bluuebunny/crossref_metadata_2025 huggingface dataset:
Secondary organizing pneumonia associated with pulmonary tuberculosis: case series and review of the literature
Authors: Kim Eun Jin , Kim Kyung Chan
Published: June 2020

Background: Secondary organizing pneumonia (SOP) is difficult to distinguish from cryptogenic organizing pneumonia (COP) considering various clinical situations. SOP caused by Mycobacterium tuberculosis is rare; indeed, it has not been reported as a sequela of disseminated tuberculosis.Methods: From January 2016 to December 2018, we identified six cases of tuberculosis-associated SOP in which Mycobacterium tuberculosis was revealed by microbiological examination; one of the cases was miliary tuberculosis.Results: Of the six cases, 17% were positive for acid fast bacillus (AFB) stain, but 100% were positive for M. tuberculosis polymerase chain reaction (MTB PCR) and AFB culture. In all cases, transbronchial lung biopsy was performed and organizing pneumonia was confirmed pathologically. All survived after treatment with anti-tuberculosis therapy.Conclusions: Even if a biopsy performed in cases with pneumonia showing slow improvement appears to suggest organizing pneumonia, the possibility of tuberculosis should always be kept in mind in areas with high tuberculosis prevalence. MTB PCR appears to be more helpful than AFB stain for the first diagnosis of SOP associated with pulmonary tuberculosis.
Pediatric Resident’s Perception of Night Float System Compared to 24 Hours System, a Prospective Study
Authors: Alsohime Fahad , Alkhalaf Hamad , Almuzini Hissah , Alyahya Malak , Allhidan Reema , Assiry Ghadeer , AlSalman Munirah , Alshuaibi Walaa , Temsah Mohamad-Hani , Alakeel Abdullah , Aleyadhy Ayman
Published: June 2020

Background: This study aims to evaluate the pediatric residents’ perceptions of the Night Float (NF) on-call system and its impact on their well-being, education and patient safety and compare it with the previous traditional 24-hour on-call system. Methods: This is a prospective study conducted in two pediatric residents training centers who applied the NF on call system as a pilot project. The senior residents enrolled in the two training centers were invited to participate in this study before changing the on-call system and 6 months after starting the new NF on-call system. A self-administered online questionnaire was distributed to them. A five-point Likert-type scale was used to rank the residents’ responses, covering three main domains; residents’ well-being, ability to deliver health care, and their medical education experience. Pre- and post-intervention scores were presented as means and compared using the t-test for paired samples. Results: A total of 42 residents participated in the survey. Of these, 24 (57.1%) were females. All participants were senior residents; 25 (59.6%) were third year residents while 17 (40.4%) were fourth year residents. Participants felt that most aspects of the three domains were improved by the introduction of the NF system. The NF system had less adverse health effect on the residents (Mean 2.37±1.01), compared to the 24 hours on-call system (Mean 4.19±0.60), P ˂0.001. The NF system had less exposure to personal harm, less negative impact on the quality of care, better work efficiency, reduced potential for medical error, more successful teaching and fewer disruptions to other rotations compared to the 24 hours on-call system, (P ˂0.001). Conclusion: In this study, we found that the NF on-call system positively impacts residents’ well-being, education and patient care. This pilot study demonstrates that the restricted duty hours are useful from pedagogic aspect and sets the ground for Pediatric residency training programs in Saudi Arabia to consider resident duty hour reform. Trial registration: Not applicable
Analysis of clinical characteristics of pertussis in 184 infants and children: a retrospective study
Authors: Wang Caiying , Zhang Huimin , Zhang Yanlan , Xu Lin , Miao Min , Yang Hongling , Liu Yuhuan , He Shuxin , Pang Lin
Published: June 2020

Backgroud: The incidence of pertussis shows an increasing trend in recent years, but some clinicians often lack sufficient understanding of the clinical characteristics and risk factors for severe pertussis, and more effective measures should be taken to reduce the incidence and mortality of pertussis in young infants. Methods: A retrospective study was conducted, and 184 infants and children with pertussis who had been hospitalized in the Department of Pediatrics of Beijing Ditan Hospital affiliated with Capital Medical University from January 2016 to December 2017 were included in the study. Clinical data of the patients were collected and the clinical characteristics were statistically analyzed. Results: Among the 184 patients, 41.85% were infants < 3 months of age, and 65.22% were not vaccinated against pertussis. There were 22 critically ill children, among whom 4 died, and compared with moderate cases, they had a higher proportion of children younger than 3 months of age and infants not vaccinated against pertussis (63.64% vs. 38.89% and 100% vs. 60.49%, respectively); a higher proportion of children with pulmonary consolidation (77.27% vs. 1.85%); higher leukocyte count(× 109/L , 35.80 ± 20.53 vs 19.41 ± 8.59); and a higher proportion of children with severe hyperleukocytosis (18.18% vs. 0%, respectively) (P<0.05). Conclusions: 1. Infants aged < 3 months who were not vaccinated for pertussis tended to be infected with pertussis and had severe pertussis. Adjusting the immunization strategy to vaccinate pregnant women to produce protective effects for the infants should be considered. 2. Severe pneumonia and hyperleukocytosis are the main mechanisms underlying severe pertussis and the key points of prevention and diagnosis of severe pertussis.
Emission Factor, Relative Ozone Formation Potential and Relative Carcinogenic Risk Assessment of VOCs Emitted from Manufacturing Industries
Authors: Yang Hsi-Hsien , Gupta Sunil Kumar , Dhital Narayan Babu
Published: June 2020

In this study, a few important manufacturing industries located in Central Taiwan were studied (n = 13) for the emission of volatile organic compounds (VOCs), relative ozone formation potential (ROFP) and relative carcinogenic risk (RCR). Higher emission factors of total VOCs (∑VOCs) were observed for stencil printing (423 mg-VOC kg-1) compared to other emission sectors. Alkanes formed the most dominant group of VOCs for steel foundry (41.6%), aluminum foundry (25.1%) and synthetic resin manufacturing (25.0%). However, for the chemical sector (synthetic and polyester resin), oxygenated organics like acetone (55.7%) and ethyl acetate (79.7%) were the predominant VOCs. Moreover, emissions from acrylic resin manufacturing had higher contributions from aromatic compounds (> 95%). Toluene was the topmost compound in terms of its contribution to ∑VOCs in plastic tape manufacturing (44.4%), aluminum foundry (39.6%), steel foundry (11.6%), plastic coating (64.3%) and stencil printing (35.3%). Analysis of ozone formation potentials showed that the metal product & machinery acrylic resin manufacturing and stencil printing had a higher normalized ROFP index and belonged to level-I emission sources. However, in terms of the RCR, integrated iron & steel manufacturing had the highest normalized RCR index belonged to level-I emission sources. Level-I represents the most important VOC emission sources.
In Vitro Antisickling Activity of Moringa Oleifera Extracts on Sickle Cells
Authors: Omer Rayan Hamid , Yousif Nusiba Abdullah , Fadlalla Toga Abdalazim , Elradi Wala Eldin Osman , Elbasheir Mohamed Mobarak , allah Elharam Ibrahim Abd
Published: June 2020

Background: Sickle cell disease is one of the major haemoglobinopathies affecting African people, in Sudan many children are suffering from this disease. Numerous studies revealed that some medicinal plants have shown an antisickling activity, which may be a new therapeutic way to a range of people who are affected by this disease. Particularly that, chemical treatment is cost effective and has many side effects. The study aimed to evaluate in vitro antisickling effect of Moringa Oliefera on sickle cells.Materials and methods: Using seeds and leaves crude (methanol extract and aqueous extract), the in vitro antisickling activities of Moringa oleifera fractions, were evaluated using erythrocyte cells deoxygenated with 2% sodium metabisulphite. Normal saline was employed as an internal negative control.Results: All extracts revealed high anti sickling activity in deoxygenated erythrocytes (P < 0.05) when compared with the negative control.Conclusions: Findings from the present study suggest the antisickling potential of the seeds and leaves of Moringa oleifera.
Il6/Sil6R Regulates Tnfα-Inflammatory Response In Synovial Fibroblasts Through Modulation of Transcriptional and Post-Transcriptional Mechanisms
Authors: Valin Alvaro , Rey Manuel J. Del , Municio Cristina , Usategui Alicia , Romero Marina , Fernández-Felipe Jesús , Cañete Juan D. , Blanco Francisco J. , Ruano Yolanda , Criado Gabriel , Pablos José L.
Published: June 2020

Introduction:
The clinical efficacy of specific interleukin-6 inhibitors has confirmed the central role of IL6 in rheumatoid arthritis (RA). However the local role of IL6, in particular in synovial fibroblasts (SF) as a direct cellular target to IL6/sIL6R signal is not well characterized. The purpose of the study was to characterize the crosstalk between TNFα and IL6/sIL6R signaling to the effector pro-inflammatory response of SF.
Methods
SF lines were stimulated with either TNFα or IL6 and sIL6R for the time and dose indicated for each experiment, and where indicated, cells were treated with inhibitors actinomycin D, adalimumab, ruxolitinib and cicloheximide. mRNA expression of cytokines, chemokines and matrix metalloproteases (MMPs) were analyzed by quantitative RT-PCR. Level of IL8 and CCL8 in culture supernatants was measured by ELISA. Mononuclear and polymorphonuclear cells migration assays were assesed by transwell using conditioned medium from SF cultures. Statistical analyses were performed as indicated in the corresponding figure legends and a p-value < 0.05 was considered statistically significant.
Results
IL6/sIL6R stimulation of TNFα treated SF cooperatively promotes the expression of mono- and lymphocytic chemokines such as IL6, CCL8 and CCL2, as well as matrix degrading enzymes such as MMP1, while inhibiting the induction of central neutrophil chemokines such as IL8. These changes in the pattern of chemokines expression resulted in reduced polymorphonuclear (PMN) and increased mononuclear cells (MNC) chemoattraction by SF. Mechanistic analyses of the temporal expression of genes demonstrated that the cooperative regulation mediated by these two factors is mostly induced through de novo transcriptional mechanisms activated by IL6/sIL6R. Furthermore, we also demonstrate that TNFα and IL6/sIL6R cooperation is partially mediated by the expression of secondary factors signaling through JAK/STAT pathways.
Conclusions
These results point out to a highly orchestrated response to IL6 in TNFα-induced SF and provide additional insights into the role of IL6/sIL6R in the context of RA, highlighting the contribution of IL6/sIL6R to the interplay of SF with other inflammatory cells.
Adolescent psychopathology and psychological wellbeing: A network analysis approach
Authors: Osborn Tom , Campbell Stephanie
Published: June 2020

Background

The extent to which psychological wellbeing may play a preventive and therapeutic role in the development and maintenance of adolescent emotional disorders depends, in part, on the nature of the overlap between these two constructs. We used network analysis to examine the relationship between adolescent psychopathology (measured by depression and anxiety symptoms) and psychological wellbeing (measured by happiness, optimism, social support, perceived control, and gratitude).
Methods

This was a cross-sectional study with a in a large community sample of Kenyan adolescents (N = 2,192, ages 13-to-18). Network analyses was conducted to examine the topology, stability, centrality, and bridge nodes of a network of psychopathology and psychological wellbeing measures.
Results

Two distinct community clusters emerged, one for psychopathology nodes and another for wellbeing nodes, suggesting that these are two distinct but connected concepts. Central and bridge nodes of the wellbeing and psychopathology network are identified. The most central nodes in the network were general gratefulness and worry; the strongest negative edges between psychopathology and psychological wellbeing were depressed mood—I love life and irritability—I am a joyful person; the main bridge nodes were optimistic about future and special person around for me.
Conclusions

Our findings expand understanding of the relationship between wellbeing and psychopathology in an understudied population and are suggestive of how psychological wellbeing can inform psychopathological treatment/preventive efforts in low-income regions such as those in Sub Saharan Africa.
Distribution of ABO blood groups and association to low risk of COVID-19 infection in patients
Authors: Peng Minfei , Huang Shigao , Zhu Shitu , Chen Chaochao , Qin Jiajia , He Minmin , Yang Jie , Zhao Qi
Published: June 2020

Background

Since December 2019, the novel coronavirus pandemic (COVID-19) has become a global health emergency. To date, studies on the correlation between ABO blood groups and COVID-19 infected risk had rarely reported. This study aimed to describe the ABO blood groups distribution and association to low risk of COVID-19 infection for effectively concerning about the susceptible population.
Methods

We included 138 COVID-19 diagnosed patients and 82 non- COVID-19 patients between January 21 and February 20, 2020.We compared ABO blood group distribution, gender distribution and correlation analysis in Severe, Non-severe and Non-COVID19 patients, and analyzed the laboratory indexes of type O and non-type O groups in COVID19 patients.
Results

The laboratory results were significantly difference between type O and non-type O COVID19 patients (P < 0.05). Patients with blood type O had lower risk of severe COVID-19 infection (χ2 = 4.066, p = 0.044, OR = 0.380), and especially, female with the type O blood had lower risk in deteriorating severe COVID19 infection (p = 0.049).
Conclusion

Patients with the blood group of type O had relatively lower risk of COVID19 infection, especially, female with the type O blood had lower risk in deteriorating severe COVID19 infection. We should concern more to the patients with non-type O blood to minimize the risk of COVID19 infection.
Is prophylactic extraction of mandibular third molar indicated? A retrospective study.
Authors: Ye Zhouxi , Qian Wenhao , Wu Yubo , Sun Bing , Li Zhiyao , Ling Feng , Li Hongquan , Xiang Fei , Zhu Minwen , Zhang Yu
Published: June 2020

Background To evaluate the associations of impaction patterns of mandibular third molars (M3Ms) with pathologies caused by them. Methods In this study, 262 patients with 432 impacted M3Ms were included. The pathologies include pericoronitis, mandibular second molar (M2M) caries, and M2M distal periodontal pathology. The impaction patterns of M3Ms and the pathologies were examined, and the M2Ms outcomes after the surgeries were evaluated. χ2 test was used to analyze the data and a P value of <0.05 was considered statistically significant. Results Pericoronitis was the major symptom in all patients, whereas the propensities of M2M distal caries and periodontal pathologies increased in older patients. Soft tissue impacted and vertically angulated teeth were more associated with the pericoronitis (p <0.05); Mesio-angular impacted teeth in less deep positions had greater risks of M2Ms distal caries (p <0.05); Mesio-angular and horizontal impacted teeth in relative deep positions were more likely to cause M2Ms distal periodontal pathologies (p <0.05). Conclusions Extractions of soft tissue impacted teeth in vertical angulations should be considered. While removals of mesially and horizontally angulated or bony impacted teeth could be delayed.
Spatiotemporal Assessment of Health Burden and Economic Losses attributable to short-term exposure to Ozone During 2015 - 2018 in China
Authors: Zhang Zihan , Yao Minghong , Wu Wenjing , Zhao Xing , Zhang Juying
Published: June 2020

Ground-level Ozone (O3) pollution is currently the main severe environmental problem in China. Although existing studies have quantified the O3-related health impact and economic loss, few have focused on the acute health effects of short-term exposure to O3 and have been limited to a single temporal and spatial dimension. Based on the O3 concentration obtained from ground monitoring networks in 334 Chinese cities in 2015 - 2018, this study used a two-stage exposure parameter weighted Log-linear exposure-response function to estimate the cause-specific mortality for short-term exposure to O3. The value of statistical life (VSL) method that were used to calculate the economic loss at the city-level. Our results show that in China, the national all-cause mortality attributed to O3 was 0.18 (95% CI: 0.09 - 0.36) to 0.26 (95% CI: 0.13 - 0.45) million across 2015 - 2018. The estimated economic loss caused by O3 was 253.83 (95% CI: 128.44 - 590.96) to 397.09 (95% CI: 203.54 - 759.27) billion CNY, accounting for 0.34% to 0.46% of total reported GDP. Overall, the O3 attributed health and economic burden has begun to decline in China since 2017. However, highly polluted areas still face severe burden, and undeveloped areas suffer from high GDP losses. There are substantial health impacts and economic losses related to short-term O3 exposure in China. The government should pay attention to the emerging Ozone pollution, and continue to strengthen the intervention in traditional priority areas while solving the pollution problem in non-priority areas.
Preconception air pollution exposure and glucose tolerance in healthy pregnant women in a middle income country
Authors: Zareie Mehdi , Gohari Ali , Haghighi Leyla , Heydari Hafez , miri Mohammad
Published: June 2020

Background: The effect of preconception exposure to air pollution on glucose tolerance during pregnancy in developing and middle-income countries is under debate yet. Therefore, this study aimed to assess the relationship between exposure to ambient particulate matter (PM) and traffic indicators with glucose tolerance in healthy pregnant women in Sabzevar, Iran (2019). Methods: Accordingly, 250 healthy pregnant women with singleton pregnancies of 24-26 weeks of gestations were participated in our study. Land use regression (LUR) models were applied to estimate the annual mean of PM1, PM2.5 and PM10 at residential address. Traffic indicators, including distance from home to the nearest major road (DHMR) as well as total streets length in 100, 300 and 500m buffers around the home (TSL-100, 300 and 500) were calculated using the street map of Sabzevar. Oral glucose tolerance test (OGTT) was used to assess glucose tolerance during pregnancy. Multiple linear regression adjusted for relevant covariates was used to estimate the association of fasting blood glucose (FBG), 1-h and 2-h post-load glucose with PMs and traffic indicators. Results: Exposure to PM1, PM2.5 and PM10 was significantly associated with higher FBG concentration. Higher TSL-100 was associated with higher FBG and 1-h glucose concentrations. Each one interquartile range (IQR) increase in DHMR the levels of FBG and 1-h post-load glucose were decreased -3.42 mg/dL (95% confidence interval (CI): -4.47, -2.37, P-value < 0.01) and -4.65 mg/dL (95% CI: -8.03, -1.26, P-value < 0.01), respectively. Conclusion: We found higher preconception exposure to air pollution and exposure to air pollution during pregnancy were negatively associated with glucose tolerance during pregnancy in a middle income country.
Gut Microbiota Characteristics in Mice with Antibiotic-Associated Diarrhea
Authors: Shao Haoqing , Zhang Chenyang , Xiao Nenqun , Tan Zhoujin
Published: June 2020

Background
Antibiotic-associated diarrhea (AAD), defined as diarrhea that occurs in association with the administration of antibiotics and without another clear etiology, is one of the most commonly adverse drug event of antibiotics therapy. We established a diarrhea model induced by gentamycin and cefradine to investigate the microbiota characteristics in the intestinal lumen of mice with AAD and provide insights into noteworthy bacterial related to gentamicin and cefradine-associated diarrhea.
Results
The number of OTUs in the model group and the normal group was 983 and 1235, respectively, and 872 identical OTUs were shared between two groups. Species richness and species diversity of intestinal microbe were altered by antibiotics administration. The dominant phyla of AAD mice were Firmicutes (52.63%) and Proteobacteria (46.37%). The abundance of 8 genera, Enterococcus, Eubacterium, Clostridium, Coprococcus, Aerococcus, Oceanobacillus, Brachybacterium, and Paucibacter, increased significantly, and the abundance of 2 genera, Prevotella and Parabacteroides, decreased significantly in the model group compared to those in the control group (p < 0.05).
Conclusions
The bacterial diversity of the intestinal lumen was diminished after gentamicin and cefradine administration. The alterations in the abundance and composition of gut microbiota further led to the dysfunction of gut microbiota. More specifically, gentamicin and cefradine significantly increased the abundance of the opportunistic pathogens, of which Enterococcus and Clostridium were the most prominent and most worthy of attention.
Relationships Between Indices of Arm Anthropometry, Bioimpedance, and Laboratory in Maintenance Hemodialysis Patients
Authors: Wang Jenn-Yeu , Chen Shu- Chin , Hwang Betau
Published: June 2020

Background Maintenance hemodialysis patients often experience protein- calorie malnutrition. Our aim is to evaluate the independent prediction accuracy of bioelectrical impedance analysis derived variables by the measurements of upper arm anthropometry and clinical laboratory indexes for assessment of nutritional status of hemodialysis patients. Furthermore, the relationship between measurements of upper arm anthropometry and clinical laboratory indexes and cross –sectional evaluation of the prevalence of malnutrition with the use of the norms and thresholds were done. Methods In a cross- sectional study of 32 stable hemodialysis patients (aged 28 to 82 years) in hemodialysis unit of Taipei Municipal Zhongxiao Hospital, we evaluated measurements of upper arm anthropometry with measurements of single frequency bioelectrical impedance analysis and clinical laboratory indexes. Results The comparisons between measurements of upper arm anthropometry with measurements of single frequency bioelectrical impedance analysis and some of clinical laboratory indexes were statistically significant. This study further found that both mid-arm fat area and triceps skin-fold thickness were independent contributors to percent fat mass after adjustment for body mass index and gender in the multiple regression models. This study also demonstrated that mid-arm muscle circumference, or mid-arm muscle area, or corrected mid-arm muscle area independently predicted height normalized indices of fat-free mass respectively after adjustment for body mass index and gender in the multiple regression models. The prevalence of protein wasting measured by mid-arm muscle circumference (50%) appears to be equivalent to that measured by serum albumin concentration (50%). Conclusions Mid-arm muscle and fat variables by upper arm anthropometry correlated with nutritional variables of single frequency bioelectrical impedance analysis and clinical laboratory indexes. Mid-arm muscle and fat variables by upper arm anthropometry were independent predictors of body composition regarding height-normalized indices of fat-free mass and percent fat mass of hemodialysis patients even after adjustment of gender and BMI.
Development of engineered ferredoxin reductase systems for the efficient hydroxylation of steroidal substrates
Authors: Zhu Zhangliang , Gao Xin , Song Zhan , Li Chao , Lu Fuping , Tanokura Masaru , Qin Hui-Min
Published: June 2020

Background
9α-hydroxy-4-androstene-3,17-dione (9OHAD), catalyzed by 3-ketosteroid-9-hydroxylase (KSH) using 4-androstene-3,17-dione (AD) as a substrate, is an important precursor for the synthesis of adrenocortical hormones. Whole-cell catalyst in microorganisms with this KSH system for desirable hydroxylated steroids in high purity and productivity have rarely been successful.
Results
The rate-limiting step for the biosynthesis of 9OHAD is catalyzed by the reductase KshB, which is an important component of electrons donor. A sufficient supply system of the cofactor NADH was constructed on KshB by introducing the formate dehydrogenase (FDH) gene. Several reductases were then screened to find a TDO reductase containing a ferredoxin, which showed a maximal NADH activity with a catalytic efficiency (kcat/Km) of 0.43 s− 1 µM− 1 and 54.8% of 9OHAD yield via multienzyme cascade catalysis in vitro. TDO mutagenesis was further performed via a protein engineering strategy, resulting in a 2.25-fold improvement in activity and a 74.8% 9OHAD yield. The modification of a Rieske [2Fe-2S] cluster in KshB and TDO showed 9OHAD yields of 56.1% and 74.5% higher than wild-type ones, which implied Rieske [2Fe-2S] ferredoxin strengthening for electrons transferring. The biosynthesis of 9OHAD was further optimized in a whole-cell catalysis system with FDH, KshA, and TDO_M9 mutant with the Rieske [2Fe-2S] ferredoxin (BLKA-RMT-F), resulting in a final production of 5.24 g/L 9OHAD, a considerable yield of 99.3% of theoretical without by-products.
Conclusion
An efficient whole-cell catalyst was constructed with considerable production and yield by modification of a Rieske [2Fe-2S] cluster in TDO with increased the efficiency of electron transfer. This research provided comprehensive insight into the electron transfer system for these steroid hydroxylation reactions and NADH regeneration systems.
pH-responsive and hyaluronic acid-functionalized metal-organic frameworks for therapy of osteoarthritis
Authors: Xiong Feng , Qin Zainen , chen haimin , Lan Qiumei , Wang Zetao , Lan Nihan , Yang Yuan , Zheng Li , Zhao Jinmin , Kai Dan
Published: June 2020

Drug therapy of osteoarthritis (OA) is limited by the short retention and lacking of stimulus-responsiveness after intra-articular (IA) injection. The weak acid microenvironment in joint provides a potential trigger for controlled drug release systems in the treatment of OA. Herein, we developed an pH-responsive metal−organic frameworks (MOFs) system modified by hyaluronic acid (HA) and loaded with an anti-inflammatory protocatechuic acid (PCA), designated as MOF@HA@PCA, for the therapy of OA. Results demonstrated that MOF@HA@PCA could smartly respond to acidic conditions in OA microenvironment and gradually release PCA, which could remarkably reduce synovial inflammation in both IL-1β induced chondrocytes and the OA joints. MOF@HA@PCA also down-regulated the expression of inflammatory markers of OA and promoted the expression of cartilage-specific makers. This work may provide a new insight for the design of efficient nanoprobes for precision theranostics of OA.
Snapshot of narcotic drugs and psychoactive substances in Kuwait: a qualitative analysis of illicit drugs and their associated mortality in Kuwait from 2015 to 2018
Authors: Al-Matrouk Abdullah , Al-Hasan Mohammed , Al-Abkal Neamat , Mohammed Hanan , Haider Meshaal , Al-Shammeri Dalal , Bojbarah Haider
Published: June 2020

Background
The misuse of illicit substances is associated with increased morbidity and mortality; thus, substance abuse is a global health concern. However, a lack of laboratory-based research has limited the scientific assessment of drug misuse in the Arabian Gulf region. Thus, the primary aim of this study was to assess the problem of illicit drugs in Kuwait using laboratory-based analyses.
Methods
We investigated the type and quantity of detained narcotic drugs and psychotropic substances from 2015 to 2018, number of abusers, and mortality among abusers. In total, 6220 cases from the Narcotic and Psychotropic Laboratory and 17,755 cases from the Forensic Toxicology Laboratory were reviewed and analyzed. Substances were identified and documented using gas chromatography–mass spectrometry and liquid chromatography–mass spectrometry.
Results
Cannabis, including marijuana, was the most seized substance, followed by heroin, opium, and cocaine. Amphetamines, including methamphetamine, in the form of powder or pills, were seized in larger quantities than other psychoactive substances. Benzodiazepines, tramadol, Khat, synthetic cannabinoids, and psilocin were also seized. The most consumed substances were, in order, amphetamines (including methamphetamine), benzodiazepines, cannabis, and heroin. Drug misuse was considerably higher among men than among women. We report the death rate associated with the abuse of various illegal drugs according to sex. The mortality rate associated with single-drug use was the highest among abusers of heroin, benzodiazepines, and methamphetamine. The mortality rate asscoaited with multiple-drug use was the highest among abusers of heroin–benzodiazepines, cannabis–benzodiazepines, and cannabis–amphetamines.
Conclusions
Our study shows the changing trends in quantity and variety of substances illegally abused and marketed in Kuwait. Additionally, we report a direct gender-based association between mortality and consumption of certain substances. These findings suggest that there is a growing need to conduct larger scale studies to implement new strategies, policies, and interventions in populations affected by illicit drugs.
Initial symptoms of patients with coronavirus disease 2019 in Japan.
Authors: Komagamine Junpei , Yabuki Taku
Published: June 2020

Background: Fever, cough, malaise, and throat pain are the most common initial symptoms of coronavirus disease 2019 (COVID-19). However, no studies have ever been conducted to investigate the initial symptoms of COVID-19 in Japan. Methods: We investigated 707 consecutive COVID-19 patients who were diagnosed in ten prefectures of Japan until May 16, 2020 by using publicly available data. The primary outcome was initial symptoms on the day of symptom onset. The proportion of patients with individual symptoms among symptomatic patients was calculated.Results: Of all the patients, 79 (11.2%) were asymptomatic. Among the 628 symptomatic patients, the most common initial symptom was fever (65.9%), followed by cough (23.5%), malaise (23.5%), and throat pain (12.9%). At least one of these four symptoms was reported in 88.2% of all symptomatic patients. Nineteen patients (3.0%) reported gastrointestinal symptoms without respiratory symptoms, while six patients (1.0%) reported only loss of smell or taste as the initial symptom. Conclusions: Like other countries, the most common initial symptoms of COVID-19 patients in Japan are fever, cough, malaise, or throat pain. Gastrointestinal symptoms without respiratory symptoms and loss of smell and taste are uncommon initial symptoms in Japan.
Gender dimensions of the impact of HIV/AIDS on stunting in children under five years in Zimbabwe
Authors: Macheka Lesley , Kembo George , Kairiza Terrence
Published: June 2020

Background: HIV/AIDS can have a disastrous effect on household food and nutrition security, an example includes stunting in children. However, stunting and HIV/AIDS are highly gendered phenomena that need to be explored in order to get an in-depth understanding of the interrelationship. This study was therefore aimed at investigating gender dimensions of the impact of HIV/AIDS on stunting in children under five years from HIV/AIDS affected households in Zimbabwe. Methods: The study uses a large scale nationally representative cross-sectional dataset of 13 854 Zimbabwean households for the year 2019. To test hypothesis 1, the study employs binary choice models (Probit and Logit) since the outcome variable household HIV/AIDS status is dichotomous. To test hypothesis 2 and 3, the study employs the Propensity Score Matching (PSM) approach to circumvent the self selection problem in the creation of treatment and control groups for households affected by HIV/AIDS and those that are not. Results: The results revealed that household HIV/AIDS status is independent of the gender of household head. On the other hand, the results for the PSM estimates show that the probability of the household having a stunted child under five years is higher for households with an HIV positive member compared to those without. In addition, female headed households with an HIV positive member are more likely to have a stunted child under five years compared to male headed households under similar circumstances. Conclusion: Overall, the results provide evidence of a higher risk of stunting among children from households affected by HIV/AIDS. The study offers three major findings. Firstly, the study finds no significant association between gender of the household head and household HIV/AIDS status. Secondly, households that have at least one HIV positive member are more likely to have a stunted child under five years. Lastly, female headed households with at least one HIV positive member are more likely to have a stunted child under five years compared to male headed household with similar HIV/AIDS status. The findings have important policy implications towards improved integration of HIV/AIDS status, household head gender and child nutrition services in affected households.
Egr-1 mediates low dose Arecoline induced human oral mucosa fibroblasts proliferation by transaction the expression of Wnt5a
Authors: Chen Qiang , Jiao Jiuyang , Wang Youyuan , Mai Zhihui , Ren Jing , He Sijie , Li Xiaolan , Chen Zheng
Published: June 2020

Background
Arecoline is the main carcinogens in Areca nut that induce oral submucous fibrosis to develop into cancer. However, many previous studies have showed that Arecoline may inhibit proliferation and prevent collagen synthesis of fibroblasts.
Results
High dose Arecoline (> 32 µg/ml) could inhibit but low dose Arecoline (< 16 µg/ml) could promote the proliferation of human oral fibroblasts. Wnt5a was both sufficient and necessary for the promotion of fibrobasts proliferation. Egr-1, but not NF-κB, FOXO1, Smad2 or Smad3, mediated the expression of Wnt5a in fibrobasts. The specific siRNAs of Egr-1, Egr inhibitors or Wnt5a antibodies treatment blocked Arecoline induced Wnt5a upregulation and fibroblasts proliferation.
Conclusions
Egr-1 mediates low dose Arecoline induced human oral mucosa fibroblasts proliferation by transaction the expression of Wnt5a, and Egr inhibitors or Wnt5a antibodies are potential therapeutic drugs of oral submucosal fibrosis and oral cancer.
Blood Coagulation Parameters in Patients with Severe COVID-19
Authors: Sayad Babak , Rahimi Zohreh
Published: June 2020

Background: Infection with coronavirus disease 2019 (COVID-19) could be complicated with coagulopathy and high risk of thromboembolic events. Methods: Coagulation parameters were analyzed in 74 confirmed severe COVID-19 patients admitted to the intensive care unit of Farabi University Hospital, Kermanshah, Western Iran.Results: Around 42% of patients had abnormal prothrombin time (PT) and international normalized ratio (INR). The rate of abnormal coagulation parameters in the mean age 76.6±7.7 and 46.6±10.3 years were 62 and 38%, respectively. Patients with comorbidities had significantly longer PT and higher INR that increased the rate of mortality to around 77% in these individuals. The abnormal pattern of coagulation parameters was highly associated with comorbidities and poor prognosis. Conclusions: Our study demonstrated abnormal coagulation parameters and a high rate of coagulopathy in hospitalized patients with COVID-19 that was associated with age, comorbidities and mortality which should be considered in management of these patients.
The Added Value of CA125 Normalization Before Interval Debulking Surgery to the Chemotherapy Response Score for the Prognostication of Ovarian Cancer Patients Receiving Neoadjuvant Chemotherapy for Advanced Disease
Authors: Liang Wei-feng , Wang Li-juan , Wu Jie-ying , Liu Chang-hao , Wu Miao-fang , Li Jing
Published: June 2020

Objective: To investigate whether CA125 normalization following neoadjuvant chemotherapy (NACT) can complement the chemotherapy response system (CRS) in the prognostication of patients with tubo-ovarian high-grade serous carcinoma (HGSC).Methods: In total, 106 HGSC patients who received NACT followed by interval debulking surgery (IDS) for FIGO stage IIIC-IV disease were included, and their clinical data were retrospectively reviewed. The primary endpoint was progression-free survival (PFS). Cox regression analysis was performed to identify predictors of PFS.Results: Following NACT, CRS3 was noted in 24 patients (22.6%), and CA125 normalization (≤ 35 U/ml) was noted in 54 patients (50.9%). Both CRS3 and CA125 normalization were identified as independent prognosticators of PFS. Combining these two factors, we stratified the 106 patients into three groups with different risks of recurrence: low-risk group (CRS3 + post-NACT CA125≤ 35 U/ml; n = 17, 16.0%), intermediate-risk group (CRS3 + post-NACT CA125 > 35 U/ml; n = 7, 6.6%) and high-risk group (CRS1-2; n= 82, 77.4%). The differences in PFS between the three groups were significant (log-rank test, P < 0.0001). In Cox regression analyses, the new stratification method was found to have an independent prognostic effect.Conclusion: Both the CRS system and the normalization of CA125 following NACT could reliably predict the risk of recurrence following primary treatment. The combination of the two factors refined the prognostic stratification of HGSC patients who were treated with NACT and IDS.
Evaluation of the first experience with COVID-19: An observational study on the screening policy among employees and patients of a Dutch teaching hospital
Authors: Weterings Veronica , Rijen Miranda van , Tinga Mark , Meijs Job , Bijllaardt Wouter van den , Kluytmans Jan
Published: June 2020

BackgroundIn the beginning of March 2020, the Amphia hospital in Breda was one of the first hospitals in the Netherlands that received patients with COVID-19. Within ten days after the first COVID-19 positive patient, the number of (suspected) COVID-19 cases among patients and employees increased rapidly and thus the number of requests for SARS-CoV-2 PCR tests. From mid-March, we changed to a non-test-based strategy for employees whereby a work ban was implemented, based on the presence or absence of respiratory symptoms without the use of a diagnostic test. The objective of our study was to evaluate the safety of the non-test-based strategy. MethodsThe study period was March 1 to May 22, 2020. For all patients in whom the SARS-CoV-2 PCR test was positive > 2 days after admission, the medical record was reviewed by infection control staff for (respiratory) symptoms, laboratory results and lung CT/X-ray images to assess possible hospital-onset COVID-19. For employees, the number of sick reports per week were extracted from the department of Human Resources. Reason for reporting sick was not registered. ResultsTen of the 374 patients (2.7%) developed symptoms suspected for COVID-19 ≥3 days after admission and were tested positive for SARS-CoV-2, of which nosocomial transmission is the most likely cause in three patients. In the period in which the employees were still actively tested for SARS-CoV-2, there was a temporary increase in the number of sick reports (week 10-11). After this two-week period, the number of sick reports decreased rapidly. The total number of sick reports in the first 20 weeks of 2020 is comparable or lower than the total number of sick reports in the same period in previous years.ConclusionWith this non-test-based strategy for employees combined with a restriction of visitors to the patients and strict isolation of COVID-19 (suspected) patients, there was no excessive absenteeism of work due to illness and there were only few patients with indications of COVID-19 acquisition in the hospital.
Pregnancy in GNE Myopathy Patients: A Nationwide Repository Survey in Japan
Authors: Yoshioka Wakako , Miyasaka Naoyuki , Okubo Ryo , Shimizu Reiko , Takahashi Yuji , Oda Yuriko , Nishino Ichizo , Nakamura Harumasa , Mori-Yoshimura Madoka
Published: June 2020

Background: GNE myopathy is an autosomal recessive adult-onset distal myopathy. While a few case reports have described the progression of GNE myopathy during pregnancy, none have examined progression after delivery or obstetric complications. Objective: This study aimed to reveal maternal complications, newborn complications, and the impact of pregnancy on disease progression in GNE myopathy patients. Methods: We conducted a questionnaire survey on pregnancy, delivery, and newborns involving female GNE myopathy patients who are currently registered in a national registry in Japan.Results: The response rate for the questionnaire survey was 60.0% (72/120). Of the 72 respondents, 44 (61.1%) had pregnancy experience (average, 1.8 pregnancies; 53 pregnancies before onset and 28 after onset). The incidence of threatened abortion was 26.9% among post-onset pregnancies, which was higher compared to those of the general Japanese population (p=0.03). No other maternal or infant complications were commonly observed. Over 80% were unaware of changes in disease progression during pregnancy or after delivery, while 19.0% experienced disease exacerbation within a year after delivery. Six patients developed myopathy within a year after delivery, while none developed myopathy during pregnancy.Conclusions: There were no serious maternal or newborn complications, and subjective progression did not differ during or after delivery in the majority of GNE myopathy patients. However, our findings suggest the importance of considering the possibility of threatened abortion and disease progression after delivery.
Flexible Thermoplastic Starch Films Functionalized With Copper Particles for Packaging of Food Products
Authors: López Olivia , Villanueva María E. , Copello Guillermo J. , Villar Marcelo A
Published: June 2020

Biodegradable films based on thermoplastic corn starch (TPS) and copper particles with antimicrobial capacity were developed. Copper nanoparticles (Cu) and silica coated copper microparticles (Si-Cu) in the range of 0.25 to 5 % were used. Composite films were obtained by melt-mixing and subsequent thermo-compression. Particles distribution within TPS matrix and the presence of some pores and cracks, induced by Si-Cu particles, was evaluated by SEM. The presence of both fillers gave to composite films a brown pigmentation and decreased their transparency; these effects were more pronounced at higher particles concentrations. Regarding mechanical properties, copper particles at 1 and 5 % acted as reinforcing agents increasing the maximum tensile strength but their presence lead to a decrease in elongation at break, affecting films ductility. Composites inhibited the growth of Gram+ and Gram- bacteria, demonstrating their antimicrobial capacity. Copper effectively migrated to a simulant of aqueous foods and naked particles concentration in the simulant medium resulted higher than the minimum inhibitory concentration for bacteria.The characteristics and properties of developed composite films make them an interesting material for food primary packaging, mainly for meat fresh products.
Management Protocol for Emergency Aneurysm Craniotomy Clipping in Non-Major COVID-19 Epidemic Areas in Beijing, China
Authors: Chen Yu , Chen Xiaolin , Ma Li , Deng Xiaofeng , Li Zelin , Ye Xun , Wang Hao , Kang Shuai , Zhang Yan , Wang Rong , Zhang Dong , Cao Yong , Zhao Yuanli , Wang Shuo , Zhao Jizong
Published: June 2020

Background: An epidemic of COVID-19 outbroke in Wuhan, China since December 2019. The ordinary medical service were hindered, however, the emergency cases including aneurysmal subarachnoid hemorrhage (aSAH) still required timely intervention and provoked challenges to the management protocol. In this study, we summarized our experience in the emergency management of aSAH (Beijing Tiantan Protocol, BTP) in Beijing, China.Methods: Demographic, clinical and imaging data of consecutive emergency aSAH patients who underwent craniotomy clipping during the COVID-19 epidemic season were reviewed and compared with the retrospective period last year. Subgroup analysis was further performed to assess the outcomes of different screening results and different detail protocols. Neurological outcome was assessed with the modified Rankin Scale (mRS).Results: A total of 127 aSAH referred to our emergency department and 42 (33.1%) underwent craniotomy clipping between January 20, 2020 and March 25, 2020. Compared with the retrospective period last year, the incidence of preoperative hospitalized adverse events and postoperative outcomes were similar (0.1, 95% CI 1.0 to 0.8, P = 0.779). In the subgroup analysis, 8 (19.0%) were initially screened as preliminary undetermined COVID-19 and 2 of them underwent craniotomy clipping in the negative pressure operating room (OR), the prognosis of patients with varied COVID-19 screening results was similar (F(2, 39) = 0.393, P = 0.678). Since February 28, 12 cases (28.6%) received COVID-19 nucleic acid testing (NAT) upon admission and all showed negative, the false negative rate was 0.0%. The preoperative hospitalized adverse events and postoperative prognosis were still similar between patients with and without COVID-19 NAT (-0.3, 95% CI -1.4 to 0.9, P = 0.653).Conclusions: Our emergency surgery management protocol (BTP) is reliable for scheduling emergency aneurysm craniotomy clipping in non-major epidemic areas.
A Novel Prognostic Model Predicts Overall Survival in Patients With Nasopharyngeal Carcinoma Based on Clinical Features and Blood Biomarkers
Authors: Lai Changchun , Zhang Chunning , Lv Hualiang , Huang Hanqing , Ke Xia , Zhou Chuchan , Chen Hao , Chen Shulin , Zhou Lei
Published: June 2020

Background: To develop and validate a novel prognostic model to estimate overall survival (OS) in nasopharyngeal carcinoma (NPC) patients based on clinical features and blood biomarkers. And assess its incremental value to TNM staging system, clinical treatment, and Epstein-Barr virus DNA (EBV DNA) for individual OS estimation. Methods: We retrospectively analyzed 519 consecutive NPC. A prognostic model was generated by using the Lasso-Cox regression model in training cohort (n= 346). Then comparison of predictive accuracy between the novel prognostic model, TNM staging, clinical treatment, and EBV DNA using concordance index (C-index), time-dependent ROC (tdROC), and decision curve analysis (DCA). Subsequently, a nomogram for OS incorporating the prognostic model, TNM staging and clinical treatment was built. Finally, we stratified patients into high- risk and low-risk groups according to the model risk score, and the survival time of these two groups was analyzed using Kaplan–Meier survival plots. All the results were validated in the independent validation cohort (n= 173). Results: Using the Lasso-Cox regression, a prognostic model was established consisting of 13 variables with respect to patient prognosis. The C-index, tdROC and DCA all showed the prognostic model had good predictive accuracy and discriminatory power than TNM staging, clinical treatment and EBV DNA in training cohort. Nomogram consisting of the prognostic model, TNM staging, clinical treatment and EBV DNA shown some superior net benefit. According to the model risk score, we split the patients into two subgroups: low- risk (risk score ≤ -1.423) and high-risk (risk score > -1.423). There had significant differences in OS between the two subgroups of patients. In the validation cohort, similar results were obtained. Conclusions: The proposed novel prognostic model based on clinical features and serological markers represents a promising signature for estimating OS in NPC patients.