bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of Protein C level and Activated Partial Thromboplastin Time among neonates suffering of sepsis-Omdurman Maternity Hospital, Sudan.
Authors: AHMED ALBARA , Mohammed Babiker , Nasr Abdelhalim M , Elhag Wafa I , Abass Awadelkareem
Published: April 2020

Objectives: The study aimed to assess Activated Partial Thromboplastin Time (APTT) and Protein C (PC) among Sudanese neonates with sepsis (Cases) in Omdurman maternity hospital, Sudan compared with healthy neonates (controls) for recognizing haemostatic alteration in APTT and PC, considering the gender, gestational age, delivery mode among both groups, case group categorized additionally regarding; sepsis onset, outcome, and Gram stain typing of the causative agent. Results: A total of 100 neonates divided equally into septic cases and healthy controls, died neonates were constituted 10 (20%) while 40 (80%) were recovered among case group. APTT showed significant prolongation in septic neonates compared to controls (mean; 47.8 and 37.5 sec for cases and controls, respectively) P. value was 0.00. Among case group; dead neonates showed significant prolongation compared recovered (mean; 61.5 and 44.4sec) P.value 0.00. PC showed significant decrease in dead neonates compared to recovered (mean; 25.4 and 36.2% for dead and improved) p value 0.04. APTT&PC can be useful as marker of neonatal sepsis mortality.Insignificant difference in PC reported between case and control group. None of the gender, gestational age, delivery mode, sepsis onset, and causative agent showed significant correlation with APTT and PC.
Antibiotic-induced alterations and repopulation dynamics of yellowtail kingfish microbiota
Authors: Legrand Thibault Philippe Raymond Albert , Catalano Sarah R. , Wos-Oxley Melissa L. , Wynne James W. , Weyrich Laura S. , Oxley Andrew P.A.
Published: April 2020

Background The use of antibiotics in aquaculture is a common infection treatment and is increasing in some sectors and jurisdictions. While antibiotic treatment can negatively shift gut bacterial communities, recovery and examination of these communities in fish of commercial importance is not well documented. Examining the impacts of antibiotics on farmed fish microbiota is fundamental for improving our understanding and management of healthy farmed fish. This work assessed yellowtail kingfish (Seriola lalandi) skin and gut bacterial communities after an oral antibiotic combination therapy in poor performing fish that displayed signs of enteritis over an 18-day period. In an attempt to promote improved bacterial re-establishment after antibiotic treatment, faecal microbiota transplantation (FMT) was also administered via gavage or in the surrounding seawater, and its affect was evaluated over 15 days post-delivery. Results Antibiotic treatment greatly perturbed the global gut bacterial communities of poor-performing fish – an effect that lasted for up to 18 days post treatment. This perturbation was marked by a significant decrease in species diversity and evenness, as well as a concomitant increase in particular taxa like an uncultured Mycoplasmataceae sp., which persisted and dominated antibiotic-treated fish for the entire 18-day period. The skin-associated bacterial communities were also perturbed by the antibiotic treatment, notably within the first 3 days; however, this was unlike the gut, as skin microbiota appeared to shift towards a more ‘normal’ (though disparate) state after 5 days post antibiotic treatment. FMT was only able to modulate the impacts of antibiotics in some individuals for a short time period, as the magnitude of change varied substantially between individuals. Some fish maintained certain transplanted gut taxa (i.e. present in the FMT inoculum; namely various Aliivibrio related ASVs) at Day 2 post FMT, although these were lost by Day 8 post FMT. Conclusion As we observed notable, prolonged perturbations induced by antibiotics on the gut bacterial assemblages, further work is required to better understand the processes/dynamics of their re-establishment following antibiotic exposure. In this regard, procedures like FMT represent a novel approach for promoting improved microbial recovery, although their efficacy and the factors that support their success requires further investigation.
Is high dose intravenous acetaminophen affect liver function in premature neonates with patent ductus arteriosus?
Authors: Bahrami Reza , Ezzatabadi Aida , Mehdizadegan Nima , Mohammadi Hamid , Amoozgar Hamid , Edraki Mohammad Reza
Published: April 2020

Objectives
The aim of this study was to collect consistent data on the efficacy and safety and evaluation hepatotoxicity of intravenous acetaminophen for the treatment of PDA in preterm infants.
Methods
This is an observational longitudinal prospective study on 46 preterm infants with PDA who treated with high dose of acetaminophen and evaluated with echocardiography and serum liver enzymes at Hafez and Zeinabiyeh hospitals from January 2016 to December 2019.
Result
Forty-six preterm infants with PDA treated with intravenous acetaminophen. Rate of closure of PDA was 82.6. There was no significant difference after treatment regarding AST, ALT, Albumin, total and direct bilirubin (P value > 0.05) and no adverse side effects were observed in association with intravenous acetaminophen.
Conclusion
High dose of acetaminophen is an effective and safe therapeutic option without hepatotoxic side effect for PDA closure.
Health Variations Among Breast-Cancer Patients from Different Disease States: Evidence from China
Authors: Qing Yang , Zhang wei , Yu Xuexin
Published: April 2020

Background To obtain health utility data for different disease status of breast cancer in China in order to obtain important parameters in health economics modeling. To explore the feasibility of establishing a breast cancer health utility mapping model in China.Methods Multivariate regression models, including linear regression model, ordinal logistic regression model and Tobit model, were employed to analyz. Subgroup analyses were performed to analyze variations in sub-dimensional health attributes derived from FACT-B and EQ-5D-5L. A mapping function was used to estimate health utility from quality of life.Results 446 breast cancer patients with different disease states were analyzed. The utility of breast cancer patients with P state(without cancer recurrence and metastasis), R state(with cancer recurrence within a year), S state(with primary and recurrent breast cancer for the second year and above) and M state(metastasis cancer) were 0.81 (SD ±0.23), 0.90 (SD ±0.12), 0.78 (SD ±0.31), and 0.74 (SD ±0.27), respectively. All scores, including the FACT-B domain, showed a positive correlation( p <0.001). Multivariate analysis suggested that patients in R and M state had lower scores in overall quality of life (R,β = -9.45, p < 0.01; M, β = -6.72, P <0.05). Patients in M state had a lower probability of achieving higher health utility compared with patients in P state (β = -0.11, p < 0.05). Estimated health utilities derived from quality of life, using mapping function, were significantly correlated with directly measured health utilities ( p <0.001).Conclusions We obtained the health utility and HRQoL scores of Chinese breast cancer patients with different disease states. Mapping health utilities from quality of life in four disease states could be a plausible approach in health economic analysis, while the mapping function may need further revise.
Defining Ambulatory Care Sensitive Conditions for adults in Portugal
Authors: Sarmento João , Rocha João Vitor Muniz , Santana Rui
Published: April 2020

BackgroundAmbulatory Care Sensitive Conditions (ACSCs) are health conditions for which adequate management, treatment and interventions delivered in the ambulatory care setting could potentially prevent hospitalization. Which conditions are sensitive to ambulatory care varies according to the scope of health care services and the context in which the indicator is used. The need for a country-specific validated list for Portugal has already been identified, but currently no national list has been developed yet. MethodsA modified web-based Delphi panel approach was designed, in order to determine which conditions can be considered ACSCs in the Portuguese adult population. The selected experts were general practitioners and internal medicine physicians identified by the most relevant Portuguese scientific societies. Experts were presented with previously identified ACSC and asked to select which could be accepted in the Portuguese context. They were also asked to identify other conditions they considered relevant. We estimated the number of ACSC hospitalizations in 2017 in Portugal according to the identified conditions. ResultsAfter three rounds the experts agreed on 34 of the 45 initially proposed items. Fourteen new conditions were proposed and four achieved consensus, namely uterine cervical cancer, colorectal cancer, thromboembolic venous disease and voluntary termination of pregnancy. In 2017 136626 hospitalizations were for ACSC (16.1% of all hospitalizations). This represents a rate of 1,540 per 100,000 adults. The most frequent diagnosis were pneumonia, chronic obstructive pulmonary disease/chronic bronchitis, heart failure, hypertensive disease, colorectal cancer, atrial fibrillation, urinary tract infections and complications of diabetes mellitus. ConclusionsNew ACSC where identified. It is expected that this list could be used henceforward by epidemiologic studies, health services research and for healthcare management purposes.
A description of the influenza vaccination program for health care workers in Vietnam
Authors: Ha Nga , Nguyen Thoa Thi Minh , Nguyen Tung Xuan , Tran Phu Dac , Nguyen Hang Minh , Ha Van Thi Cam , Lafond Kathryn E. , Seward Jane F. , McFarland Jeffrey W. , Chu Susan Y.
Published: April 2020

Background: In 2017, the Vietnam Ministry of Health conducted a demonstration project to introduce seasonal influenza vaccination to health care workers. A total of 11,000 doses of influenza vaccine, single-dose prefilled syringes, were provided free to HCWs at 29 selected hospitals, clinics, and research institutes in four provinces: Hanoi, Khanh Hoa, Dak Lak and Ho Chi Minh City. Methods: Before the campaign, a workshop was organized to discuss an implementation plan including technical requirements, cold chain, uptake reporting, and surveillance for adverse events following immunization. All sites distributed communication materials and encouraged their staff to register for vaccination. Following immunization sessions, sites sent reports on uptake and adverse events following immunization. Left-over vaccine was transferred to other sites to maximize vaccine use. Results: The average uptake was 57% for all health care workers, with 11 sites achieving 90% and above. These 11 sites were small with less than 500 staff, including 5 primary hospitals, 3 preventive medicine units, and 2 referral hospitals. Among the six biggest sites with over 1,000 staff, four sites had the lowest uptake (14%-47%). Most of the high-uptake sites were from the central to the south; only one site, a referral hospital, was from the north. After redistribution of left-over vaccine, only 130 vaccine doses (1.2%) were not used and destroyed. Based on factors that affected uptake, including registration levels, differing communication strategies, availability of vaccination, and commitment by health facility leaders, we recommended ways to increase health care worker coverage; recommendations to improve reporting adverse events following immunization were also made.Conclusions: The project demonstrated that it was feasible to conduct influenza vaccination campaigns among health care workers in Vietnam. Improvements in promotion of registration, more intense pre-planning, especially at larger facilities, and wider, more consistent availability of communication materials will result in increased efficiency and coverage in this program’s future expansion.
A Framework of Evidence-Based Decision-Making in Health System Management: Applying Best-Fit Framework Synthesis
Authors: Shafaghat Tahereh , Bastani Peivand , Nasab Mohammad Hasan Imani , Bahrami Mohammad Amin , Kavosi Zahra , Montazer Mahsa Roozrokh Arshadi , Zarchi Mohammad Kazem Rahimi
Published: April 2020

Background: Scientific evidence is the basis for improving public health; decision-making without sufficient attention to evidence may lead to unpleasant consequences. In recent years, efforts have been made to create more comprehensive guidelines for evidence-based decision-making (EBDM), thus the purpose of the present study was developing a framework for EBDM to make the best decisions concerning to scare resources and too many needs. Methods: The present basic-applied research was a secondary study carried out using qualitative research method in 2019. A Systematic Scoping Review (SSR) was done for the comprehensive review of the existing published studies in this area. This method, according to Arksey and O’Malley approach, consists of five main stages and one optional stage. Results: Based on the SSR, 3751 studies from 7 databases were found, and due to the full-text screening of the studies, 30 final studies were selected for extracting the components and steps of EBDM in Health System Management (HSM). After collecting, synthesizing, and categorizing key information, the framework of EBDM in HSM is developed in the form of four general scopes of inquiring, inspecting, implementing and integrating, which includes 10 main steps and 56 sub-steps. Conclusions: The present framework tries to present a sequential systematic map to achieve evidence-based decision and policy making specially for under developed and developing countries which mostly suffer from applying update and applied evidences in their decision-making process. At the same time, it seems that the present framework tries to synthesize and integrate the fragmented elements of the other models and in this way can be tested by developed countries to improve their EBDM cycle.
A longitudinal study of the turning points and trajectories in therapeutic relationship development
Authors: Horton Ayana , Hebson Gail , Holman David
Published: April 2020

Background The therapeutic relationship refers to the interpersonal relationship between the healthcare professional and patient (Peplau, 1997). The importance of the therapeutic relationship is widely recognised across healthcare professions (e.g., nurses - Peplau, 1997; physicians - Weeger & Farin, 2017; psychotherapists - Martin et al, 2000; occupational therapists - Weiste, 2018; physiotherapists- Fuentes et al, 2014). Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories. Methods Data collection was based on the Retrospective Interview Technique (RIT) and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data. Results Therapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional. Conclusion This study makes an important contribution to our understanding of therapeutic relationship dynamics. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.
Waiting times in emergency departments: a resource allocation or an efficiency issue?
Authors: Vainieri Milena , Panero Cinzia , Coletta Lucrezia
Published: April 2020

Background: In recent years, the flow of patients to emergency departments (ED) in Western countries has steadily increased, generating overcrowding and extended waiting times. Scholars have identified four main causes for this phenomenon, related to continuity of primary care services; availability of specific clinical pathways for chronic patients; ED’s personnel endowment; and organization of the ED. This study aims to provide a logical diagnostic framework to support managers in investigating specific solutions to be applied to their EDs to cope with high ED waiting times. The framework is based on the ED waiting times and ED admission rate matrix. It is applied to Tuscan EDs as illustrative example. Methods: To provide the factors to be analysed once the EDs are positioned into the matrix, a list of issues is identified. The matrix is applied to Tuscan EDs. Data are collected from the Tuscan performance evaluation system, integrated with specific data on Tuscan EDs’ personnel. The Tuscan ED matrix, descriptive statistics for each quadrant and Spearman’s rank correlation analysis among waiting times, admission rates and a set of performance indicators were conducted to help managers to read the phenomena that they need to investigate. Results: The combined reading of the correlations and waiting times–admission rates matrix shows that there are no optimal rules for all the EDs in managing admission rates and waiting times, but solutions have to be found considering mixed and personalized strategies. Conclusions: The waiting times–admission rates matrix provides a tool able to support managers in detecting problems related to the management of ED services. In particular, using this matrix, healthcare managers can be facilitated in the identification of possible solutions for their specific situation.
Implementing Continuity of Midwife Carer – Just a Friendly Face? A Realist Evaluation
Authors: McInnes Rhona Jean , Arbuckle Alix Aitken , Lake Suzanne , Martin Caroline J Hollins , MacArthur Juliet
Published: April 2020

BACKGROUND: Good quality midwifery care saves the lives of women and babies. Continuity of midwife carer (CMC), a key component of good quality midwifery care, results in better clinical outcomes, higher care satisfaction and enhanced caregiver experience. However, CMC uptake has tended to be small scale or transient. We used realist evaluation in one Scottish health board to explore implementation of CMC as part of the Scottish Government 2017 maternity plan. METHODS: Participatory research, quality improvement and iterative data collection methods were used to collect data from a range of sources including facilitated team meetings, local and national meetings, quality improvement and service evaluation surveys, audits, interviews and published literature. Data analysis developed context-mechanism-outcome configurations to explore and inform three initial programme theories, which were refined into an overarching theory of what works for whom and in what context.RESULTS: Trusting relationships across all organisational levels are the context in which CMC works. However, building these relationships during implementation requires good leadership and effective change management to drive whole system change and foster trust across all practice and organisational boundaries. Trusting relationships between midwives and women were valued and triggered a commitment to provide high quality care; CMC team relationships supported improvements in ways of working and sustained practice, and relationships between midwives and providers in different care models either sustained or constrained implementation. Continuity enabled midwives to work to full skillset and across women’s care journey, which in turn changed their perspective of how they provided care and of women’s care needs. In addition to building positive relationships, visible and supportive leadership encourages engagement by ensuring midwives feel safe, valued and informed.CONCLUSION: Leadership that builds trusting relationships across all practice and organisational boundaries develops the context for successful implementation of CMC. These relationships then become the context that enables CMC to grow and flourish. Trusting relationships, working to full skill set and across women’s care journey trigger changes in midwifery practice. Implementing and sustaining CMC within NHS organisational settings requires significant reconfiguration of services at all levels, which requires effective leadership and cannot rely solely on ground-up change.
Immunoinformatic based identification of cytotoxic T lymphocyte epitopes from the Indian isolate of SARS-CoV-2
Authors: Mulpuru Viswajit , Mishra Nidhi
Published: April 2020

The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has turned into a pandemic with about a million confirmed cases worldwide. Being an airborne infection, it can be highly fatal to populous countries like India. This study sets to identify potential cytotoxic T lymphocyte (CTL) epitopes in the SARS-CoV-2 Indian isolate which can acts act as an effective vaccine candidate for the majority of the Indian population. The immunogenicity and the foreignness of the epitopes towards the human body have to studies to further confirm their candidacy. The top-scoring epitopes were subjected to molecular docking studies to study their interactions with the corresponding human leukocyte antigen (HLA) system. The CTL epitopes were observed to bind at the peptide-binding groove of the corresponding HLA system, indicating their potency as a vaccine candidate. The identified epitopes can be subjected to further studies for the development of SARS-CoV-2 vaccine.
Comparative effectiveness of two methods for inducing osteoarthritis in a novel animal model, the Diannan small-ear pig
Authors: Jia Di , He Yinghong , Cai Guofeng , Zheng Jiali , Yang Yuye , Li Yanlin
Published: April 2020

Background: Varieties of animals were used to study osteoarthritis pathogenesis. The Diannan small-ear pig, which is native to Yunnan, China, is thought to have an articular anatomy similar to that of humans and is more likely to be a source of pathological tissues than other animals. The aim of this study was determine whether this animal can serve as a more effective osteoarthritis model.Methods: Twenty-seven adult pigs were randomly divided into three groups and underwent the Hulth procedure, papain articular injection, and conventional breeding. After 4, 8, and 12 weeks, cartilage tissues from knee joint were extracted for general and histological observation, immunofluorescence, and biochemical analysis. Synovium was taken out for stromal cell-derived factor-1 analysis. Results: Histopathological observation showed obvious cartilage loss in two experimental groups, this cartilage loss was more severe in the chemical groups. Synovial stromal cell-derived factor1 levels increased over time in all groups. mRNA and protein levels of matrix metalloproteinase-3 were much higher in the chemical groups than in the other groups, whereas levels of collagen type II and aggrecan were significantly lower in the chemical groups than in the other groups. Immunofluorescence assays of collagen type II revealed an apparent reduction in this marker in the chemical groups compared with the other groups. Conclusions: These results indicated that the Diannan small-ear pig can be used as an effective osteoarthritis model. In addition, it is much more convenient and much faster to induce osteoarthritis by intra-articular injection of papain, which is a method worthy of being promoted.
Identification and fine mapping of a novel qGR6.2 locus controlling rice salt tolerance during seed germination
Authors: Zeng Peng , Zhu Peiwen , Qian Luofeng , Qian Xumei , Mi Yuxin , Lin Zefeng , Dong Shinan , Aronsson Henrik , Zhang Hongsheng , Cheng Jinping
Published: April 2020

Background Rice growth is frequently affected by salinity. When rice plants are exposed to high salinity, seed germination and seedling establishment are significantly inhibited. In particular, with the promotion of rice direct-seeding in Asia, improving rice salt tolerance during seed germination is of strong importance for rice breeding. Results In this study, we found that the indica rice landrace Wujiaozhan (WJZ) showed a high capability of seed germination under both water (H 2 O) and salt (NaCl) conditions, particularly under high salt stress. The BC 1 F 2 population produced by crossing WJZ with japonica Nipponbare (Nip) was used to evaluate the germination traits under water (H 2 O) and salt (300 mM NaCl) conditions using germination rate (GR) and germination index (GI). A total of 13 quantitative trait loci (QTLs) were identified, including eight QTLs of GR, two QTLs of GI under H 2 O conditions, six QTLs of GR, and three QTLs of GI under 300 mM NaCl conditions. Six QTLs ( qGR6.1 , qGR8.1 , qGR8.2 , qGR10.1 , qGR10.2 and qGI10.1 ) contributed to GR under both H 2 O and 300 mM NaCl conditions. Three QTLs ( qGR6.2 , qGR10.1 and qGR10.2 ) under 300 mM NaCl conditions were identified at different time points of seed germination and shared the same region with qGI6 , qGI10.1 and qGI10.2 for GI. These QTLs could be used to improve seed germination ability via marker-assisted selection (MAS). One major effective salt-tolerance-specific QTL, qGR6.2, on chromosome 6 was further confirmed via the BC 2 F 2 population, which explained more than 20% of the phenotypic variation. Fine mapping results showed that qGR6.2 was narrowed to a 65.9-kb region between the Z654 and Z619 molecular markers, with eleven candidate genes being predicted. Based on the microarray database, there were high transcript abundances of six genes ( LOC_Os06g10650 , LOC_Os06g10660 , LOC_Os06g10690 , LOC_Os06g10710 , LOC_Os06g10730 and LOC_Os06g10750 ) at all developmental stages, and only LOC_Os06g10750 was differentially expressed after salt incubation. RT-qPCR showed that two genes ( LOC_Os06g10650 and LOC_Os06g10750 ) were significantly differentially expressed at 300 mM NaCl during seed germination. This result suggested that LOC_Os06g10650 and LOC_Os06g10750 might be the causal candidate genes for the major effective salt-tolerance-specific QTL qGR6.2 identified in WJZ, which may facilitate map-based cloning and help to elucidate the molecular mechanism underlying salt tolerance during seed germination. Conclusions In our study, we identified 13 QTLs from indica landrace WJZ that confer seed germination traits under water and salt conditions. A major salt-tolerance-specific QTL qGR6.2 was confirmed and fine mapped to a 65.9-kb region flanked by the Z654 and Z619 markers. Our results provide information on the genetic basis of improving salt tolerance during seed germination by MAS.
Biventricular surgical repair of “Swiss Cheese” ventricular septal defects with two-patch and right ventricle apex excluding technique: preliminary experience and clinical results
Authors: Wu Qin , Shi Lei , Chen Rui , Xing Quansheng
Published: April 2020

Background “Swiss Cheese” ventricular septal defects (VSDs) is a kind of rare and complex congenital heart defects and the surgical management remains controversial and a challenge. We reviewed our preliminary clinical experience on biventricular surgical repair of “Swiss Cheese” VSDs with two-patch and right ventricle apex excluding technique in 10 cases. Methods From May 2014 to December 2019, a series of 10 patients (M/F=3/7) were admitted in our center. 9 cases underwent one-stage surgical repair with two-patch and right ventricle apex excluding technique and 1 case received a second-stage surgical repair with the same technique. Surgical repair was done with cardiopulmonary bypass (CPB) in all cases. 2 fresh autologous pericardium patches were used to close defects of the outflow tract area and the apex trabecular area respectively and as a result, the right ventricular apex was excluded from the right ventricular inflow tract. Results All the operations were successful. Median CPB time and aortic clamping time were 96 min and 68 min respectively. Delayed chest closure were done in 2 cases within 48-72 hours postoperatively. The Median time of mechanical ventilation and ICU stay were 131.3 hours and 8 days respectively. Median length of stay after operation was 11 （9-42）days. There was no mortality and major complication except for 2 cases of ventilator associated pneumonia. There was no death and major complication during the median follow-up time of 3.2 years.. The latest echocardiography results showed the left and right heart function was normal in all the cases. Conclusions Biventricular surgical repair of “Swiss Cheese” VSDs with two-patch of fresh autologous pericardium and right ventricle apex excluding technique in infants is safe and feasible with favorable early and mid-term results. Long term results need to be evaluated with more cases.
Associations of Serum Lipids and Lipoproteins with the Estimated Glomerular Filtration Rate in the Adult Chinese Population: A Cross-sectional Study
Authors: Kong Xiaomu , Yang Zhaojun , Zhang Bo , Yu Liping , Zhu Haiqing , Xing Xiaoyan , Yang Wenying , Chen Xiaoping
Published: April 2020

Background: Dyslipidemia has a critical impact on renal dysfunction, but the exact types of lipids and lipoproteins that influence the estimated glomerular filtration rate (eGFR) are under investigation. Observations from an adult Chinese population ≥20 years old are lacking. The present study is to investigate the associations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) with eGFR, and the risks for a mildly and a moderately/severely reduced eGFR. Methods: A total of 16,206 participants from a national representative adult population (20 years of age or older) in China were included. All calculations were weighted based on the Chinese population data and the sampling scheme. Results: Upon stratifying the population based on lipids or lipoprotein categories, we observed a significantly lower mean eGFR as well as a higher estimated prevalence of impaired eGFR among Chinese adults with TG levels in the ranges of 1.7 mmol/L≤ TG <2.3 mmol/L [mean eGFR: 110.99 mL/min per 1.73 m 2 , P =0.0000; prevalence of mildly eGFR impairment: 30.92%, P =0.0000; prevalence of moderately/severely eGFR impairment: 2.01%, P =0.1842] and ≥2.3 mmol/L [111.62 mL/min per 1.73 m 2 , P =0.0000; 27.92%, P =0.0000; 2.81%, P =0.0174], compared to those among individuals with normal TG [122.03 mL/min per 1.73 m 2 ; 19.96%; 1.20%]. Also, a higher prevalence of mildly impaired eGFR was observed with 3.4 mmol/L≤ LDL-C <4.1 mmol/L (27.93%) compared with LDL-C <3.4 mmol/L (22.61%, P =0.0092). An elevated TG was proven to be an independent risk factor for decreased eGFR [β(SE) -0.0238(0.0039), P =0.0000], and each per mmol/L increase in TG was associated with the 1.19-fold and 1.31-fold increased risks for mildly impaired eGFR and moderately/severely impaired eGFR, respectively ( P =0.0000, 0.0001). A decreased HDL-C also showed a negative contribution to eGFR [-0.0883(0.0176), P =0.0000]. In contrast, increased TC was associated with increased eGFR [0.0314(0.0060), P =0.0000] and a reduction in the risk for mildly impaired eGFR by 0.91-fold ( P =0.0302). Increased LDL-C also contributed to an elevated eGFR [0.0251(0.0070), P =0.0004]. Conclusion: A decreased eGFR could be attributed independently to an elevated TG or reduced HDL-C. It emphasizes the importance of effective control of TG and HDL-C for preserving eGFR.
A seven-year surveillance study of the epidemiology, antifungal susceptibility, risk factors and mortality of candidaemia among paediatric and adult inpatients in a tertiary teaching hospital in China
Authors: Zeng Zhangrui , Ding Yinhuan , Tian Gang , Yang Kui , Deng Jian , Li Guangrong , Liu Jinbo
Published: April 2020

Background There are no current national estimates of the candidaemia burden in China, and epidemiological candidaemia data from the underdeveloped region of China are lacking. Methods A 7-year retrospective study was carried out to analyse the prevalence, species distribution, antifungal susceptibility, risk factors and inpatient mortality of candidaemia among paediatric and adult paitents in a regional tertiary teaching hospital in China. Results During the seven-year study period, a total of 201 inpatients with candidaemia were identified. The median age of the patients was 65 years (range, 1 day to 92 years), and 114 of the patients (56.7%) were male; the mean annual incidence was 0.26 cases per 1,000 admissions (0.42 cases per 1,000 paediatric vs 0.24 cases per 1,000 adult admissions, P<0.05). Candida albicans was the most common fungal species (81/201, 40.3%) in all patients, Candida glabrata was the most common fungal species (18/35, 51.4%) in paediatric patients. Most isolates were susceptible to flucytosine (99.0%) and amphotericin B (99.0%), and the activity of antifungal agents against Candida species was no significant difference in satisfaction between paediatric and adult patients(P>0.05). The all-cause mortality rate was 20.4% (paediatric patients: 11.4% vs adult patients:22.3%, P>0.05). The univariate predictors of poor outcomes in paediatric patients were less than that in adult patients (4 vs 11 predictors). Respiratory dysfunction and septic shock were independent predictors of 30-day mortality in all patients. Conclusions The epidemiological data of candidaemia in paediatric and adult patients are only different in the distribution of Candida species and the mean annual incidence of candidaemia. Flucytosine and amphotericin B could be used as the first-choice agent when there is no the result of antifungal susceptibility tests.
Phylogenetic analysis of HA and NA genes and clinical characteristics of the co-occurring mutations in HA and NA of influenza A(H1N1)pdm09 viruses during 2015-2017 in Beijing, China
Authors: Liu Yafen , Wang Yue , Liu Baiyi , Cong Xu , Ji Ying , Guo Xiaolin , Gao Yan
Published: April 2020

Background
Influenza A(H1N1)pdm09 viruses have undergone rapid evolution, and in recent years the complementary and antagonistic effects of HA and NA have gathered more attentions; however, the effects of co-occurring mutations in HA and NA on the patients’ clinical characteristics are still poorly understood. In this study, we analyzed molecular epidemiology and evolution of A(H1N1) pdm09, explored co-occurring mutations of HA and NA, and investigated effect of co-occurring mutations on patients’ clinical features.
Methods
A(H1N1)pdm09 was confirmed by reverse transcription-polymerase chain reaction. HA and NA genes were sequenced and phylogenetically analyzed. Clinical characteristics of the co-occurring mutations were analyzed statistically.
Results
By analyzing the HA and NA gene sequences of 33 A(H1N1)pdm09 viruses during the 2015–2017 influenza season, we found that all the viruses shared high similarities to each other and the HA genes of these viruses exclusively belonged to subclade 6B.1A. Several new substitutions of HA and NA exhibited in the new sites, furthermore, co-occurring mutations of HA-V169T, A278S, E508G, D518E and NA-V67I were detected in 30.3% (10/33) A(H1N1)pdm09 virus strains when comparing with vaccine strains A/California/07/2009 and A/Michigan/45/2015 (H1N1). Sore throat was significantly associated with co-occurring mutations in HA and NA of A(H1N1)pdm09 (χ2, P < 0.05).
Conclusions
Co-occurring mutations in HA and NA were detected in A(H1N1)pdm09 isolated during 2015–2017 in Beijing. Symptomatically, sore throat was associated with co-occurring mutations in HA and NA of A(H1N1)pdm09. Therefore, studying the effect and mechanism of co-occurring mutations in HA and NA on patients’ clinical features is of note needed.
Modelling the Effects of Financial Liberalization and Economic Growth in Liberia: Evidence from Combined Cointegration Test
Authors: Sowah James Karmoh , Kirikkaleli Dervis
Published: April 2020

The research aimed was to determine the long-run relationship between financial liberalization, savings mobilization, and investment with a resultant effect on economic growth in the context of the Liberian economy as articulated by McKinnon and Shaw's hypothesis. The study employed time series data spanning from 1980 to 2016 and extracted from World Development Indicators (WDI). The data were analysed using econometric techniques of Combined Cointegration test, Dynamic Ordinary Least Squares (DOLS), Fully Modified Ordinary Squares (FMOLS), and Canonical Cointegration Regression (CCR). To our knowledge, no studies have investigated the effects of financial liberalization and economic growth in Liberia, expressly, employing Combined Cointegration Test. Our findings reveal (i) coefficient of the financial liberalization variable is positive and significant for Liberia, thus support the McKinnon and Shaw hypotheses. (ii) We found combined cointegration among the estimated models. We recommended that policymakers should refrain from any policy that will adversely affect the deposit interest rates considering its immense impact on savings mobilization, gross investment, and the overall economic growth. Furthermore, improving the level of competition will compel deposit-taking financial institutions to raise deposit interest rates in a bid to attract more depositors with a consequential reduction in the interest rates spread.
Clinical characteristics of pneumonia patients of long courses infected with SARS-CoV-2
Authors: Wang Chunli , Huang Liya , Lu Weiwei , Chen Guoxi , Cai Yuyang , Li Xiaopan , Lan Xing , Wang Yaling , Deng Xiaoqin , Zeng Guangwang , Wang Lin , Huang Hai , Ji Chen , Yang Ling
Published: April 2020

Background: Since December, 2019, Wuhan, China, has experienced an outbreak of 2019 novel coronavirus pneumonia (COVID-19). Epidemiological and clinical characteristics of patients with COVID-19 have been reported. A few studies reported clinical course of illness of median 22 days, including viral shedding of median 20 days, but there are several cases with a longer time of viral shedding.Methods: In this retrospective, single-centre cohort study, we included four cases with a longer course of illness of more than 40 days with laboratory-confirmed COVID-19 from Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or still in hospital by March 15, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records. We describe the epidemiological and clinical characteristics and the course of viral shedding.Results: Of the four patients, one was discharged and the other three were still in hospital. Two patients had comorbidity, one with hypertension and one with diabetes. We found smoking is not an independent risk factor . And D-Dimer maybe relates to severity of illness but not course of illness. Decreased lymphocyte count had a slow recovery process in three patients. elevated eosinophils count in all patients suggest maybe elevated eosinophils count was a reason of long course. Nucleic acid detection suggests maybe more sampling sites represent more virus replication sites and longer course illness.Conclusion: In this study we find some non-critical severe relatively young patients with sustained non-negative with nucleic acid detection whose character is different from former studies described. Of course, it needs much more cases to further study. It’s hoped to provide strategy of isolation of infected patients and optimal antiviral interventions in the future.
Comparison of strain and ferroelectric properties of La,Nb and Li,Nb co-modified BNKT–ST ceramics
Authors: Malik Rizwan Ahmed , Maqbool Adnan , Khan Salman Ali , Saleem Mohsin , Butt Muhammad Shoaib , Alarifi Ibrahim M , Hussain Ali , Lee Soonil , Kim Myong-Ho
Published: April 2020

A comparison between the influence of concurrent A and B-site acceptor-donor (Li,Nb) and donor-donor (La,Nb) doping in Pb-free Bi 0.5 (Na 0.84 K 0.16 ) 0.5 TiO 3 –SrTiO 3 piezoelectrics on structure, ferroelectric and high voltage induced strain were made. In this work, Lithium was chosen as acceptor and Lanthanum was chosen as donor dopant on A-site and Nb 5+ as a B-site donor. Both modifier impurities promoted a phase evolution from the coexistent of two phase structures (rhombohedral-tetragonal) into a more symmetric single pseudocubic structure. Nonetheless, (La,Nb) donor-donor doping induced the phase transition at 1 mol%, while (Li,Nb) acceptor-donor doping at 2 mol%. Interestingly, acceptor-donor (Li,Nb) co-substitution results in the broadening of ergodic relaxor and ferroelectric (ER-FE) mixed phase boundary which is favourable for multidevice applications. This comparative study show that the A-site vacancies play a substantial role to induce the phase transformation from nonergodic-ergodic relaxor (NR-ER) and the improvement in their high voltage induced strain.
Efficacy and Safety of Hydroxychloroquine and Chloroquine for Treating COVID-19: A Rapid Review
Authors: Muhamad Nor Asiah , Jeevananthan Chandrika , Dali Nor Soleha Mohd , Bakhtiar Mohammed Faizal , Aris Tahir , Lai Nai Ming
Published: April 2020

Background: Since its emergence, COVID-19 has affected more than one million people with over 100,000 deaths globally as of early April 2020. In this review, we evaluated the efficacy and safety of hydroxychloroquine and chloroquine on patients with COVID-19. Methods: PubMed, CENTRAL, Google Scholar, Chinese Clinical Trial Registry and Trial Registers: ISRCTN; UMIN-CTR (Japan's Trial Register); and the WHO portal up were searched for the in vitro and in vivo studies of hydroxychloroquine and chloroquine.Results: Moderate-certainty evidence from a single published RCT to-date showed that after a five-days treatment, patients on hydroxychloroquine may have shorter symptom duration compared to the control group, including fever (MD-1.0 day (95% CI -1.48, -0.52), cough (MD -1.1 day (95% CI -1.63, -0.57) and higher likelihood of having improved chest CT appearance (RR 1.47 (95% CI 1.02, 2.11), no clear differences was observed in the risk of progressing to severe illness and risk of adverse effects. A single non-randomized study showed marked decreased in the number with positive viral load at day 6, but due to several flaws in the study, the certainty of evidence for the outcome was very low.Conclusion: Despite the evidence on possible effects of hydroxychloroquine and chloroquine, given the paucity of available evidence especially in relation to the number on-going RCTs, conclusion on the effectiveness and safety of hydroxychloroquine cannot yet be made.
The features of SARS-CoV-2 and other human coronavirus genomes could affect interferon production and immune response
Authors: Franzo Giovanni
Published: April 2020

A new pandemic caused by the betacoronavirus SARS-CoV-2 originated in China in late 2019. Although often asymptomatic, a relevant percentage of affected people can develop severe pneumonia. Initial evidence suggests that dysregulation of the immune response could contribute to the pathogenesis, as previously demonstrated for SARS-CoV. The presence of genome composition features involved in delaying viral recognition is herein investigated for human coronaviruses (HCoVs), with a special emphasis on SARS-CoV-2. A broad collection of HCoVs polyprotein, envelope, matrix, nucleocapsid and spike coding sequences was downloaded and several statistics representative of genome composition and codon bias were investigated. A model able to evaluate and test the presence of a significant under- or over-representation of dinucleotide pairs while accounting for the underlying codon bias and protein sequence was also implemented.The study revealed the significant under-representation of CpG dinucleotide pair in all HcoV, but especially in SARS-CoV and even more in SARS-CoV-2. The presence of forces acting to minimize CpG content was confirmed by relative synonymous codon usage pattern. Codons containing the CpG pair were severely under-represented, primarily in the polyprotein and spike coding sequences of SARS-CoV-2. Additionally, a significant under-representation of the TpA pair was observed in the N and S region of SARS-CoV and SARS-CoV-2.Increasing experimental evidence has proven that CpG and TpA are targeted by innate antiviral host defences, contributing both to RNA degradation and RIG-1 mediated interferon production. The low content of these dinucleotides could contribute to a delayed interferon production, dysregulated immune response, higher viral replication and poor outcome. Significantly, the RIG-1 signalling pathway was proven to be defective in elderlies, suggesting a likely interaction between limited viral recognition and lower responsiveness in interferon production that could justify the higher disease severity and mortality in older patients.
Predicting mortality for Covid-19 in the US. Delayed Elasticity Method
Authors: Hierro Luis Ángel , Garzón Antonio José , Atienza-Montero Pedro , Márquez José Luis
Published: April 2020

The evolution of the pandemic caused by COVID-19, its high reproductive number and the associated clinical needs, is overwhelming national health systems. We propose a method for predicting the number of deaths, and which will enable the health authorities of the countries involved to plan the resources needed to face the pandemic as many days in advance as possible. We employ OLS to perform the econometric estimation, and through RMSE, MSE, MAPE, and SMAPE forecast performance measures we select the best lagged predictor of both dependent variables. Our objective is rather to estimate a leading indicator of clinical needs. Having a forecast model available several days in advance can enable governments to more effectively face the gap between needs and resources triggered by the outbreak and thus reduce the deaths caused by COVID-19.