bluuebunny/crossref_metadata_2025 huggingface dataset:
Proteotranscriptomics assisted gene annotation and spatial proteomics of Bombyx mori BmN4 cell line
Authors: Levin Michal , Scheibe Marion , Butter Falk
Published: April 2020

Background The process of identifying all coding regions in a genome is crucial for any study at the level of molecular biology, ranging from single-gene cloning to genome-wide measurements using RNA-Seq or mass spectrometry. While satisfactory annotation has been made feasible for well-studied model organisms through great efforts of big consortia, for most systems this kind of data is either absent or not adequately precise. Results Combining in-depth transcriptome sequencing and high resolution mass spectrometry, we here use proteotranscriptomics to improve gene annotation of protein-coding genes in the Bombyx mori cell line BmN4 which is an increasingly used tool for the analysis of piRNA biogenesis and function. Using this approach we provide the exact coding sequence and evidence for more than 6,200 genes on the protein level. Furthermore using spatial proteomics, we establish the subcellular localization of thousands of these proteins. We show that our approach outperforms current Bombyx mori annotation attempts in terms of accuracy and coverage. Conclusions We show that proteotranscriptomics is an efficient, cost-effective and accurate approach to improve previous annotations or generate new gene models. As this technique is based on de-novo transcriptome assembly, it provides the possibility to study any species also in the absence of genome sequence information.
PM2.5 exposure induces renal injury via the activation of the autophagic pathway in rat and HK-2 cell
Authors: Huang Xiaoliu , Li Jue
Published: April 2020

Background
Exposure to airborne fine particulate matter (PM2.5) has been declared to be harmful to the human kidney. However, whether activation of the autophagic pathway plays key roles in the nephrotoxicity caused by PM2.5 exposure is still poorly understood. The aim of this study was to explore the mechanism of kidney damage after PM2.5 exposure in vivo and in vitro.
Results
In the present study, statistically significant alterations in water intake, urine flow rate and mean blood pressure were observed between the PM2.5 group and FA group during the period of PM2.5 exposure. Exposed animals showed severe edema of renal tubular epithelial cells, capillary congestion, reduction of the glomerular urinary space and early pro-fibrotic state. Moreover, significant increases in the levels of early kidney damage markers were observed in the exposed rats and these animals exhibited more apoptosis rate in kidney cells. In addition, PM2.5 exposure resulted in the activation of the autophagic pathway, as evidenced by LC3-I to LC3-II conversion, P62 and beclin-1 activated. All of these effects are in concurrence with the presence of more autophagosomes both in vivo and in vitro after PM2.5 exposure.
Conclusions
Taken together, our findings indicated that PM2.5-induced renal injury via the activation of the autophagic pathway in renal tubular epithelial cells.
Implantation of Impella CP® left ventricular assist device under the guidance of three-dimensional intracardiac echocardiography.
Authors: Yastrebov Konstantin , Brunel Laurencie , Williams Zoe , Wise Innes , Burrows Christopher , Paterson Hugh , Bannon Paul
Published: April 2020

Impella CP® is a percutaneously inserted left ventricular assist device indicated for temporary mechanical cardiac support during high risk percutaneous coronary interventions and for cardiogenic shock. The potential application of Impella has become particularly relevant during the current COVID-19 pandemic, for patients with acute severe heart failure complicating viral illness. Standard implantation of the Impella CP® is performed under fluoroscopic guidance. Positioning of the Impella CP® can be confirmed with transthoracic or transoesophageal echocardiography. We conducted translational study in ovine model describing an alternative approach to guide implantation of the Impella CP® using two-dimensional and three-dimensional intracardiac echocardiography. This new technique can be useful in selected groups of patients when fluoroscopy, transthoracic and transoesophageal echocardiography is deemed inapplicable or limited for epidemiological or clinical reasons. Intracardiac three-dimensional echocardiography is a feasible alternative to the traditional techniques for implantation of an Impella device.
Knowledge and Attitudes about Transcranial Magnetic Stimulation Among Psychiatrists in China
Authors: Deng Jiahui , Gong Yimiao , Lin Xiao , Bao Yanping , Sun Hongqiang , Lu Lin
Published: April 2020

Background Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive form of brain stimulation. It has been used in many mental health institutions to treat mental disorders worldwide. However, comprehensive knowledge about rTMS is not yet widespread among psychiatrists. The present study assessed psychiatrists’ knowledge and attitudes about rTMS in China and investigated related factors.Methods A quantitative observational cross-sectional study was conducted using an online survey. The sample consisted of 522 psychiatrists. Multinomial logistic regression and multiple linear regression analyses were used to explore factors that contributed to psychiatrists’ knowledge about rTMS. We also ascertained psychiatrists’ attitudes about rTMS and provide recommendations for the more widespread use of rTMS.Results The majority of respondents (86.4%) reported having access to rTMS at their institution. A total of 379 psychiatrists (72.6%) knew that rTMS is approved by the United States Food and Drug Administration for treatment-resistant depression. Univariate logistic regression indicated that psychiatrists who were older, had a senior professional title, worked more years, had an onsite clinical rTMS program in their hospital, and received formal training in theory and application (all p < 0.05) were more likely to know that rTMS is approved by the Food and Drug Administration for the treatment of depression. Linear regression showed that formal training in rTMS theory and practice were associated with higher knowledge scores (all p < 0.05). Most of the subjects had negative attitudes about using rTMS to treat mental disorders. When asked about their attitudes about continuing rTMS education, nearly all of the respondents indicated that they were willing to pursue continuing training in rTMS in the future.Conclusions Many psychiatrists had an insufficient level of knowledge about rTMS and negative attitudes about rTMS. Psychiatrists who had formal rTMS training experience had higher levels of rTMS knowledge. rTMS training and relevant policy making should be strengthened.
Chlorophyll Changes Using Neural Network and Vegetation Indices in Tropical deciduous forest
Authors: Gupta Saurabh Kumar , Pandey Arvind Chandra
Published: April 2020

Background: Ongoing climate and Earth’s atmosphere changes create profound effect on distribution and composition of forest, as well as on the fauna that depends on forest. The Sentinel-2A satellite data eases the mapping of Leaf Chlorophyll Content (LCC) at higher spatial and temporal resolution. In the present study, the temporal dimension of LCC was evaluated as an indicator of plant stress. LCC was retrieved using the inversion of the radiative transfer model based on an artificial neural network. The data used for Spatio-temporal modelling of LCC was Landsat data.Result: From the Sentinel imagery derived vegetation indices, it was found that the narrowband indices having high correlation with LCC were pigment specific simple ratio and normalized difference index (45) (R2 > 0.7; p < 0.001) centred at 665 nm, 705 nm, and 740 nm. Landsat 8 infrared percentage vegetation index had a strong relationship with LCC (R2 =0.8). The Spatio-temporal (1997 to 2017) plant stress were detected using changes in LCC through an equation of correlation. The negative changes and deterioration of LCC were seen in the forest during the year 1997 to 20I7(rate = -1.2 µgcm-2year-1) showing higher rate of forest health decline. Conclusion: The 33% of plant stress increased currently in the protected forest mainly because of anthropogenic influences. These vast decline in the chlorophyll gives rise to various photosynthetic vulnerabilities in forest ecosystem and indirectly affects human including wildlife.
Hydrological Functioning of Forested Catchments, Western Himalayan Region, India.
Authors: Qazi Nuzhat Ul Qayoom
Published: April 2020

Background Forests, being the largest ecosystem and primary consumer of water, significantly affect the hydrological cycle at both global and local level and provide innumerable ecosystem services to humans. Western Himalayan forested catchments provide fresh water supply to millions of people. Hence, the understanding of linkages between forests and water is very crucial to recognize for availability and quality of water at catchment scale. Therefore, present study aims to understand hydrological response of two forested catchments (namely, Arnigad and Bansigad) in the Western Himalayan Region.Methods Three-year data (March, 2008 to February, 2011) were collected from meteorological and hydrological stations installed at Arnigad and Bansigad catchments. The present paper displays average hydrological response of forested catchments through detailed field investigation.Results The annual hyetograph analysis reveals that the rainfall at both the catchments were highly seasonal, and wet-period (June-September) plays a key role in catchment functioning. Exceedance of rainfall threshold of ~288 mm (~10% of annual rainfall) significantly increased streamflow generation at both the catchments. At Arnigad, stream was perennial with a mean baseflow of ~80 mm per month (~5% of annual streamflow) whereas, Bansigad had greater seasonality due to lack of flow during the pre-wet-period (March-May). Separation of hydrographs at Arnigad and Bansigad catchments i.e. stormflow (6% and 31%, respectively) and baseflow (50% and 32%, respectively) helps to understand the probability of flooding during wet-period and drought during dry-period. Forest ecosystem at Arnigad improves the hydrological functioning by: reducing stormflow (82%), and enhancing baseflow (52%), soil moisture (13%), steady infiltration rate (22%) and by increasing lag time (~15 minutes) relative to Bansigad. These enhanced values indicated potential for soil to store water at forested catchment (Arnigad) and helps to understand the volume of water that is available during dry-period. The decrease of denudation rate (at Arnigad) by 41% resulting in decrease of suspended sediment (18%) and bed load (75%) compared to Bansigad. Further, the enhancement of dissolved solids in stream resulted due to maximum organic matter generated in forest floor of Arnigad. Conclusion This study confirms the crucial role of forests in maintaining hydrological balances at catchment scale in the Western Himalayan region.
Multi-locus sequence typing of Mycoplasma bovis to assess its genetic diversity from 2009-2018 in Ningxia Hui Autonomous Region, China
Authors: Guo Yanan , Luo Haifeng , Guo Shuqiang , Lei Yuanyuan , Li Yong , He Shenghu
Published: April 2020

Background: Mycoplasma bovis (M. bovis) is a highly contagious cattle pathogen spreading worldwide and especially in Ningxia province in China. Methods: For investing epidemiology and population structure, we isolated 65 strains of M. bovis from infectious cattle with pneumonia or mastitis or arthritis. Multi-locus sequence typing (MLST) analysis were used to compare these 65 strains isolated from 2009 to 2018. The molecular epidemiology and population structure of M. bovis of these strains were further compared to PG45 strain and HB0801 reported for the first time in China and others strains isolated from different province of China through MLST analysis. Seven gene sequences of 65 strains in Ningxia and the strains of different STs in China and PG45 reference strains were concatenated to constructe a phylogenetic tree. Results: Totally two types of ST, ST10 and ST134, were identified in Ningxia. 37 Ningxia strains were classified to ST10 and 28 Ningxia strains were classified to ST134. ST134 strain was a new ST and first found in 2009 and was only widely distributed in Ningxia at present. The M. bovis of ST10 was widely spread in many provinces in China and was widespread in Ningxia since 2010. It is speculated that the prevalence of M. bovis ST10 in Ningxia began in 2010. Conclusion: This study is the first report on the genetic diversity of M. bovis from 2009 to 2018 in Ningxia Hui Autonomous Region and provides the epidemiological information, thus is meaningful for providing a scientific basis for the prevention and control of M.bovis in Ningxia, China.
Patient-Reported Outcomes in Young Adults with Osteonecrosis Secondary to Developmental Dysplasia of the Hip
Authors: Roposch Andreas , Marks Avi , Maor Dror , Cortina-Borja Mario , Hashemi-Nejad Aresh
Published: April 2020

Background Osteonecrosis of the femoral epiphysis is a common complication in the treatment of developmental dysplasia of the hip (DDH). While functional outcomes of affected patients are good in childhood, it is not clear how they change during the transition to young adulthood. This study looks at determining the relationship between osteonecrosis of the femoral head and hip function, physical function and health status in adolescents and young adults treated for DDH.Methods We included 149 patients with a mean (and standard deviation) age of 19.7 (3.8) years with osteonecrosis following an open or closed reduction (1995–2005) and 32 age-matched patients without osteonecrosis. All patients completed valid and reliable patient-reported outcome measures in 2015/16 to quantify their hip function (maximum score 100); physical function (maximum score 100); and general health status (maximum score 1). We graded all radiographs for severity of osteonecrosis (Bucholz-Ogden); acetabular dysplasia (centre-edge angle); subluxation (Shenton’s line); and osteoarthritis (Kellgren-Lawrence). We determined the association between the patient-reported outcomes and radiographic severity of osteonecrosis using mixed-effects regression analysis adjusted for age and acetabular dysplasia at study assessment, and number of prior operations.Results In 149 patients (186 hips) with and without osteonecrosis, the mean differences (95% confidence interval) in hip function, physical function and quality of life were − 4.7 (-10.26, 0.81), -1.03 (-9.29, 7.23) and 0.10 (-1.15, 1.18), respectively. Adjusted analysis stratified across radiographic severity of osteonecrosis showed only patients with Bucholz grade III had significantly worse hip function (p < 0.01) and physical function (p < 0.05) but no difference in health-related quality of life when compared to no osteonecrosis.Conclusion Osteonecrosis secondary to DDH is a relatively benign disorder in young adulthood. Affected patients demonstrated minimal physical disability, a normal quality of life but reduced hip function.
Clinical and Imaging characteristics of primary hepatic sarcomatoid carcinoma and sarcoma: a comparative study
Authors: Shi Dongli , Li Hongjun , Sun Jun , Ma Liang , Chang Jing
Published: April 2020

Background
Primary hepatic sarcomatous carcinoma (PHSC) and primary hepatic sarcoma (PHS) are rare malignancy with frequent overlap in the clinic and radiology. There has never been a comparative study of these tumors for the restricted cases. The purpose of our study was to analyze the clinical and imaging features of PHSCs and PHSs, with an emphasis on the particularities and similarities by comparing the two tumors.
Methods
We retrospectively analyzed the clinical and imaging features of 39 patients with pathologically proven PHSCs (n = 23) and PHSs (n = 16) from three university centres over a 9-year period from 2010–2019. Univariate analyses were performed to determine the consistent and distinctive features.
Results
The background of chronic hepatitis or cirrhosis was observed with a high frequency in both of PHSCs (73.7%) and PHSs (62.5%). Tumors with a diameter more than 10 cm were significantly more common in PHSs than PHSCs (p = 0.043) and cystic masses were more detected in PHSs (P = 0.041). Both of PHSCs and PHSs mainly present hypovascularity (73.7% vs 82.6%). The ring hyper enhancement on the arterial phase (AP) and wash out were more frequently seen in PHSCs and the iso-hypo enhancement on the AP followed persistent or progressive enhancement were more commonly detected in PHSs (all, p < 0.05).
Conclusion
PHSC and PHS generally present as mass lesions with hypovascularity. The ring hyper enhancement on the AP and wash out favor the diagnosis of PHSC. The large size greater than 10 cm, cystic lesion, iso-hypo persistent or progressive enhancement pattern might suggest the possibility of PHSs.
Observing inter-professional videos: impact of collaboration between physicians and psychologists on attitude and knowledge acquisition
Authors: Großer Johannes , Kimmerle Joachim , Shiozawa Thomas , Hirt Bernhard , Bientzle Martina
Published: April 2020

BackgroundInter-professional collaboration (IPC) is an important prerequisite for successful patient care. Even though inter-professional education (IPE) is increasingly common in undergraduate medical education, few IPE approaches explicitly address the IPC among medical students and students of psychology. IPE videos can be used to give learners the opportunity to gather relevant knowledge from different professional perspectives. So far it has been unclear whether it is enough when the topic of the video itself is inter-professional or if it is necessary for experts from different professions explicitly to appear in the video.MethodsIn an online experiment, medical students watched one of two videos about Parkinson’s disease (PD) and the care of PD patients. The information was either provided by protagonists from only one profession (i.e., physicians; mono-professional condition) or provided by protagonists from two different professions (i.e., physicians and a psychologist; inter-professional condition). Attitude toward inter-professional interaction and learning, evaluation of the entertaining and illustrative character of the video, attitude toward physicians and psychologists, importance of IPC, evaluation of psychological treatment support, and knowledge acquisition served as dependent variables.ResultsThe analysis was based on 140 participants (74 in the mono-, 66 in the inter-professional condition). We found that the inter-professional video was perceived to be more entertaining than the mono-professional video (t(138) = -2.227; p = 0.028; d= 0.38). The inter-professional video was also considered to be more illustrative (t(138) = -6.269; p < 0.001; d= 1.06). Moreover, participants improved their attitude toward physicians by watching the video (F(1, 138) = 4.860, p < 0.001, η2p = 0.11), but they did not change their attitude toward psychologists (p = 0.146). Participants who watched the inter-professional video considered IPC to be more important than participants who watched the mono-professional video (t(138) = -7.954; p < 0.001; d= 1.354). Finally, the inter-professional video led to better performance in the knowledge test (t(138) = -2.285; p = 0.024; d= 0.04).ConclusionsInter-professional videos showing explicitly the appearance of experts from different professions come along with several advantages. We discuss the implications of their application in educational practice.Trial registrationThe study was pre-registered on the pre-registration platform AsPredicted (aspredicted.org) before we began data collection (registration number: #33143).
Prevalence and factors associated with Trichomonas vaginalis infection among men who have sex with men and female sex workers in Togo, 2017.
Authors: TCHANKONI Martin Kouame , SADIO Arnold Junior , GBEASOR-KOMLANVI Fifonsi Adjidossi , FERRÉ Valentine Marie , ZIDA-COMPAORE Wendpouiré Ida Carine , DORKENOO Ameyo Monique , SAKA Bayaki , DAGNRA Anoumou Claver , CHARPENTIER Charlotte , Ekouevi Didier Koumavi
Published: April 2020

Background
The aim of this study was to estimate the prevalence and factors associated with Trichomonas vaginalis (T. vaginalis) among men who have sex with men (MSM) and female sex workers (FSW) in Togo in 2017. A cross-sectional bio-behavioral study was conducted from August to October 2017 using a respondent-driven sampling method in four cities in Togo.
Methods
A standardized questionnaire was used to record socio-demographic data and sexual behavior patterns. T. vaginalis detection by molecular biology tests was performed using Allplex STI Essential Assay which detect also 6 others micro-organisms. A blood sample was drawn and serological test using SD Bioline Duo VIH/Syphilis rapid test was performed for HIV and syphilis testing.
Results
A total of 517 key populations including 310 FSW and 207 MSM with median age 24 years, interquartile range (IQR) [20–28 years] were included. The overall prevalence of T. vaginalis, HIV, Mycoplasma genitalium, Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae were 3.9%, 16.8%, 9.3%, 7.5% and 7.2% respectively. T. vaginalis prevalence among FSW was 6.5% (95%CI= [4.1–9.9]) and 0.0% (95%CI= [0.0-2.3]) among MSM. Logistic regression was conducted to identify factors associated with T. vaginalis infection. Living in Lomé (AOR = 3.19; 95%CI= [1.11–11.49]), having had sexual intercourse before the age of 18 (AOR = 5.72; 95%CI= [1.13–10.89]), and being infected with C. trachomatis (AOR = 3.74; 95%CI= [2.95–12.25]) were factors associated with T. vaginalis among FSW.
Conclusion
The prevalence of T. vaginalis infection using molecular test was low among MSM and FSW in Togo. Extensive studies are needed to confirm and better understand the epidemiology of T. vaginalis in these populations and in other populations in Togo.
Identification of risk factors for hyperamylasemia during laparoscopy-assisted surgery for colorectal cancer: a retrospective cohort study
Authors: Zhang Jizhun , Wang Chunjian , Peng Lipan , Xu Tao , Zuo Jiyang , Zhuo Hongqing , Li Leping , Du Fengying
Published: April 2020

Background: Many complications are frequently reported in the carbon dioxide pneumoperitoneum surgery, except hyperamylasemia occurring in pancreas.Methods: Using data from 380 patients with colorectal cancer registered for a prospective cohort study comparing postoperative serum amylase level, risk factors for postoperative hyperamylasemia and surgical complications were identified by multivariate logistic regression analysis.Results: Hyperamylasemia occurred in 140 patients, and a total of 52 patients in 380 patients had short-term postoperative complications, including 25 patients with hyperamylasemia in which 2 patients with acute pancreatitis. The method of operation, injury of pancreas during operation, the duration of pneumoperitoneum and intraoperative blood loss were significant predictors of hyperamylasemia. However, the economic significance of this phenomenon is not certain.Conclusion: High incidence of hyperamylasemia in laparoscopy-assisted surgery for colorectal cancer, the incidence of postoperative infectious complications will increase significantly. Surgical treatment of rectal cancer, operation around the pancreas, intraoperative blood loss, duration of pneumoperitoneum should be considered when planning surgery. Although patient’s hospital cost and postoperative hospital stay were well documented, it is unclear whether this is of any economic significance.Trial registration: The study was registered with the China Clinical Trial Registry with registration number ChiCTR1800015311 and was registered on March 22, 2018.
Early CT imaging markers of COVID-19 progression
Authors: Chen Yanqing , Tang Ningning , Fu Zhao , Wei Youyong , Ma Longbai , Lu Yumin , Ye kun , Liao Xin , Su Yuandong , Huang Guangyi , Yuan Jun , Wu Qiuxia , Xu Fan , Yang Yingxia
Published: April 2020

Background: Early recognition of patients who are prone to develop severe or critical COVID-19 pneumonia may improve its management and modify its outcome by better treatment regimens.Objective: To investigate Computed Tomography (CT)-based early markers of COVID-19 progression. Material and methods: Thirty-two COVID-19 patients were retrospectively enrolled, including 23 moderate cases who remained moderate until being cured and discharged from hospital, and 9 progressive cases who started with moderate pneumonia and later progressed to severe or critical pneumonia. Clinical and CT data in the early course of disease were reviewed and compared. The association between early features and progression of COVID-19 were analyzed. Results: The multivariate logistic regression analysis revealed that the progression of COVID-19 were significantly associated with older age and higher CT score of the right lower lobe in the early CT images. After adjustment for relevant covariates, the relationship between CT score of the right lower lobe and COVID-19 progression persisted (odds ratio 19.28, 95% confidence interval 1.07 - 348.34).Conclusions: Higher CT Score of the right lower lobe in early images and older age appeared to be promising biomarkers for early prediction of COVID-19 prognosis. Extensive involvement of the right lower lobe at the early stage may suggest a high risk of progression.
The prognostic value of gender in gastric gastrointestinal stromal tumors: A propensity score matching analysis.
Authors: Rong Jian fang , Chen Si hai , Song Cong hua , Wang Huan , Zhao Qiao yun , Zhao Ru lin , He Ya jing , Yan Li li , Song Yan ping , Wang Fang fei , Xie Yong
Published: April 2020

Background
Gastrointestinal stromal tumors (GISTs) of the stomach are the most common GISTs. The risk, incidence and outcome of cancer are different between the sexes. Whether gender is related to the prognosis of gastric stromal tumors is unclear. Therefore, this study aims to explore the relationship between gender and gastric GIST prognosis.
Methods
Data from gastric GIST patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. After propensity score matching (PSM) was performed to reduce confounding factors, the clinicopathological features and prognosis of GIST patients were comprehensively evaluated.
Results
There were 512 male patients and 538 female patients with gastric GIST. The gender of gastric GIST patients was associated with marital status, surgical treatment, tumor size, and mitotic index (P < 0.05). The Kaplan-Meier analysis and log-rank test revealed that male patients had a higher mortality rate than female patients (P = 0.0024). After matching all the potential confounding factors, the survival of the female gastric GIST patients was better than that of the male gastric GIST patients (P = 0.042). Cox regression analysis revealed that gender was an independent risk factor for overall survival. The risk of death was higher for males than for females (HR: 1.539, 95% CI: 1.066–2.222, P = 0.021).
Conclusion
Gender could be a prognostic factor for gastric GIST survival, and male patients had a higher risk of death.
Clouds over IEMs? Perspectives for Inborn Errors of Metabolism in adults from a retrospective cohort studies in two Swiss adult metabolic Clinics
Authors: Gariani Karim , Nascimento Marnia , Superti-Furga Andrea , Tran Christel
Published: April 2020

Background: Inborn errors of metabolism (IEMs) are complex medical conditions. Thanks to improvements in diagnostics and treatment, a growing number of pediatric IEM patients reach adulthood. Thus, clinical care for adults with IEM has become an emerging and challenging reality. This purpose of this study of adults with IEM in an adult metabolic clinic at two academic hospitals (Lausanne and Geneva) was to help make informed decisions on the future organization of health care for this group of patients. Methods: All adult patients with a biochemical and/or genetic diagnosis of IEM followed at the Clinic were included in the study. Electronic patient records were reviewed for clinical features, diagnostic studies, treatment and long-term outcome. Data of undiagnosed patients referred for IEM suspicion were analyzed separately.Results: 126 patients were included in the study. The most prevalent group of diseases was small molecules disorders with 83 (66%) patients, followed by energy defects disorders with 28 (22%) patients and complex molecules disorders with 15 (12%) patients. Overall, 64% of patients were diagnosed before, and 37 % after the age 16 years. Among the 126 IEM, 51% suffered from medical complications. 79% of the patients were receiving a specific treatment for their disease. Among the 140 undiagnosed patients referred for suspicion of IEM, investigations lead to a diagnosis in 29 (21%) patients. 24 had confirmation of an IEM and 5 were found to have another genetic condition.Conclusions. This retrospective study reveals significant features of adult IEM cohort. The disorders are heterogeneous, and there is no one-size-fits-all approach – treatment must be tailored to fit each specific disorder in each individual patient. Even patients who are followed tightly are not protected from metabolic decompensations and/or chronic organ-specific complications. While it is commonly assumed that patients with IEMs are more stable once they become adults, our data show that the diseases continue to exact a lifelong toll. A coordinated monitoring of target organs by a multidisciplinary team is needed. To ensure that the success in diagnosis and treatment of individuals with IEMs is sustained, there is a clear requirement for adequately staffed adult IEM clinics.
Comparison Of Human Articular Cartilage Tissue And Chondrocytes Isolated From Peripheral vs Central Regions Of Traumatic Lesions
Authors: Acevedo Lina , Iselin Lukas , Berkelaar Majoska , Salzmann Gian , Wolf Francine , Feliciano Sandra , Vogel Nicole , Pagenstert Geert , Martin Ivan , Pelttari Karoliina , Barbero Andrea , Arnold Markus P.
Published: April 2020

Background. It is generally assumed that traumatic cartilage lesions affect the whole joint homeostasis. However, it remains unknown to which extent the properties of chondrocytes within lesions are affected compared to cells from adjacent locations. To unravel cellular and molecular events occurring in cartilage regions close to injury sites, we collected cartilage biopsies from the central part of the lesions ( central ) and from regions closely surrounding the lesion ( peripheral , 2-5mm distance from defect) of traumatic joints and assessed their key functional properties. Additionally, we investigated the correlation of these properties with the inflammatory features of the joint and the quality of the initial cartilage biopsy. Methods. Cartilage samples were collected from the knee joints of 42 patients (male:female = 7:3, age range: 18-60y) with traumatic knee injuries and analysed for cell phenotype (by RT-PCR), histological quality (using a grading score based on glycosaminoglycan staining), cellularity (cell numbers/gram tissue, isolated after enzymatic digestion), cell viability, proliferation capacity (cell doublings/day) and post-expansion chondrogenic capacity of chondrocytes (Bern score of chondrogenically cultured cells in pellets). In addition, synovial tissues were harvested and analysed for the expression of inflammatory cytokine genes. Results. Cartilage quality and post-expansion chondrogenic capacity were higher in peripheral vs central samples. Differences between these two parameters were more pronounced in joints with high (vs low) inflammatory features, as characterised by >100-fold difference in the mRNA levels of IL-6 and IL-8 in the corresponding synovial tissues. Peripheral chondrocytes isolated from initially good compared to bad quality biopsies expressed higher levels of chondrogenic markers (type II/I collagen and aggrecan/versican ratios) and lower levels of cartilage degrading markers MMP13 and ADAMTS5. They also exhibited reduced proliferation and enhanced cartilage-forming capacity. Conclusions. Chondrocytes at the periphery of traumatic lesions better maintain properties typical of healthy cartilage as compared to those isolated from central parts even when derived from bad quality tissues harvested from highly inflamed joints. Future studies will be necessary to investigate the change of functional properties of peripheral chondrocytes over time and, consequently, to identify a “point of no return” (since onset of symptoms) for a possible use of such chondrocytes in cartilage repair strategies.
High triglyceride-glucose index is associated with adverse cardiovascular outcomes in patients with acute myocardial infarction
Authors: Zhang Yue , Ding Xiaosong , Hua Bing , Liu Qingbo , Gao Hui , Chen Hui , Zhao Xue-Qiao , Li Weiping , Li Hongwei
Published: April 2020

Background
Triglyceride glucose (TyG) index is considered a new marker for metabolic disorders. Although recent studies have found an association between TyG index level and vascular disease development, the prognostic value of TyG index in patients with acute myocardial infarction (AMI) remains unclear.
Methods
A total of 3181 patients with AMI, who underwent coronary angiography, were identified from the Cardiovascular Center of Beijing Friendship Hospital Database Bank and included in the analysis. Patients were stratified into 2 groups according to their baseline TyG index levels: the TyG index < 8.88 group and the TyG index ≥ 8.88 group. Clinical characteristics,biochemical parameters, and the incidence of major adverse cardiovascular events (MACEs) during a median of 33.3-month follow-up were recorded. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2].
Results
Kaplan-Meier analysis revealed no significant difference in the incidence of all-cause death and cardiac death between the 2 groups. Compared with the TyG index < 8.88 group, the TyG index ≥ 8.88 group had significantly higher incidences of non-fatal MI, revascularization, cardiac rehospitalization and composite MACEs. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death [HR (95% CI): 1.51 (1.10,2.06), P = 0.010], cardiac death [HR (95%CI): 1.68 (1.19,2.38), P = 0.004], revascularization [HR (95%CI): 1.50 (1.16,1.94), P = 0.002], cardiac rehospitalization [HR (95%CI): 1.25 (1.05,1.49), P = 0.012], and composite MACEs [HR (95%CI): 1.19 (1.01,1.41), P = 0.046] in patients with AMI. The independent predictive effect of TyG index on all-cause death and cardiac death was mainly reflected in the subgroups of male gender, body mass index ≥ 25 kg/m2, smoker, diabetes mellitus, estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2, high-density lipoprotein cholesterol ≥ 1.01 mmol/L and left ventricular ejection fraction (LVEF) ≥ 0.50. The results also revealed that diabetes mellitus, previous AMI, eGFR, LVEF, and multi-vessel/left main coronary artery lesions were independent predictors of MACEs in patients with AMI (all P < 0.05).
Conclusions
High TyG index levels appeared to be associated with an increased risk of MACEs in patients with AMI. The TyG index might be a valid predictor of cardiovascular outcomes of patients with AMI.
Trial registration:
retrospectively registered
Women empowerment for abortion and family planning decision making among marginalised women in Nepal: a mixed method study
Authors: KC Heera , Shrestha Mangala , Pokharel Nirmala , Niraula Surya Raj , Pyakurel Prajjwal , Parajuli Surya Bahadur
Published: April 2020

Background
Women empowerment is multidimensional. Women’s education, employment, income, reproductive healthcare decision making, household level decision making and social status are vital for women empowerment. Nepal is committed to achieving women empowerment and gender equality, which directly affects the reproductive health issues. This can only be achieved by addressing the issues of the poor and marginalised communities. In this context, we aimed to find the association of women empowerment with abortion and family planning decision making among marginalised women in Nepal.
Methods
A mixed-method study was conducted at selected municipalities of Morang district of Nepal from February 2017 to March 2018. Cross sectional study was conducted among 316 married marginalised women of reproductive age (15–49 years) and key informants interview was conducted among 15 representative healthcare providers and local leaders. From key informants, data were analysed using the thematic framework method. Findings obtained from two separate analyses were drawn together and meta inferences were made.
Results
Women empowered above average were 50.6%. Current use of modern contraceptives were more among below average empowerment groups (p 0.041, OR 0.593 C.I. 0.36–0.98). We could not find any statistical significant differences among women empowerment with abortion knowledge (p 0.549); family planning knowledge (p 0.495) and women’s’ decision for future use of modern contraceptives (p 0.977). Most of key informants reported that unsafe abortion was into practice.
Conclusions
Women empowerment has no direct role for family planning and abortion decision making at marginalised communities of Morang district of Nepal. There was direct influence of different organisations for seeking healthcare services on abortion and family planning despite having women empowerment.
Large-scale screening of thalassemia in Ji’an, P.R. China
Authors: Qiu Yu , Mao Liangwei , Chen Shiping , Li Hao , Wang Hairong , Guan Liping , Huang Jin , Wu Xuan , Liu Yu , Xiao Jie , Fang Yuan
Published: April 2020

Background: To evaluate the prevalence of alpha- and beta-thalassemia in Ji'an City, Jiangxi Province, 28,941 people in the region were genetically screened to identify various thalassemia genotypes.

Methods: High-throughput amplicon sequencing and gap-PCR was used to screen 301 thalassemia alleles in 28,941 people in the region. Pregnant women were the focus of this screening, and if a pregnant woman harbored mutations in a thalassemia-inducing gene, her spouse was also genetically tested.

Results: Of the participants, 2,380 people were carriers of thalassemia, with at least one thalassemia allele, including 1,742 alpha-thalassemia carriers, 686 beta-thalassemia carriers and 48 composite alpha- and beta-thalassemia carriers. The total carrying rate of thalassemia in Ji'an was 8.22%, and the carrying rates of alpha- and beta-thalassemia were 6% and 2.37%, respectively. In addition, the first measured carrier rate of composite alpha- and beta-thalassemia in Ji'an was 0.17%. According to the geographical distribution of the 1,742 alpha -thalassemia carriers, the city with the highest carrier rate was Suichuan, followed by Wan’an and Taihe. According to the geographical distribution of the 686 beta-thalassemia carriers, the top three cities with high carrier rates were Suichuan, Wan'an and Xiajiang, sequentially.

Conclusions: This research emphasizes the importance of large-scale population screening and that comprehensive molecular epidemiology data are necessary for the proper prevention and treatment of thalassemia. The epidemiological data updated in this research may enable the local government to focus on the severity of this disease and determine a method for effective resource allocation under limited resource conditions.
Effectiveness of SMS messaging for diarrhoea measurement: a factorial cross-over randomised controlled trial
Authors: Rego Ryan Trevor Titus , Watson Samuel , Ishengoma Philbert , Langat Philemon , Otieno Hezekiah Pireh , Lilford Richard
Published: April 2020

BackgroundText messaging systems are used to collect data on symptom prevalence. Using a text messaging system, we evaluated the effects of question load, question frequency, and financial incentive on response rates and reported infant diarrhoea rates in an infant diarrhoea survey.MethodsWe performed a factorial cross-over randomised controlled trial of an SMS surveying system for infant diarrhoea surveillance with treatments: financial incentive (yes/no), question load (1-question/3-question), and questioning frequency (daily/fortnightly). Participants progressed through all treatment combinations over eight two-week rounds. Data were analysed using multivariable logistic regressions to determine the impacts of the treatments on the response rates and reported diarrhoea rates. Attitudes were explored through qualitative interviews.ResultsFor the 141 participants, the mean response rate was 47%. In terms of percentage point differences (ppd), daily questioning was associated with a lower response rate than fortnightly (-1·2[95%CI:-4·9,2·5]); high (3-question) question loads were associated with a lower response rate than low (1-question) question loads (-7·0[95%CI:-10·8,-3·1]); and financial incentivisation was associated with a higher response rate than no financial incentivisation (6·4[95%CI:2·6,10·2]).The mean two-week diarrhoea rate was 36·4%. Daily questioning was associated with a higher reported diarrhoea rate than fortnightly (29·9[95%CI:22·8,36·9]); with little evidence for impact by incentivisation or question load.ConclusionsClose to half of all participants responded to the SMS survey. Daily questioning evoked a statistically higher rate of reported diarrhoea, while financial incentivisation and low (1-question) question loads evoked higher response rates than no incentive and high (3-question) question loads respectively.Trial RegistrationThe protocol was registered on ISRCTN on the 20th of March 2019 under number ISRCTN11410773.
Motivation Factors Affecting the Job Attitude of Medical Doctors and the Organizational Performance of Public Hospitals in Warsaw, Poland
Authors: Chmielewska Malgorzata , Stokwiszewski Jakub , Filip Justyna , Hermanowski Tomasz
Published: April 2020

Background: This paper explores the relationship between organizational performance of hospitals and selected motivation factors that affect the attitude to work among medical doctors at public hospitals.Methods: This study was based on World Health Organization questionnaires designed to estimate motivation factors and to measure the levels of organizational performance of hospitals in the social aspect. A survey was conducted among physicians (N=249) with either surgical or non-surgical specialty, in 22 departments/units of general public hospitals in Warsaw (Poland).Results: The survey revealed that motivation factors related to “quality and style of supervision” have the greatest impact on the hospital’s organizational performance (Spearman's rank correlation coefficient = 0.490; p<0.001), whereas “performance feedback” was rated the lowest among the surveyed healthcare professionals (54% of physicians). Conclusion: The principles of Individual Performance Review should be incorporated into strategies designed to improve the organizational performance of hospitals (with NHS serving as a role model) in order to establish specific rules on how to share performance feedback among individual physicians. This study makes a research contribution to literature on human resource management in the healthcare sector, highlighting the importance of social aspects in improving organizational performance in a hospital setting.
Measuring Healthcare Services Productivity with Environmental Constraints in China
Authors: Yu Jinna , liu zhen , Zhang Tingting , Hatab Assem Abu , Lan Jing
Published: April 2020

Objectives: A growing literature the efficiency and productivity of health system, however, environmental pollution factors have not been used as undesirable outputs in Chinese research. Considering the amount of medical waste from healthcare services, this paper analyzes the growth and decomposition of Total Factor Productivity (TFP) change in the provision of healthcare services across 31 provinces in China.Methods: We employed the Meta-frontier undesirable super-efficiency slack-based measure (SBM) model and the Global Malmquist-Luenberger (GML) Index to analysis the growth and decomposition of TFP. We used balanced panel data for 2005-2016 covering 31 Provinces in China. The data came from 2006-2017 China Health and Family Planning Statistical Yearbook (which is also called the China Health Statistics Yearbook, depending on the year).Results: The first valley of TFP change appeared in 2009, the second valley of TFP change occurred in 2015. The rate of technological change (TC) shows a slow decline. The rate of efficiency change (EC) is slowly increasing. The average annual growth rate of TFP, EC, TC, and technology gap change (TGC) in eastern China is 1.8%, 2.08%, -0.03%, and -0.77%, respectively. These indicators in the central region are -2.48%, 2.2%, -4%, and -0.01%, respectively. These indicators in western China are 0.72%, 1.73%, -0.45%, and 0.12%, respectively. With the national average being the benchmark, there are 17 provinces and cities whose TFP exceed the average, 16 provinces and cities whose efficiency changes are above average, 9 provinces and cities whose technology change rates exceed the average, and 13 provinces and cities whose changes in the Technology Gap Ratio (TGR) are above average. Conclusions: (1) Considering the entire country, healthcare services’ TFP shows a slow decline, which is due to insufficient technical innovation. However, an increase in technical catch-up can alleviate this trend. (2) The effect of technical catch-up in the eastern, middle, and western regions of China is significant across all three, while the effect of technical innovation was negative. (3) There are differences between province-level TFPs. These findings suggest that, under existing environmental constraints, relevant government departments should improve technical innovation in the supply of healthcare services and medical waste treatment, increase technical efficiency in the factor of healthcare production, strengthen regional health planning, and balance the development of regional healthcare.