bluuebunny/crossref_metadata_2025 huggingface dataset:
iNOS/NO is required for IRF1 activation in response to liver ischemia-reperfusion in mice
Authors: Du Qiang , Luo Jing , Yang Mu-Qing , Liu Quan , Heres Caroline , Yan Yi-He , Stolz Donna , Geller David A.
Published: June 2020

Background

Ischemia and reperfusion (I/R) induces cytokines, and up-regulates inducible nitric oxide synthase (iNOS), interferon regulatory factor-1(IRF1) and p53 up-regulated modulator of apoptosis (PUMA), which contribute to cell death and tissue injury. However, the mechanisms that I/R induces IRF1-PUMA through iNOS/NO is still unknown.

Methods

Ischemia was induced by occluding structures in the portal triad (hepatic artery, portal vein, and bile duct) to the left and median liver lobes for 60 min, and reperfusion was initiated by removal of the clamp. Induction of iNOS, IRF1 and PUMA in response to I/R were analyzed. I/R induced IRF1 and PUMA expression were compared between iNOS wild-type and iNOS knockout (KO) mice. Human iNOS gene transfected-cells were used to determine iNOS/NO signals targeting IRF1. To test whether HDAC2 was involved in the mediation of iNOS/NO-induced IRF1 transcriptional activities and its target gene (PUMA and p21) expression, NO donors were used in vitro and in vivo.

Results

IRF1 nuclear translocation and PUMA transcription elevation were markedly induced following I/R in the liver of iNOS wild-type mice compared with that in knock-out mice. Furthermore, I/R induced hepatic HDAC2 expression and activation, and decreased H3AcK9 expression in iNOS wild-type mice, but not in the knock-out mice. Mechanistically, over-expression of human iNOS gene increased IRF1 transcriptional activity and PUMA expression, while iNOS inhibitor L-NIL reversed these effects. Cytokine-induced PUMA through IRF1 was p53 dependent. IRF1 and p53 synergistically up-regulated PUMA expression. iNOS/NO-induced HDAC2 mediated histone H3 deacetylation and promoted IRF1 transcriptional activity. Moreover, treating the cells with romidepsin, an HDAC1/2 inhibitor decreased NO-induced IRF1 and PUMA expression.

Conclusions

This study demonstrates a novel mechanism that iNOS/NO is required for IRF1/PUMA signaling through a positive-feedback loop between iNOS and IRF1, in which HDAC2-mediated histone modification is involved to up-regulate IRF1 in response to I/R in mice.
Salmonella enterica serovar Typhimurium sseK3 induces apoptosis and enhances glycolysis in macrophages
Authors: Yu Chuan , Du Fuyu , Zhang Chunjie , Li Yinju , Liao Chengshui , He Lei , Cheng Xiangchao , Zhang Xiaojie
Published: June 2020

Background

Salmonella entericaserovar Typhimurium (S.Typhimurium) is an important infectious disease pathogen that can survive and replicate in macrophages. Glycolysis is essential for immune responses againstS.Typhimurium infection in macrophages, and is also associated with apoptosis.S.Typhimurium secreted effector K3 (SseK3) was recently identified as a novel translated and secreted protein. However, there is no study about the role ofsseK3in the relationship between apoptosis and glycolysis in cells infected withS.Typhimurium. It is unclear whether this protein exerts a significant role in the progress of apoptosis and glycolysis inS.Typhimurium-infected macrophages.

Results

Macrophages were infected withS.Typhimurium SL1344 wild-type (WT), ΔsseK3mutant orsseK3-complemented strain, and the effects ofsseK3on apoptosis and glycolysis were determined. The adherence and invasion in the ΔsseK3mutant group were similar to that in the WT andsseK3-complemented groups, indicating that SseK3 was not essential for the adherence and invasion ofS.Typhimurium in macrophages. However, the percentage of apoptosis in the ΔsseK3mutant group was much lower than that in the WT andsseK3-complemented groups. Caspase-3, caspase-8, and caspase-9 enzyme activity in the ΔsseK3mutant group were significantly lower than in the WT group andsseK3-complemented groups, indicating thatsseK3could improve the caspase-3, caspase-8, and caspase-9 enzyme activity. We also found that there were no significant differences in pyruvic acid levels between the three groups, but the lactic acid level in the ΔsseK3mutant group was much lower than that in the WT andsseK3-complemented groups. The ATP levels in the ΔsseK3mutant group were remarkably higher than those in the WT andsseK3-complemented groups. These indicated that thesseK3enhanced the level of glycolysis in macrophages infected byS.Typhimurium.

Conclusions

S.TyphimuriumsseK3is likely involved in promoting macrophage apoptosis and modulating glycolysis in macrophages. Our results could improve our understanding of the relationship between apoptosis and glycolysis in macrophages induced byS.TyphimuriumsseK3.
Evaluation of seed nitrate assimilation and stimulation of phenolic-linked antioxidant on pentose phosphate pathway and nitrate reduction in three feed-plant species
Authors: Lin Derong , Huang Yichen , Zhao Jingjing , Wu Zhijun , Liu Shuliang , Qin Wen , Wu Dingtao , Chen Hong , Zhang Qing
Published: June 2020

Background

Soil and water pollution due to nitrate are becoming increasingly serious worldwide. The government also put forward relevant governance policies, and a large number of scholars studied chemical physics and other methods to remove nitrate in water, but the cost was substantial. Studies have found that planting systems including grasses have the potential to remove nitrates. However, there are few studies on nitrate linked pathway and nitrate assimilation during its early growth.

Results

We have evaluated three different feed-plant species with three levels of overnight seed nitrate treatments along with a control. The activity of different enzymes from 2 weeks old shoots was measured to get a comprehension of proline-associated pentose phosphate pathway coupled with nitrate assimilation and phenolic-linked antioxidant response system in these species under nitrate treatments. All three feed-plant species showed high nitrate tolerance during germination and early growth stages. It is perceived that the accumulation of total soluble phenolics and total antioxidant activity was high in all three feed-plant species under high nitrate treatments. In terms of high G6PDH activity along with low SDH activity in alfalfa, there may be a shift of carbon flux in this species under high nitrate treatments. Higher activity of these enzymes along with higher SOD and GPX activity was observed in alfalfa. The efficient mechanism of nitrate stress tolerance of alfalfa also correlated with higher photochemical efficiency. Perennial ryegrass also showed excellent potential under high nitrate treatments by adopting an efficient mechanism to counter nitrate-induced oxidative stress.

Conclusions

Under the condition of nitrate treatment, the germination rates of the three feed-plant species are still ideal, and they have good enzyme activity and have the potential to remove nitrate.
Metabolite profiling of rhizosphere soil of different allelopathic potential rice accessions
Authors: Li Yingzhe , Xu Lining , Letuma Puleng , Lin Wenxiong
Published: June 2020

Background

Identification of the allelopathy-interrelated metabolites from the allelopathic rice rhizosphere is crucial to understand the allelopathic mechanism of rice, which in turn can promote its applications to farming. In this study, the metabolites from the rhizosphere soil of five different rice lines, including allelopathic rice accession PI312777 (PI) and non-allelopathic rice accession Lemont (Le) as well as their genetic derivatives (e.g., phenylalanine ammonia-lyase (PAL) gene overexpression transgenic lines of PI and Le, namely, PO and LO respectively, andPALRNA interference line of PI, namely, PR) were identified and comparatively analyzed to explore the positive compounds that are involved in the process of rice allelopathy.

Results

The results showed that 21 non-polar compounds and 21 polar compounds differed in content in the rhizosphere soil of PI and Le, which include several volatile fatty acids and long-chain fatty acids. The relative contents of fatty acids also differed betweenPALoverexpressing or RNA interference (RNAi)-silenced line and their wild-type respectively. Acetic acid content also differed among groups, i.e., it is higher in the high allelopathic potential rice. Further analysis showed that different metabolites from the ADS8 resin-extracted phase were more abundant than that those from the ADS21 resin-extracted phase, suggesting that the allelochemicals in root exudates of allelopathic rice are mainly non-polar substances. KEGG annotation of these differential metabolites revealed that these compounds were related to nutrient metabolism, secondary metabolite synthesis, signaling substance synthesis, and toxin degradation.

Conclusions

Rice allelochemicals deposited in the ADS8 resin-extracted phase were more abundant than those in the ADS21 resin-extracted phase. Allelochemicals in root exudates of allelopathic rice are mainly non-polar substances, and long-chain fatty acids are considered as allelopathy interrelated metabolites.
Value of routine test for identifying colorectal cancer from patients with nonalcoholic fatty liver disease
Authors: Yang Rong , Chen Yu , Chen Xianlai
Published: June 2020

Background

Nonalcoholic fatty liver disease (NAFLD) is a risk factor for colorectal neoplasms. Our goal is to explore the relationship between NAFLD and colorectal cancer (CRC) and to analyze potential indicators for screening CRC in NAFLD based on clinical big data.

Methods

Demographic information and routine clinical indicators were extracted from Xiangya Medical Big Data Platform. 35,610 NAFLD cases without CRC (as group NAFLD-CRC), 306 NAFLD cases with CRC (as group NAFLD-NonCRC) and 10,477 CRC cases without NAFLD were selected and evaluated. The CRC incidence was compared between NAFLD population and general population by Chi-square test. Independent sample t-test was used to find differences of age, gender and routine clinical indicators in pairwise comparisons of NAFLD-CRC, NAFLD-NonCRC and nonNAFLD-CRC.

Results

NAFLD population had a higher CRC incidence than general population (7.779‰ vs 3.763‰, P < 0.001). Average age of NAFLD-CRC (58.79 ± 12.353) or nonNAFLD-CRC (59.26 ± 13.156) was significantly higher than NAFLD-nonCRC (54.15 ± 14.167, p < 0.001). But age had no significant difference between NAFLD-CRC and nonNAFLD-CRC (P > 0.05). There was no different gender distribution for three groups (P > 0.05). NAFLD-CRC had lower anaemia-related routine clinical indicators such as decrease of red blood cell count, mean hemoglobin content and hemoglobin than NAFLD-nonCRC (P < 0.05 for all). Anemia of NAFLD-CRC was typical but it might be slighter than nonNAFLD-CRC. More interestingly, NAFLD-CRC had distinct characteristics of leukocyte system such as lower white blood cell count (WBC) and neutrophil count (NEU_C) and higher basophil percentage (BAS_Per) than nonNAFLD-CRC and NAFLD-nonCRC (P < 0.05 for all). Compared with NAFLD-nonCRC, the change of WBC, BAS_Per and NEU_C in NAFLD-CRC was different from that in nonNAFLD-CRC. In addition, NAFLD-CRC had a higher level of low density lipoprotein (LDL) and high density lipoprotein (HDL), lower level of triglyceride (TG) and Albumin-to-globulin ratio (A/G) than NFLD-nonCRC (P < 0.05 for all).

Conclusions

NAFLD is associated with a high incidence of CRC. Age is an important factor for CRC and the CRC incidence increases with age. Anemia-related blood routine clinical indicators, leukocyte system and blood lipid indicators may be more important variables for identifying CRC in NAFLD. So blood routine test and liver function/blood lipid test are valuable for screening CRC in NAFLD.
Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women
Authors: Novak Masuma , Waern Margda , Johansson Lena , Zettergren Anna , Ryden Lina , Wetterberg Hanna , Gudmundsson Pia , Skoog Ingmar
Published: June 2020

Background

This study examined whether loneliness predicts cardiovascular- and all-cause mortality in older men and women.

Methods

Baseline data from the Gothenburg H70 Birth Cohort Studies, collected during 2000 on 70-year-olds born 1930 and living in Gothenburg were used for analysis (n = 524). Mortality data were analyzed until 2012 through Swedish national registers.

Results

Perceived loneliness was reported by 17.1% of the men and 30.9% of the women in a face-to-face interview with mental health professional. A total of 142 participants died during the 12-year follow-up period, with 5334 person-years at risk, corresponding to 26.6 deaths/1000 person-years. Cardiovascular disease accounted for 59.2% of all deaths. The cumulative rates/1000 person-years for cardiovascular mortality were 20.8 (men) and 11.5 (women), and for all-cause mortality 33.8 (men) and 20.5 (women), respectively. In Cox regression models, no significant increased risk of mortality was seen for men with loneliness compared to men without loneliness (cardiovascular mortality HR 1.52, 95% CI 0.78–2.96; all-cause HR 1.32, 95% CI 0.77–2.28). Increased risk of cardiovascular mortality was observed in women with loneliness compared to those without (HR 2.25 95% CI 1.14–4.45), and the risk remained significant in a multivariable-adjusted model (HR 2.42 95% CI 1.04–5.65).

Conclusions

Loneliness was shown to be an independent predictor of cardiovascular mortality in women. We found no evidence to indicate that loneliness was associated with an increased risk of either cardiovascular- or all-cause mortality in men.
Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review
Authors: Hounkpatin Hilda O. , Fraser Simon D. S. , Honney Rory , Dreyer Gavin , Brettle Alison , Roderick Paul J.
Published: June 2020

Background

There are a growing number of studies on ethnic differences in progression and mortality for pre-dialysis chronic kidney disease (CKD), but this literature has yet to be synthesised, particularly for studies on mortality.

Methods

This scoping review synthesized existing literature on ethnic differences in progression and mortality for adults with pre-dialysis CKD, explored factors contributing to these differences, and identified gaps in the literature. A comprehensive search strategy using search terms for ethnicity and CKD was taken to identify potentially relevant studies. Nine databases were searched from 1992 to June 2017, with an updated search in February 2020.

Results

8059 articles were identified and screened. Fifty-five studies (2 systematic review, 7 non-systematic reviews, and 46 individual studies) were included in this review. Most were US studies and compared African-American/Afro-Caribbean and Caucasian populations, and fewer studies assessed outcomes for Hispanics and Asians. Most studies reported higher risk of CKD progression in Afro-Caribbean/African-Americans, Hispanics, and Asians, lower risk of mortality for Asians, and mixed findings on risk of mortality for Afro-Caribbean/African-Americans and Hispanics, compared to Caucasians. Biological factors such as hypertension, diabetes, and cardiovascular disease contributed to increased risk of progression for ethnic minorities but did not increase risk of mortality in these groups.

Conclusions

Higher rates of renal replacement therapy among ethnic minorities may be partly due to increased risk of progression and reduced mortality in these groups. The review identifies gaps in the literature and highlights a need for a more structured approach by researchers that would allow higher confidence in single studies and better harmonization of data across studies to advance our understanding of CKD progression and mortality.
Hospitalization and mortality following non-attendance for hemodialysis according to dialysis day of the week: a European cohort study
Authors: Fotheringham James , Smith Michael T. , Froissart Marc , Kronenberg Florian , Stenvinkel Peter , Floege Jürgen , Eckardt Kai-Uwe , Wheeler David C.
Published: June 2020

Background

The extension of the interdialytic interval due to due to dialysis session non-attendance varies according to which session of the week the patient misses. The impact of this on subsequent hospitalization and mortality is unknown.

Methods

The ARO cohort study prospectively collected data from hemodialysis patients across 15 European countries on demography, comorbidity, laboratory, hospitalisation, mortality and individual hemodialysis sessions from 2007 to 2014. Event rates for death and hospitalisation according to dialysis day of the week were calculated for patients who attended the three previous scheduled hemodialysis sessions, who then on the next scheduled dialysis day either attended or did not attend. The hazard ratio for these events following non-attendance for the first compared to the second dialysis session of the week was estimated using Cox proportional hazards model adjusted for patient demographics.

Results

3.8 million hemodialysis sessions in 9397 patients were analysed. The non-attendance rates for Monday/Wednesday/Friday sessions were 0.8, 0.9% & 1.4% respectively, and for Tuesday/Thursday/Saturday sessions were 0.6, 1.0% & 1.2% respectively. Compared to those who attended, for the 48–72 h between non-attendance and the next scheduled haemodialysis session, mortality significantly increased from 4.86 to 51.9/100 pt-yrs and hospitalisation increased from 0.58 to 2.1/yr. As time from the two-day break increased, the risk associated with non-attendance lessened: compared to missing the second hemodialysis session, missing the first session had a hazard ratio for mortality of 2.04 (95% CI 1.27–3.29), and for hospitalisation 1.78 (95% CI 1.29–2.47). In patients who attended their scheduled dialysis session and the three preceding, after the two-day break there were absolute increases in mortality (8.3 vs. 4.9/100 pt-yrs) and hospitalisation (1.0 vs. 0.6/yr for the rest of the week) comparable to previous studies.

Conclusions

In addition to hospitalisation and mortality increases seen after the two-day break, additional harm may be manifested in the greater increases in mortality and hospitalisation observed after non-attendance for the first hemodialysis session after the two-day break compared to missing other sessions.
Development and analytical validation of real-time PCR for the detection of Streptococcus agalactiae in pregnant women
Authors: Escobar Daniel F. , Diaz-Dinamarca Diego A. , Hernández Carlos F. , Soto Daniel A. , Manzo Ricardo A. , Alarcón Pedro I. , Pinto Camila H. , Bastias Diego N. , Oberg-Bravo Carolayn N. , Rojas Robert , Illanes Sebastián E. , Kalergis Alexis M. , Vasquez Abel E.
Published: June 2020

Background

Group B Streptococcus (GBS) is the leading cause of invasive neonatal infection. In this study, we aimed to evaluate the analytical validation of qualitative real-time polymerase chain reaction (qPCR) as a means to detect GBS.

Methods

Genomic DNA (gDNA) was purified from 12 ATCC bacterial strains, two belonging to GBS and the remainder acting as negative controls. Additionally, gDNA was isolated from 21 strains of GBS from various serotypes (Ia, Ib and II-VIII). All gDNA was used to evaluate the analytical validation of the qPCR method employing a specific Taqman probe. Inclusivity, exclusivity, anticipated reportable range, the limit of detection and robustness were evaluated. The methods used are described in international guidelines and other existing reports. The performance of this qPCR method for detecting GBS was compared to other microbiological methods used with vaginal-rectal samples from pregnant women.

Results

Our qPCR method for detecting GBS was analytically validated. It has a limit of detection of 0.7 GE/μL and 100% analytical specificity. It detects all strains of GBS with the same level of performance as microbiological methods.

Conclusion

Data suggest that this qPCR method performs adequately as a means to detect GBS in vaginal-rectal swabs from pregnant women.
Incidence and determinants of neonatal near miss in south Ethiopia: a prospective cohort study
Authors: Tekelab Tesfalidet , Chojenta Catherine , Smith Roger , Loxton Deborah
Published: June 2020

Background

For every neonate who dies, many others experience a near miss event that could have but did not result in death. Neonatal near miss is three to eight times more frequent than neonatal deaths and, therefore, is more useful for assessing the determinants of adverse neonatal outcomes. The aim of this study was to assess the incidence and determinants of neonatal near miss in south Ethiopia.

Methods

A facility-based prospective study was conducted among 2704 neonates between 12 July to 26 November 2018. The neonates were followed from the time of admission to hospital discharge or seven postpartum days if the newborn stayed in the hospital. The data were collected by interviewer-administered questionnaire and medical record review. Logistic regression was employed to identify the distant, intermediate and proximal factors associated with neonatal near miss. The independent variables were analysed in three hierarchical blocks. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were used to determine the strength of the associations.

Results

The incidences of neonatal near miss and neonatal death were 45.1 (95% CI = 37.7–53.8) and 17.4 (95% CI = 13.0–23.3) per 1000 live births, respectively. Of those newborns who experienced neonatal near miss, more than half (59.8%) of their mothers were referred from other health facilities. After adjusting for potential confounders, the odds of neonatal near miss were significantly higher among neonates with a low monthly income (< 79 USD monthly), a birth interval of less than 24 months and where severe maternal complications had occurred.

Conclusion

Strategies to improve neonatal survival need a multifaceted approach that includes socio-economic and health-related factors. The findings of this study highlight important implications for policymakers with regard to neonatal near miss. In particular, addressing inequalities by increasing women’s income, promoting an optimal birth interval of 24 months or above through postpartum family planning, and preventing maternal complications may improve newborn survival.
Albumin-to-alkaline phosphatase ratio serves as a prognostic indicator in unresectable pancreatic ductal adenocarcinoma: a propensity score matching analysis
Authors: Zhang Ke , Dong Shu , Jing Yan-Hua , Gao Hui-Feng , Chen Lian-Yu , Hua Yong-Qiang , Chen Hao , Chen Zhen
Published: June 2020

Background

Recent evidence suggests that albumin-to-Alkaline Phosphatase Ratio (AAPR) functions as a novel prognostic marker in several malignancies. However, whether it can predict the prognosis of unresectable pancreatic ductal adenocarcinoma (PDAC) remains unclear. Herein, we seek to investigate this possibility by a propensity score matching (PSM) analysis.

Methods

This was a retrospective cohort study in which 419 patients diagnosed with unresectable PDAC and receiving chemotherapy were recruited. Patients were stratified based on the cutoff value of AAPR. The PSM analysis was performed to identify 156 well-balanced patients in each group for overall survival (OS) comparison and subgroup analysis. Univariate and multivariate analyses were carried out to examine the potential of AAPR to indicate the prognosis of unresectable PDAC. The prediction performance of conventional model and combined model including AAPR was compared using the Akaike Information Criterion (AIC) and concordance index (C-index).

Results

We identified an AAPR of 0.4 to be the optimal cutoff for OS prediction. Patients with AAPR≤0.4 had significantly shorter OS compared with patients with AAPR> 0.4 (6.4 versus 9.3 months; P < 0.001). Based on the PSM cohort and entire cohort, multivariate Cox analysis revealed that high pretreatment for AAPR was an independent marker predicting favorable survival in unresectable PDAC (hazard ratio, 0.556; 95% confidence interval, 0.408 to 0.757; P < 0.001). Significant differences in OS were observed in all subgroups except for the group of patients age ≤ 60. Combined prognostic model including AAPR had lower AIC and higher C-index than conventional prognostic model.

Conclusions

Pretreatment AAPR servers as an independent prognostic indicator for patients with unresectable PDAC. Inclusion of AAPR improved the prediction performance of conventional prognostic model, potentially helping clinicians to identify patients at high risk and guide individualized treatment.
A cross-sectional study on caregivers’ perspective of the quality of life and adherence of paediatric HIV patients to highly active antiretroviral therapy
Authors: Lahai Michael , James Peter Bai , Wannang Noel Nen’man , Wurie Haja Ramatulai , Conteh Sorie , Bah Abdulai Jawo , Samai Mohamed
Published: June 2020

Background

Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with Human immunodeficiency virus/Acquired immunodeficiency syndrome (HIV/AIDS) because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART.

Methods

We conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children’s Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee.

Results

The study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p = 0.019*) to the physical health domain (mean = 64.61 SD = 8.1). Caregiver HIV status showed a strong association with the physical (mean = 58.3, SD = 11.7 and p = 0.024*), and psychological health domains (mean = 68.2, SD = 14.7 and p = 0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean = 58.0, SD = 10.6, p <  0.001), psychological (mean 68.2 SD = 14.81 p <  0.001) and environmental health domains (mean = 59.7, SD = 13.47, p <  0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p = 0.014) and adherent paediatric patients (p = 0.005). Nuclear family also showed a strong association with psychological (p <  0.001) and environmental (p = 0.001) health domains.

Conclusion

This study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.
Milk-borne bacterial health hazards in milk produced for commercial purpose in Tigray, northern Ethiopia
Authors: Berhe Gebretsadik , Wasihun Araya Gebreyesus , Kassaye Enquebaher , Gebreselasie Kibrom
Published: June 2020

Background

Milk being a suitable medium for bacterial growth, it can serve as a source of bacterial contamination. Pathogenic bacteria in milk pose a serious health threat to humans and constitute about 90% of all dairy-related diseases. However, there are few studies that examined the health hazards of raw milk consumption in Ethiopia. Therefore, the objective of this study was to assess the prevalence of bacterial contamination and associated factors in milk produced for commercial purpose in Tigray region, northern Ethiopia.

Methods

This study used a cross-sectional study design, selected 315 persons (168 cafeterias, 96 dairy farms, and 51 milk vendors) for interview and collected the same number of bulk raw milk samples using systematic sampling procedure. Data were collected on socio-demographic, farm hygiene and milk handling practices by trained health professionals. Bacterial contamination was defined as total bacterial count (TBC) > 1 × 105, staphylococcus count (SC) > 105, or coliform count (CC) > 102 CFU/ml by culture and the species of bacteria were determined by standard biochemical tests.

Results

From the 315 milk samples tested, the prevalence of bacterial contamination was 52% (95% CI: 46.5–57.6). The mean counts of contaminated samples of TBC, SC, and CC were 8.94 ± 0.46 Standard Deviation (SD), 8.52 ± 0.6 SD, and 8.78 ± 0.49 SD log CFU/ml, respectively. The proportion of contamination was significantly lower in milk collected from dairy farms (32/96, 33.3, 95% CI: 24.5–43.2) compared to milk from vendors (33/51, 64.7, 95% CI: 51.4–66.2) and cafeterias (99/168, 58.9, 95% CI, 50.9–76.85). The milk samples were culture-positive for Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, K. oxytoca and Citrobacter freundii.

Conclusions

Over half of the sampled raw milk exhibited bacterial contamination with increasing trend from farmers to points of sale. Thus, milk vendors and cafeteria owners should apply good hygienic and sanitation practices during handling of milk; use appropriate, clean containers, and cold chain during milk transportation; and refrigeration of milk during storage.
Knowledge and stigma of latent tuberculosis infection in Brazil: implications for tuberculosis prevention strategies
Authors: Rebeiro Peter F. , Cohen Mollie J. , Ewing Heather M. , Figueiredo Marina Cruvinel , Peetluk Lauren Saag , Andrade Kleydson B. , Eakin Marshall , Zechmeister Elizabeth J. , Sterling Timothy R.
Published: June 2020

Background

Tuberculosis (TB) elimination requires treatment of millions of persons with latent M. tuberculosis infection (LTBI). LTBI treatment acceptance depends on population-wide TB knowledge and low stigma, but limited data are available on the relationship between stigma and knowledge. We assessed knowledge of TB disease and LTBI throughout Brazil and examined their association with TB stigma and incidence.

Methods

We performed a nationwide survey with multi-stage probability design through AmericasBarometer from April–May 2017; the sample was representative of Brazil at regional and national levels. Knowledge of and stigma toward TB were assessed by validated survey questions.

Results

Survey-weighted responses of 1532 individuals suggest that 57% of the population knew LTBI can occur, and 90% would seek treatment for it. Regarding active TB, 85% knew TB symptoms, 70% reported they should avoid contact with someone with active TB, and 24% had stigma toward persons with TB (i.e., thought persons with tuberculosis should feel ashamed, or deserved their illness). In regression models adjusting for clinical and demographic variables, knowledge of LTBI was associated with increased stigma toward persons with TB (adjusted odds ratio [OR] = 2.13, 95% confidence interval [CI]: 1·25–3.63, for “should feel ashamed”; OR = 1·82, 95% CI: 1·15–2·89, for “deserve illness”). Adjusting for regional TB incidence did not affect this association.

Conclusions

High proportions of this representative Brazilian population had knowledge of LTBI and were willing to seek treatment for it. However, such knowledge was associated with TB-specific stigma. Strategies to educate and implement treatment of latent tuberculosis must include efforts to decrease TB stigma.
Fixation of delayed distal radial fracture involving metaphyseal diaphyseal junction in adolescents: a comparative study of crossed Kirschner-wiring and non-bridging external fixator
Authors: Li Jin , Rai Saroj , Tang Xin , Ze Renhao , Liu Ruikang , Hong Pan
Published: June 2020

Background

Conservative treatment remains the preferred choice for distal radius fracture in children. However, loss of reduction is problematic, especially in an older child. Crossed Kirschner-wires is widely used to treat distal radius fracture in adolescents. This study aimed to compare the application of crossed Kirschner-wiring (KW) and non-bridging external fixator (EF) for the treatment of delayed distal radial fracture involving metaphyseal diaphyseal junction (MDJ) in adolescents.

Methods

Between January 2012 to January 2017, 146 (male = 101, female = 45) patients in EF group and 117 (male = 76, female = 41) in KW group, were reviewed retrospectively. Preoperative data were collected from the hospital database, and postoperative clinical outcomes data were collected during the follow-up visits. We used SPSS for data analysis.

Results

There existed no significant difference between EF and KW regarding sex, body weight, fracture side, duration from injury to surgery. The duration of surgery was significantly shorter in EF (30.5 ± 6.1 min) than the KW group (44.6 ± 9.4 min), P < 0.001. The number of intraoperative X-ray images was significantly lower in EF (6.5 ± 1.1) than KW (11.8 ± 2.3), P < 0.001. The incidence of tendon irritation is significantly higher in the KW (19.7%) than the EF group (0%), P < 0.001. The residual angulation on the AP view was higher in KW (3.8 ± 2.3, degrees) than the EF group (2.5 ± 1.6, degrees), P < 0.001. The volar tilting is better in EF (6.6 ± 1.1, degrees) than the KW group (1.0 ± 1.5, degrees), P < 0.001. However, the functional outcomes of the wrist showed no significant difference between EF and KW group, P = 0.086.

Conclusion

The EF was superior to KW in the treatment of radial MDJ fractures in adolescents. The EF displayed shorter duration of surgery, less tendon irritation, and better radiographic outcomes than the KW. However, the cost-effect analysis remains to be investigated, because the EF is more expensive than KW.
Subclinical hypothyroidism and the risk of cancer incidence and cancer mortality: a systematic review
Authors: Gómez-Izquierdo Juan , Filion Kristian B. , Boivin Jean-Franҫois , Azoulay Laurent , Pollak Michael , Yu Oriana Hoi Yun
Published: June 2020

Background

Thyroid hormone has been shown to be involved in carcinogenesis via its effects on cell proliferation pathways. The objective of this study is to determine the association between subclinical hypothyroidism (SCH) and the risk of incident cancer and cancer mortality via systematic review.

Methods

A systematic search was performed on Medline and Pubmed to identify relevant studies. Randomized controlled trials, and observational studies assessing SCH or its treatment and the risk of incident cancer or cancer mortality were identified.

Results

A total of 7 cohort and 2 case-control studies met our inclusion criteria. In general, these studies were of medium to good quality. Overall, studies revealed no association between SCH and breast and prostate cancer. One study found that untreated SCH may be associated with an increased risk of colorectal cancer (adjusted odds ratio [OR]: 1.16; 95% confidence interval [CI]: 1.08–1.24). One study showed an increased risk in thyroid cancer incidence (adjusted OR: 3.38; 95% CI: 2.05–5.59) associated with elevation of a thyroid stimulating hormone (TSH) of > 1.64mIU/L. Two studies found an increase in cancer mortality among patients with SCH compared to euthyroid individuals; in contrast one study found no association between subclinical hypothyroidism and cancer mortality among aging men.

Conclusion

The number of studies examining thyroid dysfunction and cancer risk and mortality is limited. Future studies assessing the association between thyroid dysfunction and cancer risk and mortality are needed, which will further address the need to treat subclinical hypothyroidism.
Association between periodontitis and all-cause and cancer mortality: retrospective elderly community cohort study
Authors: Chung Ping-Chen , Chan Ta-Chien
Published: June 2020

Background

Periodontal infection induces inflammation, which may increase the risk of tumor-promoting effects. The aim of this study was to assess the association between periodontitis and all-cause mortality, and all-cancer and specific cancers’ mortality in a health examination cohort of the elderly in the communities.

Methods

A dataset of health examinations for the elderly with cause of death from 2005 to 2012 was obtained from the Department of Health, Taipei City Government. We enrolled 82,548 study participants with 262,035 visits. A Cox proportional hazards model and Cox frailty model were used for calculating the hazard ratios under different periodontal status by using SAS and Rstudio.

Results

Being male, elderly, having a low education level, and smoking were risk factors for mortality in this retrospective elderly community cohort study. Participants with periodontitis followed across time had significantly higher hazard ratios (HRs) for all-cause mortality and all-cancer mortality (HR = 1.092, 95% confidence interval (CI):1.038 to 1.149, HR = 1.114, 95% CI:1.032 to 1.203, respectively) in the Cox frailty models after adjusting for age, marital status, education level, sex, and smoking status. After adjusting for age and sex, the hazard ratio was 1.185 (95% CI: 1.027 to 1.368) for lung cancer mortality, and 1.340 (95% CI: 1.019 to 1.762) for prostate cancer mortality in the periodontitis group with each visit.

Conclusions

The findings indicated that being male, having a low education level, and daily smoking were risk factors for mortality, and showed mixed evidence that periodontal disease is associated with all-cause, all-cancer and specific-cancer mortality including lung and prostate cancer. We suggest the importance of regular health screening in order to achieve early disease detection and lower mortality risk.
Characterizing patients issued DNR orders who are ultimately discharged alive: a retrospective observational study in Japan
Authors: Mori Tomoari , Mori Katsumi , Nakazawa Eisuke , Bito Seiji , Takimoto Yoshiyuki , Akabayashi Akira
Published: June 2020

Background

The present study aimed to characterize factors associated with patients issued DNR orders during hospitalization who are discharged alive without any instruction orders by physicians regarding end-of-life treatment, with a focus on the timing of DNR order issuance.

Methods

In total, 2997 DNR cases from all 61,037 patients aged ≥20 years admitted to a representative general hospital in Tokyo were extracted and divided into two groups by patient hospital release status (discharged alive/deceased). Study items included age, sex, disease type (non-cancer/cancer), hospital department (internal medicine/others), timing of DNR order issuance, implementation (or not) of life-sustaining treatment (LST) or the presence of any restrictions on LST and hospital length of stay. We conducted multiple logistic regression analysis, setting hospital release status as the dependent variable and each above study item as explanatory variables.

Results

DNR orders were issued at a rate of 4.9%. The analysis revealed that patients with a DNR who were ultimately discharged alive were statistically more likely to be those for whom DNR orders are issued early after admission (adjusted odds ratio: AOR, 13.7), non-cancer patients (AOR, 3.4), internal medicine department patients (AOR, 1.63), females (AOR, 1.34), and elderly (aged ≥85 years; AOR, 1.02); these patients were also less likely to be receiving LST (AOR, 0.36).

Conclusions

By focusing on those with DNR orders who were ultimately discharged alive, we discovered that these patients were likely to have DNR orders issued early after admission, and that they were more likely to be elderly, female, non-cancer patients, or those in internal medicine departments. Further examination of these data may help to elucidate why these particular DNR-related characteristics (including socio-economic and cultural factors) are evident in patients who end up being discharged alive.
Pharmacy students’ perspectives on the initial implementation of a teaching electronic medical record: results from a mixed-methods assessment
Authors: Vlashyn Olga O. , Adeoye-Olatunde Omolola A. , Illingworth Plake Kimberly S. , Woodyard Jamie L. , Weber Zachary A. , Russ-Jara Alissa L.
Published: June 2020

Background

Electronic medical records (EMRs) have been used for nearly three decades. Pharmacists use EMRs on a daily basis, but EMRs have only recently been incorporated into pharmacy education. Some pharmacy programs have implemented teaching electronic medical records (tEMRs), but best practices for incorporating tEMRs into pharmacy education remain unknown. The objectives of this study were to 1) assess pharmacy students’ views and experiences with a tEMR; and 2) identify current learning activities and future priorities for tEMR use in pharmacy education.

Methods

We used a mixed-methods approach, including three, two-hour student focus groups and a 42-item web-based survey to examine student perspectives of the tEMR. All first, second, and third year professional pharmacy students were eligible to participate in the survey and a focus group. Web-based survey items were measured on a 7-point Likert scale, and quantitative analyses included descriptive statistics. Two researchers independently coded transcripts using both deductive and inductive approaches to identify emergent themes. These analysts met and resolved any coding discrepancies via consensus.

Results

Focus groups were conducted with 22 total students, with 6–8 students represented from each year of pharmacy training. The survey was completed by 156 students: 47 first year, 55 second year, and 54 third year. Overall, 48.7% of survey respondents altogether agreed or strongly agreed that using the tEMR enhanced their learning in pharmacy classes and laboratories. Qualitative data were organized into four major themes regarding tEMR adoption: current priorities for use within the pharmacy curriculum; tEMR benefits; tEMR barriers; and future priorities for tEMR use to prepare students for pharmacy practice.

Conclusions

This study reveals pharmacy students’ perspectives and attitudes towards using a tEMR, the types of classroom activities that incorporate the tEMR, and students’ future suggestions to enhance the design or application of the tEMR for their learning. Our research findings may aid other pharmacy programs and promote more effective use of tEMRs in pharmacy education. In the long-term, this study may strengthen pharmacy education on EMRs and thus increase the efficacy and safety of pharmacists’ EMR use for patients’ medication management.
Contemporary public image of the nursing profession in Saudi Arabia
Authors: Elmorshedy Hala , AlAmrani Abrar , Hassan Mona Hassan Ahmed , Fayed Amel , Albrecht Susan Ann
Published: June 2020

Background

In the Kingdom of Saudi Arabia, the nursing profession faces significant challenges including; failure to recruit high school students into nursing education, poor nursing identity, and lack of awareness about the nursing profession. The level of community awareness and public image of the nursing profession are critical to recruit and retain students into nursing education, and to improve nurses’ sense of identity.

Aim

To explore the level of community awareness and public image of the nursing profession in Saudi Arabia.

Methods

We conducted a cross-sectional study with a convenient sample of 502 adults including106 males and 396 females, their mean age was 22.93 ± 6.76 years. Data collected included; socio-cultural data, gender preference in getting nursing care, awareness, and perceived socio-cultural barriers to pursue a nursing career. Data were analyzed using SPSS version 21.0.

Results

Only 32.5% preferred to get nursing care by Saudis. The nursing profession was not viewed as a respected job as 71.5% of participants would be ashamed of having a nurse in their families. The study revealed a low median knowledge score (50.0, IQR: 50.0–66.7)). The study highlighted a number of socio-cultural barriers to pursue a nursing career including; the gender-mixed working environment (35.9%), delayed marriage of female nurses (20.3%), and the negative effect of nursing profession on social life (64.5%).

Conclusions

Half of the sample had a knowledge score below 50.0 out of 100. This level of poor awareness, in addition to socio-cultural perceived barriers are the main factors contributing to the negative public image of the nursing profession in Saudi Arabia. Understanding these factors could contribute to implementing focused intervention to improve the negative stereotype of the nursing profession among Saudis.
Ultrastructural changes in endothelial cells of buffaloes following in-vitro exposure to Pasteurella multocida B:2
Authors: Puspitasari Yulianna , Salleh Annas , Zamri-Saad Mohd
Published: June 2020

Background

Pasteurella multocidaB:2 causes haemorrhagic septicaemia in cattle and buffaloes. However, buffaloes are found to be more susceptible to the infection than cattle. Upon infection, the pathogen rapidly spread from the respiratory tract to the blood circulation within 16-72 h, causing septicaemia. So far, limited study has been conducted to evaluate the response of endothelial cells of buffalo towardsP. multocidaB:2 and its lipopolysaccharide (LPS). This study aimed to evaluate the ultrastructural changes in the aortic endothelium of buffaloes (BAEC) following exposure toP. multocidaB:2 and its endotoxin. The endothelial cells were harvested from the aorta of healthy buffaloes and were prepared as monolayer cell cultures. The cultures were divided into 3 groups before Group 1 was inoculated with 107 cfu/ml of whole cellP. multocidaB:2, Group 2 with LPS, which was extracted earlier from 107 cfu/ml ofP. multocidaB:2 and Group 3 with sterile cell culture medium. The cells were harvested at 0, 6, 12, 18, 24, 36, and 48 h post-inoculation for assessment of cellular changes using transmission electron microscopy.

Results

The BAEC of Groups 1 and 2 demonstrated moderate to severe endothelial lysis, suggestive of acute cellular injury. In general, severity of the ultrastructural changes increased with the time of incubation but no significant difference (p > 0.05) in the severity of the cellular changes between Groups 1 and 2 was observed in the first 18 h. The severity of lesions became significant (p < 0.05) thereafter. Both treated Groups 1 and 2 showed significantly (p < 0.05) more severe cellular changes compared to the control Group 3 from 6 h post-inoculation. The severity reached peak at the end of the study period with score 3 for Group 1 and score 2.8 for Group 2.

Conclusions

This study revealed that both whole cellsP. multocidaB:2 and LPS endotoxin showed similar moderate to severe cellular damage, but whole-cellP. multocidaB:2 appeared to be more potent in causing much severe damage than LPS alone.