bluuebunny/crossref_metadata_2025 huggingface dataset:
Outpatient Management of Oligosymptomatic Patients with Respiratory Infection in the Era of SARS-CoV-2. Experience from Rural German General Practitioners
Authors: Wernhart Simon , Förster Tim Henning , Weihe Eberhard
Published: October 2020

Background: Covid-19 is causing a pandemic and forces physicians to restructure their work. We want to share our experience in the outpatient management of potentially-infected patients with special consideration of altered national test strategies during the crisis.Methods: We analysed patients with respiratory symptoms reporting to our three rural general practitioner (GP) offices in North Rhine-Westphalia, Germany, from 27.01-20.04.2020 (n=489 from a total of 6,090 patients). A history of symptoms was taken at the doorstep following a specific questionnaire. Patients with respiratory symptoms were examined in a separated isolation area, while the others were allowed to enter the office. We applied the first recommended algorithm of the German Robert Koch Institute (RKI) to test suspected patients and compared our results with an adapted, more liberal version of the RKI, which is currently applied in Germany.Results: Eighty patients (16.36%, mean age: 47.03 years+-18.08) were sent to a nasopharyngeal smear. Five patients (6.25%) proved to be positive, four of whom had established risk factors for COVID-19. Overall, the most common symptoms were cough (83.75%), sore throat (71.25%), as well as myalgia and fatigue (66.25%). The most common diagnoses were rhinopharyngitis (37.22%) and acute bronchitis (30.27%). A sore throat was more common in positively-tested patients (80% vs. 12%). Applying the first RKI test strategy yielded 6.25% of positive tests (n=80), while the more liberal later RKI recommendation would have achieved 1.36% positive tests from 369 patients. No positive test was missed by applying the conservative strategy. None of our employees called in sick during this period, which emphasises the efficacy and safety of our screening methods. Conclusion: A clinical distinction between ordinary respiratory infections and COVID-19 is not possible in a low-prevalence population. Our model to prevent unprotected physical contact, screen patients in front of the office with protective equipment, and examine respiratory infections in separated areas works in the GP setting without overt health risks for employees. Thus, this approach should be used as a GP standard to uphold patient care without major health risks for the personnel. Large multi-centre studies are necessary to work out the most suitable test strategy.
TLR2 deficiency promotes IgE and inhibits IgG1 class-switching following ovalbumin sensitization
Authors: Li Yuqin , Chen Qiu , Ji Wei , Fan Yujie , Huang Li , Chu Chu , Zhou Wei-fang
Published: October 2020

Background: To explore the roles of Toll-like receptor (TLR)2 in Th2 cytokine production and immunoglobulin (Ig) class switching following ovalbumin (OVA) sensitization.Methods: TLR2-/- and wild-type C57BL/6 mice were sensitized by intraperitoneal injection with OVA. Lung pathology was assessed by hematoxylin and eosin staining. Abundance of interleukin (IL)4, IL5, IL13, and IL21 transcripts in the lungs was quantified by RT-PCR. OVA-specific IgG1, IgG2a, IgG2b, IgE and IgM were quantified by enzyme-linked immunosorbent assay. Phosphorylated signal transducer and activator of transcription (STAT)3 in lung tissue was detected by immunohistochemistry staining and nuclear factor (NF) κB activation was measured by immunofluorescence staining. STAT3 activation was inhibited using cryptotanshinone (CPT) treatment. Germline transcripts (Iμ-Cμ, Iγ-Cγ, Iα-Cα or Iε-Cε), post-recombination transcripts (Iμ-Cγ, Iμ-Cα or Iμ- Cε) and mature transcripts (VHDJH-Cγ, VHDJH-Cα or VHDJH-Cε) were analyzed from splenic B cells of OVA-sensitized wild-type mice (with or without CPT treatment) and TLR2-/- mice (with or without IL21 treatment). Results: The lungs of TLR2-/- mice showed a lesser degree of inflammation than wild-type mice after OVA sensitization. Following OVA sensitization, levels of IL4, IL13, and IL21, but not IL5, were significantly lower in TLR2-/- compared with wild-type mice. Moreover, OVA-specific IgG1 and IgE titers were markedly lower and higher, respectively, in TLR2-/- mice. TLR2 deficiency inhibited STAT3 activation but not NF-κB p65 activation. CPT treatment reduced IgG1 titers via inhibition of Stat3 phosphorylation. Both TLR2 knockout and CPT treatment reduced the frequencies of Iγ1-Cγ1, Iγ3-Cγ3 and Iα-Cα transcripts, but IL21 treatment compensated for the effects of TLR2 deficiency.Conclusion: These results suggest a role of TLR2 in restricting OVA-sensitized lung inflammation via promotion of IgG1 and inhibition of IgE class switching regulated by IL21 and STAT3.
Genome-wide identification, phylogenetic and expression pattern analysis of GATA family genes in Brassica napus
Authors: Zhu Weizhuo , Guo Yiyi , Chen Yeke , Wu Dezhi , Jiang Lixi
Published: October 2020

Background: Transcription factors GATAs are involved in plant developmental processes and respond to environmental stresses through binding DNA regulatory regions to regulate their downstream genes. However, little information on the GATA genes in Brassica napus is available. The release of the reference genome of B. napus provides a good opportunity to perform a genome-wide characterization of GATA family genes in rapeseed. Results: In this study, 96 GATA genes randomly distributing on 19 chromosomes were identified in B. napus , which were classified into four subfamilies based on phylogenetic analysis and their domain structures. The amino acids of BnGATAs were obvious divergence among four subfamilies in terms of their GATA domains, structures and motif compositions. Gene duplication and synteny between the genomes of B. napus and A. thaliana were also analyzed to provide insights into evolutionary characteristics. Moreover, BnGATAs showed different expression patterns in various tissues and under diverse abiotic stresses. Single nucleotide polymorphisms (SNPs) distributions of BnGATAs in a core collection germplasm are probably associated with functional disparity under environmental stress condition in different genotypes of B. napus . Conclusion: The present study was investigated genomic structures, evolution features, expression patterns and SNP distributions of 96 BnGATAs. The results enrich our understanding of the GATA genes in rapeseed.
Prevalence and social determinants of psychological distress among people who use drugs in Cambodia
Authors: Saing Chan Hang , Prem Kiesha , Uk Ponha , Chann Navy , Chhoun Pheak , Mun Phalkun , Tuot Sovannary , Yi Siyan
Published: October 2020

Background: People who use drugs are at a disproportionately higher risk of mental disorders due to prolonged exposure to psychosocial challenges. However, studies on mental health among people who use drugs in resource-constrained countries are scarce. This study sheds light on the prevalence and correlates of psychological distress among people who use drugs in Cambodia.Methods: We conducted this cross-sectional study in the capital city and 11 provinces in 2017. The Respondent Driven Sampling method was adapted to recruit 1677 people who used drugs for face-to-face interviews using a structured questionnaire. Psychological distress was measured using the General Health Questionnaire (GHQ-12). A total score of GHQ-12>2 indicated high psychological distress. We performed a multiple logistic regression analysis to identify factors associated with psychological distress. Results: We included 1598 participants in the analyses, with a mean age of 28.6 years (SD= 7.8). Of the total, 42% had high psychological distress – 50% in women and 37% in men. The adjusted odds of having high psychological distress were significantly higher among participants who were 25-34 years old and 35 years and above, had been to a drug rehabilitation center, had been insulted by family members, and had been sexually harassed/abused by someone when they were growing up. The odds of having high psychological distress were significantly lower among participants who were male, lived in their own dwelling, reported injecting as the mode of the first drug use, and had someone taking care of them when they got sick.Conclusions: This study documents a high prevalence of psychological distress among people who use drugs in Cambodia. Intervention programs that attempt to address mental health problems among people who use drugs in resource-limited settings should be gender- and age-sensitive and target more marginalized subpopulations. Mental health services can be integrated into HIV and harm-reduction programs for people who use drugs.
Assessment of Cardiac Amyloidosis with 99mTc-Pyrophosphate (PYP) Quantitative SPECT
Authors: Ren Chao , Ren Jingyun , Tian Zhuang , Du Yanrong , Hao Zhixin , Zhang Zongyao , Fang Wei , Li Fang , Zhang Shuyang , Hsu Bailing , Huo Li
Published: October 2020

Background: 99mTc-PYP scintigraphy provides differential diagnosis of ATTR cardiomyopathy (ATTR-CM) from light chain cardiac amyloidosis and other myocardial disorders without biopsy. This study was aimed to assess the diagnostic feasibility and the operator reproducibility of 99mTc-PYP quantitative SPECT.Method: Thirty-seven consecutive patients underwent a 99mTc-PYP thorax planar scan followed by SPECT and CT scans to diagnose suspected ATTR-CM were enrolled. For the quantitative SPECT, phantom studies were initially performed to determine the image conversion factor (ICF) and partial volume correction (PVC) factor to recover 99mTc-PYP activity concentration in myocardium for calculating the standardized uptake value (SUV) (unit: g/ml). SUVmax was compared among groups of ATTR-CM, AL cardiac amyloidosis and other pathogens (Others), and among categories of Perugini visual scores (Grade: 0-3). The intra- and inter-operator reproducibility of quantitative SPECT was verified, and the corresponded repeatability coefficient (RPC) was calculated.Results: The ICF was 79,327 Bq/ml to convert count rate in pixel to 99mTc activity concentration. PVC factor as a function of the measured activity concentration ratio in myocardium and blood-pool was [y=1.424*(1-exp(-0.759*x)) +0.104]. SUVmax of ATTR-CM (7.50±2.68) was significantly higher than those of AL (1.96±0.35) and Others (2.00±0.74) (all p<0.05). SUVmax of Grade 3 (8.95±1.89) and Grade 2 (4.71±0.23) were also significantly higher than those of Grade 1 (1.92±0.31) and Grade 0 (1.59±0.39) (all p <0.05). Correlation coefficient (R2) of SUVmax reached 0.966 to 0.978 with only small systematic difference (intra=-0.14; inter=-0.23) between two repeated measurements. Intra- and inter-operator RPCs were 0.688 and 0.877.Conclusions: 99mTc-PYP quantitative SPECT integrated with adjustable PVC factors is feasible to quantitatively and objectively assess the burden of cardiac amyloidosis for diagnosis of ATTR-CM.
A new anabolic compound, LLP2A-Ale, reserves periodontal bone loss in mice through augmentation of bone formation
Authors: Jiang Min , Liu Lixian , Liu Ruiwu , lam Kit S , Lane Nancy E , Yao Wei
Published: October 2020

Background. Currently, there are no effective medications that reverse periodontal disease (PD)-induced bone loss. The objective of this study was to test a new anabolic compound, LLP2A-Ale, or with the combination treatment of mesenchymal stromal cell (MSC), in the treatment of bone loss secondary to PD. Methods. PD was induced in mice by placing a ligature around the second right molar. At one week after disease induction, the mice were treated with placebo, LLP2A-Ale, MSCs, or combination of LLP2A-Ale + MSCs, and euthanized at week 4. Results. We found that PD induced alveolar bone loss that was associated with reduced bone formation. LLP2A alone and in combination with MSCs sustained alveolar bone formation and reversed alveolar bone loss. Additionally, PD alone caused systemic inflammation and increased the circulating levels of G-CSF, IP-10, MIP-1a, and MIP2, which were suppressed by LLP2A-Ale +/- MSCs. LLP2A-Ale +/- MSCs increased bone formation at the peripheral skeletal site (distal femur), which was otherwise suppressed by PD. Conclusion. Our findings indicated that LLP2A-Ale treatment rescued alveolar bone loss caused by PD, primarily by increasing bone formation. LLP2A-Ale also attenuated the circulating levels of a series of inflammatory cytokines and reversed the PD-induced suppression of systemic bone formation.
Knowledge, Attitude and Practice towards Anthrax in Northern Ethiopia: a mixed approach study
Authors: Romha Gebremedhin , Girmay Weldemelak
Published: October 2020

Background: Anthrax is the second most highly prioritized zoonotic disease in Ethiopia due to its negative impact at the household level, causing disease and production losses in livestock and severe disease in humans. This study seeks to assess the knowledge of, attitudes towards, and practices addressing (KAPs) anthrax in the communities of Eastern Tigray, Northern Ethiopia. Methods : A cross-sectional survey was conducted concurrently with focus group discussions (FGD) and key informant interviews (KII) between May 2019 and April 2020. A total of 862 respondents participated in the questionnaire survey. Of these, 800 were local community members, while 62 were professionals working at health service institutions. In addition, qualitative data were collected using six FGDs and 11 KIIs. Results : Sixty-two percent (496/800) of the community respondents said that they were aware of anthrax while 38% (304/800) of them did not. Only 9.3% (74/800) of the respondents reported that the causative agent of anthrax is germs/microbial. About 56.5% (35/62) of professional respondents said that it is bacterial. More than sixty percent (64.1%, 513/800) of the respondents did not know that whether the disease was zoonotic or not. Regarding clinical signs, 26.3 (210/800) and 36.8% (294/800) of the respondents could identify at least one in animals and humans, respectively, while 21.3 (170/800) and 20.1% (161/800) knew one or more transmission routes in animals and humans, respectively. Moreover, 43.4% (347/800) and 45.6% (365/800) of the respondents mentioned one or more control/prevention method(s) in animals and humans, respectively. Regarding qualitative results, some of the participants knew the disease (in animals) by their local names: Lalish and Tafia (splenomegaly), and Gulbus (abdominal cramps and shivering). Some reported that anthrax was exclusively a human disease while others recognized its zoonotic potential after the clinical signs in both animals and humans were listed. Conclusion : The KAP of the participants regarding anthrax was low. There was no consistent understanding of the disease among the participants. The study also revealed that the participants did not receive consistent, adequate, and continuous education regarding the disease.
15q26 Deletion in a Patient with Congenital Heart Defect, Growth Restriction and Intellectual Disability: Case Report and Literature Review
Authors: BENBOUCHTA Yahya , de Leeuw Nicole , Amasdl Saadia , Sbiti Aziza , Smeets Dominique , Sefiani Abdelaziz , Sadki Khalid
Published: October 2020

Background 15q26 deletion is a relatively rare chromosomal disorder described in only few cases. Patients with this aberration display numerous symptoms particularly, pre- and postnatal growth restriction, microcephaly, intellectual disability, dysmorphic gestalt and various congenital malformations. Case presentation We report on a girl, four years old, of consanguineous parents, with a de novo 15q26 deletion. Clinical manifestations included failure to thrive, microcephaly, dysmorphic facies with broad forehead, hypertelorism, narrowed eyelid slits and protruding columella. The patient also showed skeletal abnormalities, especially clinodactyly of the 5th finger, varus equine right foot and left club foot. Additionally, she had teething delay and divergent strabismus. Heart ultrasound displayed a left-to-right shunt, two atrial septal defects, enlarging the right heart cavities. Routine cytogenetic analysis revealed a shortened 15 chromosome with an abnormally short ened long (q) arm. Subsequent array analysis disclosed a terminal 9.15 Mb deletions detected in band 15q26.1-q26.3. Five candidate genes associated with 15q26 deletion phenotype were within the deleted region, i.e. IGF1R, NR2F2, MEF2A, MCTP2, and CHD2.Conclusion 15q26 monosomy should be considered when growth retardation is associated with ear anomaly, clinodactyly and/or abnormal toe, heart defect mainly atrioventricular septal defects (AVSDs) and/or aortic arch anomaly (AAA).
Kinetic Analysis of Dominant Intraprostatic Lesion of Prostate Cancer Using Quantitative Dynamic [18F]DCFPyL-PET: Comparison to [18F]fluorocholine-PET
Authors: Yang Dae-Myoung , Li Fiona , Bauman Glenn , Chin Joseph , Pautler Stephen , Moussa Madeleine , Rachinsky Irina , Valliant John , Lee Ting-Yim
Published: October 2020

Purpose Identification of the dominant intraprostatic lesion(s) (DILs) can facilitate diagnosis and treatment by targeting biologically significant intra-prostatic foci. A PSMA ligand, [18F]DCFPyL (2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid), is better than choline-based [18F]FCH (Fluorocholine) in detecting and localizing DIL because of higher tumour contrast, particularly when imaging is delayed to one hour post injection. The goal of this study was to investigate whether the different imaging performance of [18F]FCH and [18F]DCFPyL can be explained by their kinetic behaviour in prostate cancer (PCa) and to evaluate whether DIL can be accurately detected and localized using a short duration dynamic positron emission tomography (PET).Methods 19 and 23 PCa patients were evaluated with dynamic [18F]DCFPyL and [18F]FCH PET, respectively. The dynamic imaging protocol with each tracer had a total imaging time of 22 mins and consisted of multiple frames with acquisition times from 10-180 s. Tumour and benign tissue regions identified by sextant biopsy were compared using standardized uptake value (SUV) and tracer kinetic parameters from kinetic analysis of time-activity curves.Results For [18F]DCFPyL, logistic regression identified Ki and k4 as the optimal model to discriminate tumour from benign tissue (84.2% sensitivity and 94.7% specificity) while only SUV was predictive for [18F]FCH (82.6% sensitivity and 87.0% specificity) The higher k3 (binding) of [18F]FCH than [18F]DCFPyL explains why [18F]FCH SUV can differentiate tumour from benign tissue within minutes of injection. Superior [18F]DCFPyL tumour contrast was due to the higher k4/k3 (more rapid washout) in benign tissue compared to tumour tissue.Conclusions DIL was detected with good sensitivity and specificity using 22-min dynamic [18F]DCFPyL PET and avoids the need for delayed post-injection imaging timepoints. The dissimilar in-vivo kinetic behaviour of [18F]DCFPyL and [18F]FCH could explain their different SUV images.
Therapeutic evaluation of palbociclib and its compatibility with other chemotherapies for primary and recurrent nasopharyngeal carcinoma
Authors: xue zhichao , Lui Vivian Wai Yan , Li Yongshu , Lin Jia , You Chanping , Li Xin , Piao Wenyin , Yuan Hui , Khong Pek Lan , Lo Kwok Wai , Cheung Lydia Wai Ting , Lee Victor Ho Fun , Lee Anne Wing Mui , Tsao Sai Wah , Tsang Chi Man
Published: October 2020

Background: Recent genomic analyses revealed that druggable molecule targets were detectable in approximately 6% of patients with nasopharyngeal carcinoma (NPC). However, a dependency on dysregulated CDK4/6–cyclinD1 pathway signaling is an essential event in the pathogenesis of NPC. In this study, we aimed to evaluate the therapeutic efficacy of a specific CDK4/6 inhibitor, palbociclib, and its compatibility with other chemotherapeutic drugs for the treatment of NPC by using newly established xenograft models and cell lines derived from primary, recurrent, and metastatic NPC. Methods: We evaluated the efficacies of palbociclib monotherapy and concurrent treatment with palbociclib and cisplatin or suberanilohydroxamic acid (SAHA) in NPC cell lines and xenograft models. RNA sequencing was then used to profile the drug response–related pathways. Palbociclib-resistant NPC cell lines were established to determine the potential use of cisplatin as a second-line treatment after the development of palbociclib resistance. We further examined the efficacy of palbociclib treatment against cisplatin-resistant NPC cells. Results: In NPC cells, palbociclib monotherapy was confirmed to induce cell cycle arrest in the G1 phase in vitro . Palbociclib monotherapy also had significant inhibitory effects in all six tested NPC tumor models in vivo , as indicated by substantial reductions in the total tumor volumes and in Ki-67 proliferation marker expression. In NPC cells, concurrent palbociclib treatment mitigated the cytotoxic effect of cisplatin in vitro . Notably, concurrent treatment with palbociclib and SAHA synergistically promoted NPC cell death both in vitro and in vivo . This combination also further inhibited tumor growth by inducing autophagy-associated cell death. NPC cell lines with induced palbociclib or cisplatin resistance remained sensitive to treatment with cisplatin or palbociclib, respectively. Conclusions: Our study findings provide essential support for the use of palbociclib as an alternative therapy for NPC and increase awareness of the effective timing of palbociclib administration with other chemotherapeutic drugs. Our results provide a foundation for the design of first-in-human clinical trials of palbociclib regimens in patients with NPC.
Clinical implementation of PLANET®Dose for dosimetric assessment after [177Lu]Lu-DOTA-TATE: comparison with Dosimetry Toolkit® and OLINDA/EXM® V1.0
Authors: Santoro Lore , Pitalot Laurine , Trauchessec Dorian , Mora-Ramirez Erick , Kotzki Pierre-Olivier , Bardiès Manuel , Deshayes Emmanuel
Published: October 2020

Background: The aim of this study was to compare a commercial dosimetry workstation (PLANET®Dose) and the dosimetry approach (GE Dosimetry Toolkit® and OLINDA/EXM® V1.0) currently used in our department for quantification of the absorbed dose (AD) to organs at risk after peptide receptor radionuclide therapy with [177Lu]Lu-DOTA-TATE.Methods: An evaluation on phantom was performed to determine the SPECT calibration factor variations over time and to compare the Time Integrated Activity Coefficients (TIACs) obtained with the two approaches. Then, dosimetry was carried out with the two tools in 21 patients with neuroendocrine tumours after the first and second injection of 7.2 ± 0.2 GBq of [177Lu]Lu-DOTA-TATE (40 dosimetry analyses with each software). SPECT/CT images were acquired at 4h, 24h, 72h and 192h post-injection and were reconstructed using the Xeleris software (General Electric). The liver, spleen and kidneys masses and TIACs were calculated using Dosimetry Toolkit® (DTK) and PLANET®Dose. The ADs were calculated using OLINDA/EXM® V1.0 and the Local Deposition Method (LDM) or Dose voxel-Kernel convolution (DK) on PLANET®Dose.Results: With the phantom, the 3D calibration factors showed a slight variation (0.8% and 3.3%) over time, and TIACs of 225.19h and 217.52h were obtained with DTK and PLANET®Dose, respectively. In patients, the root mean square deviation value was 8.9% for the organ masses, 8.1% for the TIACs, and 9.1 and 7.8% for the ADs calculated with LDM and DK, respectively. The Lin’s concordance correlation coefficient was 0.99 and the Bland-Altman plot analysis estimated that the AD value difference between methods ranged from -0.75 Gy to 0.49 Gy, from -0.20 Gy to 0.64 Gy, and from -0.43 to 1.03 Gy for 95% of the 40 liver, kidneys and spleen dosimetry analyses. The dosimetry method had a minor influence on AD differences compared with the image registration and organ segmentation steps. Conclusions: The ADs to organs at risk obtained with the new workstation PLANET®Dose are concordant with those calculated with the currently used software and in agreement with the literature. These results validate the use of PLANET®Dose in clinical routine for patient dosimetry after targeted radiotherapy with [177Lu]Lu-DOTA-TATE.
A cross-sectional study of gastrointestinal symptoms, depressive symptoms and trait anxiety in young adults
Authors: Söderquist Fanny , Syk Mikaela , Just David , Novicic Zorana Kurbalija , Rasmusson Annica J. , Hellström Per M. , Ramklint Mia , Cunningham Janet L.
Published: October 2020

Background: Patients with functional gastrointestinal disorders have a high psychiatric co-morbidity. This study aimed to investigate and characterise gastrointestinal symptoms in relation to depressive symptoms and trait anxiety in a well-defined population of young adult psychiatric outpatients and healthy controls. Methods: Gastrointestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS). Depressive symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale- Self assessment (MADRS-S). Trait anxiety was estimated with three of the Swedish universities of Personality (SSP) scales: Somatic trait anxiety, Psychic trait anxiety and Stress susceptibility. Self-ratings were collected from 491 young adult psychiatric outpatients and 85 healthy controls. gastrointestinal symptom severity was compared between patients with and without current psychotropic medication and controls. Associations between gastrointestinal symptoms, depressive symptoms and trait anxiety were assessed using Spearman’s coefficients and generalized linear models adjusting for possible confounders (sex, body mass index, bulimia nervosa). Results: Patients, with and without current psychotropic medication, reported significantly more gastrointestinal symptoms than controls. In the generalized linear models, total MADRS-S score (p<0.001), Somatic trait anxiety (p<0.001), Psychic trait anxiety (p=0.002) and Stress susceptibility (p=0.002) were independent predictors of the total GSRS-IBS score. Further exploratory analysis using unsupervised learning revealed a diverse spectrum of symptoms that clustered into six groups.Conclusion: Gastrointestinal symptoms are both highly prevalent and diverse in young adult psychiatric outpatients, regardless of current psychotropic medication. Depressive symptom severity and degree of trait anxiety are independently related to the total gastrointestinal symptom burden.
Fabrication of chitosan-polyvinyl alcohol and silk electrospun fiber seeded with differentiated keratinocyte for skin tissue regeneration in animal wound model
Authors: Fathi Afshin , Khanmohammadi Mehdi , Goodarzi Arash , Foroutani Lale , Mobarakeh Zahra Taherian , Saremi Jamileh , Arabpour Zohre , Ai Jafar
Published: October 2020

Hybrid fibrous mat containing cell interactive molecules offers the ability to deliver the cells and drugs in wound bed, which will help to achieve a high therapeutic treatment. In this study, a co-electrospun hybrid of polyvinyl alcohol (PVA), chitosan (Ch) and silk fibrous mat was developed and their wound healing potential by localizing bone marrow mesenchymal stem cells (MSCs)-derived keratinocytes on it was evaluated in vitro and in vivo. It was expected that fabricated hybrid construct could promote wound healing due to its structure, physical, biological specifications. The fabricated fibrous mats were characterized for their structural, mechanical and biochemical properties. The shape uniformity and pore size of fibers showed smooth and homogenous structures of them. Fourier transform infrared spectroscopy (FTIR) verified all typical absorption characteristics of Ch-PVA + Silk polymers as well as Ch-PVA or pure PVA substrates. The contact angle and wettability measurement of fibers showed that mats found moderate hydrophilicity by addition of Ch and silk substrates compared with PVA alone. The mechanical features of Ch-PVA + Silk fibrous mat increase significantly through co-electrospun process as well as hybridization of these synthetic and natural polymers. Higher degrees of cellular attachment and proliferation obtained on Ch-PVA + Silk fibers compared with PVA and Ch-PVA fibers. In terms of the capability of Ch-PVA + Silk fibers and MSC-derived keratinocytes, histological analysis and skin regeneration results showed this novel fibrous construct could be suggested as a skin substitute in the repair of injured skin and regenerative medicine applications.
Building cohesion in distributed telemedicine teams: Findings from the Department of Veterans Affairs National Telestroke Program
Authors: Patel Himalaya , Damush Teresa M. , Miech Edward J. , Rattray Nicholas A. , Martin Holly A. , Savoy April , Plue Laurie , Anderson Jane , Martini Sharyl , Graham Glenn D. , Williams Linda S.
Published: October 2020

Background: As telemedicine adoption increases, so does the importance of building cohesion among physicians in telemedicine teams. For example, in acute telestroke services, stroke specialists provide rapid remote stroke assessment and treatment to patients at hospitals without stroke specialty care. In the National Telestroke Program (NTSP) of the U.S. Department of Veterans Affairs, a virtual (distributed) hub of stroke specialists throughout the country provides 24/7 consultations nationwide. We examined how these specialists adapted to distributed teamwork, and we identified cohesion-related factors in program development and support. Methods: We studied the virtual hub of stroke specialists employed by the NTSP. Semi-structured, confidential interviews with stroke specialists in the virtual hub were recorded and transcribed. We explored the extent to which these specialists had developed a sense of shared identity and team cohesion, and we identified factors in this development. Using a qualitative approach with constant comparison methods, two researchers coded each interview transcript independently using a shared codebook. We used matrix displays to identify themes, with special attention to team cohesion, communication, trust, and satisfaction. Results: Of 13 specialists with at least 8 months of NTSP practice, 12 completed interviews; 7 had previously practiced in telestroke programs in other healthcare systems. Interviewees reported high levels of trust and team cohesion, sometimes even more with their virtual colleagues than with co-located colleagues. Factors facilitating perceived team cohesion included a weekly case conference call, a sense of transparency in discussing challenges, engagement in NTSP development tasks, and support from the NTSP leadership. Although lack of in-person contact was associated with lower cohesion, annual in-person NTSP meetings helped mitigate this issue. Despite technical challenges in establishing a new telehealth system within existing national infrastructure, providers reported high levels of satisfaction with the NTSP. Conclusion: A virtual telestroke hub can provide a sense of team cohesion among stroke specialists at a level comparable with a standard co-located practice. Engaging in transparent discussion of challenging cases, reviewing new clinical evidence, and contributing to program improvements may promote cohesion in distributed telemedicine teams.
Understanding forgotten exposures towards achieving Sustainable Development Goal 3: the case of herbal medicine use in Tanzania
Authors: Kessy Anna Tengia , Msalale George Chombe
Published: October 2020

Background: In most sub-Sahara African countries, herbal medicines are widely used during pregnancy or delivery for various motives despite their unclear pharmacology and potential toxicity. All risky exposures, including use of herbs during pregnancy or delivery should be restricted in order to facilitate achieving the Sustainable Development Goal (SDG) 3: “ensure healthy lives and promote wellbeing for all including reduction of morbidity and mortality among mothers and newborns”. This study assessed use of herbal medicines during pregnancy or delivery and determined factors associated with the practice in Tabora, Tanzania.Methods: This cross-sectional quantitative study gathered information from 340 women who delivered a live-born baby in the preceding two years. Using a two-stage-sampling technique, we selected and interviewed women attending reproductive, maternal and child health clinics in public health facilities in Tabora, central Tanzania. We compared proportions using chi-square test and performed a Poisson regression analysis to determine independent correlates of herbal use.Results: Of 340 recruited women, 208 (61.2 %; 95%CI: 55.4, 66.3%) used herbal medicines during pregnancy or delivery. Major reasons for use included shortening of labour duration, 81 (38.9%) and reducing labour pain, 58 (27.9%). The independent predictors of herbal use were number of antenatal visits and the stance of maternity health care providers on the use of herbs. Women who made less than four visits had 24% higher prevalence ratio of using herbal medicines as compared to those who made at least four visits (aPR:1.24; 95%CI: 1.02, 1.50, p=0.03). Furthermore, the adjusted prevalence ratio of using herbs was 35% higher among women who were not discouraged by the health care providers against using herbs versus those who were discouraged (aPR: 1.35; 95%CI: 1.13, 1.60, p=0.01). Conclusions: Use of herbal medicines during pregnancy or delivery in Tanzania is high. This calls for comprehensive investigations on the effects of using herbs during pregnancy or delivery as a step towards understanding some of the challenges in achieving SDG 3. Additionally, maternity health care providers ought to strengthen provision of health education messages during antenatal visits on the undesirable effects of using herbs.
COVID-19: A National Survey on Perceived Level of Knowledge, Attitude and Practice among Frontline Healthcare Workers in Nepal
Authors: Tamang Nira , Rai Punam , Dhungana Siddhartha , Sherchan Binod , Shah Bikash , Pyakurel Prajjwal , Rai Saroj
Published: October 2020

Background: The primary aim of this national survey was to determine the knowledge, attitude and practice(KAP) regarding the COVID-19 among frontline healthcare workers(F-HCWs) working at different hospitals in Nepal, and the secondary aim was to find the factors associated with KAP. Methods: We used a web-based survey to collect data from 603 F-HCWs working at different hospitals in Nepal during the first week of June 2020. A self-administered questionnaire was utilized to assess the KAP perceived by the F-HCWs. It was divided into 4-parts consisting of 30-items, demographic characteristics (10-items), knowledge (10-items), attitude (5-items), and practice (5-items). It consisted of both multiple-choice questions and Likert scale items questionnaire. Results: Among the participants, 76% reported adequate knowledge, 54.7% reported positive attitude, and 78.9% reported appropriate practice. Statistically significant differences regarding the perceived level of knowledge among F-HCWs were observed among independent variables, including age, gender, level of education, marital status, profession, work experience, source of information, infection prevention and control (IPC) training, and online course(p<0.05). Similarly, statistically significant differences regarding the attitude among F-HCWs were observed among independent variables, including age, gender, level of education, profession, and online course(p<0.05). Moreover, only 2-independent variables, including the profession and online course, showed statistically significant differences with practice(p<0.05). Pearson correlation analysis showed a significant association between knowledge, attitude and practice at the level of p=0.01. The factors significantly associated with adequate knowledge were male gender (aOR: 3.66; 95%CI: 1.97-6.82), nurse and doctor (aOR: 2.10; 95%CI: 1.18-3.72), websites (aOR: 1.83; 95%CI: 1.83 (1.13-2.97) and IPC training (aOR: 1.53; 95%CI: 1.02-2.31). Similarly, factors significantly associated with positive attitude were online course related to COVID-19 (aOR: 1.49; 95%CI: 1.02-2.17) only. Moreover, factors significantly associated with appropriate practice were master’s degree or above (aOR: 0.56; 95%CI: 0.31-1.00) and online course related to COVID-19 (aOR: 2.43; 95%CI: 1.44-4.09) Conclusions: F-HCWs reported adequate overall knowledge with a positive attitude and adopted the appropriate practice.The experienced F-HCWs with higher education and who received IPC training and online course regarding COVID-19 had better KAP. So, the stakeholders must arrange the educational programs and training for F-HCWs for better preparedness tackling with COVID-19.
Predictive factors for the medical hospitalization of patients who visited to emergency department with suicide attempt
Authors: Kim Hye Jin , Lee Duk Hee
Published: October 2020

Background Suicide is a significant public health problem. Individuals are estimated to make up to 20 suicide attempts before suicide. The emergency department (ED) is the first location where individuals are brought after a suicide attempt. This study investigated the factors related to delays in the medical hospitalization of patients who attempted suicide and aimed to provide criteria for hospitalization decisions for physicians. Methods This study included who had deliberately self-harmed (age ≥19 years) and who presented at the EDs of two tertiary teaching hospitals between March 2017 and April 2020. Those for whom relevant demographic and clinical information were unavailable and those who were admitted to the psychiatric wards were excluded. Results This study included 414 patients in the hospitalization group and 1,346 in the discharged group. The mean patient age was 50.3 ± 20.0 years and 40.7 ± 17.0 years in the hospitalized and discharged groups ( p <0.001), respectively. The mean ED length of stay (LOS) was 4.2 ± 12.3 and 11.4 ± 18.8 h in the hospitalized and discharged groups, respectively . In the hospitalized group, the odds ratio and confidence interval for aged 35~64 (2.222, 1.343–3.678), aged over 65 (2.788, 1.416-5.492), sex -male (2.041, 1.302–3.119), and consciousness (1.840, 1.253–2.466). The Risk-Rescue Ratio Scale (RRRS) was (1.298, 1.255–1.343). A receiver operating characteristics analysis of RRRS for the decision to hospitalize patients who attempted suicide showed a cut-off value of 42, with sensitivity, specificity, and area under the curve being 85.7%, 85.5%, and 0.924, respectively. Conclusion The level of consciousness and the RRRS of patients who attempted suicide can be the factors to decide medical hospitalization and reduce ED LOS and crowding.
Bionomics of Anopheles arabiensis from Mamfene in KwaZulu-Natal (South Africa): an area of high malaria transmission in the province
Authors: Maharaj Rajendra , Lakan Vishan , Maharaj Kiash
Published: October 2020

Background

Although great strides have been made in controlling malaria, the disease is of significant public health importance. Historically, efforts to control the vector has concentrated on adult vector control targeting the female Anopheles mosquitoes. As there is now a focus on eliminating residual malaria from KwaZulu-Natal, new strategies are being investigated to increase the impact of malaria elimination strategies. Greater attention is now being given to larval control, as a complementary measure to indoor residual spraying. However, there is a large gap in knowledge of the bionomics of the larval stages of this mosquito vector of malaria in South Africa. In order to focus on both larval and adult mosquito control methods, larval development and the reproductive stages of the vector were investigated since these variables influences our ability to impact mosquito populations through larval control. This study was therefore conducted to determine the peak eruption times and the emergent sex ratios, as well as the peak egg oviposition time in order to attack the mosquito when it is at its most vulnerable and when control interventions will have the most impact.

Results

Oviposition studies showed two peaks corresponding with late evening and again just before dawn. Most eggs were also laid in the first half of the night (18h00 – midnight). Most mosquitoes erupted just after sunset and the sex ratios showed that twice as many females as males emerged. Females readily took a bloodmeal after oviposition or just after erupting. Hatch rate to viable first instar larvae was 74.5%.

Conclusions

The results of this study have provided information as to when interventions would be most effective in controlling mosquito populations and have provided information that highlights the value of larval control as a complementary measure to adult mosquito control. The most vulnerable stages of the female Anopheles arabiensis are when they have just emerged or when they have just oviposited. Vector control strategies should be designed to target these vulnerable stages at the breeding sites in order to have maximum impact.
Routine blood parameters are helpful for early identification of influenza infection in children
Authors: Zhu Ronghe , Chen Cuie , Wang Qiu , Zhang Xixi , Lu Chaosheng , Sun Yuanyuan
Published: October 2020

Purpose Routine blood parameters, such as the lymphocyte (LYM) count, platelet (PLT) count, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), LYM*PLT and mean platelet volume-to-platelet ratio (MPV/PLT), are widely used to predict the prognosis of infectious diseases. We aimed to explore the value of these parameters in the early identification of influenza virus infection in children.Methods We conducted a single-center, retrospective, observational study of fever with influenza-like symptoms in pediatric outpatients from different age groups and evaluated the predictive value of various routine blood parameters measured within 48 hours of the onset of fever for influenza virus infection. Results The LYM count, PLT count, LMR and LYM*PLT were lower, and the NLR and MPV/PLT were higher in children with an influenza infection (PCR-confirmed and symptomatic). The LYM count, LMR and LYM*PLT in the influenza infection group were lower in the 1- to 6-year-old subgroup, and the LMR and LYM*PLT in the influenza infection group were lower in the >6-year-old subgroup. In the 1- to 6-year-old subgroup, the cutoff value of the LMR for predicting influenza A virus infection was 3.75, the sensitivity was 81.87%, the specificity was 84.31%, and the area under the curve (AUC) was 0.886; the cutoff value of the LMR for predicting influenza B virus infection was 3.71, the sensitivity was 73.58%, the specificity was 84.31%, and the AUC was 0.843. In the >6-year-old subgroup, the cutoff value of the LMR for predicting influenza A virus infection was 3.05, the sensitivity was 89.27%, the specificity was 89.61%, and the AUC was 0.949; the cutoff value of the LMR for predicting influenza B virus infection was 2.88, the sensitivity was 83.19%, the specificity was 92.21%, and the AUC was 0.924.Conclusions Routine blood tests are simple, inexpensive and easy to perform, and they are useful for the early identification of influenza virus infection in children. The LMR had the strongest predictive value for influenza virus infection in children older than 1 year, particularly influenza A virus infection.
Effects of Whole Body Vibration exercise on Lumbar-Abdominal Muscles Activation for patients with chronic low back pain
Authors: Dong Yulin , Wang Huifang , Zhu Yan , Chen Binlin , Zheng Yili , Liu Xiaochen , Qiao Jun , Wang Xueqiang
Published: October 2020

Background: Whole body vibration (WBV) training as an intervention method can cure chronic low back pain (CLBP). Different WBV parameters exert different effects on lumbar-abdominal muscle performance. Currently, there is a lack of study researched the influence of WBV training on patients with CLBP by lumbar–abdominal muscle activity. Therefore, this study aimed to investigate how WBV and exercise and their interactions influence lumbar-abdominal muscle activity in patients with CLBP.Methods: a group of ambulatory patients with chronic low back pain. Muscle activities of the multifidus (MF), erector spinae (ES), abdominal oblique externus muscle (AOE) and the rectus abdominis muscle (RA) were measured by surface electromyography, whereas participants performed 4 different exercises (single bridge, plank, side stay and V crunch) during three whole body vibration conditions and a no-vibration condition in a single experimental session. Results: Compared with the same exercises without whole body vibration, muscle activity increased when whole body vibration was added to the exercises. MF；the WBV frequency (P=0.002,) and exercise (P<0.001) presented significant effects on the root mean square of MF, whereas exercise * frequency (P=0.044) also resulted in significant interaction effects. ES: the significant differences were detected at WBV frequency (P<0.001), exercise (P<0.001), the interaction effect of exercise and frequency (P=0.225) was no significant. RA: the significant difference was detected at WBV frequency (P=0.018), the effect of exercise (P=0.590) and the exercise * frequency interaction (P=0.572) were no significant. AOE: the significant difference was detected at WBV frequency (P<0.001), the effect of exercise (P=0.152) and the exercise * frequency interaction (P=0.380) were no significant.Conclusion: Adding whole body vibration to exercise could increase muscle activation of lumbar–abdominal muscle in patients with CLBP. The optimum frequency for lumbar–abdominal muscles is 15 Hz. The best exercises include plank for multifidus and erector spinae, V crunch for rectus abdominis and single bridge for abdominal oblique externus. Clinical registration Trial registration:ChiCTR-TRC-13003708. Registered 19 October 2013, http://www.chictr.org.cn/showproj.aspx?proj=5852
CD83 expression regulates antibody production in response to influenza A virus infection
Authors: Akauliya Madhav , Gautam Avishekh , Maharjan Sony , Park Byoung Kwon , Kim Jinsoo , Kwon Hyung-Joo
Published: October 2020

Background: CD83 is known to regulate lymphocyte maturation, activation, homeostasis, and antibody response to immunization and infection. While CD83 has a major part in B cell function, its role in influenza A virus infection has not yet been investigated. Methods: We investigated the role of CD83 using C57BL/6J wild type mice and CD83 knockout (KO) mice after intraperitoneal administration of the influenza A/WSN/1933 virus. We analyzed cells of the peritoneal cavity, splenocytes, and cells of the bone marrow with FACS to investigate CD83 expression and cell population change in response to the virus infection. ELISA was performed with sera and peritoneal cavity fluids to detect A/WSN/1933 virus-specific IgG and the subclasses of IgG. Results: FACS analysis data showed a transient but distinct induction of CD83 expression in the peritoneal B cells of wild type mice. CD83 KO mice exhibited a delayed recovery of B cells in the bone marrow after influenza virus infection and overall, a smaller T cell population compared to wild type mice. The peritoneal cavity and serum of the wild type mice contained a high titer of IgG within 14 days after infection, whereas the CD83 KO mice had a very low titer of IgG. Conclusions: These results show the importance of CD83 in lymphocytes homeostasis and antibody production during influenza A virus infection.