bluuebunny/crossref_metadata_2025 huggingface dataset:
Circ-Foxo3 is positively associated with the Foxo3 gene and leads to better prognosis of acute myeloid leukemia patients
Authors: Zhou Jiao , Zhou Ling-Yu , Tang Xi , Zhang Jing , Zhai Ling-Ling , Yi Yun Yun , Yi Jing , Lin Jiang , Qian Jun , Deng Zhao-Qun
Published: September 2019

Background

The Foxo3 gene, belonging to the forkhead family, is one of the classes of transcription factors characterized by a forkhead DNA-binding domain, which usually considered being a cancer suppressor gene. Circ-Foxo3 is a circular structure which connects the 3’end to the 5’end. Scholars detected that circ-Foxo3 could compete with Foxo3 for binding to some miRNAs.

Methods

In this study, we will test the expression of Foxo3 and circ-Foxo3 in de novo acute myeloid leukemia (AML) patients to explore the relationship between Foxo3 gene and circ-Foxo3. All the de novo AML samples and normal control samples was measured by real-time quantitative PCR. A receiver operating characteristic curve was conducted to differentiate AML patients from control people. Association of Foxo3 expression and overall survival was conducted by Kaplan-Meier survival analysis.

Results

We found that the expression of Foxo3 gene in de novo patients was significantly lower than control samples (P = 0.009). Meanwhile, circ-Foxo3 also expressed lower in de novo AML patients than in control samples (P = 0.040). In different classifications, this trend could be observed more remarkably. In non-M3 patients, the Foxo3 high patients’ survival time was longer than Foxo3 low patients (P = 0.002). Besides, in non-favorable risk groups, patients with low expression of Foxo3 had longer survival time than Foxo3 high patients (P = 0.004). Furthermore, in normal Karyotypic patients, the overall survival time of patients with high-expressed Foxo3 was significantly longer than those with low expression (P = 0.034). Besides, Pearson analysis was also conducted between these two genes in AML patients. Results revealed that they were positively correlated (R = 0.63, P < 0.001).

Conclusion

In conclusion, we found that low expression of circ-Foxo3 and Foxo3 were frequent in AML patients, and patients with high expression of Foxo3 often had a trend of better prognosis.
Mapping patterns of metastatic lymph nodes for postoperative radiotherapy in thoracic esophageal squamous cell carcinoma: a recommendation for clinical target volume definition
Authors: Yu Jing , Ouyang Wen , Li Chunyang , Shen Jiuling , Xu Yu , Zhang Junhong , Xie Conghua
Published: September 2019

Background

The clinical target volume (CTV) for postoperative radiotherapy for thoracic esophageal squamous cell carcinoma (TESCC) needs to be defined. The study aim was to map metastatic lymph nodes (LNMs) in a computed tomography (CT)-based atlas and delineate the postoperative radiotherapy target area.

Methods

Sixty-nine TESCC patients with first recurrent regional LNMs after esophagectomy were included. The LNM epicenters were registered onto corresponding anatomic axial CT images of a standard patient in the treatment position, with reference to the surrounding vascular and bony structures. The LNM sites were based on lymph node map of esophageal cancer, AJCC 8th. The lymph metastasis risk for different segments of thoracic esophagus was assessed.

Results

One hundred and seventy-nine LNMs were mapped onto standard axial CT images. The upper-middle mediastinum region (station 1 to 8 M) contained 97% of metastases in the upper segment of thoracic esophagus, 90% in the middle segment, and 66% in the lower one. Advanced pathological stage (≥IIIB) might be a predictive factor for upper abdominal region (UAR) relapse in lower TESCC. Lower cervical para-tracheal LNMs were within a 4.3-cm bilaterally expanded area from the midline of the body and a 2.2-cm expanded area from the anterior of vertebral body, from the superior border of the C7, to the inferior border of the first thoracic vertebra.

Conclusion

A modified target from the upper border of C7 to the lower border of caudal margin of the inferior pulmonary vein level could cover the high-risk area of TESCC underwent postoperative radiotherapy. UAR seems to be an elective irradiation target for lower TESCC at pathological IIIB stage and higher.
Acanthamoeba keratitis related to contact lens use in a tertiary hospital in China
Authors: Li Weiwei , Wang Zhiqun , Qu Jinghao , Zhang Yang , Sun Xuguang
Published: September 2019

Background

To report the clinical and microbiological features of Acanthamoeba keratitis (AK) related to contact lens use in a tertiary hospital in China.

Methods

In this retrospective study, the medical results of 61 cases of AK related to contact lens use from January 2000 to December 2017 were reviewed. The data included patients’ demographics, lens type, history, risk factors, disease stages, corneal scraping and culture reports, and treatments. Moreover, genotypic identification of some of the isolates was carried out with a PCR assay and sequence analysis of the 18S ribosomal DNA gene.

Results

There were 64 eyes included in the study. A total of 32.8% of the patients wore soft contact lenses, and 67.2% of patients used overnight orthokeratology. In the cases (20 eyes) in the early stage, 65% (13 eyes) had positive results according to Giemsa-stained smears, and 0.9% sodium chloride (NaCl) wet mounts revealed trophozoites in 7 eyes (35%). Six eyes (30%) were diagnosed by confocal microscopy combined with clinical signs. In the orthokeratology patients, 87.8% (36/41) rinsed their lenses and/or cases with tap water; 55% of soft-lens wearers wore their lenses while showering. The genotype of 9 isolates was determined, and all the strains belonged to genotype T4. In the orthokeratology group, the number of patients who required therapeutic penetrating keratoplasty after 2005 was less than that before 2005 (chi-square test, χ2 = 4.209, P = 0.04).

Conclusions

More than two-thirds of the cases were associated with orthokeratology. Examinations with Giemsa-stained smears, 0.9% NaCl wet mounts and confocal microscopy should be performed for patients who are highly suspected of having early-stage AK to help with early diagnosis. In the orthokeratology group, the rate of therapeutic keratoplasty after 2005 was less than that before 2005.
SLC39A8 is a risk factor for schizophrenia in Uygur Chinese: a case-control study
Authors: Jian Xuemin , Chen Jianhua , Li Zhiqiang , Song Zhijian , Zhou Juan , Xu Wei , Liu Yahui , Shen Jiawei , Wang Yonggang , Yi Qizhong , Shi Yongyong
Published: September 2019

Background

Schizophrenia is a severe mental disease with high morbidity and heritability. The SLC39A8 gene is located in 4q24 and encodes a protein that transports many metal ions. Multiple previous studies found that one of the most pleiotropic single nucleotide polymorphisms (SNPs) in SLC39A8, rs13107325, is associated with schizophrenia in the European population. However, the polymorphism of this locus is rare in other populations. In China, the Han Chinese and the Uygur Chinese are two ethnic populations that originate from different races.

Methods

A case-control study was conducted with 983 schizophrenia cases and 1230 healthy controls of the Chinese Uygur population. To validate the most promising SNP, meta-analyses were conducted with the Han Chinese and the European PGC2 data sets reported previously.

Results

A susceptible locus, rs10014145 (pallele = 0.014, pallele = 0.098 after correction; pgenotype = 0.004, pgenotype = 0.032 after correction) was identified in case-control study of the Chinese Uygur population. Further, the association between rs10014145 and schizophrenia was supported by a meta-analysis of Han and Uygur Chinese samples (pooled OR [95% CI] =1.10 [1.03–1.17], Z = 2.73, p = 0.006). The association between rs10014145 and schizophrenia was not significant in a meta-analysis of combined Chinese and European samples (pooled OR [95% CI] =1.07 [1.00–1.14], Z = 1.88, and p = 0.06). In addition, the “CCAC” haplotype of rs4698844-rs233814-rs13114343-rs151394 was significantly associated with schizophrenia in Uygur Chinese (P = 0.003, corrected p = 0.012).

Conclusions

The results of this study support that SLC39A8 is a susceptible gene for schizophrenia in the populations of Han Chinese and Uygur Chinese in China, further studies are suggested to validate the association.
‘Walk this way’: results from a pilot randomised controlled trial of a health coaching intervention to reduce sedentary behaviour and increase physical activity in people with serious mental illness
Authors: Williams Julie , Stubbs Brendon , Richardson Sol , Flower Cathy , Barr-Hamilton Lucy , Grey Barbara , Hubbard Kathryn , Spaducci Gilda , Gaughran Fiona , Craig Tom
Published: September 2019

Background

Cardiovascular disease (CVD) is the leading cause of premature death among people with serious mental illness (SMI). Sedentary behaviour (SB) is an independent risk factor for CVD and mortality and people with SMI are highly sedentary. We developed a health coaching intervention called ‘Walk this Way’ to reduce SB and increase physical activity (PA) in people with SMI and conducted a pilot randomised controlled trial (RCT) to test its feasibility and acceptability.

Methods

We randomised people with SMI from three community mental health teams into either the WTW intervention or treatment as usual. The WTW intervention lasted 17 weeks and included an initial education session, fortnightly coaching, provision of pedometers and access to a weekly walking group. Objective SB and PA were measured with accelerometers. Cardiometabolic risk factors and wellbeing measures were collected.

Results

We recruited 40 people of whom 33 (82.5%) were followed up. 13/20 (65%) of participants allocated to the coaching intervention completed it. In the intervention group SB decreased by 56 min and total PA increased by 32 min per day on average which was sustained 6 months later. There was no change in PA or SB in the control group. When interviewed, participants in the intervention found the intervention helpful and acceptable. No adverse events were reported from the intervention.

Conclusions

The intervention was feasible and acceptable to participants. Preliminary results were encouraging with improvement seen in both SB and PA. A larger study is needed to assess the effectiveness of the intervention and address any implementation challenges.

Trial registration

ISRCTN Registry identifier: ISRCTN37724980, retrospectively registered 25 September 2015.
Improvement in early urinary continence recovery after robotic-assisted radical prostatectomy based on postoperative pelvic anatomic features: a retrospective review
Authors: Nakane Akihiro , Kubota Hiroki , Noda Yusuke , Takeda Tomoki , Hirose Yasuhiko , Okada Atsushi , Mizuno Kentaro , Kawai Noriyasu , Tozawa Keiichi , Hayashi Yutaro , Yasui Takahiro
Published: September 2019

Background

We investigated the impact of postoperative membranous urethral length and other anatomic characteristics of the pelvic floor shape as measured by magnetic resonance imaging on the improvement in continence following robotic-assisted radical prostatectomy.

Methods

We retrospectively reviewed data from 73 patients who underwent postoperative prostate magnetic resonance imaging following robotic-assisted radical prostatectomy between 2013 and 2018. Patient demographics; pre-, peri-, and post-operative parameters; and pelvic anatomic features on magnetic resonance imaging were reviewed. Patients who used no urinary incontinence pads or pads for protection were considered to have achieved complete continence.

Results

Urinary continence was restored in 27.4, 53.4, 68.5, and 84.9% of patients at 1, 3, 6, and 12 months after robotic-assisted radical prostatectomy, respectively. When patients were divided into early and late continence groups based on urinary continence at 3 months after robotic-assisted radical prostatectomy, no significantly different clinical characteristics or surgical outcomes were found. However, the mean membranous urethral length (18.5 mm for the early continence group vs. 16.9 mm for the late continence group), levator muscle width (7.1 vs. 6.5 mm, respectively), and bladder neck width on the trigone side (7.2 mm vs. 5.4 mm, respectively) were significantly different between groups (all p < 0.05). Multivariate logistic regression analysis showed that membranous urethral length (odds ratio, 1.227; 95% confidence interval, 1.011–1.489; p = 0.038) and bladder neck width (odds ratio, 1.585; 95% confidence interval, 1.050–2.393; p = 0.028) were associated with the period of early urinary continence.

Conclusions

Postoperative membranous urethral length and bladder neck width were significantly associated with early urinary continence recovery after robotic-assisted radical prostatectomy. It is highly recommended that surgeons focus on preserving the membranous urethral length and increasing the bladder neck width on the trigone side during surgery to achieve optimal continence outcomes after robotic-assisted radical prostatectomy.
The maintenance of stable yield and high genetic diversity in the agricultural heritage torreya tree system
Authors: Zhang Jian , Hu Liangliang , Guo Liang , Ren Weizheng , Zhao Lufeng , Wang Ningjing , Zhang Entao , Tang Jianjun , Chen Xin
Published: September 2019

Background

Understanding how traditional agriculture systems have been maintained would help design sustainable agriculture. In this study, we examined how farmers have used two types of local trees (Torreya grandis) for stable yield and maintaining genetic diversity in the “globally important agricultural heritage torreya tree system”. The two type of torreya trees are grafted torreya (GT) tree and non-grafted-torreya (NGT) tree. The GT tree has only female and was used to produced seed yields. The NGT tree has both male and female and was used to support GT tree by providing pollens and rootstocks. We first tested the ratio of GT tree to NGT tree, their age groups, ratio of female trees (including GT and NGT trees) to male, and the flowering period of GT and NGT trees. We then tested seed yields and genetic diversity of GT and NGT trees. We further tested gene flow among NGT trees, and the relationship of gene flow with exchange rates of pollens and seeds.

Results

GT and NGT trees (male and female) were planted in a mosaic pattern with a ratio of 4:1 (GT:NGT). In this planting pattern, one NGT male trees provided pollen for 20 female trees of GT and NGT. The trees were classified into four age groups (I = 100–400 years old; II = 400–700 years old; III = 700–1000 years old; and IV = 1000–1300 years old) based on basal diameter. The entire flowering period was longer for NGT trees than for GT trees that ensured GT trees (which lack of males) being exposed to pollens. GT tree had high and stable seed yield that increased with age groups. High genetic diversity has been maintained in both rootstocks of the GT trees and NGT trees. There was a strong gene flow among NGT trees, which positive correlated with the exchange rates of pollens and seeds.

Conclusions

Our results suggest that farmers obtain stable seed yields, and maintain high genetic diversity by ingeniously using the local GT tree as yield producer and NGT tree as supporter. These GT and NGT trees together ensure sustainable torreya production.
Mapping out bare-nosed wombat (Vombatus ursinus) burrows with the use of a drone
Authors: Old Julie M. , Lin Simon H. , Franklin Michael J. M.
Published: September 2019

Background

Wombats are large, nocturnal herbivores that build burrows in a variety of habitats, including grassland communities, and can come into conflict with people. Counting the number of active burrows provides information on the local distribution and abundance of wombats and could prove to be an important management tool to monitor population numbers over time. We compared traditional ground surveys and a new method employing drones, to determine if drones could be used to effectively identify and monitor bare-nosed wombat burrows.

Results

We surveyed burrows using both methods in eight 5-ha transects in grassland, that was interspersed with patches of tussock grassland. Ground surveys were conducted by systematically walking transects and searching for burrows. Drone surveys involved programming flights over transects to capture multiple images, from which an orthomosaic image of each transect was produced. These were subsequently viewed using ArcMap to detect burrows. A total of 204 individual burrows were recorded by drone and/or ground survey methods. In grassland, the methods were equally effective in terms of the numbers of burrows detected in transects. In the smaller areas of tussock grassland, ground surveys detected significantly more burrows, because burrow openings were obscured in orthomosaic images by overhanging grasses. There was agreement between the methods as to whether burrows were potentially active or inactive for most burrows in both vegetation communities. However, image interpretation tended to classify grassland burrows as potentially active. Overall time taken to conduct surveys was similar for both methods, but ground surveys utilised three observers and more time in the field.

Conclusions

Drones provide an effective means to survey bare-nosed wombat burrows that are visible from the air, particularly in areas not accessible to observers and vehicles. Furthermore, drones provide alternative options for monitoring burrows at the landscape level, and for monitoring wombat populations based on observable changes in burrow appearance over time.
Efficacy evaluation of ethanolic extract of Tamarindus indica L. leaves as possible alternate therapy in septic arthritis model of rabbit
Authors: Sinha Bishnu Prasad , Chatterjee Souvick , Buragohain Rinku , Samanta Indranil , Joardar Siddhartha Narayan , Mukherjee Prasenjit , Maji Asit Kumar , Das Partha , Mandal Tapan Kumar , Sar Tapas Kumar
Published: September 2019

Background

Our previous study exhibited free radicals scavenging and antioxidant activities of ethanolic and aqueous extracts ofTamarindus indicaL. leaves in chronic sodium fluoride poisoning in rats.Tamarindus indicaL. seed extract was also reported to have anti-arthritic efficacy by inhibiting cartilage and bone degrading factors. Therefore, an attempt was made to evaluate the effects of ethanolic extract ofTamarindus indicaL. leaves in septic arthritis.

Methods

The safety study was performed by oral dosing of ethanolic extract of the plant leaves at 2 g kg− 1for consecutive 28 days in rabbits. Septic arthritis was induced in rabbits by single intra-articular inoculation of 104c.f.u. ofStaphylococcus aureusto the left stifle joint and was monitored by bacterial colony count, some relevant biochemical parameters and histopathological interpretation of the affected joint. For efficacy evaluation in septic arthritis, linezolid at 75 mg kg− 1twice daily for 10 days and the ethanolic extract ofTamarindus indicaL. at 500 and 1000 mg kg− 1for consecutive 14 days were administered orally to the rabbits after 48 h of induction of arthritis.

Results

In sub-acute toxicity study ofTamarindus indicaL. leaves ethanolic extract, no significant change between days was found for aspertate aminotransferase, alanine transaminase, alkaline phosphatase, blood urea nitrogen and creatinine compared to day 0 values of the same group. The bacterial colony count of synovial fluid followingStaphylococcus aureusinoculation to left stifle joint was found to be 1.08 ± 0.47 and 1.19 ± 0.29 c.f.u. mL− 1in ethanolic extract low dose and high dose groups respectively, on day 2 which was reduced to 0.057 ± 0.036 c.f.u. mL− 1and nil on day 16. The test extract was also found to markedly reduce simultaneous glucose difference, total protein ratio of serum and synovial fluid, joint radius and joint narrowing.

Conclusion

Ethanolic extract ofTamarindus indicaL. leaves at 500 mg kg− 1and 1000 mg kg− 1produced anti-arthritic effects againstS. aureusinduced septic arthritis in rabbits. However, the ethanolic extract at 1000 mg kg− 1orally for consecutive 14 days showed better effects in septic arthritis.
Policy analysis of the Iranian Health Transformation Plan in primary healthcare
Authors: Doshmangir Leila , Moshiri Esmaeil , Mostafavi Hakimeh , Sakha Minoo Alipouri , Assan Abraham
Published: September 2019

Background

Health systems reform is inevitable due to the never-ending changing nature of societal health needs and policy dynamism. Today, the Health Transformation Plan (HTP) remains the major tool to facilitate the achievements of universal health coverage (UHC) in Iran. It was initially implemented in hospital-based setting and later expanded to primary health care (PHC). This study aimed to analyze the HTP at the PHC level in Iran.

Methods

Qualitative data were collected through document analysis, round-table discussion, and semi-structured interviews with stakeholders at the micro, meso and macro levels of the health system. A tailored version of Walt & Gilson’s policy triangle model incorporating the stages heuristic model was used to guide data analysis.

Results

The HTP emerged through a political process. Although the initiative aimed to facilitate the achievements of UHC by improving the entire health system of Iran, little attention was given to PHC especially during the first phases of policy development – a gap that occurred because politicians were in a great haste to fulfil a campaign promise.

Conclusions

Health reforms targeting UHC and the health-related Sustainable Development Goals require the political will to improve PHC through engagements of all stakeholders of the health system, plus improved fiscal capacity of the country and financial commitments to implement evidence-informed initiatives.
Immunization with recombinant rHc23 partially protects lambs against trickle infections by Haemonchus contortus
Authors: González-Sánchez María Elena , Ndombasi-Bokuy Melissa , Cuquerella Montserrat , Alunda José María
Published: September 2019

Background

Haemonchosis is one of the most economically important parasitic diseases affecting small ruminants all over the world. Chemotherapeutic control has several shortcomings (limited anthelmintic arsenal, frequent resistance) and is hardly affordable by many farm economies. A recombinant antigen (rHc23) was shown to induce significant protection in vaccination trials with single dose challenges and different adjuvants.

Results

Lambs were vaccinated with 100 μg rHc23/dose + bacterial immunostimulant (BI) (LPS from Escherichia coli + Propionibacterium acnes extract) (days − 2, 0, 7 and 14) and subjected to a trickle infection with two dosages [6x, 1000 infective larvae (L3) or 6x, 2000 L3]. Vaccinated lambs showed a significant antibody response against rHc23 and Haemonchus contortus soluble extract as assessed by ELISA and Western blot (WB). Fecal egg counts (epg) along the experiment of vaccinated and BI treated lambs were significantly reduced. All vaccinated animals showed total egg output and abomasal helminth burdens (median, average) lower than those from unvaccinated or BI-treated animals lambs although differences were not statistically significant.

Conclusions

Vaccination with 100 μg rHc23/dose + BI against H.contortus trickle infections apparently induced lower epg values and helminth burdens at the end of the experiment. Intragroup individual variations did not allow to obtain conclusive results and more research is needed including adjuvants and larger groups of animals to validate the potential value of rHc23 as candidate to develop a recombinant vaccine for lambs haemonchosis.
Deconvolution of transcriptomes and miRNomes by independent component analysis provides insights into biological processes and clinical outcomes of melanoma patients
Authors: Nazarov Petr V. , Wienecke-Baldacchino Anke K. , Zinovyev Andrei , Czerwińska Urszula , Muller Arnaud , Nashan Dorothée , Dittmar Gunnar , Azuaje Francisco , Kreis Stephanie
Published: September 2019

Background

The amount of publicly available cancer-related “omics” data is constantly growing and can potentially be used to gain insights into the tumour biology of new cancer patients, their diagnosis and suitable treatment options. However, the integration of different datasets is not straightforward and requires specialized approaches to deal with heterogeneity at technical and biological levels.

Methods

Here we present a method that can overcome technical biases, predict clinically relevant outcomes and identify tumour-related biological processes in patients using previously collected large discovery datasets. The approach is based on independent component analysis (ICA) – an unsupervised method of signal deconvolution. We developed parallel consensus ICA that robustly decomposes transcriptomics datasets into expression profiles with minimal mutual dependency.

Results

By applying the method to a small cohort of primary melanoma and control samples combined with a large discovery melanoma dataset, we demonstrate that our method distinguishes cell-type specific signals from technical biases and allows to predict clinically relevant patient characteristics. We showed the potential of the method to predict cancer subtypes and estimate the activity of key tumour-related processes such as immune response, angiogenesis and cell proliferation. ICA-based risk score was proposed and its connection to patient survival was validated with an independent cohort of patients. Additionally, through integration of components identified for mRNA and miRNA data, the proposed method helped deducing biological functions of miRNAs, which would otherwise not be possible.

Conclusions

We present a method that can be used to map new transcriptomic data from cancer patient samples onto large discovery datasets. The method corrects technical biases, helps characterizing activity of biological processes or cell types in the new samples and provides the prognosis of patient survival.
Natural selection and genetic diversity of domain I of Plasmodium falciparum apical membrane antigen-1 on Bioko Island
Authors: Wang Ya-Nan , Lin Min , Liang Xue-Yan , Chen Jiang-Tao , Xie Dong-De , Wang Yu-Ling , Ehapo Carlos Salas , Eyi Urbano Monsuy , Huang Hui-Ying , Wu Jing-Li , Xu Dan-Yan , Chen Zhi-Mao , Cao Yi-Long , Chen Hai-Bin
Published: September 2019

Background

Plasmodium falciparumapical membrane antigen-1 (PfAMA-1) is a promising candidate antigen for a blood-stage malaria vaccine. However, antigenic variation and diversity ofPfAMA-1 are still major problems to design a universal malaria vaccine based on this antigen, especially against domain I (DI). Detail understanding of thePfAMA-1 gene polymorphism can provide useful information on this potential vaccine component. Here, general characteristics of genetic structure and the effect of natural selection of DIs among BiokoP. falciparumisolates were analysed.

Methods

214 blood samples were collected from Bioko Island patients withP. falciparummalaria between 2011 and 2017. A fragment spanning DI ofPfAMA-1 was amplified by nested polymerase chain reaction and sequenced. Polymorphic characteristics and the effect of natural selection were analysed using MEGA 5.0, DnaSP 6.0 and Popart programs. Genetic diversity in 576 globalPfAMA-1 DIs were also analysed. Protein function prediction of new amino acid mutation sites was performed using PolyPhen-2 program.

Results

131 different haplotypes ofPfAMA-1 were identified in 214 Bioko IslandP. falciparumisolates. Most amino acid changes identified on Bioko Island were found in C1L. 32 amino acid changes identified inPfAMA-1 sequences from Bioko Island were found in predicted RBC-binding sites, B cell epitopes or IUR regions. Overall patterns of amino acid changes of BiokoPfAMA-1 DIs were similar to those in globalPfAMA-1 isolates. Differential amino acid substitution frequencies were observed for samples from different geographical regions. Eight new amino acid changes of Bioko island isolates were also identified and their three-dimensional protein structural consequences were predicted. Evidence for natural selection and recombination event were observed in global isolates.

Conclusions

Patterns of nucleotide diversity and amino acid polymorphisms of Bioko Island isolates were similar to those of globalPfAMA-1 DIs. Balancing natural selection across DIs might play a major role in generating genetic diversity in global isolates. Most amino acid changes in DIs occurred in predicted B-cell epitopes. Novel sites mapped on a three dimensional structure ofPfAMA-1 showed that these regions were located at the corner. These results may provide significant value in the design of a malaria vaccine based on this antigen.
Plasmodium vivax cerebral malaria in an adult patient in Sudan
Authors: Mukhtar Maowia M. , Eisawi Omer A. , Amanfo Seth A. , Elamin Elwaleed M. , Imam Zeinab S. , Osman Faiza M. , Hamed Manasik E.
Published: September 2019

Background

Plasmodium vivax infection is rising in sub-Saharan Africa, where Plasmodium falciparum is responsible for more than 90% of malaria cases. While P. vivax is identified as a major cause of severe and cerebral malaria in South east Asia, the Pacific and South America, most of the severe and cerebral cases in Africa were attributed to P. falciparum. Cases of severe malaria due to P. vivax are emerging in Africa. A few severe P. vivax cases were reported in Eastern Sudan and they were underestimated due to the lack of accurate diagnosis, low parasitaemia and seldom use of rapid diagnostic tests (RDTs).

Case presentation

A 60-year-old Sudanese male presented to the Al Kuwaiti hospital in the Sudan capital Khartoum. On admission, the patient was complaining of fever (measured temperature was 38 °C), sweating, chills, vomiting and confusion in the past 2 days prior to his admission. He rapidly deteriorated into a coma state within 48 h of the admission, with significant neck stiffness. He was admitted to the intensive care unit and was suspected of meningitis. Lumbar puncture was not performed since the patient was suffering from spinal cord disc. Brain CT scan was unremarkable. Several biochemical, haematological tests, and blood film for malaria were performed. The results of the laboratory tests were within the normal range except of mild elevation of the total white blood cell count and a significant decrease in the platelets count. Malaria parasites were seen in the blood film with high parasitaemia (quantified as 3 +++). The patient was diagnosed as P. vivax cerebral malaria based on the positive blood film and the amplification of P. vivax specific 499 bp amplicon using Plasmodium multi-species multiplex Polymerase Chain Reaction (PCR). The patient was treated with quinine 10 mg/kg body weight for 10 days followed by primaquine 15 mg/days PO for 2 weeks. The symptoms subsided within 48 h and the patients was cured and released from the hospital.

Conclusions

Plasmodium vivax is an emerging cause of cerebral malaria in adults in Sudan and should be considered in the differential diagnosis of cerebral malaria for proper management of patients.
I could take the judgment if you could just provide the service: non-prescription syringe purchase experience at Arizona pharmacies, 2018
Authors: Meyerson Beth E. , Lawrence Carrie A. , Cope Summer Dawn , Levin Steven , Thomas Christopher , Eldridge Lori Ann , Coles Haley B. , Vadiei Nina , Kennedy Amy
Published: September 2019

Background

Community pharmacies are important for health access by rural populations and those who do not have optimum access to the health system, because they provide myriad health services and are found in most communities. This includes the sale of non-prescription syringes, a practice that is legal in the USA in all but two states. However, people who inject drugs (PWID) face significant barriers accessing sterile syringes, particularly in states without laws allowing syringe services programming. To our knowledge, no recent studies of pharmacy-based syringe purchase experience have been conducted in communities that are both rural and urban, and none in the Southwestern US. This study seeks to understand the experience of retail pharmacy syringe purchase in Arizona by PWID.

Methods

An interview study was conducted between August and December 2018 with 37 people living in 3 rural and 2 urban Arizona counties who identified as current or former users of injection drugs. Coding was both a priori and emergent, focusing on syringe access through pharmacies, pharmacy experiences generally, experiences of stigma, and recommendations for harm reduction services delivered by pharmacies.

Results

All participants reported being refused syringe purchase at pharmacies. Six themes emerged about syringe purchase: (1) experience of stigma and judgment by pharmacy staff, (2) feelings of internalized stigma, (3) inconsistent sales outcomes at the same pharmacy or pharmacy chain, (4) pharmacies as last resort for syringes, (5) fear of arrest for syringe possession, and (6) health risks resulting from syringe refusal.

Conclusions

Non-prescription syringe sales in community pharmacies are a missed opportunity to improve the health of PWID by reducing syringe sharing and reuse. Yet, current pharmacy syringe sales refusal and stigmatization by staff suggest that pharmacy-level interventions will be necessary to impact pharmacy practice. Lack of access to sterile syringes reinforces health risk behaviors among PWID. Retail syringe sales at pharmacies remain an important, yet barrier-laden, element of a comprehensive public health response to reduce HIV and hepatitis C among PWID. Future studies should test multilevel evidence-based interventions to decrease staff discrimination and stigma and increase syringe sales.
Photopheresis efficacy in the treatment of rheumatoid arthritis: a pre-clinical proof of concept
Authors: Coppard Céline , Bonnefoy Francis , Hannani Dalil , Gabert Françoise , Manches Olivier , Plumas Joel , Perruche Sylvain , Chaperot Laurence
Published: September 2019

Background

Despite major advances in rheumatoid arthritis outcome, not all patients achieve remission, and there is still an unmet need for new therapeutic approaches. This study aimed at evaluating in a pre-clinical murine model the efficacy of extracorporeal photopheresis (ECP) in the treatment of rheumatoid arthritis, and to provide a relevant study model for dissecting ECP mechanism of action in autoimmune diseases.

Methods

DBA/1 mice were immunized by subcutaneous injection of bovine collagen type II, in order to initiate the development of collagen-induced arthritis (CIA). Arthritic mice received 3 ECP treatments every other day, with psoralen + UVA-treated (PUVA) spleen cells obtained from arthritic mice. Arthritis score was measured, and immune cell subsets were monitored.

Results

ECP-treated mice recovered from arthritis as evidenced by a decreasing arthritic score over time. Significant decrease in the frequency of Th17 cells in the spleen of treated mice was observed. Interestingly, while PUVA-treated spleen cells from healthy mouse had no effect, PUVA-treated arthritic mouse derived-spleen cells were able to induce control of arthritis development.

Conclusions

Our results demonstrate that ECP can control arthritis in CIA-mice, and clarifies ECP mechanisms of action, showing ECP efficacy and Th17 decrease only when arthritogenic T cells are contained within the treated sample. These data represent a pre-clinical proof of concept supporting the use of ECP in the treatment of RA in Human.
“That’s a woman’s problem”: a qualitative analysis to understand male involvement in maternal and newborn health in Jigawa state, northern Nigeria
Authors: Sharma Vandana , Leight Jessica , Giroux Nadège , AbdulAziz Fatima , Nyqvist Martina Bjorkman
Published: September 2019

Background

Maternal and newborn mortality continue to be major challenges in Nigeria. While greater participation of men in maternal and newborn health has been associated with positive outcomes in many settings, male involvement remains low. The objective of this analysis was to investigate male involvement in maternal and newborn health in Jigawa state, northern Nigeria.

Methods

This qualitative study included 40 event narratives conducted with families who had experienced a maternal or newborn complication or death, in-depth interviews with 10 husbands and four community leaders, and four focus group discussions with community health workers. The interviews focused on understanding illness recognition and care seeking as well as the role of husbands at each stage on the continuum of maternal and newborn health. Data were transcribed, translated to English, and coded and analyzed using Dedoose software and a codebook developed a priori.

Results

This paper reports low levels of knowledge of obstetric and newborn complications among men and limited male involvement during pregnancy, childbirth and the post-partum period in Jigawa state. Men are key decision-makers around the location of the delivery and other decisions linked to maternal and newborn health, and they provide crucial resources including nutritious foods and transportation. However, they generally do not accompany their wives to antenatal visits, are rarely present for deliveries, and do not make decisions about complications arising during delivery and the immediate post-partum period. These gendered roles are deeply ingrained, and men are often ridiculed for stepping outside of them. Additional barriers for male involvement include minimal engagement with health programs and challenges at health facilities including a poor attitude of health providers towards men and accompanying family members.

Conclusion

These findings suggest that male involvement is limited by low knowledge and barriers related to social norms and within health systems. Interventions engaging men in maternal and newborn health must take into account these obstacles while protecting women’s autonomy and avoiding reinforcement of gender inequitable roles and behaviors.
Adult and young women communication on sexuality: a pilot intervention in Maputo-Mozambique
Authors: Frederico Mónica , Arnaldo Carlos , Michielsen Kristien , Decat Peter
Published: September 2019

Background

Communication on sexuality within the family has been considered a determinant factor for the sexual behaviour of young women, contributing to delaying sexual initiation. Taking into account that young women are increasingly exposed to sexualized messages, they need clear, trustful and open communication on sexuality more than ever. However, in Mozambique, communication about sexuality is hampered by strict social norms. This paper evaluates the case of an intervention aimed at reducing the generational barrier for talking about sexuality and to contribute to better communication within the family context.

Methods

The intervention consisted of three weekly one-hour coached sessions in which female adults and young interacted about sexuality. Realist evaluation was used as a framework to assess context, mechanisms, and outcomes of the intervention. Interviews were conducted among 13 participants of the sessions.

Result

The interaction sessions were positively appreciated by the participants and contributed to change norms and attitudes towards communication on sexuality within families. Recognition of similarities and awareness of differences were key in the mechanisms leading to these outcomes. This was reinforced by the use of visual materials and the atmosphere of respect and freedom of speech that characterized the interactions. Limiting factors were related to the long-standing taboo on sexuality and existing misconceptions on sexuality education and talks about sex.

Conclusion

By elucidating mechanisms and contextual factors our study adds knowledge on strategies to improve transgenerational communication about sexuality.
Contextual-relationship and stress-related factors of postpartum depression symptoms in nulliparas: a prospective study from Ljubljana, Slovenia
Authors: Rus Prelog Polona , Vidmar Šimic Marijana , Premru Sršen Tanja , Rus Makovec Maja
Published: September 2019

Background

For a significant proportion of women, postpartum depression (PPD) is the first mood episode in their lives, yet its aetiology still remains unclear. Insecure attachment in close adult relationships is considered to be a risk factor for depressive symptoms. This study aimed to gain further insight into the risk factors for postpartum depression symptoms (PPDS) of nulliparas in Slovenia and to examine vulnerability to developing depressive symptoms, with an emphasis on contextual and stress-related characteristics.

Methods

The sample consisted of 156 nulliparas in the third trimester of pregnancy enrolled in a childbirth preparation program. The following instruments were applied: Experiences in Close Relationships-Revised, the Edinburgh Postpartum Depression Scale (EPDS), the Zung Anxiety Scale and a question battery designed by the research team including questions about emotional support and work-related stress. Logistic regression was used to test the association between demographic, social, environmental, personality and attachment variables and PPD of nulliparas (EPDS ≥10), controlling for baseline (prepartum) depression score. A multivariable linear regression model was built with the postpartum EPDS continuous score as a dependent variable.

Results

28/156 (17,9%) were evaluated as being at risk for depression (EPDS≥10) in the last trimester and 25/156 (16%) at six weeks postpartum. The results of the logistic regression model controlled for prepartum depression score showed that increased risk for developing PPDS was associated with anxiety level postpartum, intimate-partner-attachment anxiety postpartum, and elevated stress due to loss of employment or an unsuccessful search for employment in the previous year. The results of the multivariable regression model, however, showed the association with education and postpartum anxiety with PPDS continuous score; EPDS after giving birth was higher for more educated and more anxious primiparas.

Conclusions

Our findings demonstrate the importance of anxiety symptoms and higher education level in assessments of nulliparas’ mental health. The results of our study show and confirm the results of previous research that anxiety symptoms in the immediate postpartum period are likely to be associated with depressive symptoms in nulliparas. The results also suggest that higher level of education of first-time mothers might not be a protective factor, especially for nulliparas with the university level of education. Further studies on larger samples should be considered.
Paving the way for a better understanding of the pathophysiology of gait impairment in myotonic dystrophy: a pilot study focusing on muscle networks
Authors: Naro Antonino , Portaro Simona , Milardi Demetrio , Billeri Luana , Leo Antonino , Militi David , Bramanti Placido , Calabrò Rocco Salvatore
Published: September 2019

Background

A proper rehabilitation program targeting gait is mandatory to maintain the quality of life of patients with Myotonic dystrophy type 1 (DM1). Assuming that gait and balance impairment simply depend on the degree of muscle weakness is potentially misleading. In fact, the involvement of the Central Nervous System (CNS) in DM1 pathophysiology calls into account the deterioration of muscle coordination in gait impairment. Our study aimed at demonstrating the presence and role of muscle connectivity deterioration in patients with DM1 by a CNS perspective by investigating signal synergies using a time-frequency spectral coherence and multivariate analyses on lower limb muscles while walking upright. Further, we sought at determining whether muscle networks were abnormal secondarily to the muscle impairment or primarily to CNS damage (as DM1 is a multi–system disorder also involving the CNS). In other words, muscle network deterioration may depend on a weakening in signal synergies (that express the neural drive to muscles deduced from surface electromyography data).

Methods

Such an innovative approach to estimate muscle networks and signal synergies was carried out in seven patients with DM1 and ten healthy controls (HC).

Results

Patients with DM1 showed a commingling of low and high frequencies among muscle at both within– and between–limbs level, a weak direct neural coupling concerning inter–limb coordination, a modest network segregation, high integrative network properties, and an impoverishment in the available signal synergies, as compared to HCs. These network abnormalities were independent from muscle weakness and myotonia.

Conclusions

Our results suggest that gait impairment in patients with DM1 depends also on a muscle network deterioration that is secondary to signal synergy deterioration (related to CNS impairment). This suggests that muscle network deterioration may be a primary trait of DM1 rather than a maladaptive mechanism to muscle degeneration. This information may be useful concerning the implementation of proper rehabilitative strategies in patients with DM1. It will be indeed necessary not only addressing muscle weakness but also gait-related muscle connectivity to improve functional ambulation in such patients.
Association between the content of intracellular and extracellular fluid and the amount of water intake among Chinese college students
Authors: Zhang Na , Zhang Jianfen , Du Songming , He Hairong , Yan Xinyu , Ma Guansheng
Published: September 2019

Background

Normal distribution of body fluid is important for maintaining health through the balance of water metabolism. Studies have shown that disease states and diuretics perturb the balance and then induce abnormal intracellular/extracellular fluid ratio. However, there are relatively few researches on the associations between water intakes and body fluid. The objective of this study was to explore the association between body fluid and water intake.

Methods

A total of 159 young adults in Baoding, China were recruited in this cross-sectional survey and completeness of follow-up was 98.1%. A 7-day fluid specific diary was used to record total fluid intake (TFI). Water intake from foods (FWI) for 3 days was measured using the methods of weighting, duplicate portion method and laboratory analysis by researchers. Body fluid was measured using bioelectrical impedance analysis.

Results

Total body water (TBW), intracellular fluid (ICF) and extracellular fluid (ECF) of participants were 32.8[28.0,39.2], 20.5[17.3,24.5] and 12.4[10.7,14.7], (kg). This represented 55.2 ± 6.2, 34.4 ± 4.0 and 20.8 ± 2.3 (%) of body weight (BW), respectively. ICF, ECF and TBW among male participants who drank more than or equal to adequate TFI was higher than those who drank less (Z = -1.985, p = 0.047; Z = -2.134, p = 0.033; Z = -2.053, p = 0.040). Among both males and females, the values of TBW/BW in participants whose TWI met or exceeded the AI were higher than those with TWI less than AI (t = − 2.011, p = 0.046; t = − 2.716, p = 0.008). Among all participants, there was moderate correlation between water intakes (TFI/BW, FWI/BW and TWI/BW) and body fluid (ICF/BW,ECF/BW and TBW/BW) (p < 0.01 for all). Same correlations were found among both males and females.

Conclusion

There is a certain degree of association between water intake and body fluid. However, whether TFI or TWI achieve AI or not do not disturb the balance on the distribution of body fluid. More studies should be conducted to find the diagnostic threshold on TFI and TWI which may disrupt the distribution of body fluid so as to prevent related diseases.

Trial registration

Chinese clinical trial registry. Name of the registry: Relationship of drinking water and urination. Trial registration number: ChiCTR-ROC-17010320. Date of registration: 01/04/2017. URL of trial registry record: http://www.chictr.org.cn/edit.aspx?pid=17601&htm=4.