bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of in-vitro antibacterial and antifungal activities of crude extracts and solvent fractions of methanol extract of leaves of Ricinus communis Linn (Euphorbiaceae) against selected pathogens
Authors: Kebede Bedaso , Shibeshi Workineh
Published: September 2020

Background Impacts of infectious diseases are reduced due to development of antimicrobial agents. However, the effectiveness of the antimicrobial agents is reduced over time because of the emergence of antimicrobial resistance.To overcome these problems scholars have been searching for alternative medicines, particularly focusing on traditionally used medicinal plants. Ricinus communis Linn is used as a traditional treatment for bovine mastitis, wound infection, and other medicinal purposes. Moreover, the antimicrobial activity of Ricinus communis Linn leaf at crude extract level has been confirmed against human originated pathogens in the previous studies. The objective of the present study was to further evaluate the antimicrobial activities of Ricinus communis Linn leaf extracts and fractions. The Ricinus communis Linn leaves were macerated in absolute methanol and acetone solvents. The methanol crude extract was shown best antimicrobial activity and exposed to further fractionation via increasing polarity of solvents (n-hexane, chloroform, ethyl acetate, and aqueous). Test microorganisms included in the study were six laboratory reference bacteria (E. coli, S. aureus, S. agalactiae, K. pneumoniae, P. aeruginosa, and S. Pyogenes), two clinical isolate bacteria (E. coli and S. aureus), and Candida albicans. The agar well diffusion method was employed to determine antimicrobial activity. The minimum inhibitory concentrations (MIC) and minimum bactericidal/fungicidal concentrations (MBC/MFC) were determined through broth microdilution method. Results The results indicated that the best antimicrobial activity(based on zone of inhibition) for ethyl acetate fraction ranging from 14.67 mm (clinical E. coli) to 20.33 mm (S. aureus) at 400mg/ml however, n-hexane exhibited lowest antimicrobial activity. Among tested fractions, ethyl acetate fraction was produced lowest MIC values ranging from 1.5625mg/ml (S. aureus) to 16.67 mg/ml (Candida albicans). The ethyl acetate fraction showed bactericidal activity against all tested microorganisms. Conclusion Methanol extract of Ricinus communis Linn leaf exhibited better antimicrobial activity than acetone extract. Hence, ethyl acetate fraction of crude methanol extract exhibited best antimicrobial activity indicating its potential for development of antimicrobial products.
The Treatment and Prophylaxis Usage Profile of Intravenous Vancomycin Medication in Orthopedics
Authors: Wang Liang , Qi Lei , Jiang Yunpeng , Li Mu
Published: September 2020

Background: Despite vancomycin has been widely used in orthopedics, the details of vancomycin usage in orthopedics remains unknown. The purpose of the study was to evaluate the usage profile of intravenous vancomycin medication in orthopedics.Methods: The medical records of inpatients receiving intravenous vancomycin medication from January 2015 to December 2019 in a single center of orthopedics department were retrospectively reviewed. The gender, age, diagnosis, surgical information, microbiological data, duration of vancomycin medication were collected. The related data were analyzed and compared between subgroups.Results: A total of 258 cases receiving intravenous vancomycin medication (≥3 days) were enrolled. The mean age was 57.3 years. There were 141 cases in treatment and 117 in Prophylaxis group. The mean duration of vancomycin medication was 11.2 days. The duration was longer in Treatment than Prophylaxis group (14.8 versus 6.9 days, P<0.05). The main reasons for treatment were PJI after TKA (46.7%) and THA (18.2%) in Joint subgroup and SSI after spine surgery (51.5%) for Spine subgroup. For prophylaxis usage, the main reasons were postoperative clinical suspicious infection. The bacteria responsible for infections in Treatment group were S. epidermidis (34.6%), S. aureus (31.8%), other Staphylococcus (12.1%), MRSA (7.5%), Streptococcus (7.5%), Enterococcus faecalis (3.7%) and Bacillus (2.8%).Conclusion: Taken together, our research firstly revealed the treatment and prophylaxis usage profile of intravenous vancomycin medication in orthopedics. It provides the different purposes, main causes, bacteriological data and medication duration for treatment and prophylaxis vancomycin usage in orthopedics.
Incidence and Economic Burden of Infections in Cancer Patients Receiving Immune Checkpoint Inhibitors: A Retrospective Cohort Study
Authors: Nalluru Swarna , Piranavan Paramrajan , Narimiti Anvesh , Siddiqui Ahmad D. , Abraham George M.
Published: September 2020

BACKGROUNDAlong with antitumor effects, Immune Checkpoint Inhibitors (ICPI) have shown great potential in treating chronic infections such as HIV, Hepatitis B and malaria, in ex-vivo studies. However, several case reports and case series have suggested an increased infection risk in cancer patients. The purpose of our study was to assess the risk of infections in cancer patients receiving ICPI. We also attempted to evaluate the role of a multidisciplinary approach (Oncology and Infectious disease specialists) and the cost associated with treatment. METHODS:Records on all cancer patients over age ≥18 years old who had received at least one dose of ICPI between 2015 to 2018 at a major community teaching hospital in the central Massachusetts region were reviewed. Several risk factors associated with infection were identified. A two-tailed, unpaired t-test was used to analyze the association between risk factors and infection. We calculated the cumulative length of stay (LOS) and cost per admission with a multidisciplinary vs. non-multidisciplinary approach. The calculated total average cost per admission was compared to a matched population (without an oncologic diagnosis) admitted with infections similar to that in our study, to compare the economic burden. RESULTSRetrospective chart review of 169 cancer patients receiving ICPI showed sixty-two episodes of infection in thirty-seven (21.8%) patients and a mortality rate of 3.5% due to associated complications. Risk factors like COPD, prior chemotherapy and steroid use were significantly associated (P<0.05) with infections. Further sub-group analysis showed increase in cumulative LOS from 5.9 to 8.1 days but approximately similar average cost per admission ($52,047 vs. $54,510) with non-multidisciplinary vs. multidisciplinary approach. The calculated total cost per admission during an episode of infection in this cohort of patients was $35,484; three-fold higher when matched to similar infections in a general non-oncologic population ($11,527). CONCLUSIONSA significant incidence of infections and associated health care resource utilization continues to prevail in cancer patients despite the utility of ICPI. A multidisciplinary approach to manage the infections and associated complications in cancer patients receiving ICPI increased the cumulative LOS but not the average cost per admission.
The Effectiveness of Partial Versus Radical Nephrectomy for pT3aN0M0 Renal Cell Carcinoma: A Propensity Score Analysis
Authors: Yang Zheuyu , Li Jibin , Liu Zefu , Chen Peng , Bi Xing , Li Zhiyong , Dong Pei , Han Hui , He Xiaobo , Mao Xiaopeng , Guo Shengjie
Published: September 2020

Background

The survival benefit of partial nephrectomy (PN) in pT3a RCC patients is controversial. Here we aimed to determine the benefit of PN for T3aN0M0 renal cell carcinoma (RCC).
Methods

Data of patients with pT3aN0M0 RCC who were diagnosed between 2010–2012 in the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database were retrospectively collected. We compared overall survival (OS) and cancer specific survival (CSS) using a Cox proportional hazards model between PN and radical nephrectomy (RN) in pT3aN0M0 RCC. Propensity score (–adjusted, –stratified, –weighted, and –matched) analyses were performed to control for imbalances in individual risk factors.
Results

A total of 1277 patients with pT3aN0M0 RCC were identified, of whom 200 patients were treated with PN and 1077 patients were RN. Patients who received PN were more likely to have small tumor size, well/moderately differentiation, peritumoral fat invasion, and less likely to have multiple site invasion and clear cell adenocarcinoma type (p < 0.05). PN showed favorable OS and CSS in 0-4cm pT3aN0M0 RCC (p < 0.05), and similar OS and CSS in 4-7cm pT3aN0M0 RCC, compared with RN using un-adjusted analyses. The Propensity score analyses further demonstrated the survival benefit of PN compared with the RN in 0-4cm pT3aN0M0 RCC (p < 0.05).
Conclusions

In this observational study, PN was associated with improved survival compared with RN in 0-4cm pT3aN0M0 RCC. Moreover, survival was comparable between PN and RN in 4-7cm pT3aN0M0 RCC. These data provided evidence that PN is an alternative choice for T3aN0M0 RCC less than 7 cm. Patients with 0-4cm pT3aN0M0 RCC may benefit from PN.
A Prospective Phase II Study on The Use Of Convalescent Plasma Monotherapy For The Treatment of Severe Covid-19 Disease: A Preliminary Report.
Authors: Pappa Vasiliki , Politou Marianna , Papageorgiou Sotirios G , Antoniadou Anastasia , Kotanidou Anastasia , Bouchla Anthi , Pagoni Maria , Korompoki Eleni , Poulakou Garyfalia , Grouzi Elissavet , Mentis Andreas , Stamoulis Konstantinos , Matsouka Chara , Panagiotakopoulos George , Bamias Aristotelis , Tsiodras Sotirios , Terpos Evangelos , Dimopoulos Meletios-Athanasios
Published: September 2020

Currently, there are no effective treatments for novel corona virus disease 2019 (COVID-19). In this study, we report the preliminary results on the efficacy and safety of convalescent plasma (CP) infusion, as monotherapy in 9 patients with severe COVID-19 disease. The median time from symptom onset to CP transfusion was 6 days. All symptoms improved significantly after a median of 8 days. In 6/9 patients, symptomatic improvement was observed already after the 1st dose of CP transfusion. Laboratory parameters associated with disease severity tended to significantly decrease over time and lymphocyte counts significantly increased on day 14. All patients exhibited significant increases in SARS-CoV-2 IgA and IgG antibodies starting on day 7 through day 21 after CP infusion with concurrent reduction of SARS-CoV-2 RNA on days 7 and 14 with 44.4% % of the patients having undetectable SARS-CoV-2 RNA on day 14. After a median follow-up of 66 days, all patients remain alive. Eight patients recovered completely and were discharged from hospital after a median duration of hospitalization of 21 days. No severe adverse events were observed. In conclusion, this preliminary report suggests that CP infusion monotherapy administered early in the disease course may be a safe and effective strategy for patients with severe COVID-19 disease. Trial registration: NCT04408209. Registered 05 May 2020- Retrospectively registered, (https://clinicaltrials.gov/ct2/show/NCT04408209?term=NCT04408209&draw=2&rank=1).
Coronavirus Disease 2019 Induced Inflammatory Response are Associated with Changes in Lipid Profiles
Authors: Li Chuanwei , Zhang Wen , Xu Chunmei , Tan Hu , Cao Guoqiang , Li Li , Sun Qidi , Wu Gengze , Hu Mingdong , Wu Shuang , Li Qi , Wang Guansong , Zhang Xiaohua , Zeng Chunyu
Published: September 2020

Background: Previous studies have found some evidence of association between changes in lipids and lipoprotein and viral pneumonia. No data are available about the effect of coronavirus disease 2019 (Covid-19) on lipids. The aim of this study was to investigate the relationships between lipid profiles and inflammation markers among patients with Covid-19. Methods: In this retrospective analysis, Covid-19 patients in Jin-yin-tan Hospital and healthy individuals from Daping Hospital were enrolled. The clinical and biochemical characteristics of Covid-19 patients and healthy controls were compared. We correlated lipid parameters to disease severity and inflammatory markers. The severity of Covid-19 for all patients were stipulated according to the diagnostic and treatment guideline for Covid-19 issued by Chinese National Health Committee (the 7th edition).Results: A total of 242 Covid-19 patients and 242 sex-age matched controls were enrolled. Compared with controls, Covid-19 patients had lower lymphocyte counts as well as total cholesterol (TC), high density lipoprotein (HDL-c), low density lipoprotein cholesterol (LDL-c), non-high density lipoprotein cholesterol (non-HDL-c) and apoA-I levels on admission. Whereas apolipoprotein B (apoB) and apoB/apoA-I ratio were slightly higher in patients with Covid-19. There was no difference in lipid levels between the moderate and severe groups. The total lymphocytes were weakly positively associated with TC, LDL-c and apoA-I. Conclusion: Patients with Covid-19 are associated with decreased lipid and lipoprotein levels. Covid-19 infection induced inflammation response and cytokine storm were associated with a shift of lipids, lipoproteins toward a more atherogenic lipid profile.
Confinement and Entanglement Dynamics on a Digital Quantum Computer
Authors: Vovrosh Joseph , Knolle Johannes
Published: September 2020

Confinement describes the phenomenon when the attraction between two particles grows with their distance, most prominently found in quantum chromodynamics (QCD) between quarks. In condensed matter physics, confinement can appear in quantum spin chains, for example, in the one dimensional transverse field Ising model (TFIM) with an additional longitudinal field, famously observed in the quantum material cobalt niobate or in optical lattices. Here, we establish that state-of-the-art quantum computers have reached quantum simulation capabilities to explore confinement physics in spin chains. We report quantitative confinement signatures of the TFIM on an IBM quantum computer observed via two distinct velocities for information propagation from domain walls and their mesonic bound states. We also find the confinement induced slow down of entanglement spreading by implementing randomized measurement protocols for the second order Renyi entanglement entropy. Our results are a crucial step for probing non-perturbative interacting quantum phenomena on digital quantum computers beyond the capabilities of classical hardware.
Study on the Characteristics of Gut Microbiota in Chronic Hepatitis B Patients With Damp Heat Syndrome and Liver Depression and Spleen Deficiency Syndrome
Authors: Jiang Kaiping , Jiang Qunfang , Mo Xiaoai , Li Jianhong , Hu Hongtao , Huang Qinghua , Guo Wenqiang , Qiu Tengyu , Ren Jian , Zhang Lei , Xie Youqing , Huang Kaizhou
Published: September 2020

Background: To explore the potential biological characteristics of traditional Chinese medicine(TCM) syndromes in CHB patients is of great significance to improve the level of TCM treatment.This study was designed to explore the characteristics of gut microbiota in CHB patients with two most common TCM Syndromes.Methods: According to the diagnostic criteria of Western medicine, TCM and screening exclusion criteria, 65 cases of CHB patients with damp heat syndrome and 28 cases of CHB patients with liver depression and spleen deficiency syndrome were finally included in the study. All the basic information was gathered and the fresh fecal samples were collected for 16S rDNA sequencing. 16S rDNA of gut microbiota was sequenced using Illumina hiseq 2500 high-throughput sequencing platform.Based on the optimized sequence, OTU clustering analysis and taxonomic annotation were carried out. Results: The difference in relative abundance of gut microbiota was significant between damp heat syndrome and liver depression and spleen deficiency syndrome in CHB patients. Cyanobacteria was only found in damp heat syndrome.The relative abundance of Erysipelotrichia and Subdoligranulum were higher in liver depression and spleen deficiency syndrome,while the relative abundance of Rhodospirillales, Alphaproteobacteria,and Lachnospira were higher in the damp heat syndrome.LEfSe analysis showed that Lachnospira,Olsenella and Subdoligranulum had significant difference in species among the two TCM syndromes.Conclusions: The different characteristics of gut microbiota in the two TCM syndromes of CHB patients may play an important role in syndrome formation of TCM,which provides a new field of vision for the accurate diagnosis and treatment of TCM.
Validity of ultrasonography derived predictions for estimating skeletal muscle volume- A systematic literature review
Authors: Liegnell Rasmus , Wessman Fredrik , Shalabi Adel , Harringe Marita
Published: September 2020

Background: The amount of muscle mass or muscle volume (MV) varies between individuals and is important for health, wellbeing, and performance. Imaging is a useful tool to monitor MV, magnetic resonance imaging (MRI) is considered gold standard. MRI are not always easily accessible, and the measurements are expensive, therefore ultrasonography (US) has become a more accessible method for estimating MV. Methods: A systematic literature review was conducted in the electronic databases PubMed, CINHAL and Web of Science with the purpose of collecting the current published equations to estimate MV with US and answering the following question: How well does US derived equations based on muscle thickness (MT) predict MV based on MRI? Results: The literature search resulted in 363 citations. Twelve articles met the eligibility criteria and were included. Ten articles scored eight out of eleven on the QUADAS score and two scored nine out of eleven. 36 different prediction equations were identified. Correlations were good, r values ranged between 0.53-0.961 and the standard error of estimates (SEE) ranged between 6-25.6%. Eight studies did further analysis with a Bland-Altman plot and found no systematic errors. The overall strength and quality of the evidence was rated as “low quality” as defined by the GRADE system. Conclusions: We conclude that the validity of US derived equations based on MT is specific to the populations from where it is developed. The agreement with MV based on MRI is moderate with SEE ranging between 6-12% in healthy populations. Suggestions for future research are to investigate if testing positions or increasing the number of measuring points could improve the validity for prediction equations.
Total Spine Magnetic Resonance Imaging for Detection of Multifocal Infection in Pyogenic Spondylodiscitis: A Retrospective Observational Study
Authors: Henkelmann Jeanette , Denecke Timm , Pieroh Philipp , Einhorn Stephanie , Hoeh Nicolas H. von der , Heyde Christoph-Eckhard , Voelker Anna
Published: September 2020

Background:Due to the unspecific symptoms of spondylodiscitis (SpD), an early radiological examination is necessary. However, controversially discussed is the need for an magnetic resonance imaging of the entire spine to exclude multisegmental infections and to determine the required surgical interventions. The aims of this study were to assess the incidence of multilevel non-contiguous pyogenic SpD and compare comorbidities, pain symptoms, and subsequent surgical strategies between unifocal (uSpD) and multifocal (mSpD) SpD. Methods:We retrospectively evaluated the data of patients with confirmed, surgically treated, pyogenic SpD who had received a total spine MRI in a single spine center between 2016 and 2018. MRI findings were classified according to Pola-classification and demographics, duration of clinical symptoms (pain and neurology) and Charlson Comorbidity-Index (CCI) results were compared between uSpD und mSpD groups. Surgical therapy was evaluated in patients with mSpD. Results: uSpD was detected by MRI in 69 of 79 patients (87 %). Of these, mSpD was detected in 10 patients (13%) with 21 infected segments (cervical and/ or thoracic and/ or lumbar region). Age and CCI were similar between uSpD and mSpD and 24 of all SpD regions were clinically unapparent. All patients with uSpD were treated operatively. In seven patients with mSpD, all infected levels of the spine were treated surgically in a one-stage procedure; one patient had a two-stage procedure and one patient had surgery at the lumbar spine, and an additional infected segment of the upper thoracic spine was treated conservatively. One patient died before a planned two-stage procedure was performed. Conclusions:Due to mSpD being found in approximately 13% of SpD cases, and considering the risk of overlooking an mSpD case, MRI imaging of the total spine is recommended. The detection of multiple infection levels can have an impact on the therapeutic strategy chosen.
Discontinuance among California’s electric vehicle buyers: Why are some adopters abandoning electric vehicles?
Authors: Hardman Scott , Tal Gil
Published: September 2020

For the market share of plug-in electric vehicles (PEVs) to continue to increase and reach 100% of the market, adopters of the technology, who initially buy PEVs, will need to continue choosing them in subsequent purchases. While much research has focused on the reasons for and barriers to initial PEV adoption, less has been devoted to the reasons for discontinuance—abandoning a new technology after first adopting it. Based on results from five questionnaire surveys, we find that PEV discontinuance in California occurs at a rate of 21% for plug-in hybrid vehicle adopters and 17% for battery electric vehicle adopters. We show that discontinuance is related to dissatisfaction with the convenience of charging, having preferences for vehicles with lower energy efficiencies, being a later adopter, not having level 2 (220-volt) charging from home, and not being male.
The impact of androgen receptor (AR) and histone deacetylase 1 (HDAC1) expression on the prognosis of ductal carcinoma in situ (DCIS)
Authors: Lee Choong Man , Kim Jisun , Park Yang Soon , Yoon Gyung Won , Jo Hwi Gyeong , Park Hye Jin , Lee Hee Jin , Lee Sae Byul , Chung Il Yong , Kim Hee Jeong , Ko Beom Seok , Lee Jong Won , Son Byung Ho , Ahn Sei-Hyng
Published: September 2020

Background Ductal carcinoma in situ (DCIS) display favorable outcome but little is known about the factors associated with invasive recurrence. To identify better prognostic biomarkers, we performed gene expression analysis followed by immunohistochemistry (IHC) staining validation. Methods Differential gene expression (DGE) analysis of 24 pure DCIS patients was performed using a nanostring platform. RNA was extracted from paraffin blocks from age/estrogen receptor matched recurrence-free (n=16) and invasive-recurrence (n=8) cases (disease-free interval >5 years). External validation was done among independent 61 cases, invasive-recurrence (n=16) and recurrence-free (n=45) pure DCIS cases by IHC staining. Results Eight differentially expressed genes were found statistically significant (log 2-fold change <–1 or >1 and p<0.001). Less than ½ fold expression of CUL1, AR, RPS27A, CTNNB1, MAP3K1, PRKACA, GNG12, MGMT genes were observed in REC cases compared to NED cases. Androgen receptor (AR) and histone deacetylase 1 (HDAC1) were selected for external validation (AR: log 2-fold change –1.35, p<0.001, and HDAC1; log 2-fold change –0.774, p<0.001). AR and HDAC1 protein expression was externally validated by IHC staining of 61 pure DCIS cases (16 invasive-recurrence versus 45 recurrence-free). Absence of AR and high HDAC1 expression was an independent risk factor for invasive recurrence (hazard ratio 5.04, 95% CI: 1.24, 20.4; p=0.023, hazard ratio 3.07, 95% CI: 1.04, 9.04; p=0.042). High nuclear grade (NG 3) was also associated with long term invasive recurrence. Conclusion Comparative gene expression analysis of pure DCIS revealed 8 genes differentially expressed among recurred cases. Immunohistochemistry validation within an independent cohort suggests that, absence of AR and overexpression of HDAC1 was associated with greater risk of long term invasive recurrence among pure DCIS.
Plasma Amyloid-β Oligomerization Tendency Predicts Amyloid PET Positivity
Authors: Pyun Jung-Min , Ryu Ji Sun , Lee Ryan , Shim KyuHawn , Youn Young Chul , Ryoo Nayoung , Han Sang-Won , Park Young Ho , Kang Sungmin , An Seong Soo , Kim SangYun
Published: September 2020

Background: Among other emerging amyloid-targeting blood-based biomarkers, Multimer Detection System-Oligomeric Amyloid-β (MDS-OAβ) measures dynamic changes in concentration of oligomeric amyloid-β (OAβ), which is considered the main pathogenic culprit of Alzheimer’s disease (AD), in plasma after spiking with synthetic amyloid-β (Aβ). We aimed to investigate predictability of MDS-OAβ on amyloid Positron Emission Tomography (PET) positivity.Methods: A total of 96 subjects who visited Seoul National University Bundang Hospital for medical check-up complaining of cognitive decline and had undergone extensive medical assessment were recruited. Amyloid statuses were dichotomized into positive or negative based on visual assessment of amyloid PET. Plasma OAβ concentration was measured by MDS-OAβ. In the previous validation study, 0.78ng/ml was established as the cut-off value and the plasma OAβ concentration higher than or equal to the cut-off value was defined MDS-OAβ positive.Results: MDS-OAβ positivity could discriminate amyloid PET positivity with the AUC value of 0.855 (95% CI 0.776–0.933). Adding MDS-OAβ positivity to prediction models including age, MMSE score, and APOE ε4 status improved the performance up to the AUC value of 0.926 (95% CI 0.871–0.980).Conclusions: The Aβ oligomerization tendency in plasma could predict amyloid PET positivity with high performance, and when it is combined with age, MMSE score, and APOE ε4 status, the predictability was improved substantially. This suggests the potential of MDS-OAβ as a useful initial stage test in clinical and research field of AD.
Assessment of surveillance core and support functions regarding neglected tropical diseases in Kenya
Authors: Ng'etich Arthur Kipkemoi Saitabau , Voyi Kuku , Mutero Clifford Maina
Published: September 2020

Background: Effective surveillance and response systems are vital to achievement of disease control and elimination goals. Kenya adopted the revised guidelines of the integrated disease surveillance and response system in 2012. Previous assessments of surveillance system core and support functions in Africa are limited to notifiable diseases with minimal attention given to neglected tropical diseases amenable to preventive chemotherapy (PC-NTDs). The study aimed to assess surveillance system core and support functions relating to PC-NTDs in Kenya. Methods: A mixed method cross-sectional survey was adapted involving 192 health facility workers, 50 community-level health workers and 44 sub-national level health personnel. Data was collected using modified World Health Organization generic questionnaires, observation checklists and interview schedules. Descriptive summaries, tests of associations using Pearson’s Chi-square or Fisher’s exact tests and mixed effects regression models were used to analyse quantitative data. Qualitative data derived from interviews with study participants were coded and analysed thematically. Results: Detection of PC-NTDs was minimal at the peripheral level with limited (60%) use of standard case definitions. Case registration and confirmation capacities were suboptimal at the lower levels with 52% of facilities having functional laboratories. Presence of well-equipped laboratories (p = 0.007), provision for PC-NTDs in reporting forms (p = 0.004) and training of personnel on surveillance (p<0.001) were associated with higher odds of having a functional surveillance system. Lower levels lacked sufficient action thresholds and feedback was limited across all surveillance levels. Supervisory visits frequency at the community (73%) and facility (53%) levels were minimal. Challenges facing PC-NTDs surveillance activities implementation revealed through qualitative data included lack of surveillance guidelines and reporting tools, minimal data analysis, inconsistent feedback, limited supervisory activities, minimal training and low resource provision. Conclusions: Sufficient milestones have been achieved towards improving performance of surveillance functions in Kenya. However, challenges exist relating to PC-NTDs. Core functions including case detection, registration and confirmation, reporting, data analysis and feedback perform sub-optimally at the facility and community levels. Additionally, support functions including standards and guidelines, supervision, training and resources are particularly weak at the sub-national level. Improved PC-NTDs surveillance performance sub-nationally requires strengthened capacities.
SUITOR: selecting the number of mutational signatures through cross-validation
Authors: Lee Donghyuk , Wang Difei , Yang Xiaohong , Shi Jianxin , Landi Maria Teresa , Zhu Bin
Published: September 2020

For de novo mutational signature analysis, the critical first step is to decide how many signatures should be expected in a cancer genomics study. An incorrect number could mislead downstream analyses. Here we present SUITOR (selecting the number of mutational signatures through cross-validation), an unsupervised cross-validation method that requires little assumptions and no numerical approximations to select the optimal number of signatures without overfitting the data. In vitro studies and in silico simulations demonstrated that SUITOR can correctly identify signatures, some of which were missed by other widely used methods. Applied to 1,536 whole-genome sequenced tumors across eight cancer types, SUITOR selected signatures with the smallest prediction errors and almost all signatures of breast cancer selected by SUITOR were validated in an independent study. SUITOR is a powerful tool to select the optimal number of mutational signatures, facilitating downstream analyses with etiological or therapeutic importance.
Strategies to improve the quality of midwifery care and developing midwife-centered care in Iran: Analyzing the attitudes of midwifery experts
Authors: Khosravy Shahla , Babaey Farah , Abedi Parvin , Kalahroodi Zohreh Mazaheri , Hajimirzaie Saeideh Sadat
Published: September 2020

Background: This study was conducted to provide strategies for improving the quality of midwifery care and developing midwife-centered care in Iran. Methods: A qualitative study using the content analysis method was conducted. Data were collected from 121 participants, including midwifery board members, gynecologists, head of midwifery departments, midwifery students, in charge midwives in the hospitals, and midwives in the private sector in order to find the best strategies for improving the quality of midwifery care and developing midwife-centered care in Iran. Focused-group discussions were used for data gathering, and data were analyzed using content analysis method. Results: The main strategies that participants mentioned for improving the quality of midwifery care were as follow: education, manpower, incentive and support system, midwifery care and duties, equipment and facilities, policy making, monitoring and interdisciplinary activities. Conclusion: Authorities and policymakers may set the stage for developing high quality and affordable midwifery care by relying on the strategies presented in this study.
Oil Price Shock and Regime Switching Behaviour of Exchange Rate in Nigeria
Authors: AYINDE Taofeek Olusola , ADEYEMI Farouq A.
Published: September 2020

This study examines the relationship between oil prices and exchange rate in Nigeria by viewing this relationship in another dimension which is the ability of exchange rate to move from one regime to the other. The period of investigation spanned the period 1980–2017. The regime switching characteristics of exchange rate were examined with the Markov Switching Model technique. The regime switching test suggests that there are two exchange rate regimes of managed float and fixed regimes. It was found that the probability of exchange rate to move from a managed float regime to a fixed regime was very low as compared to switching from fixed to managed float regimes. In fact, the expected duration of transitions is about 4 years for managed float but 9 years for fixed exchange rate regime. Both oil price and exchange rate move in opposite direction; despite the regime changes.
Dynamic Behavior of Coal Pillar Under Different Load Percentage by Numerical Simulation
Authors: Dong Guo-wei , Liu Hai-yang , Zhu Guang-an
Published: September 2020

The stability and dynamic response of coal pillar is of great importance in underground coal mining. In this paper, a series of uniaxial compressiveexperimentswerefirst carried out to investigate the mechanical properties of coal. Subsequently, a statistical constitutive damage model for coal was proposed and applied to the numerical simulation. The proposed strain damage softening function showed almostthe same goodness-of-fit on the experimental curve. A numericalmodel FLAC3Dwas created to investigate the dynamic behavior of the coal pillar under different load percentage(LD). Modelling suggests that the incident and transmitted wave stress evolution observesa similar rule and its process can be divided into three stages, namely, static preload, dynamic disturbance and stabilized stages.Under the same load percentage, the peak incident and transmitted wave stress increase with the increase of dynamic disturbance intensity. On the contrary, the attenuation decrease. It is also observed that the failure zone interior the coal can be predicted by the wave propagation.
Correlation between topographic progression of geographic atrophy and visual acuity changes
Authors: You Jong In , Kim Do Gyun , Kim Eung Suk , Yu Seung-Young , Kim Kiyoung
Published: September 2020

Background: To analyze topographic progression of geographic atrophy with different concentric circles centered on the fovea in correlation with decrease of visual acuity. Methods: We retrospectively analysed 36 eyes of 26 patients diagnosed with geographic atrophy and followed at least 1 year. 1mm circular area at the foveal center were defined as Zone 1, and doughnut shape areas from between 1 and 2 mm to between 5 and 6 mm were defined as Zone 2 to Zone 6. Then, changes of geographic atrophy area in each zone were measured with semi-automatic software. Correlation analysis and regression analysis were performed to determine the relationship between changes in visual acuity and atrophic area in each zone. Result: Mean age was 76.9 years and follow-up period were 3.38 years. The mean atrophic area increased from 8.09 to 16.34 mm2 and visual acuity decreased from 0.39 to 0.69 on logMAR. Mean change of total geographic atrophy area was not significantly correlated with visual acuity decrease. While geographic atrophy progression within Zone 1, Zone 2 and Zone 3 showed significant causal relationship with decrease of visual acuity (all p<0.05). Conclusion: In contrast to the total geographic atrophy area, progression of geographic atrophy in parafoveal area was significantly correlated with decrease of visual acuity.
Evolutionary Expansion and Expression Analysis of the Oligopeptide Transporter Gene Family Between Cucurbita Moschata and Cucurbita Maxima
Authors: Shen Changwei , Yuan Jingping
Published: September 2020

Background: Pumpkin is an important non-saline economic vegetable, salt stress often restricts the growth of pumpkin roots and the transportation and balance of mineral ions in the body. Oligopeptide transporter (OPT) plays an important role in transporting small peptides, secondary amino acids, Glutathione and minerals. However, information about the family of OPT in pumpkin is still limited. Results: In this study, 45 OPT transporters were identified from two cultivated species of Cucurbita moschata and Cucurbita maxima. Phylogenetic analysis showed that these OPT families were divided into two evolutionary branches: OPT clade and yellow stripe-like (YSL) clade. All of these genes contain the typical structure of OPT superfamily, OPT clade contains 12 conserved motifs, while the YSL clade contains 7 conserved motifs. There are tandem gene replication events on chromosomes 13, 16 and 18 of Cucurbita moschata and Cucurbita maxima, and 17 and 18 pairs of genes were collinear with Arabidopsis thaliana, respectively. Promoter element analysis showed that there were many cis-acting elements in the upstream promoters of these genes in Cucurbita moschata and Cucurbita maxima, which responded to 10 kinds of stress, especially hormones (MeJA and ABA) and hypoxia. The expression patterns based on transcriptome data sources showed that some OPT genes were organ-specific and tissue-specific, which might be involved in plant functional development. Transcriptome and qRT-PCR verification tests showed that CmoYSL7, CmaOPT15 and CmaYSL7 of Cucurbita moschata and Cucurbita maxima might play a key role in regulating the balance of metal ions between leaf mesophyll and leaf veins under salt stress. Conclusions: Overall, the data obtained from our study contribute to a better understanding of the complexity of the OPT genes family in pumpkins. These results will provide new insights into the mechanism of salt tolerance and the structure and function of OPT genes in pumpkin.
Epidemiology, clinical presentation, treatment, and follow-up of mercury poisoning in China: a retrospective analysis
Authors: Yawei Sun , Jianhai Long , Junxiu Zhao , Xiaobo Peng , Zewu Qiu
Published: September 2020

Background: There are no reports on the incidence of mercury poisoning in a large population in China. This study investigated the epidemiology, clinical manifestations, treatment, and follow-up of Chinese patients with mercury poisoning. Methods: Data for 288 mercury poisoning patients were collected at our hospital from July 2014 to September 2019, including sex, age, admission time, blood mercury content, urine mercury content, creatinine, urinary mercury/creatinine ratio, 24-h urinary protein levels, electromyography (EMG) findings, renal biopsy, and follow-up. Patient characteristics were evaluated by statistical and correlation analyses. Results: First, mercury poisoning in China mainly occurred through occupational exposure and the inappropriate use of mercury-containing cosmetics and Chinese folk remedies (CFRs). Second, the most common symptoms were nervous system (50.3%), kidney (16.4%) and breathing (8.0%). Mercury poisoning-induced Nephrotic syndrome (NS) and peripheral neuropathy are common long-term complications. The complications of occupational and cosmetics-induced mercury poisoning are consistent with international belief. However, the NS caused by CFRs is mainly membranous nephropathy and the probability of peripheral neuropathy caused by CFRs is higher than other pathogens. Third, follow-up data shows that 13 patients with EMG-confirmed neurological injury, 10 showed full recovery after 38.5 ± 8.03 months. Furthermore, among 18 patients with NS, 15 had normal urine protein and serum albumin levels after 22.67 ± 10.26 months.Conclusions: Regulation of skin-lightening cosmetic products, safety surveillance of CFRs, and prevention and control of occupational exposure must be improved to decrease the incidence of mercury poisoning in China.
Efficacy and safety of lenvatinib versus sorafenib for unresectable hepatocellular carcinoma: A meta-analysis
Authors: sui wei fan , li jian yun , fu jian hua
Published: September 2020

Background

Although sorafenib was recommended as a first-line systemic therapy to prolong overall survival time in unresectable hepatocellular carcinoma (HCC), two randomized phase 3 noninferiority trials demonstrated that lenvatinib was noninferior to sorafenib in unresectable HCC.
Methods

This study included three trials containing 1462 patients identified by a database search using standard terms. We conducted the data analysis in Review Manager version 5.3 software.
Results

The outcomes showed that there were nonsignificant differences in OS of 6, 12, 18, 30 and 36 months, PFS of 18, 24, 30 and 36 months and AEs (grade < 3) between the lenvatinib group and the sorafenib group, and there were significant differences in OS of 24 months (p = 0.01), PFS of 6 (p < 0.00001) and 12 (p < 0.00001) months, ORR (p < 0.00001) and DCR (p < 0.00001) between the lenvatinib group and the sorafenib group.
Conclusions

Lenvatinib was not superior to sorafenib in terms of OS and AEs, and lenvatinib was superior to sorafenib in terms of secondary endpoints, including PFS, ORR and DCR, in unresectable HCC.
Prevalence and Associated Factors for Protein Energy Malnutrition Among Children Below 5 Years Admitted at Jinja Regional Referral Hospital, Uganda
Authors: SUBERU Safiu Adewale , MAALIM Leila Aweis , AKINOLA Saheed Adekunle , FASEUN Yusuf Olusola
Published: September 2020

Background Undernutrition immensely contribute to the death of almost half of the children under 5 years, translating into the loss of about 3 million young lives a year. In developing countries, penultimate to hunger that constitute to the death of most children, Protein Energy Malnutrition (PEM) amongst other factors account for the death of 49% of children below the age of five. Due to incessant increase in poverty level in Uganda, Jinja District five-year development plan of 2011 was designed to curb menace posed by malnutrition not only on children but also adults in this district. The objective of this study is to assess the prevalence and factors associated with PEM among under-fives admitted in the paediatric wards of Jinja Regional Referral Hospital (JRRH). Methods To carry out this study, a descriptive questionnaire-based and facility-based cross-sectional study design was used which will apply both qualitative and quantitative approaches. The study involved a sample size of 364 with the study population being under-fives admitted in the paediatric wards of JRRH between March and August 2019.Results Results of this study shows that 52 out of 364 admissions were due to PEM giving a prevalence of 14.29%, males being affected more than females, with suboptimal immunization history. Children aged between 12 – 24 months contributed the highest (34.62%) cases of PEM and most are living in rural areas with low family socio-economic status and poor breastfeeding and feeding practices. The under-five PEM case-fatality rate was 2% (1 out of 52). Conclusion In conclusion, both the prevalence and case fatality rates of under-five PEM were high, calling for appropriate interventions based on the associated factors.
Optimization of Whole-Genome Sequencing of Plasmodium Falciparum From Low-Density Dried Blood Spot Samples
Authors: Teyssier Noam , Chen Anna , Duarte Elias , Sit Rene , Greenhouse Bryan , Tessema Sofonias
Published: September 2020

Background: Whole-genome sequencing (WGS) is becoming increasingly useful to study the biology, epidemiology, and ecology of malaria parasites. Despite ease of sampling, DNA extracted from dried blood spots (DBS) has a high ratio of human DNA compared to parasite DNA, which poses a challenge for downstream genetic analyses. We evaluated the effects of multiple methods for DNA extraction, digestion of methylated DNA, and amplification on the quality and fidelity of WGS data recovered from DBS. Results: At 100 parasites/μL, Chelex-Tween-McrBC samples had higher coverage (5X depth = 93% genome) than QIAamp extracted samples (5X depth = 76% genome). The two evaluated sWGA primer sets showed minor differences in overall genome coverage and SNP concordance, with a newly proposed combination of 20 primers showing a modest improvement in coverage over those previously published. Conclusions: Overall, Tween-Chelex extracted samples that were treated with McrBC digestion and are amplified using 6A10AD sWGA conditions had minimal dropout rate, higher percentages of coverage at higher depth, and more accurate SNP concordance than QiaAMP extracted samples. These findings extend the results of previously reported methods, making whole genome sequencing accessible to a larger number of low density samples that are commonly encountered in cross-sectional surveys.
The Association of Quality of Life and Personality Characteristics with Adolescent Metabolic Syndrome: A Cohort Study
Authors: liang xiaohua , Zhang Peng , Luo Shunqing , Zhang Guifang , Tang Xian , Liu Lingjuan
Published: September 2020

Background: Increased prevalence of adolescent metabolic syndrome (MS) is a tracking factor for adulthood cardiovascular diseases. This study aimed to explore the potential relationship of quality of life (QoL) and personality traits with adolescent MS. Methods：1961 participants aged 11.68 years from a cohort study established in 2014 and followed in 2019 was included in Chongqing. Quality of life (QoL) and Eysenck’s personality questionnaire and MS components were collected.Results：The prevalence of adolescent MS is 4.69% (95% confidence interval, 3.84%-5.72%). Higher QoL domain score of physical activity ability (PAA) was a protective factor for both MS and MS score (all P<0.01), which was mainly negatively correlated with central obesity, diastolic blood pressure (DBP) and triglycerides levels, and positively correlated with high density lipoprotein cholesterol (HDL-C) level. Total score of QoL was negatively correlated with triglycerides level and positively correlated with DBP (all P<0.01). High extraversion personality score was a protective factor of adolescent MS (P=0.04) and MS score (P=0.06), which was mainly negatively correlated WC systolic blood pressure and TGs, and positively correlated with HDL-C (all P≤0.01).Conclusions：QoL score and extraversion personality score were independent protective factors for both MS prevalence and MS score, suggesting the community intervention to improve the QoL and psychological health of children is essential.
Pharmacological Ascorbate Induces Osteosarcoma Cells Death via H2O2 Mediated-Oxidative Stress and Enhances the Efficacy of Cisplatin in Osteosarcoma
Authors: Zhou Liangfu , Zhao Xixi , Wang Shenghang , Lv Huanhuan , Shaikh Atik Badshah , Shang peng
Published: September 2020

Background: Finding emerging strategies for new use of the “old drug-vitamin C” on cancer treatment-combined with chemotherapy drugs.Methods: This study investigates the mechanisms that pharmacological ascorbate (vitamin C, AA) mediated toxicity in osteosarcoma cells and the effects of pharmacological ascorbate combined with cisplatin (DDP) on osteosarcoma cells in vitro and in vivo.Results: Pharmacological ascorbate not only promoted the production of hydrogen peroxide (H2O2) to kill osteosarcoma cells, but also improved its lethality to tumor cells by reducing the activity of catalase (CAT). DNA damage was the primary reason leading to osteosarcoma cell death, and depletion of nicotinamide adenine dinucleotide (NAD+) and adenosine triphosphate (ATP), activated apoptosis-inducing factor (AIF) all contribute to ascorbate-induced toxicity. The combination of pharmacological ascorbate with cisplatin showed synergistic effect on osteosarcoma cells in vitro. Pharmacological ascorbate enhanced the efficacy of cisplatin on inhibiting osteosarcoma tumor growth in orthotopic intra-tibial mouse model.Conclusion: These results suggest that pharmacological ascorbate causes DNA damage and induces osteosarcoma cells death via H2O2 mediated-oxidative stress. The combination of pharmacological ascorbate and cisplatin has synergistic effects on osteosarcoma cells and orthotopic intra-tibial mouse model. Pharmacological ascorbate could be a safe and effective adjuvant agent against osteosarcoma tumor.