bluuebunny/crossref_metadata_2025 huggingface dataset:
Measles and Rubella Serosusceptibity among Population Vaccinated with Different Schedule: The potential impact on Measles-Rubella elimination in Iran.
Authors: Saffar Hana , Khalifeloo Maryam , Saffar mohammed-Jafar , Abdollahi Ali-Reza , Parsaei Mohammad-Reza , Ghorbani Gholam-Reza , Salarvand Samaneh , Aarabi Mohsen
Published: January 2021

Background: Iranian children have been vaccinated with the scheduled two doses of monovalent measles vaccine (mMV) since 1984. In December 2003, a nationwide campaign of measles-rubella (MR) immunization targeted 5-25 years population was established. In 2004, the mMV was replaced with measles- mumps-rubella (MMR) vaccine. Despite the high vaccination coverage, the outbreaks of measles still occurs in the country. In this Study, the measles-rubella immunity status of various age groups, vaccinated with different schedules was investigated, and the immunologic response of seronegative subjects to revaccination was examined. Methods: This cross-sectional study was conducted among 7- 33-year-old healthy individuals with a documented history of measles vaccination from November 2017-to June 2018. The subjects were categorized as fallow: groupA: including 20-33 years-old; vaccinated with 1-2 dose of mMV, and revaccinated with MR, groupB, including 15-19-year-old individuals, vaccinated with two doses of mMV at nine and 15 months of age, and in addition to one dose MMR upon school entrance, groupC, including 11-14 year-old individuals vaccinated, with two-doses of MMR at the ages of 15 months and six years, and groupD, including 7-10 year individuals vaccinated with two-doses of MMR vaccine at the ages 12 and 18 months, respectively. Nest the consecrations of antimeasles-antirubella IgG antibodies in the collected sera were measured. Among seronegative subjects, the antimeasles-antirubella IgM and IgG were reexamined at 4-6 weeks after MMR revaccination. The collected data were analyzed using descriptive statistical methods.Results: A total of 635 individuals, including 322 females were investigated in this study. The relative distribution of subjects in each group was as falows: groupA, 98; groupB, 295; groupC, 139; and groupD, 103 persons. Overall, 12.3% and 18.4% of the population were seronegative for measles and rubella antibodies. This rate varied greatly between the 4 groups: groupA, 2%-0/0%; groupB,15.2%- 25.0%; groupC,11.5%- 17.2%; and groupD,14.6%- 18.4%. After revaccination, 92% and 94.9% of seronegative individuals only showed IgG response to measles and rubella vaccines, respectively.Conclusion: Despite the high coverage rate of M-R containing vaccines, a significant numbers of vaccinated subjects were seronegative for measles and rubella, possibly because of secondary vaccine failure; this may negatively affect measles-rubella elimination targets in the country. If these findings are confirmed in similar future studies, a more robust regional/national supplementary immunization activity should be considered.
Reconstruction of massive tibial bone and soft tissue defects by trifocal bone transport combined with soft tissue distraction: experience from 31 cases
Authors: Xu Yong-Qing , Fan Xin-Yu , He Xiao-Qing , Wen Hong Jie
Published: January 2021

Background Large post-traumatic tibial bone defects combined with soft tissue defects are a common orthopedic clinical problem associated with poor outcomes when treated using traditional surgical methods. The study was designed to investigate the safety and efficacy of trifocal bone transport (TFT) and soft-tissue transport with the Ilizarov technique for large posttraumatic tibial bone and soft tissue defects. Methods We retrospectively reviewed 31 patients with massive posttraumatic tibial bone and soft tissue defects from May 2009 to May 2016. All of the eligible patients were managed by TFT and soft-tissue transport. The median age was 33.4 years (range, 2-58 years). The mean defect of bone was 11.87cm ± 2.78cm (range, 8.2-18.2cm) after radical resection performed by TFT. The soft tissue defects ranged from 7cm x 8cm to 24cm x 12cm. The observed results included bone union time, wound close time and true complications. The Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system was used to assess bone and functional results and postoperative complications were evaluated by Paley classification. Results The mean duration of follow-up after frame removal was 32 months (range, 12-96 months). All cases achieved complete union in both the elongation sites and the docking sites, and eradication of infection. The mean bone transport time was 94.04 ± 23.33 days (range, 63.7-147 days). The mean external fixation time was 22.74 ± 6.82 months (range, 14-37 months), and the mean external fixation index (EFI) was 1.91 ± 0.3 months/cm (range, 1.2–2.5 months/cm). The bone results were excellent in 6 patients, good in 14 patients, fair in 8 patients and poor in 3 patients. The functional results were excellent in 8 patients, good in 15 patients, fair in 5 patients and poor in 3 patients. Conclusion: TFT, in conjunction with soft tissue transport technique, can give good results in most patients (in this article, good and excellent results were observed in 64% of patients). Soft tissue transport is a feasible method in providing good soft tissue coverage on the bone ends. Although it has no advantages over microvascular techniques, it might be an good alternative in the absence of an experienced flap surgeon. Nonetheless, high-quality controlled studies are needed to assess its long-term safety and efficacy.
Validity and reliability of smartphone applications for measurement of hip rotation, compared with three-dimensional motion analysis
Authors: Ganokroj Phob , Sompornpanich Nuchanun , Kerdsomnuek Pichitpol , Vanadurongwan Bavornrat , Lertwanich Pisit
Published: January 2021

Background Measurement of hip rotation is a crucial clinical parameter for the identification of hip problems and the monitoring of symptoms. The objective of this study was to determine whether the use of two smartphone applications is valid and reliable for the measurement of hip rotation.Methods An experimental, cross-sectional study was undertaken to assess passive hip internal and external rotation in three positions by two examiners. The hip rotational angles were measured by a smartphone clinometer application in the sitting and prone positions, and by a smartphone compass application in the supine position; their results were compared with those of the standard, three-dimensional, motion analysis system. The validities and inter-rater and intra-rater reliabilities of the smartphone applications were evaluated.Results The study involved 24 participants. The validities were good to excellent for the internal rotation angles in all positions (ICC 0.81–0.94), good for the external rotation angles in the prone position (ICC 0.79), and fair for the sitting and supine positions (ICC 0.70–0.73). The measurement of the hip internal rotation in the supine position had the highest ICC value of 0.94 (0.91, 0.96). The two smartphone applications showed good-to-excellent intra-rater reliability, but good-to-excellent inter-rater reliability for only three of the six positions (two other positions had fair reliability, while one position demonstrated poor reliability).Conclusions The two smartphone applications have good-to-excellent validity and intra-rater reliability, but only fair-to-good inter-rater reliability for the measurement of the hip rotational angle. The most valid hip rotational position in this study was the supine IR angle measurement, while the lowest validity was the ER angle measurement in the sitting position. The smartphone application is one of the practical measurements in hip rotational angles.Trial registration: Number 20181022003 at the Thai Clinical Trials Registry (http://www. clinicaltrials.in.th) which was retrospectively registered at 2018-10-18 15:30:29. http://www.clinicaltrials.in.th/index.php?tp=utf8&task=regtrial&id=4100&menu=regtrial&smenu=trialmodify&ts=20200711091413
Plasmatic and cell-based enhancement by microparticles originated from platelets and endothelial cells under simulated in vitro conditions of a dilutional coagulopathy
Authors: Boehm Julia , Schäfer Nadine , Maegele Marc , Stümpges Birgit , Bauerfeind Ursula , Caspers Michael
Published: January 2021

Background: Aggressive fluid management and other external factors may lead to hypothermia, acidosis and hemodilution (defined as Lethal Triad, LT) contributing to a trauma-induced coagulopathy (TIC) that worsens patients’ outcomes. Procoagulant microparticles (MP) are crucial players at the interface of cellular and plasmatic coagulation. However, their functions remain largely unexplored. This study aimed to characterize effects of MP subtypes and concentrations on functional coagulation under in vitro simulated conditions. Methods: Blood from eleven volunteers were collected to simulate in vitro conditions of hemodilution (HD) and LT, respectively. HD was induced by replacing a blood volume of 33% by crystalloids and for LT, samples were further processed by reducing the temperature to 32 °C and lowering the pH to 6.8. MP were obtained either from platelet concentrates (platelet-derived MP, PDMP) or from cell culture (ECV304 cells for endothelial-derived MP, EDMP) by targeted stimulation. After introducing MP to in vitro conditions, we measured their concentration-dependent effects (1.000, 10.000 and 15.000 MP/µl blood) on coagulation compared to whole blood (WB). For each condition, coagulation was characterized by flow cytometric platelet activation and by quantification of fibrin clot propagation using Thrombodynamics® technology.Results: MP originated from platelets and endothelial cells affected blood coagulation in a concentration-dependent manner. Particularly, high PDMP quantities (10.000 and 15.000 PDMP/µl blood) significantly induced platelet activation and fibrin clot growth and size in HD conditions. In LT conditions as well, only high PDMP concentration induced platelet activation, clot growth and size. In contrast, EDMP did not induce platelet activation, but resulted in enhanced formation of spontaneous clots, irrespective of simulated condition. With increasing EDMP concentration, the time until the onset of spontaneous clotting decreased in both HD and LT conditions.Discussion: The study demonstrates an essential role of MP within the coagulation process under simulated coagulopathic conditions. PDMP affected platelets promoting clot formation likely by providing a surface enlargement. EDMP presumably affected clotting factors of the plasmatic coagulation resulting in an increased formation of spontaneous clots.Conclusion: Under simulated conditions of a dilutional coagulopathy, MP from different cellular origin indicate a divergent but both procoagulant mechanism within the coagulation process.
Mental health and marital satisfaction changes of pregnant and lactating women during the COVID-19 pandemic: A comparative cross-sectional study
Authors: Gharagozloo Mahshid , Sadatmahalleh Shahideh Jahanian , Khomami Mahnaz Bahri , Moini Ashraf , Kazemnejad Anoshirvan
Published: January 2021

Background: Women' mental health during reproductive age is a major public health concern in both developing and developed countries. There is a relationship between mental health and marital satisfaction. This study aimed to assess mental health, anxiety, depression, and marital satisfaction among pregnant and lactating women and compared the results with non-pregnant/lactating (as control group) during the COVID-19 pandemic in Iran. Methods: A cross-sectional study among married women in range of 18 to 45 years via online questionnaires was conducted from 20 March to 25 April, 2020. A total of 604 valid questionnaires were analyzed, including 200 pregnant women, 203 lactating women, and 201 non-pregnant/lactating women. Mental health, COVID-19-related anxiety, and marital satisfaction were respectively assessed by the General Health Questionnaire (GHQ), the Corona Disease Anxiety Scale (CDAS), and ENRICH Marital Satisfaction Scale (EMS Scale). The data were analyzed using Statistical Package for Social Sciences (SPSS) software. Results: The scores of mental health problems in pregnant and lactating women were significantly higher than the control group (18.86±12.56 and 18.83±13.99 vs. 13.01±8.15, P<0.00). The total CDAS score in the control group was significantly less than pregnant women (30.87±10.56 vs. 26.05±6.12, P<0.001) and lactating women (30.80±11.37 vs. 26.05±6.12, P<0.001). The mean of marital satisfaction was significantly lower in the pregnant women (28.06±2.67 vs. 29.64±3.18, P < 0.001) and lactating women (28.74±3.58 vs. 29.64±3.18, p = 0.01) compared with the control group. There was no statistically significant difference in the depression among three groups (P < 0.05).Conclusions: Pregnant and lactating women had more mental health problems, more anxiety and less marital satisfaction in comparison to non-pregnant/lactating women in the course of COVID-19 outbreaks. Further study is needed to investigate the effect of COVID-19 prevalence on mental health and marital satisfaction of pregnant and lactating women, considering the socioeconomic status.
The Analgesic Efficacy of Ultrasound-guided Transversus Abdominis Plane (TAP) Block Combined With Oral Multimodal Analgesia In Comparison With Oral Multimodal Analgesia After Caesarean Delivery: A Randomized Controlled Trial
Authors: Yu Yang , Gao Shenshan , Yuen Vivian Manying , Choi Wai Siu , Xu Xuebing
Published: January 2021

Background: The transversus abdominis plane (TAP) block is used increasingly in parturients after caesarean delivery. This is a randomized controlled trial to evaluate the effectiveness of bilateral single-shot of TAP blocks in patients who received multimodal oral analgesia for postoperative pain relief.Methods: Parturients who were scheduled for elective caesarean delivery under spinal anaesthesia were recruited and randomized to receive bilateral single-shot of TAP blocks or placebo in addition to multimodal oral analgesia which consisted of regular tramadol, celecoxib and paracetamol, with oral oxycodone used as a rescue for breakthrough pain. Only parturients in the TAP group would receive the TAP blocks with an injection of 15ml (0.25%) ropivacaine on each side under aseptic techniques. All the parturients were evaluated for pain or related complications in the first 24 hours after surgery. The primary outcome is the percentage of parturients who required oxycodone as a rescue analgesia. Results: 80 and 79 parturients were allocated to the TAP and placebo group respectively. 9 out of 79 (11.4%) parturients in the TAP group and 15 out of 73 (20.5%) parturients in the placebo group required oxycodone for breakthrough pain, P = 0.122. Conclusions: Bilateral single-shot of TAP blocks confer little additional benefit when a multimodal oral analgesic regimen is used for pain control after caesarean section under spinal anaesthesia.Trial registration: Clinical Trial Registry of China (http://www.chictr.org.cn) identifier:ChiCTR-INR-16010130, retrospectively registered on Dec 12, 2016.
First records of powdery mildew fungi (Erysiphales) on medicinal plants in Taiwan
Authors: Yeh Yu-Wei , Chou Pei-Yi , Hou Hsin-Yu , Kirschner Roland
Published: January 2021

Background: Production of medicinal plants in Taiwan is not only hampered by international market competition, but also lack of knowledge of their pathogens, such as powdery mildew fungi (Erysiphales, Ascomycota). Records of these fungi in Taiwan originate from few researchers for the last one hundred years and are still incomplete. Since powdery mildews in tropical/subtropical environments rarely develop the sexual stages with morphologically diagnostic characteristics, internal transcribed spacer sequences (ITS) of the ribosomal RNA genes obtained from the asexual stages have become important modern tools for species identification.Results: Powdery mildews on medicinal plants from educational and ornamental plantations in Taiwan were identified based on the anamorph morphology and ITS sequences. Four powdery mildews on medicinal plants are new records for Taiwan, Arthrocladiella mougeotii on Lycium chinense, Erysiphe glycines on Pueraria lobata, Erysiphe lespedezae on Bauhinia sp., Desmodium caudatum, and Uraria crinita, and E. lonicerae on Lonicera japonica. Eryngium foetidum is a new host for Erysiphe heraclei hitherto known on other host plants in Taiwan. Eryngium foetidum and Uraria crinita are new host plants for powdery mildews worldwide. Only specific field collection of the pathogens yielded the new records, not checking plant specimens in a phanerogam herbarium. The pathogens did not cause death of the host plants, but appeared to enhance stress by infection of mature leaves.Conclusions: Taxonomic study of powdery mildews in Taiwan results into new host records of economically important medicinal plants in Taiwan with potential consequences for plant production and quarantine and also shows that host records are quite incomplete worldwide. Although ITS sequences were useful for species identification, the lack of data for several species on the same host genus on the one hand and the low variation between closely related species on the other indicate the need for further study.
Life satisfaction in families with a child in an Unresponsive Wakefulness Syndrome
Authors: Chadasch Christiane , Kotchoubey Boris
Published: January 2021

Background: The article examines life conditions in families living together with a child in an Unresponsive Wakefulness Syndrome (UWS). Such families experience severe stress at financial, logistical, and existential level.Methods: We investigated a large sample of families living with a UWS child (comprising 13% of the total population) and compared these families with families without a chronically ill child. A set of four questionnaires aimed to evaluate life conditions entails a total of 204 items. One of the questionnaires was developed by the corresponding author specifically for this study. The questionnaires were positively accepted by the persons concerned and permitted us to test six specific hypotheses. Results: Life satisfaction (LS) in families with a UWS child was significantly lower than in control families. LS was significantly affected by external situational factors (everyday support, home visits, support by a doctor, nursing service, health insurance, etc.). Self-management skills were on average lower in families with a UWS child than in controls. These skills strongly and directly correlated with LS. Further, LS was not significantly related to the acceptance of feelings and negatively correlated with the floods of emotions. The relationship with the own child was equally satisfactory in families with and without a UWS child indicating that the families regard their UWS child as a full family member.Conclusions: The data show that happy life is possible in families living together with a UWS child. They further specify conditions for satisfactory life under multiple highly severe challenges. Personal self-management skills, coping strategies, and resilience, as well as outside social support, appear to be critical factors.
New insights into intrinsic foot muscle morphology and composition using ultra-high-field (7-Tesla) magnetic resonance imaging.
Authors: Smith Melinda Maree Franettovich , Elliott James M , Al-Najjar Aiman , II Kenneth A Weber , Hoggarth Mark , Vicenzino Bill , Hodges Paul W , Collins Natalie J
Published: January 2021

Background: The intrinsic muscles of the foot are key contributors to foot function and are important to evaluate in lower limb disorders. Magnetic resonance imaging (MRI), provides a non-invasive option to measure muscle morphology and composition, which are primary determinants of muscle function. Ultra-high-field (7-T) magnetic resonance imaging provides sufficient signal to evaluate the morphology of the intrinsic foot muscles, and, when combined with chemical-shift sequences, measures of muscle composition can be obtained. Here we aim to provide a proof-of-concept method for measuring intrinsic foot muscle morphology and composition with high-field MRI.Methods: One healthy female (age 39 years, mass 65 kg, height 1.73 m) underwent MRI. A T1-weighted VIBE – radio-frequency spoiled 3D steady state GRE – sequence of the whole foot was acquired on a Siemens 7T MAGNETOM scanner, as well as a 3T MAGNETOM Prisma scanner for comparison. A high-resolution fat/water separation image was also acquired using a 3D 2-point DIXON sequence at 7T. Coronal plane images from 3T and 7T scanners were compared. Using 3D Slicer software, regions of interest were manually contoured for each muscle on 7T images. Muscle volumes and percentage of muscle fat infiltration were calculated (muscle fat infiltration % = Fat/(Fat+Water) x100) for each muscle. Results: Compared to the 3T images, the 7T images provided superior resolution, particularly at the forefoot, to facilitate segmentation of individual muscles. Muscle volumes ranged from 1.5 cm3 and 19.8 cm3, and percentage muscle fat infiltration ranged from 9.2% to 15.0%. Conclusion: This proof-of-concept study demonstrates a feasible method of quantifying muscle morphology and composition for individual intrinsic foot muscles using advanced high-field MRI techniques. This method can be used in future studies to better understand intrinsic foot muscle morphology and composition in healthy individuals, as well as those with lower disorders.
Validation of a QTL for grain size and weight using an introgression line from a cross between Oryza sativa and Oryza minuta 
Authors: Feng Yue , Yuan Xiaoping , Wang Yiping , Yang Yaolong , Zhang Mengchen , Yu Hanyong , Xu Qun , Wang Shan , Niu Xiaojun , Wei Xinghua
Published: January 2021

Background: Grain size and weight are important target traits determining grain yield and quality in rice. Wild rice species possess substantial elite genes that can be served as an important resource for genetic improvement of rice. In this study, we identify and validate a novel QTL on chromosome 7 affecting the grain size and weight using introgression lines from cross of Oryza sativa and Oryza minuta. Results: An introgression line ‘IL188’ has been achieved from a wild species Oryza minuta (2n = 48, BBCC, W303) into O. sativa japonica Nipponbare. The F2 and F2:3 populations derived from a cross between IL188 and Nipponbare were used to map QTLs for five grain size traits, including grain length (GL), grain width (GW), grain length to width ratio (LWR), grain thickness (GT) and thousand grain weight (TGW). A total of 12 QTLs for the five grain traits were identified on chromosomes 1, 2, 3, 6, 7, and 8. The QTL-qGL7 controlling GL on chromosome 7 was detected stably in the F2 and F2:3 populations, and explained 15.09-16.30% of the phenotypic variance. To validate the effect of qGL7, eight residual heterozygous line (RHL) populations were developed through selfing four F2:3 and four F2:4 plants with different heterozygous segments for the target region. By further developing SSR and Indel markers in the target interval, qGL7 was delimited to a ~261 kb region between Indel marker Y7-12 and SSR marker Y7-38, which also showed significant effects on grain width and thousand grain weight. Comparing with the reference genome of Nipponbare, stop or frameshift mutations in the exon of the three putative genes LOC_Os07g36830, LOC_Os07g36900 and LOC_Os07g36910 encoding F-box domain-containing proteins may be the candidate genes for qGL7. Scanning electron microscopy analysis of the glume's epidermal cells showed that the cell length and width of NIL-qGL7IL188 was higher than NIL-qGL7Nip, indicating that qGL7 increases grain size and weight by regulating cell expansion. Conclusions: In this study, we detected 12 QTLs regulating grain size and weight using an introgression line from a cross between an Oryza sativa and Oryza minuta. Of these loci, we confirmed and delimited the qGL7 to a ~261 kb region. Three putative genes, LOC_Os07g36830, LOC_Os07g36900 and LOC_Os07g36910 encoding F-box domain-containing proteins may be the candidate genes for qGL7. These results provide a basis for map-based cloning of the qGL7 gene and useful information for marker assisted selection in rice grain quality improvement.
Physical mapping and InDel marker development for the restorer gene Rf2 in cytoplasmic male sterile CMS-D8 cotton 
Authors: Feng Juanjuan , Zhang Xuexian , Zhang Meng , Guo Liping , QI Tingxiang , Tang Huini , Zhu Haiyong , Wang Hailin , Qiao Xiuqin , Xing Chaozhu , Wu Jianyong
Published: January 2021

Background: Cytoplasmic male sterile (CMS) with cytoplasm from Gossypium Trilobum (D8) fails to produce functional pollen. It is useful for commercial hybrid cotton seed production. The restore line of CMS-D8 containing Rf2 gene can restore the fertility of the corresponding sterile line. This study combined the whole genome resequencing bulked segregant analysis (BSA) with high-throughput SNP genotyping to accelerate the physical mapping of Rf2 locus in CMS-D8 cotton. Methods: The fertility of backcross population ((sterile line×restorer line)×maintainer line) comprising of 1623 individuals was investigated in the field. The fertile pool (100 plants with fertile phenotypes, F-pool) and the sterile pool (100 plants with sterile phenotypes, S-pool) were constructed for BSA resequencing. The selection of 24 single nucleotide polymorphisms (SNP) through high-throughput genotyping and the development insertion and deletion (InDel) markers were conducted to narrow down the candidate interval. The pentapeptide repeat (PPR) family genes and upregulated genes in restore line in the candidate interval were analysed by qRT-PCR. Results: The fertility investigation results showed that fertile and sterile separation ratio was consistent with 1:1. BSA resequencing technology, high-throughput SNP genotyping, and InDel markers were used to identify Rf2 locus on candidate interval of 1.48 Mb on Chromosome D05. Furthermore, it was quantified in this experiment that InDel markers co-segregated with Rf2 enhanced the selection of the restorer line. The qRT-PCR analysis revealed PPR family gene Gh_D05G3391 located in candidate interval had significantly lower expression than sterile and maintainer lines. In addition, utilization of anther RNA-Seq data of CMS-D8 identified that the expression level of Gh_D05G3374 encoding NB-ARC domain-containing disease resistance protein in restorer lines was significantly higher than that in sterile and maintainer lines. Conclusions: This study not only enabled us to precisely locate the restore gene Rf2 but also evaluated the utilization of InDel markers for marker assisted selection in the CMS-D8 Rf2 cotton breeding line. The results of this study provide an important foundation for further studies on the mapping and cloning of restorer genes.
Spatial distribution and determinant factors of anaemia among adults aged 15-59 in Ethiopia; using mixed-effects ordinal logistic regression model
Authors: tusa biruk shalmeno , kebede Sewnet Adem , Weldesenbet Adisu Birhanu Birhanu
Published: January 2021

Background: Anaemia is a global public health problem particularly in developing countries. Assessing the geographical distributions and determinant factors is a key and crucial step in designing targeted prevention and intervention programmes to address anaemia. Thus, the current study aimed to assess the spatial distribution and determinant factors of anaemia among adults aged 15-59 in Ethiopia.Methods: A secondary data analysis was done based on 2016 Ethiopian Demographic and Health Surveys (EDHS). Total weighted samples of 29,140 adults were included. Data processing and analysis were performed using STATA 14; ArcGIS 10.1 and SaTScan 9.6 software. Spatial autocorrelation was checked using Global Moran’s index (Moran’s I). Hotspot analysis was made using Gettis-OrdGi*statistics. Additionally, spatial scan statistics were applied to identify significant primary and secondary cluster of Anaemia. Mixed effect ordinal logistics were fitted to determine factors associated with the level of Anaemia.Result: The spatial distribution of anemia among adults age 15-59 was found to be clustered in Ethiopia (Global Moran’s I = 0.81, p value < 0.0001). In the multivariable mixed-effect ordinal regression analysis; Females [AOR = 1.53; 95% CI: 1.42, 1.66], Never married [AOR = 0.86; 95% CI: 0.77, 0.96], higher educated [AOR = 0.71; 95% CI: 0.60, 0.84], rural residents [AOR = 1.53; 95% CI: 1.23, 1.81], rich wealth status [AOR = 0.77; 95% CI: 0.69, 0.86] and underweight [AOR = 1.15; 1.06, 1.24] were significant predictors of anemia among adults.Conclusions: A significant clustering of anemia among adults aged 15-59 were found in Ethiopia and the significant hotspot areas with high cluster anemia were identified in Somalia, Afar, Gambella, Dire Dewa and Harari regions. Besides, gender, marital status, educational level, place of residence, region, wealth index and BMI were significant predictors of anemia. Therefore, effective public health intervention and nutritional education should be designed in the identified hotspot areas and risk groups to decrease the incidence of anaemia.
Characteristics and Patient-reported Outcomes Associated to Dropout in Severely Affected Oncological Patients
Authors: Gebert Pimrapat , Schindel Daniel , Frick Johann , Schenk Liane , Grittner Ulrike
Published: January 2021

BackgroundPatient-reported outcome measures (PROMs) are commonly used and are surrogates for clinical outcomes in cancer research. In the research setting of very severe diseases such as cancer, it is difficult to avoid the problem of incomplete questionnaires from drop-out or missing data due to patients who deceased during observation period. We aimed to explore patient characteristics and patient-reported outcomes associated with the time-to-dropout. MethodsIn the Oncological Social Care Project (OSCAR) study the condition of participants was assessed four times within 12 months (t0: baseline, t1: 3 months, t2: 6 months, and t3: 12 months) by validated PROMs. We performed competing-risks regression based on Fine and Gray’s proportional sub-distribution hazards model for exploring factors associated with time-to-dropout. Death was considered as competing risk. ResultsThree hundred sixty-two participants were analyzed in the study. 193 (53.3%) completed follow-up at 12 months, 67 (18.5%) patients dropped out, and 102 patients (28.2%) died during the study period. Poor subjective social support was related to higher risk for drop-out (SHR=2.10; 95%CI: 1.01 – 4.35). Lower values in health-related quality of life were related to drop-out and death. The subscales global health status/QoL, role functioning, physical functioning, and fatigue symptom in the EORTC QLQ-C30 were key characteristics associated with early drop-out.ConclusionSeverely affected cancer patients with poor social support and poor quality of life seem more likely to drop out of studies compared to patients with higher levels of social support and quality of life. This should be considered when planning studies assessing cancer patients. Methods to monitor drop-outs timely and handle missing outcomes might be used. Results of such studies have to be interpreted with caution in light of the particular drop-out mechanisms.
Correlation between Preoperative Ultrasonic Features of Medullary Thyroid Carcinoma and Postoperative Recurrence
Authors: Zhu Qiaodan , Xu Dong
Published: January 2021

Background: To investigate the factors that affect postoperative recurrence in medullary thyroid carcinoma (MTC) patients, including preoperative ultrasonic characteristics and other factors. Method: A retrospective analysis of seventy four MTC patients who underwent the first thyroid surgery from 2009 to 2018 and who had complete follow-up data was conducted. According to the follow-up results, these patients were divided into the recurrence group (17 cases) and non-recurrence group (57 cases). The preoperative ultrasound characteristics, preoperative and postoperative calcitonin levels, and general informations of the two groups were recorded, respectively. Univariate and multivariate analyses were performed. Results: Single factor Kaplan-Meier (K-M) analysis showed that: ① Preoperative ultrasonic characteristics including tumor size > 40.0 mm, capsular invasion, and metastatic cervical lymph nodes, as well as preoperative calcitonin level > 565.8 pg/ml, and postoperative calcitonin (within one week) level > 45.0 pg/ml were positively correlated with the risk of postoperative recurrence of MTC (P <0.05); ② There was no evidence to show that gender and age had a statistically significant effect on postoperative recurrence of MTC (P> 0.05). Multivariate Cox regression analysis showed that metastatic lymph nodes shown by ultrasound (HR=5.368, 95%CI 1.063-27.104, P=0.042) was an independent risk factor for postoperative recurrence of MTC. Conclusions: MTC patients with metastatic lymph nodes shown by ultrasound are prone to postoperative recurrence of MTC. In addition, MTC patients with a tumor > 40.0 mm, capsular invasion, preoperative calcitonin level > 565.8 pg/ml, and postoperative calcitonin level > 45.0 pg/ml are more likely to have postoperative recurrence.
Relationships of gut microbiota, short-chain fatty acids, inflammation, and the gut barrier in Parkinson's disease
Authors: Aho Velma T , Houser Madelyn Crawford , Pereira Pedro AB , Chang Jianjun , Rudi Knut , Paulin Lars , Hertzberg Vicki , Auvinen Petri , Scheperjans Filip , Tansey Malu Gamez
Published: January 2021

Background

Previous studies have reported that gut microbiota, permeability, short-chain fatty acids (SCFAs), and inflammation are altered in Parkinson’s disease (PD), but how these factors are linked and contribute to disease processes and symptoms remains uncertain. This study sought to compare and identify associations among these factors in PD patients and controls to elucidate their interrelations and links to clinical manifestations of PD.

Methods

Stool and plasma samples and clinical data were collected from 55 PD patients and 56 controls. Levels of stool SCFAs and stool and plasma inflammatory and permeability markers were compared between patients and controls and related to one another and to the gut microbiota.

Results

Calprotectin was increased and SCFAs decreased in stool in PD in a sex-dependent manner. Inflammatory markers in plasma and stool were neither intercorrelated nor strongly associated with SCFA levels. Age at PD onset was positively correlated with SCFAs and negatively correlated with CXCL8 and IL-1β in stool. Fecal zonulin correlated positively with fecal NGAL and negatively with PD motor and non-motor symptoms. Microbiota diversity and composition were linked to levels of stool SCFAs, inflammation, and zonulin. Certain relationships differed between patients and controls and by sex.

Conclusions

Intestinal inflammatory responses and reductions in fecal SCFAs occur in PD, are related to the microbiota and to disease onset, and are not reflected in plasma inflammatory profiles. Some of these relationships are PD- and sex-dependent. Alterations in microbiota-host interactions and links between intestinal inflammation and reduced SCFA levels and earlier PD onset warrant further investigation.
An Intersectional Analysis Providing More Precise Information on Inequities in Self-Rated Health
Authors: Wemrell Maria , Karlsson Nadja , Vicente Raquel Perez , Merlo Juan
Published: January 2021

Background: Intersectionality theory combined with an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) can facilitate our understanding of health disparities. This enables the application of proportionate universalism for resource allocation in public health. Analyzing self-rated health (SRH) in Sweden, we show how an intersectional perspective allows for a detailed mapping of health inequalities while avoiding simplification and stigmatization based on indiscriminate interpretations of differences between group averages. Methods: We analyzed participants (n=133,244) in 14 consecutive National Public Health Surveys conducted in Sweden in 2004-2016 and 2018. Applying AIHDA, we investigated the risk of bad SRH across 12 intersectional strata defined by gender, income and migration status, adjusted by age and survey year. We calculated odds ratios (with 95% confidence intervals) to evaluate between-strata differences, using native-born men with high income as the comparison reference. We calculated the area under the receiver operating characteristic curve (AU-ROC) to evaluate the discriminatory accuracy of the intersectional strata for identifying individuals according to their SRH status. Results: The analysis of intersectional strata showed clear average differences in the risk of bad SRH. For instance, the risk was seven times higher for immigrated women with low income (OR 7.00 [95% CI 6.14-7.97]) than for native men with high income. However, the discriminatory accuracy of the intersectional strata was small (AU-ROC=0.67). Conclusions: The intersectional AIHDA approach provides more precise information on the existence (or the absence) of health inequalities, and can guide public health interventions according to the principle of proportionate universalism. The low discriminatory accuracy of the intersectional strata found in this study warrants universal interventions rather than interventions exclusively focused on strata with a higher average risk of bad SRH.
CircTP63 promotes hepatocellular carcinoma progression by sponging miR-155-5p and upregulating ZBTB18
Authors: Wang Jiantao , Che Jinbiao
Published: January 2021

Background: Hepatocellular carcinoma (HCC) is the leading cause of tumor-related death worldwide due to high morbidity and mortality, yet lacking effective biomarkers and therapies. Circular RNAs (circRNAs) are a group of non-coding RNAs that regulate gene expression through interacting with miRNAs, implicating in the tumorigenesis and progression. A novel circRNA, circTP63, was reported to be an oncogene in HCC. However, its role in HCC remains unclear.Methods: qRT-PCR was used to assess the mRNA levels of CircTP63 in 90 pairs of tumor and adjacent normal tissues from HCC patients, one human normal hepatic epithelial cell line and HCC cell lines. CCK-8, colony formation, transwell, and flow cytometry assays were performed to detect the cellular function of circTP63/miR-155-5p/ZBTB18 in HCC cells. HCC xenograft mice models were established to assess the in vivo effect of circTP63. Bioinformatic analysis, RNA pull-down and luciferase assays were used to determine the interaction among circTP63/miR-155-5p/ZBTB18. Results: circTP63 was significantly upregulated in HCC tissues and cell lines. High circTP63 expression is closely associated with the tumor stages, lymph node metastasis, and poor prognosis of HCC patients. Functionally, knockdown of circTP63 inhibited cell proliferation, migration, invasion, and promoted cell apoptosis of HCC. Meanwhile, overexpression of circTP63 enhanced HCC progression. Mechanically, circTP63 was a sponge of miR-155-5p to facilitate the ZBTB18 expression, and the ZBTB18 expression in HCC tissues was negatively associated with the survival rate of HCC patients. Furthermore, rescued assays revealed that the reduced tumor-promoting effect on HCC cells induced by knockdown of circTP63 can be reversed by miR-155-5p inhibitor or ZBTB18 overexpression. Conclusion: Our data highlight a critical circTP63-miR-155-5p-ZBTB18 regulatory network involved in the HCC progression, gaining mechanistic insights into the function of circRNAs in HCC progression, and providing effective biomarkers and therapeutic targets for HCC treatment.
Maternal Death Surveillance and Response in Tanzania: Comprehensiveness of narrative summaries and action points from maternal death reviews
Authors: Said Ali , Pembe Andrea B. , Massawe Siriel , Hanson Claudia , Malqvist Mats
Published: January 2021

Background Maternal deaths reviews are proposed as one strategy to address high maternal mortality in low and middle-income countries, including Tanzania. Review of maternal deaths relies on comprehensive documentation of medical records that can reveal the sequence of events leading to death. The World Health Organization’s and the Tanzanian Maternal Death and Surveillance (MDSR) system propose the use of narrative summaries during maternal death reviews for discussing the case to categorize causes of death, identify gaps in care and recommend action plans to prevent deaths. Suggested action plans are recommended to be Specific, Measurable, Attainable, Relevant and Time bound (SMART). To identify gaps in documenting information and developing recommendations, comprehensiveness of written narrative summaries and action plans were assessed. Methods A total of 76 facility maternal deaths that occurred in two regions in Southern Tanzania in 2018 were included for analysis. Using a prepared checklist from Tanzania 2015 MDSR guideline, we assessed comprehensiveness by presence or absence of items in four domains, each with several attributes. These were socio-demographic characteristics, antenatal care, referral information and events that occurred after admission. Less than 75% completeness of attributes in all domains was considered poor while 95% and above were good/comprehensive. Action plans were assessed by application of SMART criteria and according to the place of planned implementation (community, facility or higher level of health system).Results Almost half of narrative summaries (49%) scored poor, and only1% scored good/comprehensive. Summaries missed key information such as demographic characteristics, time between diagnosis of complication and commencing treatment (65%), investigation results (47%), summary of case evolution (51%) and referral information (47%). A total of 285 action points were analysed. Most action points, 242(85%), recommended strategies to be implemented at health facilities and were mostly about service delivery, 120(42%). Only 42% (32/76) of the action points were deemed to be SMART.Conclusions Abstraction of information to prepare narrative summaries used in the MDSR system is inadequately done. Most recommendations were unspecific with a focus on improving quality of care in health facilities
Impact of Post-diagnosis Weight Change on Survival Outcomes in Black and White Breast Cancer Patients
Authors: Shang Lihua , Hattori Masaya , Fleming Gini , Jaskowiak Nora , Hedeker Donald , Olopade Olufunmilayo I , Huo Dezheng
Published: January 2021

Purpose: To evaluate weight change patterns over time following the diagnosis of breast cancer, and to examine the association of post-diagnosis weight change and survival outcomes in Black and White patients.Methods: The study included 2,888 women diagnosed with non-metastatic breast cancer in 2000-2017 in Chicago. Longitudinal repeated measures of weight and height were collected, along with a questionnaire survey including questions on body size. Multilevel mixed-effects models were used to examine changes in body mass index (BMI). Delayed entry Cox proportional hazards models were used to investigate the impacts of changing slope of BMI on survival outcomes. Results: At diagnosis, most patients were overweight or obese with a mean BMI of 27.5 kg/m2 and 31.5 kg/m2 for Blacks and Whites, respectively. Notably, about 45% of the patients had cachexia before death and substantial weight loss started about 30 months before death. In multivariable-adjusted analyses, compared to stable weight, BMI loss (>0.5 kg/m2/year) showed greater than 2-fold increased risk in overall survival (hazard ratio [HR]=2.60, 95%CI 1.88-3.59), breast cancer specific survival (HR=3.05, 95%CI 1.91-4.86), and disease-free survival (HR=2.12, 95%CI 1.52-2.96). The associations were not modified by race, age at diagnosis, and pre-diagnostic weight. BMI gain (>0.5 kg/m2/year) was also related to worse survival, but the effect was weak (HR=1.60, 95%CI 1.10-2.33 for overall survival).Conclusion: BMI loss is a strong predictor of worse breast cancer outcomes. Growing prevalence of obesity may hide diagnosis of cancer cachexia, which can occur in a large proportion of breast cancer patients long before death.
Optimization of whole-genome sequencing of Plasmodium falciparum from low-density dried blood spot samples
Authors: Teyssier Noam , Chen Anna , Duarte Elias , Sit Rene , Greenhouse Bryan , Tessema Sofonias
Published: January 2021

Background: Whole-genome sequencing (WGS) is becoming increasingly useful to study the biology, epidemiology, and ecology of malaria parasites. Despite ease of sampling, DNA extracted from dried blood spots (DBS) has a high ratio of human DNA compared to parasite DNA, which poses a challenge for downstream genetic analyses. We evaluated the effects of multiple methods for DNA extraction, digestion of methylated DNA, and amplification on the quality and fidelity of WGS data recovered from DBS.Results: At 100 parasites/μL, Chelex-Tween-McrBC samples had higher coverage (5X depth = 93% genome) than QIAamp extracted samples (5X depth = 76% genome). The two evaluated sWGA primer sets showed minor differences in overall genome coverage and SNP concordance, with a newly proposed combination of 20 primers showing a modest improvement in coverage over those previously published. Conclusions: Overall, Tween-Chelex extracted samples that were treated with McrBC digestion and are amplified using 6A10AD sWGA conditions had minimal dropout rate, higher percentages of coverage at higher depth, and more accurate SNP concordance than QiaAMP extracted samples. These findings extend the results of previously reported methods, making whole genome sequencing accessible to a larger number of low density samples that are commonly encountered in cross-sectional surveys.
Improvements in HOMA indices and pancreatic endocrinal tissues in type 2-diabetic rats by DPP-4 inhibition and antioxidant potential of an ethanol fruit extract of Withania coagulans 
Authors: Ram Heera , Kumar Pramod , Purohit Ashok , Kashyap Priya , Kumar Suresh , Kumar Shivani , Singh Garima , Alqarawi Abdulaziz A. , Hashem Abeer , Abd_Allah Elsayed Fathi , Singh Bhim Pratap
Published: January 2021

Context: Withania coagulans (Stocks) Dunal fruits are used in the therapeutics of several ailments due to possessing of potent phytoconstituents which is also used traditionally for curing the diabetes. Objective: The present study was assessing the amelioration potential of the phytochemicals of an ethanol fruit extract of Withania coagulans (Stocks) Dunal in the HOMA (Homeostatic model assessment) indices and pancreatic endocrinal tissues by inhibition of DPP-4 and antioxidants activities.Material and methods: The identification of phytoconstituents of the test extract was performed by LCMS. Further, assessments of in-vitro, in-vivo and in-silico were achieved by following standard methods. In-vivo studies were conducted on type-2 diabetic ratsResults: The chosen extract inhibited DPP-4 activity by 63.2% in an in vitro assay as well as significantly inhibit serum DPP-4 levels. Accordingly, the administration of the ethanol fruit extract resulted in a significant (𝑃≤ 0.001) alterations in the lipid profile, antioxidant levels, and HOMA indices. Moreover, pancreatic endocrinal tissues (islet of Langerhans) appeared to have the restoration of normal histoarchitecture as evidenced by increased cellular mass. Molecular docking (Protein - ligands) of identified phytoconstituents with DPP-4 (target enzyme) shown incredibly low binding energy (Kcal/mol) as required for ideal interactions. ADMET analysis of the pharmacokinetics of the identified phytoconstituents indicated an ideal profile as per Lipinski laws. Conclusion: It can be concluded that the phytoconstituents of an ethanol fruit extract of Withania coagulans have the potential to inhibit DPP-4 which result in improved glucose homeostasis and restoration of pancreatic endocrinal tissues in type-2 diabetic rats.