bluuebunny/crossref_metadata_2025 huggingface dataset:
Shared Decision-making between health care providers and patients at a Tertiary Hospital Diabetic Clinic in Tanzania
Authors: Vedasto Oswald , Morris Baraka , Furia Francis Fredrick
Published: May 2020

BackgroundPatients’ participation in decision making regarding their treatment is defined in ethical, legal and human rights standards in the provision of care that concerns health providers and the entire community.ObjectiveTo assess practices and challenges of diabetic patients and healthcare providers’ participation in shared decision making at Muhimbili National Hospital in Dar es Salaam.MethodsThis study employed a phenomenological study design using in-depth interview technique. Study participants were diabetic patients visiting the clinic and healthcare providers working at Muhimbili national hospital. Data was collected using the semi-structured interview guide with open-ended questions using an audio digital recorder. Content analysis method was used during analysis whereby categories were reached through the process of coding with assistance by Nvivo 12 software.ResultsThe study found that most participants participate in shared decision making. Few patients indicated partial participation in shared decision making. Decision aids were found important for execution of shared decision making but they are scarce. Likewise, the study found that beliefs and values, time and education level are barriers to shared decision making.ConclusionAlthough this study indicated that shared decision making is practiced at Muhimbili national hospital, further search in this area is needed to be done in other hospitals.
Modulation of inflammatory factors predicts the outcome following spinal cord injury
Authors: Yu Zepeng , Sun Xingwei , Xia Rui , Chen Qian , Wu Qin , Zheng Weiwei
Published: May 2020

BACKGROUND: The correlation between inflammatory responses caused by spinal cord injury (SCI) and the prognosis of patients with SCI still remains controversial.METHODS: In the present study, we preliminary investigated the serum levels of interleukin (IL)-4, IL-10, major histocompatibility complex (MHC)-I and inducible nitric oxide synthase (iNOS), and compared the serum IL-4 and IL-10 expression in rats of high Basso-Beattie-Bresnahan (BBB) scores with these of low BBB scores. Besides, the infiltration of macrophage and the axonal regeneration of the injured spinal cord were observed from day10 to day30.RESULTS: We found that higher serum levels of IL-4 and IL-10 can reflect the restorability degree of SCI and could be potential biomarkers for the prognosis of SCI. The infiltration of the M2 subtype of macrophage and the axons regrowth might contribute to a better prognosis.CONCLUSIONS：The current study demonstrates that the serum levels of IL-4 and IL-10 are preliminary adopted as serologic markers to forecast SCI, and high serum levels of IL-4 and IL-10 may indicate a better prognosis. Moreover, the way to promote macrophage polarization from M1 to M2 may contribute to better axonal regeneration.
One-stage anterior focus debridement, interbody graft using titamium mesh cages, and anterior instrumentation and fusion in the surgical treatment of short segment thoracic tuberculosis
Authors: zhang huijun , lu zenghui , wei lin , ding chao , yang junsong
Published: May 2020

Study design:This is a retrospective studyObjective:The purpose of this study was to evaluate the clinical efficacy of primary anterior debridement, bone graft fusion and internal fixation in the treatment of short segmental thoracic tuberculosis. MethodsWe performed a retrospective analysis of 16 adult patients with short segment thoracic spinal TB who underwent surgery between September 2013 to March 2017. All the 16 patients were treated using a single primary anterior debridement, bone graft fusion and internal fixation. Clinical manifestations, laboratory, neurological symptoms,bone fusion and imaging results were subjected to statistical analysis.ResultsAll patients underwent operation successfully. The symptoms of chest and back pain were alleviated and disappeared at 1–6 months postoperatively.Patients were followed up for 24–48months (average, 35.6 ±9.6 months). Among 16 patients, no recurrence, and all the patients got bony spinal fusion within 4 to 8 months after surgery judging by spinal x-ray film.The preoperative ESR and CRP level of all patients were 72.6 ± 27.5 mm/h and 75.7 ± 25.9 mg/L, which decreased to 15.9 ± 4.6 mm/h and 4.7 ± 2.0 mg/L at the final follow-up, respectively. The preoperative thoracic kyphosis angle were 18.2± 4.1°respectively. The corresponding postoperative angles were ameliorated significantly to 9.1 ±1.9°. During the follow-up, spinal paraplegia was significantly improved in all patients. Neurologic status of the 16 patients with preoperative neurologic defcit was 3 with grade A recovered to normal; 4 with grade B recovered to normal; 4 with grade C recovered to normal; 3 with grade A recovered to grade D; 1 with grade B recovered to grade D;1 with grade C recovered to D.ConclusionThe clinical results of primary anterior debridement, bone graft fusion and internal fixation in the treatment of short segmental thoracic tuberculosis with paraplegia or incomplete paralysis can be an effective and feasible treatment method.
Equity, Anti-Racism and Social Justice: Mission Statements, Vision and Values of British Columbia’s Health Delivery System
Authors: Kang-Dhillon Harminder Bindy Kaur , Varcoe Colleen , Reimer-Kirkham Sheryl , Thobani Sunera
Published: May 2020

Background

Framed by a universal healthcare philosophy, publically funded Canadian healthcare delivery organizations are presumed to provide primary care for all residents. However, despite this universal coverage, healthcare inequity is evidenced for non-dominant racialized patients and healthcare providers.
Methods

To examine the diversity commitments of healthcare delivery organizations in British Columbia, we analyzed mission statements, visions and values with a list of 23 health equity markers.
Results

Our findings reveal that health equity for racialized non-dominant communities is not prioritized in the mission, vision or value statements for 7 of the 8 healthcare delivery organizations.
Conclusion

The absence of these markers reaffirms that anti-racist ideologies are not conceptualized into the institutional identities of British Columbia’s healthcare delivery organizations. Further, without an anti-racism equity framework embedded into institutional identity, organizations have a limited ability to meaningfully address inequities experienced by racialized non-dominant patients and healthcare providers. We recommend that healthcare delivery organizations review and revise their guiding documents with a lens of equity, social justice and cultural safety; and to incorporate education for all healthcare leadership and staff through the lens of anti-racist pedagogy.
Effect of Olive Mill Wastewaters on Scenedesmus Sp. Growth, Metabolism and Phenols Removal
Authors: Moussa Ines Dahmen-Ben , Masmoudi Mohamed Ali , Feki Firas , Choura Sirine , Sayadi Sami
Published: May 2020

The authors have withdrawn this preprint due to author disagreement.
A comparative study on the time to achieve negative nucleic acid testing and hospital stays between Danoprevir and Lopinavir/Ritonavir in the treatment of patients with COVID-19
Authors: Zhang Zhicheng , Wang Shumei , Tu Xianglin , Peng Xuping , Huang Yanxia , Wang Li , Ju Weihua , Rao Jianfeng , Li Xue , Zhu Donghong , Sun Huabao , Chen Hongyi
Published: May 2020

BackgroundIn late December 2019, the coronavirus disease 2019 (COVID-19) first outbroke in Wuhan city, China, and has now become a global pandemic. However, there is no specific antiviral treatment for COVID-19.MethodsThis study was approved by the Ethics Committee of the Ninth Hospital of Nanchang. This study enrolled 33 COVID-19 patients in the nineth hospital of Nanchang from January 27th to February 24th, 2020. Clinical indexes of patients upon admission/discharge were examined. Patients were divided into two groups according to different treatment plans (Danoprevir; Lopinavir/Ritonavir). The days to achieve negative nucleic acid testing and the days of hospital stays were counted and statistically analyzed.ResultsCOVID-19 patients treated with Danoprevir or Lopinavir/Ritonavir were all improved and discharged. Indexes like blood routine, inflammation and immune-related indexes were significantly recovered after treatment. Additionally, under the circumstance that there was no significant difference in patients’ general information between the two groups, we found that the mean time to achieve negative nucleic acid testing and hospital stays of patients treated with Danoprevir both were significantly shorter than those of patients with Lopinavir/Ritonavir.ConclusionCollectively, applying Danoprevir is a good treatment plan for COVID-19 patients.Highlight1. The average time to achieve negative nucleic acid testing of COVID-19 patients treated with Danoprevir was obviously shorter than that of patients treated with Lopinavir/Ritonavir;2. The average time of hospital stays of COVID-19 patients treated with Danoprevir was significantly shorter than that of patients treated with Lopinavir/Ritonavir.
The Expression of miR-513c and miR-3163 was Downregulated in Tumor Tissues Compared with Margin Tissues of Patients With Breast Cancer
Authors: Delgir Soheila , Ilkhani Khandan , Safi Asma , Seif Farhad , Bastami Milad , Alivand Mohammad-Reza , Bastami Milad
Published: May 2020

Background Breast cancer (BC) is the most common invasive cancer with different subtypes that its metabolism is unique compared with normal cells. Glutamine is considered a critical nutrition for tumor cell growth and therefore, targeting glutamine metabolism, especially Glutaminase, which catalyzed the conversion of glutamine to glutamate can be beneficial to design anti-cancer agents. Recently, evidence has shown that miRNAs with short length and single strand properties play a significant role in regulating the genes related to glutamine metabolism and may control the development of cancer.Methods Since, in-silico analysis confirmed that miR-513c and miR-3163 might be involved in glutamine metabolism, the expression level of these two miRNAs was evaluated in eighty BC tissues and margin tissues. The data were analyzed to evaluate the correlation between expression level of these miRNAs and patient’s characteristics such as abortion history, family history, and age. Furthermore, in-silico analysis was applied to predict the potential biological processes and molecular pathways of miR-513c and miR-3163 based on its gene targets.Results In-silico studies revealed the top categories of biological processes and pathways that play a critical role in cancer development were target genes for miR-513c and miR-3163. The current study showed that miR-513c (P-value = 0.02062 and fold change= -2.3801) and miR-3163 (P-value = 0.02034 and fold change= -2.3792) were downregulated in tumor tissues compared to margin tissues. Furthermore, the subgroup studies did not show any substantial relationship between expression levels of these two miRNAs and factors such as age, family history cancer, and abortion.Conclusion Based on our data, miR-513c and miR-3163 may be offered as a potential diagnosis and therapeutic targets for patients with BC.
S. Aureus Lipoteichoic Acid Failed to Activate NLRP3, but Downregulated the Transduction of NLRP3/MAPK and NF-κB Signaling Pathway in Mouse Mastitis Induced by S. Aureus
Authors: Bi Chong-Liang , Li Hui , Shen Yi-Zhao , Pauline Mirielle
Published: May 2020

Background It was confirmed that S. aureus infection activated the expression of NLRP3. As a major component of S. aureus cell wall, what about LTA? Firstly, in this study a mouse model was built following LTA intramammary infection for 0, 12, 24, 48 and 72 h, the characterization of mammary inflammatory response induced by LTA was observed. Subsequently, mouse mammary preconditioned with LTA was modelling. The effect of LTA treatment on the activation of NLRP3/ MAPK and NF-κB signaling pathways induced by S. aureus were detected.Results Results shown that the LTA intramammary infection induce mild but rapid recovery inflammation in mammary gland whereas failed to stimulate NLRP3. LTA treatment protected mammary gland against S. aureus infection by suppressed the activation of NLRP3/ MAPK and NF-κB signaling pathways. Meanwhile it is noteworthy that the expression of NLRP3/MAPK JNK induced by S. aureus was not regulated by LTA treatment.Conclusions These results suggested LTA induced mammary gland inflammation was mild and self-limiting. LTA treatment revealed a good anti-inflammation effect through downregulating the transduction of NLRP3/MAPK and NF-κB signaling pathways in mouse mastitis induced by S. aureus. Our research highlights the importance of an LTA during the innate immune response of the mammary gland and offer novel insights for new approaches concerning effective immunomodulation against a local bacterial infection.
Persistence and reversibility of arsenic-induced gut microbiome and metabolome shifts in rats after 30-days recovery duration
Authors: Du Xiaoyan , Zhang Jie , Schramm Karl-Werner , Huang Qingyu , Tian Meiping , Zhang Xi , Nan Bingru , Shen Heqing
Published: May 2020

Background: The metabolites of gut microbiome are important host-health regulating factors and can be easily interrupted by the host exposure to environmental pollution via ingestion route. Arsenic contaminated drinking water is one of the most serious environmental problems worldwide. Therefore, the arsenic-induced alterations of gut microbiome and the metabolome, especially the persistence and reversibility parts of the alterations after the long-term arsenic exposure will be interesting to know. Results: We investigated the relationship between gut microbiota and its related metabolites in male rats both after the 30-days arsenic treatment and 30-days recovery duration. The composition and diversity of gut microbiota were affected significantly by the treatment, but they presented partial improvement in recovery duration. Moreover, arsenic exposure induced the significant changes of 73 metabolites, which involved in the metabolism of glycerophospholipid, linoleic acid, as well as the biosynthesis of phenylalanine, tyrosine and tryptophan. Although it had a persistent effect, the restoration of glycerophospholipid metabolism was observed in the 30-days recovery. Integration analysis further correlated the arsenic impacting microbes with some important differential metabolites, but only Lactobacillus associated with the decreases of phosphatidylethanolamine(34:1) , 16alpha-hydroxydehydroepiandrosterone 3-sulfate, seryltryptophan and alanyltyrosine in the recovery. Lactobacillus strains have potential to work as protective agents against arsenic toxicity by restoring perturbed glycerophospholipid metabolism. Conclusions: Arsenic significantly modified gut microbiome and metabolome, but arsenic-induced disruptions of gut microbiome and metabolome are reversible to some extent after a 30-days recovery. The deeper understanding of correlation of altered gut microbiome and metabolome could be a novel strategy to combat arsenic-induced disease.
Mechanisms of different cultivars of Cucurbita pepo in resistance to Podosphaera xanthii infection through improvement of antioxidative defense system and gene expression
Authors: Zhang Shuwu , Xu Bingliang , Liu Jia
Published: May 2020

Background: Powdery mildew is one of the world’s most destructive diseases of cucurbit and the major cause of losses in its production worldwide. A number of strategies have been developed and applied to discover some suitable and alternative safe methods to manage the powdery mildew disease occurrence, but little information is regarding to screen of resistant pumpkins (Cucurbita pepo L.) germplasm and explore the mechanisms of their preventing the disease occurrence at physiological, biochemical, and molecular levels. Therefore, we evaluated and determined the ability and mechanisms of two commercial pumpkin cultivars in resistance to Podosphaera xanthii infection. Results: Compared with mock-inoculated seedlings, small and sparse spots were observed on the cultivar of Sixing F1 leaves at the 13th day after inoculation with P. xanthii, whereas a large number of disease spots or a layer of white powdery mildew were observed on the surface of Jin12 F1 leaves. Increased the inoculation time (7, 9, 11 and 13 days) significantly and continuously increased the disease incidence and index of pumpkin seedlings after inoculation. The disease incidence and index of Jin12 F1 were significantly higher than the cultivar of Sixing F1. At Day 13, the disease incidence and index of Jin12 F1 were 80.0% and 72.6, whereas the cultivar of Sixing F1 was 22.3% and 17.7, respectively. The contents of H2O2, MDA, lignin and total phenolics in the leaves of Sixing F1 and Jin12 F1 were markedly accelerated after inoculation with P. xanthii. However, the cultivar of Sixing F1 exhibited less reactive oxygen species (ROS) accumulation, a lower rate of lipid peroxidation and higher level of lignin and total phenolics contents after inoculation, whereas the cultivar of Jin12 F1 exhibited higher level of ROS accumulation and rates of lipid peroxidation, and lower level of lignin and total phenolics contents. Higher activity and transcript level of antioxidant enzymes and gene of PAL expression were observed on different tissues of both cultivars after inoculated with P. xanthii. Compared with pumpkin seedlings that were inoculated with sterile water but not P. xanthii, the level of PAL activity and gene expression in leaves, petioles and stems of Sixing F1 and Jin12 F1 were upregulated and increased significantly at different time points after inoculation. The enhancement expression of PAL activity and gene in different tissues of Sixing F1 was significantly higher than Jin12 F1, and higher in leaves, lower in petioles and stems. Conclusions: Our results indicate that the cultivar of Sixing F1 exhibited the highest ability in resistance to P. xanthii infection in comparison to Jin12 F1, and one novel possible mechanism is related to the cultivars in resistance to P. xanthii infection by activating and enhancing the antioxidative defense system and gene expression to prevent the pathogens infection.
Detection of Several Carbapenems Resistant and Virulence Genes in Classical and Hyper-virulent Strains of Klebsiella Pneumoniae Isolated From Hospitalized Neonates and Adults in Khartoum
Authors: Albasha Aalaa Mahgoub , Osman Esraa Hassan , Alhalim Saga Abd , Alshaib Elianz , Al-Hassan Leena , Altayb Hisham N
Published: May 2020

ObjectiveKlebsiella pneumoniae (K. pneumoniae) involves both community-acquired infections and nosocomial infections. It is responsible for a wide variety of infections including infections of the urinary tract, pneumonia, bacteremia, meningitis, wound infection and purulent abscesses. We constructed this study to detect several carbapenems resistant and virulence genes in classical and hyper-virulent strains of K. pneumoniae isolated from hospitalized neonates and adults in Khartoum state. ResultsSeventy percent of the isolates were resistant to ceftazidime and 8% to imipenem, 35% were multi-drug resistant, and 7% extensively drug-resistant, all neonatal blood isolates (n=15) were resistant to ceftazidime. entB was the most predominant virulence gene (93.3%), followed by mrkD (78.3%), kfu (60%), K2 (51.7%), magA (18.3%) and rmpA (5%). blaOXA-48 was the most predominant carbapenem-resistant gene (68.3%), followed by blaNDM (10%), blaKPC (8.3%), and blaIMP (3.3%). Eight hyper-virulent strains were positive for blaOXA-48 and two for blaNDM genes.
Mycobacterium mucogenicum and Mycobacterium neoaurum Bloodstream Infection in Immunocompromised Hosts
Authors: Villalobos Armelle Pérez-Cortés , Rotstein Coleman
Published: May 2020

Background

Mycobacterium mucogenicum and Mycobacterium neoaurum are an infrequent cause of bloodstream infection in humans. When they are isolated from blood, it is not unusual for them to be considered to be contaminants initially.
Methods

A retrospective chart review of patients diagnosed with M. mucogenicum and M. neoaurum bacteremia was conducted from January 1998 to December 2018 at the University Health Network, Toronto, Canada.
Results

We identified 28 patients who had bloodstream infection caused by these organisms. These patients were immunocompromised hosts, patients with chronically indwelling vascular access devices or injection drug users. In 28.5% of the patients the isolation of these mycobacteria was considered colonization, 82% of the cases received antimicrobial therapy and in 95% of the patients the central line was removed.
Conclusions

The removal of the vascular access device and treatment with either single or combination antimicrobial therapy produced successful outcomes for these infections.
Profitability analysis of family-size Biogas Plant Installation in West Hararghe Zone, Oromia National Regional State, Ethiopia
Authors: Sefera Tale Gedefa , Gelmecha Emebet Abera
Published: May 2020

Biogas technology, which converts biological waste into energy, is considered as an excellent tool to improve the lives, livelihoods, health, ecosystem and economy. In Ethiopia, biogas technology has been domesticated to improve the rural energy security and household’s income by reducing their dependence on traditional biomass energy and chemical fertilizers. The profitability of biogas installation is rendered doubtful despite its numerous benefits and domestication efforts. Hence, this study aimed at evaluating the cost-benefit analysis and Profitability of biogas technology at household level in West Hararghe zone, Eastern Ethiopia. A multi-stage sampling technique was employed to select sample households. A total of 105 biogas adopter households were selected for household survey. Results indicated the most commonly domesticated plant is fixed dome biogas with volumes of 6 m 3 and 8 m 3 . Investing 6 m 3 biogas plant with subsidy (0.73 year) had short payback period (PBP) than the 8 m 3 plant (0.97 year). This implies, subsidy has been attracting households into biogas adoption. The benefit cost ratio (BCR) under assumption with subsidy was found to be 1.34 and 1.10 at 10% discount rate for 6 m 3 and 8 m 3 plants, respectively. Under both assumptions with and without subsidy, the NPV results for 6 m 3 and 8 m 3 biogas plant sizes turn out positive. In general, the results of PBP, BCR and NPV shown that the biogas investment is preferable and profitable for continuing the investment for the future.
Diagnostic Accuracy of Transthoracic Echocardiography and Transesophageal Echocardiography for Ruptured Chordae Tendineae: A Meta-Analysis
Authors: Liao Lisi , DONG Fa-jin , ZENG Jie-ying , SHI Bo-bo , ZHONG Xiao-fang , HUANG Yu-xiang , CHEN Li-xin , Xu Jinfeng
Published: May 2020

Background

Echocardiography is significant for the diagnosis of ruptured chordae tendineae (RCT) for which transesophageal echocardiography (TEE) is always better than transthoracic echocardiography (TTE), but the diagnostic accuracy of TTE still remains confusing.
Methods

A meta-analysis of included papers was performed to evaluate the diagnostic accuracy of TTE and TEE, with surgical findings of RCT as the gold standard of patients with suspected RCT.
Results

The literature search yielded 862 papers, 6 met the inclusion criteria, included 505 patients, for detecting RCT, the sensitivity and specificity of TTE were 48% (95% CI: 35–62%) and 98% (95% CI: 89–100%), and those of TEE were 99% (95% CI: 64–100%) and 94% (95% CI: 87–98%), respectively. The summary + LR, -LR of TTE were 22.40 (95%CI: 4.89–102.62), 0.53(95%CI:0. 41–0.68), respectively. The summary + LR, -LR of TEE were 17.62(95%CI: 7.16–43.39), 0.02(95%CI:0. 00-0.57), respectively. For TTE, the area under SROC was 84% (95%CI:92%-96%),and that of TEE is 98%. The pooled + LR and -LR were calculated by setting the prior probabilities of 20% in both TTE and TEE.
Conclusions

TTE is not highly sensitive for the detection of RCT but is highly specific, so there is a potential of missing diagnosis, and subsequent TEE is almost required in highly suspected patients.
External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study
Authors: Sun DongDong , Lv Dan , Zhou Kun , Chen Jian , Gao Li-Lan , Sun Ming-Lin
Published: May 2020

PurposeTo compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula.MethodsFrom January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n = 35), plate-screw (group B, n = 30) and kirschner wire(group C, n = 26).The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups.ResultsFour patients were lost to follow-up, and 87 patients were followed up for 5–35 months (average, 14.2 months). The operation time of group C(114.92 ± 36.09 min) was shorter than that of group A (142.27 ± 47.05 min) and group B(184.00 ± 48.56 min) (P < 0.05). There was no difference in intraoperative blood loss among the three groups (P > 0.05). The surgical and implants costs in group C (5.24 ± 1.21, thousand dollars) is lower than that in group A (6.48 ± 1.11, thousand dollars) and group B (9.37 ± 2.16, thousand dollars) (P < 0.05).The fracture healing time of group C(5.67 ± 1.42months) was significantly less than that of group A (6.90 ± 1.33months) and group B(6.70 ± 1.12months) (P < 0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P < 0.05). The wound infection and needle-tract infection did not differ among the three groups (P > 0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P > 0.05).conclusionCompared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shorten the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.Fund program: National Natural Science Foundation of China (11572222)
Upregulated CDKN2A expression may be an independent protective factor in Luminal-like breast cancer
Authors: Qiu Yier , Lu Guowen , Wu Yingjie
Published: May 2020

Background Previous studies revealed that CDKN2A (cyclin-dependent kinase inhibitor 2A) functioned as a tumour suppressor in various types of malignant tumours. The aim of the study was to clarify the value of CDKN2A expression in the prognosis of breast cancer. Method Using the Cancer Genome Atlas (TCGA) database, we compared CDKN2A mRNA levels between breast cancer tissues and normal tissues and analyzed the relationship between clinical features and CDKN2A expression with the Wilcox test and the Kruskal-Wallis test. Kaplan-Meier and Cox analyses were performed to determine the correlation between CDKN2A expression and breast cancer prognosis. Gene set enrichment analysis (GSEA) was performed using the TCGA data set. Results We first found that CDKN2A expression was markedly higher in breast cancer tissues than in normal tissues using the TCGA database (P=0.000). In addition, CDKN2A mRNA expression in breast cancer was positively correlated with age (P=0.018), histological types (P=0.028), ER status (P=0.000), PR status (P=0.000) and molecular subtypes (P=0.000). Kaplan-Meier analysis showed that increased CDKN2A expression was associated with increased survival time in breast cancer patients (P=0.000), especially in Luminal-like subtype. Univariate and multivariate Cox analyses indicated that CDKN2A expression was an independent prognostic biomarker for breast cancer (P=0.037). GSEA suggested that pathways involving cell adhesion molecules (CAMs), cytokine-receptor interactions, cytosolic DNA sensing, the cell cycle, and killer cell-mediated cytotoxicity were differentially enriched in the CDKN2A-high expression group. Conclusion Our research demonstrated that high CDKN2A mRNA expression was an independent protective factor for improved prognosis in Luminal-like breast cancer. Additionally, the signaling pathways related to CAMs, cytokine-receptor interactions, cytosolic DNA sensing, the cell cycle, and killer cell-mediated cytotoxicity regulated by CDKN2A mRNA expression should be further studied.
Atherosclerosis is attenuated by acacetin via Sirt1-mediated activation of AMPK/Sirt3 signals in diabetic ApoE-/- mice
Authors: Han Wei-Min , Chen Xu-Chang , Wang Yan , Li Gui-Rong
Published: May 2020

BackgroundThe strategy of decreasing atherosclerotic cardiovascular disorder is imperative to reduce premature death and improve quality of life in patients with diabetes mellitus. The present study was designed to investigate whether the natural flavone acacetin could improve diabetes- accelerated atherosclerotic lesions.MethodsDiabetic model was established in 7-week-old ApoE−/− mice by intraperitoneal injection of STZ (daily 50 mg/kg) for 5 days. Animals of control, control with acacetin treatment, STZ-diabetes, STZ-diabetes with acacetin treatment received acacetin prodrug subcutaneously (20 mg/kg, b.i.d.) or equivolume saline for 12 weeks, and the elasticity of carotid artery and the ability of vascular wall movement were determined with ultrasound and magnetic resonance imaging. Human umbilical vein endothelial cells (HUVECs) were cultured with medium containing 5.5 mM or 33 mM glucose and treated with acacetin or vehicle. Changes of related aortic lesions and signaling molecules were determined by biochemical and molecular approaches in animals and cultured HUVECs.ResultsIt was found that acacetin significantly suppressed atherosclerotic lesions and neointima hyperplasia, improved the elasticity of carotid artery and the ability of vascular wall movement without reducing blood glucose level and reversed the impaired signaling molecules (i.e. SOD, Bcl2, PGC-1α, pAMPK, Sirt3 and Sirt1) in artery tissues in diabetic mice. In cultured HUVECs, high glucose-induced cell viability reduction, ROS over-production, decrease of anti-oxidation, increase of apoptosis, and impairment of mitochondrial function were countered by acacetin (0.3-3 µM) in a concentration-dependent manner. Moreover, acacetin relies on Sirt1 activation by increasing NAMPT and NAD+ followed by Sirt3, pAMPK and PGC-1α activation. Silencing Sirt1 abolished acacetin-induced activation of Sirt3, pAMPK, and PGC-1α.ConclusionsThese results indicate that Sirt1-mediated activation of pAMPK/Sirt3 signals is involved in protective effects of acacetin against atherosclerosis in diabetes by preserving mitochondrial function via reducing mitochondrial apoptosis and ROS production and enhancing its biogenesis, which suggests that acacetin may be a drug candidate for reducing atherosclerotic cardiovascular disorder in patients with diabetes.
Influence Of Marketing Mix On Adolescents’ Voluntary HIV Testing Uptake In Tanzania: Experience From Physical Evidence
Authors: Matemba Stephen Furaha , John Elia , Ismail Ismail J , Mwansisya Tumbwene
Published: May 2020

Background In public health, traditional 4Ps (product, price, place and promotion) of the marketing mix have been successfully used to influence clients/patients to adopt desired health behaviors and health status changes in reproductive health, tuberculosis (TB), malaria, child survival and human immuno-virus (HIV) interventions. However, the use of additional 3Ps (Physical evidence, People and Process) of the marketing mix have rarely been used in public health interventions. This study examined the influence of physical evidence on voluntary counseling and testing (VCT) uptake among adolescents in Tanzania.Methods A cross-sectional study design using quantitative method was conducted in Dodoma. A multi-stage random sampling method was used to select nine secondary schools and 449 study participants. Self-administered structured questionnaire was used. Data was analyzed using SPSS v17. Relationship between independent and dependent variables was analyzed using binary logistic regression and correlation analysis with p-value of ˂ 0.5 regarded as significant. Binary logistic regression was used to determine predictors of VCT uptake. Descriptive statistics was used to analyze participants’ characteristics and ranking of physical evidence variables’ on VCT uptake among adolescents.Results Of 449 study participants, 54% and 46% were females and males respectively. The participants’ age range was 12–19 years. 96% of respondents had knowledge of VCT, 90.6% were willing to test for HIV, however; 78% had not tested for HIV. Physical evidence variable modern equipment was highly ranked influential variable regarding VCT uptake. Independent variables modern equipment, physical facility, personnel and materials were found predictors of VCT uptake. Participant characteristics age and school type were also predictors for VCT uptake.Conclusions Despite majority of adolescents had knowledge on VCT service and were willing to test for HIV, VCT uptake was low. Meaning that knowledge and willingness a lone are not enough to influence VCT uptake. Physical evidence variables modern equipment, physical facility, personnel and materials when integrated in HIVprevention strategies and interventions can increase VCT uptake among adolescents in Tanzania. Consideration of individual expectation variations and other predictor variables like age and school type need to be incorporated in designing VCT interventions.
DHPV: A Distributed Algorithm for Large-Scale Graph Partitioning
Authors: Adoni Wilfried Yves Hamilton , Nahhal Tarik , Krichen Moez , byed Abdeltif El , Assayad Ismail
Published: May 2020

Big graphs are part of the movement of "Not Only SQL" databases (also called NoSQL) focusing on the relationships between data, rather than the values themselves. The data is stored in vertices while the edges model the interactions or relationships between these data. They offer flexibility in handling data that is strongly connected to each other. The analysis of a big graph generally involves exploring all of its vertices. Thus, this operation is costly in time and resources because big graphs are generally composed of millions of vertices connected through billions of edges. Consequently, the graph algorithms are expansive compared to the size of the big graph, and are therefore ineffective for data exploration. Thus, partitioning the graph stands out as an efficient and less expensive alternative for exploring a big graph. This technique consists in partitioning the graph into a set of k sub-graphs in order to reduce the complexity of the queries. Nevertheless, it presents many challenges because it is an NP-complete problem.

In this article, we present DPHV (Distributed Placement of Hub-Vertices) an efficient parallel and distributed heuristic for large-scale graph partitioning. An application on a real-world graphs demonstrates the feasibility and reliability of our method. The experiments carried on a 10-nodes Spark cluster proved that the proposed methodology achieves significant gain in term of time and outperforms JA-BE-JA, Greedy, DFEP
WITHDRAWN: Breastfeeding Prevalence and Factors Affecting Brestfeeding in Suburban Area in Serbia, Indjija
Authors: Mitrovic Tanja Rozek , Petrović Vesna , Višnjevac Danilo
Published: May 2020

Background: Breastfeeding and human milk are ideal and the normative standards for infant feeding and nutrition up to 6 months. The Decree on the National Breastfeeding Support Program in Serbia set the goals, as World Health Organization, baby to 6 months of age has exclusive breastfeeding for 50-60% of infants.Method: This cohort study retrospectively uses data routinely collected during health visits to the child, completing the survey by the mother who gave birth between 1. January 2013 and 31. December 2017. The study was carried out in a pediatric practice dispensary located in Indjija, suburban area in Serbia. In this study, 1089 surveys were processed . The objective of this study was to assess the prevalence of breastfeeding and recognize factors that affect breastfeeding duration.Results: The results of this study show that 27.82% of newborns breastfeeding within the first hour after birth and within the first 6h 69.59% of the newborn. Never-breastfed infants are 5.78%. Breastfeed babies up to 4 months were 61%, up to 6. months were 53.7%, and a year and longer 28.55% of infants. Factors affecting the rate breastfeeding and breastfeeding duration with statistical significance are hour of first breastfeeding, by mother: age, level of education, marital status, parity, type delivery, and by the baby: gender, year of birth, gestational age, birth weight.Conclusions: Breastfeeding prevalence and dreastfeeding duration in suburban area in Serbia shows an increasing trend with each successive generation. The Baby Friendly Hospital Initiatives still need to be implemented, in the breastfeeding support program more to include patronage and pediatric nursing, promote prepartum pregnant counseling, developmental counseling, prevention of preterm birth. A complex of nutritional, environmental, socioeconomic, psychological as well as genetic interactions establish a massive list of benefits of breastfeeding to the health outcomes of the breastfed infant and to the breastfeeding mother.
Influencing Factors for Quality Care on Prevention of Postpartum Hemorrhage in the Northern Province of Rwanda: Beneficiary and Health Worker Perspectives.
Authors: Bazirete Oliva , Nzayirambaho Manassé , Umubyeyi Aline , Uwimana Marie Chantal , Marilyn Evans
Published: May 2020

Background: Reduction of maternal mortality and morbidity is a major global health priority. However, much remains unknown regarding factors associated with postpartum hemorrhage (PPH) among childbearing women in the Rwandan context. The aim of this study is to explore the influencing factors for quality care on prevention of PPH asperceived by beneficiaries and health workers in the Northern Province of Rwanda.Methods: A qualitative descriptive exploratory study was drawn from a larger sequential exploratory‐mixed methods study. Semi‐structured interviews were conducted with 11 women who experienced PPH within the 6 months prior to interview. In addition, focus group discussions were conducted with: women’s partners or close relatives (2 focus groups), community health workers (CHWs) in charge of maternal health (2 focus groups) and health care providers (3 focus groups). A socio ecological model was used to develop interview guides to describe factors influencing the prevention of PPH in consideration of individual attributes, interpersonal, family and peer influence, intermediary determinants of health and structural determinants. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board.Results: We generated four interrelated themes:(1) Meaning factors (beliefs, knowledge and understanding of PPH) among participants; (2) Organizational factors; (3) Caring factors and family involvement and (4) Perceived risk factors and barriers to PPH prevention. The findings from this study indicate that PPH was poorly understood by women and their partners. Family members and CHWs feel that their role for the prevention of PPH is to get the woman to the health facility on time. The main factors associated with PPH as described by participants were multiparity and retained placenta. Low socioeconomic status and delays to access health care were identified as the main barriers for the prevention of PPH. Conclusions:Addressing the identified factors could enhance early prevention of PPH among childbearing women. Placing emphasis on developing strategies for early detection of women at higher risk of developing PPH, continuous professional development of health care providers, developing educational materials for CHWs and family members could improve the prevention of PPH. Involvement of all levels of the health system was recommended for better prevention of PPH. Further quantitative research, using case control design is warranted to develop a screening tool for early detection of PPH risk factors for proactive prevention.
Partograph utilization as a decision making tool and associated factors among obstetric care providers in Ethiopia: A systematic review and Meta-analysis
Authors: Ayenew Asteray , Zewdu Biruk Ferede
Published: May 2020

Background Partograph is a prestigious obstetric tool used to monitor the feto-maternal condition and follow the progress of labour. It is coast effective and affordable health intervention that could prevent obstructed and prolonged labour which is the major cause of maternal mortality that continued to be the global burden worldwide. There are various studies on partograph utilization and associated factors in different regions of Ethiopia. But no studies showed the national estimate of partograph utilization in Ethiopia. Therefore, this review was conducted to estimate the national pooled prevalence of partograph utilization and associated factors in Ethiopia. Method Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases used were; PubMed, Google scholar, Cochrane Library, African Journals Online, Ethiopian's university research repository online library, and manual searching. The search was further limited to studies conducted in Ethiopia and reported in English. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity of studies. The pooled estimate prevalence and the odds ratios with 95% confidence intervals were computed by a random effect model. Result A total of 19 studies with 6237 participants were included in the meta-analysis. The national pooled prevalence of partograph utilization was 59.95% (95% CI:46.81,73.09) . The pooled adjusted odds ratio (AOR) of partograph utilization for midwifery profession was 4 (95% CI: 2.63,5.99), female health care providers was 3.2 (95%CI:2.218,4.66), Emergency Obstetric and Newborn Care training was 2.9 (95%CI:2.19, 3.83), Knowledge of partograph was 2.5 (95%CI: 1.6, 3.87) and short term training on partograph was 5.66 (95%CI: 2.48,12.92), favorable attitude towards partograph was 2.3(AOR=2.3,95%CI:1.5,3) , and working at health center was 3.5(AOR=3.5,95%CI:2.5,4.9). Conclusion The prevalence of partograph utilization was low in Ethiopia. Being a midwifery profession, female obstetric care provider, Emergency Obstetric and Newborn Care training, knowledge of partograph, and short term training on partograph , favorable attitude towards partograph , and working at health center were found to be a significant associated factor for partograph utilization.
Pre-impaired Fasting Glucose State Is A Risk Factr for Endothelial Dysfunction Flow-mediated Dilation Japan (FMD-J) Study
Authors: Yamaji Takayuki , Harada Takahiro , Hashimoto Yu , Takaeko Yuji , Kajikawa Masato , Kihara Yasuki , Hida Eisuke , Chayama Kazuaki , Goto Chikara , Han Yiming , Yusoff Farina Mohamad , Kishimoto Shinji , Maruhashi Tatsuya , Nakashima Ayumu , Higashi Yukihito
Published: May 2020

Background

There is little information on the relationships of fasting blood glucose (FBG) including high normal blood glucose and impaired fasting glucose (IFG) with endothelial function. The purpose of this study was to evaluate the relationship between FBG level and flow-mediated vasodilation (FMD) in detail using a large sample size.
Methods

This study was a cross-sectional study. We measured FMD in 7265 subjects at 31 general hospitals. The subjects were divided into four groups based on FBG levels: <5.55 mmol/L, 5.55–6.05 mmol/L, 6.11–6.94 mmol/L, and ≥ 6.99 mmol/L or known type 2 diabetes. The subjects were also divided into six groups based on FBG levels: <5.00 mmol/L, 5.00-5.22 mmol/L, 5.27–5.50 mmol/L, 5.55–6.05 mmol/L, 6.11–6.94 mmol/L, and ≥ 6.99 mmol/L or known type 2 diabetes.
Results

FMD decreased in relation to increase in FBG level. There was a significant difference in FMD between the FBG of < 5.55 mmol/L group and the other three groups (6.7 ± 3.1% vs. 5.9 ± 2.8%, 5.7 ± 3.1%, and 5.1 ± 2.6%; p < 0.001, respectively). After adjustment for confounding factors, the odds of having the lowest quartile of FMD was significantly higher in the FBG of 5.27–5.50 mmol/L, 5.55–6.05 mmol/L, 6.11–6.94 mmol/L, and ≥ 6.99 mmol/L or known type 2 diabetes groups than in the FBG of < 5.00 mmol/L, group.
Conclusions

These findings suggest that FBG of 5.55–6.05 mmol/L and FBG of 6.11–6.94 mmol/L are similarly associated with endothelial dysfunction and that a pre-IFG state (FBG of 5.27–5.50 mmol/L) is also a risk for endothelial dysfunction compared with FBG of < 5.00 mmol/L.
Clinical Trial Registry Information:
http://www.umin.ac.jp (UMIN000012950, UMIN000012951, UMIN000012952, and UMIN000003409)
Doppler Ultrasound Evaluation of Patients with Popliteal Vascular Entrapment Syndrome
Authors: Zhong Hai , Shao Guangrui , Qi Hengtao , Zhao Yuan , Wang Maohua , Yang wubo
Published: May 2020

Background

To retrospectively evaluate Doppler ultrasound findings for patients with popliteal vascular entrapment syndrome (PVES).
Methods

Twenty-four patients (30 legs) who underwent surgical intervention for PVES were included in this study. The popliteal artery, popliteal vein, and surrounding musculotendinous structures were explored in all symptomatic lower extremities using ultrasound. Intraoperative findings served as the gold standard. In the absence of popliteal artery occlusion, popliteal arteries were examined using Doppler ultrasound at rest and during a provocative maneuver.
Results

Ultrasonography in 25 cases (25/30, 83%) showed that gastrocnemius medial head or popliteal vascular anomalies were consistent with surgical photography results. According to Whelan and Rich classification, the classic type I was found in five limbs, type II in twelve limbs, type III in seven limbs, and type V in one limb. In the remaining five cases (5/30, 17%), no anatomical abnormalities of the popliteal fossa were discovered by the ultrasound examination. Among these, two cases (2/30, 7%) were misdiagnosed as lower extremity atherosclerosis and popliteal vascular depression was not found. In addition, increasing blood flow velocity was found in three cases (3/30, 10%) of compressed popliteal arteries using Duplex scanning during active plantar flexion, with decreasing flow at the distal end. Color Doppler ultrasound of the affected popliteal vessels showed varied degrees of vascular structure pathology, including arterial stenosis in ten limbs, occlusion in fifteen limbs, and aneurysm in two limbs.
Conclusion

Doppler ultrasound may have a high diagnostic rate in PVES. Due to its simplicity, repeatability, functional evaluation of blood flow, and non-invasiveness, it can be used as a primary screening examination modality in PVES. Provocative maneuvers could help clinicians diagnose PVES.