti-inflammatory therapy nanocomplex, and may be employed as a specific and efficient anti-Lymphoma therapy.
Biomimetic black phosphorus quantum dots-based photothermal therapy combined with anti-PD-L1 treatment inhibits recurrence and metastasis in triple-negative breast cancer
Authors: Zhao Peiqi , Xu Yuanlin , Ji Wei , Zhou Shiyong , Li Lanfang , Qiu Lihua , Qian Zhengzi , Wang Xianhuo , Zhang Huilai
Published: June 2021

Background

Triple-negative breast cancer (TNBC) is a highly aggressive malignant disease with a high rate of recurrence and metastasis, few effective treatment options and poor prognosis. Here, we designed and constructed a combined photothermal immunotherapy strategy based on cancer cell membrane-coated biomimetic black phosphorus quantum dots (BBPQDs) for tumor-targeted photothermal therapy and anti-PD-L1 mediated immunotherapy.

Results

BBPQDs have good photothermal conversion efficiency and can efficiently target tumor cells through homologous targeting and tumor homing. Under near infrared irradiation, we found that BBPQDs kill tumors directly through photothermal effects and induce dendritic cells maturation. In vivo studies have confirmed that the combined photothermal immunotherapy strategy displays a stronger antitumor activity than anti-PD-L1 monotherapy. In addition, BBPQDs-mediated photothermal therapy in combination with anti-PD-L1 treatment inhibit tumor recurrence and metastasis by reprograming the immunosuppressive tumor microenvironment into an immune-active microenvironment, and promoting the local and systemic antitumor immune response. We further found that the combined photothermal immunotherapy strategy can produce an immune memory effect against tumor rechallenge.

Conclusions

This study provides a novel therapeutic strategy for inhibiting the recurrence and metastasis of TNBC, with broad application prospects.
Pediatric patients’ reasons for visiting dentists in all WHO regions
Authors: Bekes Katrin , John Mike T. , Rener-Sitar Ksenija , Al-Harthy Mohammad H. , Michelotti Ambra , Reissmann Daniel R. , Nikolovska Julijana , Sanivarapu Sahityaveera , Lawal Folake B. , List Thomas , Peršić Kiršić Sanja , Strajnić Ljiljana , Casassus Rodrigo , Baba Kazuyoshi , Schimmel Martin , Amuasi Ama , Jayasinghe Ruwan D. , Strujić-Porović Sanela , Peck Christopher C. , Xie Han , Haugaard Bendixen Karina , Simancas-Pallares Miguel Angel , Perez-Franco Eka , Naghibi Sistani Mohammad Mehdi , Valerio Patricia , Letunova Natalia , Nurelhuda Nazik , Bartlett David W. , Oluwafemi Ikeoluwa A. , Dghoughi Saloua , Ferreira Joao N. A. R. , Chantaracherd Pathamas , Sekulić Stella
Published: June 2021

Background

Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct.

Methods

Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients’ oral health problems and prevention needs were computed.

Findings

Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories.

Conclusions

The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.
Nothing so practical as theory: a rapid review of the use of behaviour change theory in family planning interventions involving men and boys
Authors: Robinson Martin , Aventin Áine , Hanratty Jennifer , Ruane-McAteer Eimear , Tomlinson Mark , Clarke Mike , Okonofua Friday , Lohan Maria
Published: June 2021

Background

There is growing recognition of the need for interventions that effectively involve men and boys to promote family planning behaviours. Evidence suggests that the most effective behavioural interventions in this field are founded on theoretical principles of behaviour change and gender equality. However, there are few evidence syntheses on how theoretical approaches are applied in this context that might guide best practice in intervention development. This review addresses this gap by examining the application and reporting of theories of behaviour change used by family planning interventions involving men and boys.

Methods

We adopted a systematic rapid review approach, scoping findings of a previously reported evidence and gap map of intervention reviews (covering 2007–2018) and supplementing this with searches of academic databases and grey literature for reviews and additional studies published between 2007 and 2020. Studies were eligible for inclusion if their title, abstract or keywords referred to a psychosocial or behavioural intervention targeting family planning behaviours, involved males in delivery, and detailed their use of an intervention theory of change.

Results

From 941 non-duplicate records identified, 63 were eligible for inclusion. Most records referenced interventions taking place in low- and middle-income countries (65%). There was a range of intervention theories of change reported, typically targeting individual-level behaviours and sometimes comprising several behaviour change theories and strategies. The most commonly identified theories were Social Cognitive Theory, Social Learning Theory, the Theory of Planned Behaviour, and the Information-Motivation-Behaviour Skills (IMB) Model. A minority of records explicitly detailed gender-informed elements within their theory of change.

Conclusion

Our findings highlight the range of prevailing theories of change used for family planning interventions involving men and boys, and the considerable variability in their reporting. Programmers and policy makers would be best served by unified reporting and testing of intervention theories of change. There remains a need for consistent reporting of these to better understand how complex interventions that seek to involve men and boys in family planning may lead to behaviour change.
Perceived quality of essential newborn care implementation among health facility deliveries in North Gondar Zone, Northwest Ethiopia: a cross-sectional study
Authors: Delele Tadesse Guadu , Biks Gashaw Andargie , Abebe Solomon Mekonnen , Kebede Zemene Tigabu
Published: June 2021

Background

Quality of essential newborn care is defined as the extent of health care services to improve the health of newborns. However, studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia.

Methods

A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities from November 2018 to March 2019. Essential newborn care implementation perceived quality was assessed in two domains (delivery and process) from clients’ perspectives. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. The research data were collected by trained midwives and nurses. A binary logistic regression model was used to identify associated factors with newborn care implementation perceived quality. Odds ratio with 95% CI was computed to assess the strength and significant level of the association at p-value < 0.05.

Results

About 338 mothers completed the interview with a response rate of 97.1%. The mean age of the study participants was 26.4 (SD = 5.7) with a range of 12 and 45 years. Most mothers, 84.3%, have attended antenatal care. The overall implementation perceived quality of essential newborn care was found to be 66.3%. The implementation perceived quality of cord care, breast-feeding and thermal care was 75.4, 72.2 and 66.3% respectively. Newborn immunization and vitamin K administration had the lowest implementation perceived quality i.e. 22.4 and 24.3% respectively. Friendly care during delivery (AOR = 5.1, 95% CI: 2.4, 11.0), partograph use (AOR = 3.0, 95% CI: 1.1, 8.6), child immunization service readiness (AOR = 2.9, 95% CI: 1.5, 5.7), BEmEONC service readiness (AOR = 2.1, 95% CI: 1.2, 3.9) and facing no neonatal illness at all (AOR = 4.2, 95% CI: 1.6, 10.9) were significantly associated with good essential newborn care implementation qualities.

Conclusions

The perceived quality of essential newborn care implementation was low in the study area. This is associated with poor readiness on BEmEONC and child immunization services, unfriendly care and not using partograph during delivery. Hence, availing the BEmEONC and the child immunization service inputs, continuous training and motivation of healthcare workers for friendly care are vital for improving essential newborn care implementation perceived quality.
Independent and joint associations of body mass index, waist circumference, waist-height ratio and their changes with risks of hyperuricemia in middle-aged and older Chinese individuals: a population-based nationwide cohort study
Authors: Zhou Zonglei , Li Kunpeng , Li Xianzhi , Luan Rongsheng , Zhou Ruzhen
Published: June 2021

Background

Previous reports regarding the predictive power of adiposity indices remain inconsistent, and longitudinal studies on this top are limited. The associations of hyperuricemia risk with changes in obesity status, as well as the joint effects of baseline adiposity indices and body adiposity change on hyperuricemia risk are not fully elucidated. This study aimed to explore the independent and joint associations of baseline adiposity indicators and body adiposity change with hyperuricemia risk among middle-aged and older population in China.

Methods

A total of 2895 participants aged ≥ 45 years from the baseline survey of the China Health and Retirement Longitudinal Study were followed up for 4 years. Anthropometric parameters (weight, height, and waist circumference) and serum uric acid were obtained using standard devices. Adjusted odds ratio and 95% confidential interval were calculated to estimate the associations between predictor variables and hyperuricemia risk using multivariate logistic regression.

Results

Of the 2895 participants, 293 (10.12%) cases of hyperuricemia were identified. Increased baseline body mass index (BMI), waist circumference, and waist-height ratio (WHtR) were significantly associated with higher risks of hyperuricemia. A slightly greater but non-significant area under the curve value was observed for waist circumference (0.622) than for BMI (0.611) and WHtR (0.614) (P = 0.447). Compared to subjects with stable adiposity status, participants with weight loss of ≥ 4 kg or waist circumference loss of ≥ 6 cm had a 56% or 55% lower risk of hyperuricemia, and those with weight gain of > 4 kg had a 1.62-fold higher risk of hyperuricemia. Compared to those without obesity, participants with incident or persistent obesity were more likely to develop hyperuricemia. Additionally, regardless of stable or increased weight/waist circumference during follow-up, individuals with obesity at baseline had a higher risk of incident hyperuricemia.

Conclusion

This study demonstrates that BMI, waist circumference, and WHtR equally predict the development of hyperuricemia, and weight loss and waist circumference reduction are favorable in preventing hyperuricemia.
Evaluation of a new foetal shielding device for pregnant brain tumour patients
Authors: Kang Seonghee , Kim Kyeong-Hyeon , Kang Sang-Won , Shin Dong-Seok , Lee Seungwan , Chung Jin-Beom
Published: June 2021

Background

The present study aimed to propose a new foetal shielding device for pregnant cancer patients to reduce the foetal dose associated with treatment techniques using multiple gantry angles, such as intensity-modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT).

Methods

Three shielding structures were designed to minimise the scattered and leaked radiation from various gantry angles and radiation scattering within the patient. The base-plate part that can be placed on the treatment couch was designed to reduce the scattered and leaked radiation generated at gantry angles located near 180°. A body shielding part that can cover the lower chest and abdomen was designed, and a neck-shielding structure was added to reduce the internal and external radiation scattering from the treatment area. Evaluation plans were generated to assess the foetal dose reduction by the foetal shielding device in terms of the shielding material thickness, distance from the field edge, and shielding component using the flattened 6 MV photon beam (6MV) and flattening filter-free 6 MV photon beam (6MV-FFF). In addition, the effectiveness of the foetal shielding device was evaluated in a pregnant brain tumour patient.

Results

The shielding material consisting of three parts was placed on frames composed of four arch shapes with a vertical curved structure, connection bar at the top position, and base plate. Each shielding part resulted in reductions in the radiation dose according to the treatment technique, as the thickness of the shielding material increased and the foetal dose decreased. In addition, a foetal dose reduction of approximately 50% was confirmed at 50 cm from the field edge by using the designed shielding device in most delivery techniques. In patients, the newly designed shielding structures can effectively eliminate up to about 49% of the foetal dose generated from various gantry angles used in VMAT or IMRT.

Conclusions

We designed a foetal shielding device consisting of three parts to effectively reduce the dose delivered to the foetus, and evaluated the device with various treatment techniques for a pregnant patient with brain tumour. The foetal shielding device shielded the scattered/leaked radiation from the treatment machine, and also effectively reduced internal scattering from the treatment area in the patient.
Conservative versus tailored surgical treatment in patients with first time lateral patella dislocation: a randomized-controlled trial
Authors: Liebensteiner M. , Keiler A. , El Attal R. , Balcarek P. , Dirisamer F. , Giesinger J. , Seitlinger G. , Nelitz M. , Keshmiri A. , Frings J. , Becher Ch. , Kappel P. , Wagner D. , Pagenstert G.
Published: June 2021

Background

Patellar instability has a high incidence and occurs particularly in young and female patients. If the patella dislocates for the first time, treatment is usually conservative. However, this cautious approach carries the risk of recurrence and of secondary pathologies such as osteochondral fractures. Moreover, there is also risk of continuous symptoms apparent, as recurrent patella dislocation is related to patellofemoral osteoarthritis as well. An initial surgical treatment could possibly avoid these consequences of recurrent patella dislocation.

Methods

A prospective, randomized-controlled trial design is applied. Patients with unilateral first-time patella dislocation will be considered for participation. Study participants will be randomized to either conservative treatment or to a tailored patella stabilizing treatment. In the conservative group, patients will use a knee brace and will be prescribed outpatient physical therapy. The surgical treatment will be performed in a tailored manner, addressing the pathologic anatomy that predisposes to patella dislocation.

The Banff Patellofemoral Instability-Instrument 2.0, recurrence rate, apprehension test, joint degeneration, and the Patella Instability Severity Score will serve as outcome parameters. The main analysis will focus on the difference in change of the scores between the two groups within a 2-year follow-up.

Statistical analysis will use linear mixed models. Power analysis was done for the comparison of the two study arms at 2-year follow-up with regard to the BPII Score. A sample size of N = 64 per study arm (128 overall) provides 80% power (alpha = 0.05, two-tailed) to detect a difference of 0.5 standard deviations in a t-test for independent samples.

Discussion

Although several studies have already dealt with this issue, there is still no consensus on the ideal treatment concept for primary patellar dislocation. Moreover, most of these studies show a unified surgical group, which means that all patients were treated with the same surgical procedure. This is regarded as a major limitation as surgical treatment of patella dislocation should depend on the patient’s anatomic pathologies leading to patellar instability. To our knowledge, this is the first study investigating whether patients with primary patella dislocation are better treated conservatively or operatively with tailored surgery to stabilize the patella.

Trial registration

The study will be prospectively registered in the publicly accessible database www.ClinicalTrials.gov.
Ultrasound-guided nusinersen administration for spinal muscular atrophy patients with severe scoliosis: an observational study
Authors: Zhang Jiao , Cui Xulei , Chen Si , Dai Yi , Huang Yuguang , Zhang Shuyang
Published: June 2021

Background

This observational study describes our experience delivering nusinersen through lumbar puncture with real-time ultrasound guidance in spinal muscular atrophy (SMA) patients with severe scoliosis.

Results

Intrathecal nusinersen via real-time ultrasound-guided lumbar puncture was given to three patients who had severe thoracic and lumbar scoliosis: a 34-year-old female with type 3a SMA, a 28-year-old male with type 2a SMA, and a 14-year-old girl with type 3a SMA. Lumbar puncture was performed without sedation under ultrasound guidance using a 22G echogenic needle in the interlaminar aspect of the L4–L5 or L5–S1 interspace and a full dose of nusinersen (12 mg/5 mL) was injected after visualizing free cerebrospinal fluid flow. Patients completed their four loading doses and one maintenance dose of nusinersen. All 15 procedures were successful and well tolerated.

Conclusions

Real-time ultrasound-guided lumbar puncture is an effective and radiation-free technique to administer intrathecal nusinersen in SMA patients with severe scoliosis when done by practitioners with expertise in this procedure.
Association between PEG3 DNA methylation and high-grade cervical intraepithelial neoplasia
Authors: Bosire Claire , Vidal Adriana C. , Smith Jennifer S. , Jima Dereje , Huang Zhiqing , Skaar David , Valea Fidel , Bentley Rex , Gradison Margaret , Yarnall Kimberly S. H. , Ford Anne , Overcash Francine , Murphy Susan K. , Hoyo Cathrine
Published: June 2021

Background

Epigenetic mechanisms are hypothesized to contribute substantially to the progression of cervical intraepithelial neoplasia (CIN) to cervical cancer, although empirical data are limited.

Methods

Women (n = 419) were enrolled at colposcopic evaluation at Duke Medical Center in Durham, North Carolina. Human papillomavirus (HPV) was genotyped by HPV linear array and CIN grade was ascertained by biopsy pathologic review. DNA methylation was measured at differentially methylated regions (DMRs) regulating genomic imprinting of the IGF2/H19, IGF2AS, MESTIT1/MEST, MEG3, PLAGL1/HYMAI, KvDMR and PEG10, PEG3 imprinted domains, using Sequenom-EpiTYPER assays. Logistic regression models were used to evaluate the associations between HPV infection, DMR methylation and CIN risk overall and by race.

Results

Of the 419 participants, 20 had CIN3+, 52 had CIN2, and 347 had ≤ CIN1 (CIN1 and negative histology). The median participant age was 28.6 (IQR:11.6) and 40% were African American. Overall, we found no statistically significant association between altered methylation in selected DMRs and CIN2+ compared to ≤CIN1. Similarly, there was no significant association between DMR methylation and CIN3+ compared to ≤CIN2. Restricting the outcome to CIN2+ cases that were HR-HPV positive and p16 staining positive, we found a significant association with PEG3 DMR methylation (OR: 1.56 95% CI: 1.03–2.36).

Conclusions

While the small number of high-grade CIN cases limit inferences, our findings suggest an association between altered DNA methylation at regulatory regions of PEG3 and high grade CIN in high-risk HPV positive cases.
Surveys about attended births appear to be deceptive in CAR: are the population saying what they think NGO’s want to hear?
Authors: Wol Philippe , Kay Christina , Roberts Leslie
Published: June 2021

Background

Non-governmental organizations (NGOs) and donors often promote certain practices to a community, such as in-facility births and then evaluate the efficacy of those interventions, in part, by surveying those populations.

Methods

A project to assess the accuracy of birth and death monitoring by local community-based monitors was undertaken with a partner health agency in areas (pop. 94,000) where they supported medical facilities. Thirty clusters of 30 households each were selected at random, probability proportional to size. Half of those households were enrolled for a monthly visitation surveillance process. To gain insights into the effects of the agency’s services, an additional 240 households were selected at random and interviewed from 8 nearby “matched villages” not serviced by any NGO as a comparison sample.

Results

The 896 households with 4243 living residents within the NGO service area were interviewed about household births and deaths within the past 8 months. They reported an annualized birth rate of 5.6% (95% CI: 4.5–6.7) with only 3% of those births occurring at home. The reported death rate was 4.2/1000/month (95% CI: 3.3–5.0). In the “matched villages,” the population reported a similar birth and death rate, but they reported 29% of births occurring within the home. The monthly surveillance data found over the year that followed that 32% of births occurred at the home. Clinic and hospital birth attendance data suggested an attended annual birth rate of only 2.8%, consistent with the surveillance data implication that a huge fraction of births occur at home.

Conclusion

It is believed that because the baseline interviews occurred with a stranger, this induced interviewees to say what they thought the interviewers wanted to hear. This calls into question the validity of household surveys when agencies have a known agenda or position, and highlights the need for external validation or triangulation of survey findings.
Reversibility of motor dysfunction in the rat model of NGLY1 deficiency
Authors: Asahina Makoto , Fujinawa Reiko , Hirayama Hiroto , Tozawa Ryuichi , Kajii Yasushi , Suzuki Tadashi
Published: June 2021

N-glycanase 1 (NGLY1) deficiency is a rare inherited disorder characterized by developmental delay, hypolacrima or alacrima, seizure, intellectual disability, motor deficits, and other neurological symptoms. The underlying mechanisms of the NGLY1 phenotype are poorly understood, and no effective therapy is currently available. Similar to human patients, the rat model of NGLY1 deficiency, Ngly1−/−, shows developmental delay, movement disorder, somatosensory impairment, scoliosis, and learning disability. Here we show that single intracerebroventricular administration of AAV9 expressing human NGLY1 cDNA (AAV9-hNGLY1) to Ngly1−/− rats during the weaning period restored NGLY1 expression in the brain and spinal cord, concomitant with increased enzymatic activity of NGLY1 in the brain. hNGLY1 protein expressed by AAV9 was found predominantly in mature neurons, but not in glial cells, of Ngly1−/− rats. Strikingly, intracerebroventricular administration of AAV9-hNGLY1 normalized the motor phenotypes of Ngly1−/− rats assessed by the rota-rod test and gait analysis. The reversibility of motor deficits in Ngly1−/− rats by central nervous system (CNS)-restricted gene delivery suggests that the CNS is the primary therapeutic target organs for NGLY1 deficiency, and that the Ngly1−/− rat model may be useful for evaluating therapeutic treatments in pre-clinical studies.
Penetrating injuries in Germany – epidemiology, management and outcome an analysis based on the TraumaRegister DGU®
Authors: Bieler D , Kollig E , Hackenberg L , Rathjen JH , Lefering R , Franke A ,   the Committee on Emergency Medicine, Intensive Care and Trauma Management(Sektion NIS) of the German Trauma Society (DGU)
Published: June 2021

Background

The management of penetrating wounds is a rare challenge for trauma surgeons in Germany and Central Europe as a result of the low incidence of this type of trauma. In Germany, penetrating injuries are reported to occur in 4–5 % of the severely injured patients who are enrolled in the TraumaRegister DGU® (trauma registry of the German Trauma Society). They include gunshot injuries, knife stab injuries, which are far more common, and penetrating injuries of other origin, for example trauma caused by accidents. The objective of this study was to assess the epidemiology and outcome of penetrating injuries in Germany, with a particular focus on the level of care provided by the treating trauma centre to gain more understanding of this trauma mechanism and to anticipate the necessary steps in the initial treatment.

Materials and methods

Since 2009, the TraumaRegister DGU® has been used to assess not only whether a trauma was penetrating but also whether it was caused by gunshot or stabbing. Data were taken from the standard documentation forms that participating German hospitals completed between 2009 and 2018. Excluded were patients with a maximum abbreviated injury scale (MAIS) score of 1 with a view to obtaining a realistic idea of this injury entity, which is rare in Germany.

Results

From 2009 to 2018, there were 1123 patients with gunshot wounds, corresponding to a prevalence rate of 0.5 %, and 4333 patients with stab wounds (1.8 %), which were frequently caused by violent crime. The high proportion of intentionally self-inflicted gunshot wounds to the head resulted in a cumulative mortality rate of 41 % for gunshot injuries. Stab wounds were associated with a lower mortality rate (6.8 %). Every fourth to fifth patient with a gunshot or stab wound presented with haemorrhagic shock, which is a problem that is seen during both the prehospital and the inhospital phase of patient management. Of the patients with penetrating injuries, 18.3 % required transfusions. This percentage was more than two times higher than that of the basic group of patients of the TraumaRegister DGU®, which consists of patients with a MAIS ≥ 3 and patients with a MAIS of 2 who died or were treated on the intensive care unit.

Conclusions

In Germany, gunshot and stab wounds have a low incidence and are mostly caused by violent crime or attempted suicides. Depending on the site of injury, they have a high mortality and are often associated with major haemorrhage. As a result of the low incidence of these types of trauma, further data and analyses are required in order to provide the basis for evaluating the long-term quality of the management of patients with stab or gunshot wounds.