bluuebunny/crossref_metadata_2025 huggingface dataset:
A new lignan from Schefflera arboricola
Authors: Ye Chang-Qing , Zhang Jia-Yi , Ye Zhi-Cheng , Xiao Mei-Tian , Zhou Xu-Dong , Ye Jing
Published: March 2020

A new lignan, arborlignan A, along with five known substances, neoechinulin A, 4-hydroxy-3,5-dimethoxybenzaldehyde, 3,3′-dimethoxy-4,4′-dihydroxystilbene, β-hydroxypropiovanillone, and coniferyl aldehyde, are isolated from Schefflera arboricola. Their structures are elucidated by mass spectrometry and nuclear magnetic resonance spectroscopy experiments and by comparison with literature data. These compounds are isolated from the genus Schefflera for the first time.
Changes in the absorption spectra and colour of tetraphenylporphyrins after redox reactions
Authors: Ogawa Kazuya , Umetsu Yuria , Kamimura Kenji
Published: March 2020

In this study, we have investigated the electrochromic properties including the change in absorption spectra and colour after oxidation and reduction reactions of tetraphenylporphyrin and its metal complexes in dichloromethane. The first oxidation potential is determined from CV measurements, and the reduction potential is estimated from comparison with literature values. Electrolytic reactions are carried out by applying the oxidation potential and reduction potential to each sample solution. The metals used are Ag(II), Cu(II), Fe(III), Mg(II), Mn(III), Ni(II) and Zn(II). Various colours can be expressed after the redox reactions by changing the central metal.
Exploring Chemical Structures From Cortex Lycii, Based on Manual and Automatic Analysis of the HPLC-Q-TOF-MS Data
Authors: Jiang Zhi-Bo , Chen Yong-Xin , Chen Jing-Zhi , Lu Xing , Guo Xin , Ma Bing-Zhen , Li Chong-Long , Fang Xuan , Tang Yong-Hong , Ma Xiao-Li
Published: March 2020

Cortex Lycii, the root barks of Lycium barbarum and L. chinense, known as “di gu pi” in traditional Chinese herbal drugs, is an important ingredient of formulations used for treating a variety of diseases. During the last 3 decades, more than 70 chemical entities have been separated and purified from either the aqueous or aqueous ethyl alcohol extracts of Cortex Lycii. In this study, high-performance liquid chromatography together with quadrupole-time-of-flight mass spectrometry (MS) was employed to explore new analog structures from aqueous ethyl alcohol extracts (50%, v/v), which led us to discover 4 new phenolic amides and a new cyclic peptide. The structure-based manual screening method, on the basis of the analysis of the fragmentation pathway of the previously known compounds, was used to make a preliminary analysis of the negative total ion chromatography and negative extract ion spectra. Three ions at m/ z 472.1, 314.1, and 445.2 were assigned to phenolic amides, and by further analysis of their MS/MS data, the structure of 1, corresponding to one of them ( m/ z 314.1), was illustrated as an analog of the known compound KN1. A parent ion at m/ z 856.1 was assigned to a cyclic peptide analog (2) in the manual analysis procedure. Furthermore, the MS/MS data were profiled on the Global Natural Product Social Molecular Networking (GNPS, https://gnps.ucsd.edu/ProteoSAFe/static/gnps-splash.jsp ) workflow to weave a visualization molecular network. Three more new analog ions ( m/ z 604.3 [3], 597.3 [4], and 611.3 [5]) were found in the aggregation of KN5 and KN7, and their structures were all determined by comparisons with known compounds. This manual and networking automatic screening method may provide a sensitive and efficient procedure to facilitate the mining of novel trace components.
Can Psychological Interventions Improve Intergroup Attitudes Post Terror Attacks?
Authors: Van Assche Jasper , Noor Masi , Dierckx Kim , Saleem Muniba , Bouchat Pierre , de Guissme Laura , Bostyn Dries , Carew Mark , Ernst-Vintila Andreea , Chao Melody M.
Published: March 2020

This research concurrently investigated the effectiveness of three established bias-reducing interventions (i.e., positive affirmation, secure attachment, and cognitive dissonance) in the wake of the Paris and Brussels terror attacks. Using frequentist and Bayesian analyses, Study 1 ( N = 1,676), launched within days of the attacks, found that compared to a control condition, the interventions did not significantly improve intergroup attitudes. Instead, the data showed strong support of the null hypotheses that there were no intervention effects. Proximity to the attacks did not moderate the effect. Study 2 ( N = 285) reexamined the effects of the three interventions 2.5 years after the attacks, generally replicating the pattern of findings in Study 1. Together, this research highlights the challenge of intergroup bias reduction following terror attacks. We conclude by discussing several recommendations for how psychological interventions could play a more impactful role in contexts of heightened conflict.
Context awareness architecture for ambient-assisted living applications: Case study of nighttime wandering
Authors: Kenfack Ngankam Hubert , Pigot Hélène , Lorrain Dominique , Viens Isabelle , Giroux Sylvain
Published: March 2020

Objectives

This work presents an ambient-assisted living application that encourages seniors during nocturnal wandering episodes to return to bed in calm and comfort reassurance.

Methods

Structuring knowledge by designing a software architecture capable of delivering high-level analysis and processing. A senior’s home has been upgraded into a smart home enabling the gathering of habits for two weeks and set up for personalized assistance over four weeks. Home automation devices associated with Actigraph monitors and self-reported sleep were used for more accuracy.

Results

The architectural model can be used in ambient-assisted living applications for which data collection is permanent and continuous. Its layered organization facilitates the management of specific and general activities of daily life. The results of the home experience show that the system gave a notification whenever the need arose. On the other hand, it allowed the caregiver to get more information about the lifestyle of the senior.

Conclusions

Future work should focus on providing more services to contextualize assistance. Ontology is used to structure all the ambient knowledge of the smart home. We also plan to do more home experiments.
Why Focusing on Test Metrics May Impede Gender Equity: Policy Insights
Authors: Cimpian Joseph R.
Published: March 2020

Accountability policies incentivize school districts to close achievement gaps on standardized tests of math and reading, but these policies omit one prominent student dimension: gender. According to the “mixed” evidence on male–female gender gaps in math test scores, a gap advantaging males may be opening early in elementary school, but the dominant evidence—standardized testing—does not reveal this emergence. In contrast to math, the evidence for the reading gender gap favoring females is clearer, but there too the apparent female advantage may not be as large as it seems. Looking across well-established large-scale tests in math and reading, this article looks to explain why some gender gaps emerge and how policymakers can help mitigate the gaps. One of the most consistent predictors of gaps in both math and reading is gender bias. Focusing on gender gaps in tests is counterproductive to actual gender equity in education, which will require a much stronger focus on uncovering and addressing gender bias.
Four-year follow-up of a randomized controlled trial of choline for neurodevelopment in fetal alcohol spectrum disorder
Authors: Wozniak Jeffrey R. , Fink Birgit A. , Fuglestad Anita J. , Eckerle Judith K. , Boys Christopher J. , Sandness Kristin E. , Radke Joshua P. , Miller Neely C. , Lindgren Christopher , Brearley Ann M. , Zeisel Steven H. , Georgieff Michael K.
Published: March 2020

Background

Despite the high prevalence of fetal alcohol spectrum disorder (FASD), there are few interventions targeting its core neurocognitive and behavioral deficits. FASD is often conceptualized as static and permanent, but interventions that capitalize on brain plasticity and critical developmental windows are emerging. We present a long-term follow-up study evaluating the neurodevelopmental effects of choline supplementation in children with FASD 4 years after an initial efficacy trial.

Methods

The initial study was a randomized, double-blind, placebo-controlled trial of choline vs. placebo in 2–5-year-olds with FASD. Participants include 31 children (16 placebo; 15 choline) seen 4 years after trial completion. The mean age at follow-up was 8.6 years. Diagnoses were 12.9% fetal alcohol syndrome (FAS), 41.9% partial FAS, and 45.1% alcohol-related neurodevelopmental disorder. The follow-up included measures of intelligence, memory, executive functioning, and behavior.

Results

Children who received choline had higher non-verbal intelligence, higher visual-spatial skill, higher working memory ability, better verbal memory, and fewer behavioral symptoms of attention deficit hyperactivity disorder than the placebo group. No differences were seen for verbal intelligence, visual memory, or other executive functions.

Conclusions

These data support choline as a potential neurodevelopmental intervention for FASD and highlight the need for long-term follow-up to capture treatment effects on neurodevelopmental trajectories.

Trial registration

ClinicalTrials.Gov #NCT01149538; Registered: June 23, 2010; first enrollment July 2, 2010
Endogenous circadian time genes expressions in the liver of mice under constant darkness
Authors: Li Huan , Zhang Shiyao , Zhang Wenxiang , Chen Siyu , Rabearivony Anjara , Shi Yujie , Liu Jie , Corton Christopher J. , Liu Chang
Published: March 2020

Background

The circadian rhythms regulate physiological functions and metabolism. Circadian Time (CT) is a unit to quantify the rhythm of endogenous circadian clock, independent of light influence. To understand the gene expression changes throughout CT, C57BL/6 J mice were maintained under constant darkness (DD) for 6 weeks, and the liver samples were collected starting at 9:00 AM (CT1), and every 4 h in a 24-h cycle (CT5, CT9, CT13, CT17 and CT21). Total RNA was extracted and subjected to RNA-Seq data (deposited as GSE 133342, L-DD). To compare gene oscillation pattern under normal light-dark condition (LD, GSE114400) and short time (2 days) dark-dark condition (S-DD, GSE70497), these data were retried from GEO database, and the trimmed mean of M-values normalization was used to normalize the three RNA-seq data followed by MetaCycle analysis.

Results

Approximate 12.1% of the genes under L-DD exhibited significant rhythmically expression. The top 5 biological processes enriched in L-DD oscillation genes were mRNA processing, aromatic compound catabolic process, mitochondrion organization, heterocycle catabolic process and cellular nitrogen compound mitotic catabolic process. The endogenous circadian rhythms of clock genes, P450 genes and lipid metabolism genes under L-DD were further compared with LD and S-DD. The oscillation patterns were similar but the period and amplitude of those oscillation genes were slightly altered. RT-qPCR confirmed the selected RNA sequence findings.

Conclusions

This is the first study to profile oscillation gene expressions under L-DD. Our data indicate that clock genes, P450 genes and lipid metabolism genes expressed rhythmically under L-DD. Light was not the necessary factor for persisting circadian rhythm but influenced the period and amplitude of oscillation genes.
Effects of shell sand burial on seedling emergence, growth and stoichiometry of Periploca sepium Bunge
Authors: Li Tian , Sun Jingkuan , Yang Hongjun , Liu Jingtao , Xia Jiangbao , Shao Pengshuai
Published: March 2020

Background

Sand burial plays an irreplaceable and unique role in the growth and distribution of vegetation on the Shell Dike Island in the Yellow River Delta. There are still some unknown on the effects of sand burial on the morphology, biomass, and especially the stoichiometry ofPeriploca sepium, as well as the relationship between these factors.

Results

Shell sand burial depth had a significant influence on seedling emergence, growth, and biomass ofP. sepium. Shallow sand burial shortened the emergence time and improved the emergence rate, morphological and biomass ofP. sepiumcompared to deep burial and the control. Burial depth significantly affected the nitrogen (N) and phosphorus (P) contents of the leaves. With deep burial, the carbon/nitrogen (C/N) and carbon/phosphorus (C/P) ratios decreased firstly and then increased with depth, while the nitrogen/phosphorus ratio (N/P) presented the contrary trend. Correlation analysis showed that the stoichiometry of N/P was positively correlated to morphology and biomass ofP. sepiumat different burial depths. Structural equation model analysis revealed that N was the largest contributor toP. sepiumbiomass.

Conclusions

Optimal burial depth is beneficial to the seedling emergence, growth and nutritional accumulation ofP. sepium. Stoichiometry has an important influence on the morphological formation and biomass accumulation.
Identification of the regulatory networks and hub genes controlling alfalfa floral pigmentation variation using RNA-sequencing analysis
Authors: Duan Hui-Rong , Wang Li-Rong , Cui Guang-Xin , Zhou Xue-Hui , Duan Xiao-Rong , Yang Hong-Shan
Published: March 2020

Background

To understand the gene expression networks controlling flower color formation in alfalfa, flowers anthocyanins were identified using two materials with contrasting flower colors, namely Defu and Zhongtian No. 3, and transcriptome analyses of PacBio full-length sequencing combined with RNA sequencing were performed, across four flower developmental stages.

Results

Malvidin and petunidin glycoside derivatives were the major anthocyanins in the flowers of Defu, which were lacking in the flowers of Zhongtian No. 3. The two transcriptomic datasets provided a comprehensive and systems-level view on the dynamic gene expression networks underpinning alfalfa flower color formation. By weighted gene coexpression network analyses, we identified candidate genes and hub genes from the modules closely related to floral developmental stages. PAL, 4CL, CHS, CHR, F3’H, DFR, and UFGT were enriched in the important modules. Additionally, PAL6, PAL9, 4CL18, CHS2, 4 and 8 were identified as hub genes. Thus, a hypothesis explaining the lack of purple color in the flower of Zhongtian No. 3 was proposed.

Conclusions

These analyses identified a large number of potential key regulators controlling flower color pigmentation, thereby providing new insights into the molecular networks underlying alfalfa flower development.
Prasugrel or ticagrelor relative to clopidogrel in triple-antiplatelet treatment combined with glycoprotein IIb/IIIa inhibitor for patients with STEMI undergoing PCI: a meta-analysis
Authors: Wang Zhe , Zhou Da-Yan , Su Yong , Si Liang-Yi , Xu Qiang
Published: March 2020

Background

For patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), the efficacy and safety of novel P2Y12 antagonists, including prasugrel or ticagrelor, has not been established relative to that of the clopidogrel-based triple-antiplatelet treatments (TAPTs; in combination with glycoprotein IIb/IIIa inhibitor). The present meta-analysis evaluated the efficacy and safety of prasugrel- or ticagrelor-based TAPTs relative to that of clopidogrel TAPTs in patients with STEMI undergoing PCI.

Methods

The databases PubMed, Embase, and Cochrane’s Library were systematically searched for relevant randomized controlled trials concerning prasugrel or ticagrelor (test) relative to clopidogrel (control). Depending on heterogeneity, studies were pooled with a random effects or a fixed effects model. Outcomes of blood flow after PCI were evaluated, including TIMI (thrombolysis in myocardial infarction), bleeding events, and major adverse cardiovascular events (MACEs).

Results

Seven studies comprising 11,874 patients conformed to the inclusion criteria. The pooled results with the fixed effects model indicated that after PCI patients in the prasugrel or ticagrelor groups were as likely as those treated with clopidogrel to achieve TIMI grade 3 flow or experience bleeding events. However, compared with the control, the test groups had significantly less risk of MACE (OR: 0.81, 95% CI: 0.70–0.94, P = 0.004), especially at the 1-year follow-up (OR: 0.79, 95% CI: 0.66–0.95, P = 0.01).

Conclusions

A prasugrel- or ticagrelor-based TAPT may reduce the rate of MACEs, without increasing bleeding in STEMI patients undergoing PCI. However, due to the limited RCT studies and variations in study weight, results of this meta-analysis should be confirmed in a large RCT with adequate sample size and follow-up duration.
Assessing left ventricular systolic function in children with a history of Kawasaki disease
Authors: Lin Zhou , Zheng Jingjing , Chen Weiling , Ding Tingting , Yu Wei , Xia Bei
Published: March 2020

Background

The incidence of Kawasaki disease (KD) is increasing. Indeed, KD has become the most common cause of acquired heart disease in children. Previous studies have well summarized the acute phase left ventricular (LV) systolic dysfunction using speckle tracking echocardiography (STE); however, changes in LV systolic function after long-term follow-up remain unclear.

Methods

One hundred children with a history of KD, but without coronary artery aneurysms, were enrolled. These children were divided into two subgroups based on the presence or absence of coronary artery dilatation (CAD). The duration of follow-up was > 7 years. The control group consisted of 51 healthy children. The LV myocardial strain were measured by two- and three-dimensional STE.

Results

Two-dimensional STE not only revealed that LV longitudinal strain decreased in part of segments in both KD groups, but also showed that global strain decreased in the KD group with CAD compared to the controls (P < 0.05). Global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS) were obtained by 3D STE. Compared to the controls, GLS and GAS decreased in both KD groups (P < 0.05). GCS and GRS decreased in the KD group with CAD, but was unchanged in the KD group without CAD (P < 0.05).

Conclusions

LV systolic dysfunction in children with KD and CAD was more severe than KD children without CAD compared to healthy children. This dysfunction can be assessed by LV regional and global myocardial strain using two- and three-dimensional STE.
Physical activity intervention for non-diabetic patients with non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials
Authors: Wang Shu-ting , Zheng Jing , Peng He-wei , Cai Xiao-lin , Pan Xin-ting , Li Hui-quan , Hong Qi-zhu , Peng Xian-E
Published: March 2020

Background

Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease nowadays. Changes in diet and lifestyle have led to a dramatic increase in the prevalence of NAFLD around the world. This meta-analysis is to investigate the efficacy of physical activity intervention on liver-specific endpoints in the population with NAFLD, including hepatic enzyme, serum lipid, glucose metabolism and intra-hepatic lipid.

Methods

PubMed and China National Knowledge Infrastructure (CNKI) databases were searched for randomized clinical trials of physical activity intervention on NAFLD patients through April 20th, 2019. Effect sizes were reported as standardized mean difference (SMD) and 95% confidence intervals (CI). Quality of included studies was assessed according to the Cochrane risk of bias tool. Meta-analyses were conducted using random-effect or fixed-effect models depending on the significance of heterogeneity. Subgroup analyses according to types and duration of physical activity were conducted to investigate clinical variability.

Results

Nine studies with a cumulative total of 951 participants met selection criteria. Physical activity was found associated with small reductions in hepatic enzyme parameters: ALT (SMD -0.17, 95% CI:-0.30 to − 0.05), AST (SMD -0.25, 95% CI: − 0.38, − 0.13) and GGT (SMD -0.22, 95% CI: − 0.36, − 0.08). Significant small improvements were also found in serum lipid parameters including TC (SMD = − 0.22, 95% CI: − 0.34, − 0.09), TG (SMD = − 0.18, 95% CI: − 0.31 to − 0.06) and LDL-C (SMD = − 0.26, 95% CI: − 0.39 to − 0.13). Significant improvement was also found in intra-hepatic lipid content (SMD = − 0.21, 95% CI: − 0.36 to − 0.06) There was no difference between physical intervention group and control group in HDL and three glucose metabolism parameters. Subgroup analysis suggested both aerobic exercise alone and resistance exercise alone can improve most liver function and longer period of exercise generally had better improvement effect.

Conclusions

Our findings suggest that physical activity alone can only slightly improve hepatic enzyme levels, most serum lipid levels and intra-hepatic lipid content in non-diabetic patients with NAFLD.
Long-term outcomes and quality of life of patients with Hirschsprung disease: a systematic review and meta-analysis
Authors: Dai Ying , Deng Yongfang , Lin Yan , Ouyang Runxian , Li Le
Published: March 2020

Background

Advances in surgical techniques and perioperative care have improved the short- and mid-term postoperative outcomes of patients with Hirschsprung disease (HD). However, the long-term outcomes of these patients (older than 10 years) have not been fully investigated. The aim of this systematic review is to clarify the prevalence of long-term outcomes and the quality of life of these patients.

Methods

PubMed, AMED, Cochrane Library, CINAHL and PsycINFO databases were searched from inception to October 2018, following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guideline. Original studies reporting the outcomes of patients older than ten years with HD were selected and reviewed. The overall prevalence of fecal incontinence, constipation, bowel function score, bladder dysfunction symptoms, and patients’ quality of life were extracted from the included studies and pooled through the random-effects meta-analysis model. The heterogeneity and variation in the pooled estimations were evaluated by Cochrane’s Q test and the I2 test. The sensitivity analysis was conducted by the sequential omission of individual studies. Publication bias was evaluated by Egger’s linear regression test. The whole procedure was conducted with Stata (version 14).

Results

In total, 3406 articles were identified from the literature search, among which twelve studies, including 625 patients, were included for analysis. The pooled prevalences of fecal incontinence, constipation, and bladder dysfunction symptoms and good to excellent bowel function scores were 0.20 (95% CI 0.13–0.28), 0.14 (95% CI 0.06–0.25), 0.07 (95% CI 0.04–0.12), and 0.95 (95% CI: 0.91–0.97), respectively; the pooled mean score of gastrointestinal-related quality of life was 118 (95% CI: 112.56–123.44).

Conclusions

HD patients older than ten years old have an overall high prevalence of fecal incontinence and a low quality of life. Targeted and evidence-based follow-up procedures and transitional care are essential to meet these patients’ long-term care needs. Prospective and multicenter research that focuses on the attributes and predictors of the long-term prognosis of patients with HD are necessary.
An internal hernia caused by Meckel’s diverticulum: a case report
Authors: Zhang Yang , Guo Yuchen , Sun Yuanlin , Xu Yuechao
Published: March 2020

Background

Meckel’s diverticulum is a remnant of the omphalomesenteric duct. It can lead to intestinal perforation, obstruction and gastrointestinal bleeding. While the internal hernia caused by Meckel’s diverticulum is rarely reported.

Case presentation

We report a case of a 45-year old female patient who presented with intestinal obstruction and on laparotomy was found to have Meckel’s diverticulum with internal hernia causing intestinal gangrene. Segmental bowel resection was performed and the patient had uneventful recovery.

Conclusions

In patients with acute intestinal obstruction without previous abdominal surgery, Meckel’s diverticulum and its complications should be suspected.
A cluster randomised trial of the program to enhance adjustment to residential living (PEARL): a novel psychological intervention to reduce depression in newly admitted aged care residents
Authors: Davison Tanya E. , McCabe Marita P. , Busija Lucy , O’Connor Daniel W. , Costa Vera Camões , Byers Jessica
Published: March 2020

Background

Depression rates are high in residential aged care (RAC) facilities, with newly admitted residents at particular risk. New approaches to address depression in this population are urgently required, particularly psychological interventions suitable for widespread use across the RAC sector. The Program to Enhance Adjustment to Residential Living (PEARL) is a brief intervention, designed to provide individually tailored care approaches to meet the psychological needs of newly admitted residents, delivered in collaboration with facility staff.

Methods

PEARL will be evaluated using a cluster randomised controlled design, comparing outcomes for residents who participate in the intervention with those residing in care as usual control facilities. Participants are RAC residents aged 60 years or above, with normal cognition or mild-moderate cognitive impairment, who relocated to the facility within the previous 4 weeks. The primary outcomes are depressive symptoms and disorders, with secondary outcomes including anxiety, stress, quality of life, adjustment to RAC, and functional dependence, analysed on an intention to treat basis using multilevel modelling.

Discussion

PEARL is an intervention based on self-determination theory, designed to reduce depression in newly admitted residents by tailoring day to day care to meet their psychological needs. This simple psychological approach offers an alternative care model to the current over-reliance of antidepressant medications.

Trial registration

ACTRN12616001726448; Registered 16 December 2016 with the Australian New Zealand Clinical Trials Registry.
Comparison of predictive models for hepatitis C co-infection among HIV patients in Cambodia
Authors: Buyze Jozefien , Weggheleire Anja De , van Griensven Johan , Lynen Lutgarde
Published: March 2020

Background

Hepatitis C virus (HCV) infection is a major global health problem. WHO guidelines recommend screening all people living with HIV for hepatitis C. Considering the limited resources for health in low and middle income countries, targeted HCV screening is potentially a more feasible screening strategy for many HIV cohorts. Hence there is an interest in developing clinician-friendly tools for selecting subgroups of HIV patients for whom HCV testing should be prioritized. Several statistical methods have been developed to predict a binary outcome. Multiple studies have compared the performance of different predictive models, but results were inconsistent.

Methods

A cross-sectional HCV diagnostic study was conducted in the HIV cohort of Sihanouk Hospital Center of Hope in Phnom Penh, Cambodia. We compared the performance of logistic regression, Spiegelhalter-Knill-Jones and CART to predict Hepatitis C co-infection in this cohort. We estimated the number of HCV co-infections that would be missed. To correct for over-optimism, the leave-one-out bootstrap estimator was used for estimating this quantity.

Results

Logistic regression misses the fewest HCV co-infections (8%), but would still refer 98% of HIV patients for HCV testing. Spiegelhalter-Knill-Jones (SKJ) and CART respectively miss 12% and 29% of HCV co-infections but would only refer about 30% for HCV testing.

Conclusions

In our dataset, logistic regression has the highest log-likelihood and smallest proportions of HCV co-infections missed but Spiegelhalter-Knill-Jones has the highest area under the ROC curve. The likelihood ratios estimated by Spiegelhalter-Knill-Jones might be easier to interpret for clinicians than odds ratios estimated by logistic regression or the decision tree from CART. CART is the most flexible method, and no model has to be specified regarding presence of interactions and form of the relationship between outcome and predictor variables.
Pulmonary endarteritis and endocarditis complicated with septic embolism: a case report and review of the literature
Authors: Khosravi Arezoo , Rostami Zohreh , Javanbakht Mohammad , Jafari Nematollah Jonaidi , Ghahroudi Mohsen Sadeghi , Kalantar-Motamed Mohammad Hassan , Jafari Ramezan , Einollahi Behzad
Published: March 2020

Background

Pulmonary endarteritis is a rare clinical phenomenon with congenital heart that can potentially lead to major complications.

Case presentation

We report a 47-year-old man with pulmonary endarteritis. This patient presented with hypertension, chest pain and a previous history of pulmonary valve disease during childhood. Also, eight-months prior, he was hospitalized with dyspnea (Functional Class III), cough, phlegm, and night sweats without fever. Echocardiographic diagnosis in the first transtransthoracic echocardiography (TTE) was intense pulmonary valve stenosis (PVS) an, thus, the pulmonary valve vegetation and PVS, established by transesophageal echocardiography (TEE). He was referred for surgery after 1 weeks of intravenous antibiotic therapy for removal of the vegetation.

Conclusions

Finally he was asymptomatic at 3-months of follow-up and was clinically in good condition. Therefore, the detection of infective endocarditis of the lung valve must not lengthy be prolonged.
Rubella IgM epidemiology in the pre-rubella vaccination era in Uganda
Authors: Bagenda Fred , Mulogo Edgar Mugema , Apecu Richard Onyuthi , Kisakye Anette , Opar Benard Toliva
Published: March 2020

Background

Control of Rubella and Congenital Rubella Syndrome using vaccination has shown great success in the America’s. Uganda is due to introduce the Rubella vaccine however the magnitude of transmission is not well documented. Therefore this study was done to determine IgM sero-prevalance for Rubella in order to help monitor vaccine effectiveness post introduction of the vaccine in routine vaccination programme.

Methods

A retrospective review of suspected measles cases data for the reporting period January 2007 to December 2016 in Uganda was Done. rubella IgM testing was done on 15,296 of the cases and the data was analyzed using STATA version 13.

Results

In total 15,296 cases were tested and 4255 (27.8%) tested positive and among females aged 15-49 years 88 out of 322 (27%) tested positive. The age distribution range was 0–80 years, rubella IgM positivity was reported in all the 15 regions of Uganda and throughout the ten year period in every month. Age group 5–15 years had OR 2.5 p-value < 0.001 of being rubella IgM positive compared to age < 5 years and testing measles IgM negative OR 6.3 p-value < 0.001.

Conclusion

Rubella is endemic in Uganda and although rubella IgM positivity is highest in the age 5-15 years even the younger, older and women of reprodutive age are affected. This means the risk of Congenital Rubella Syndrome is high hence the need to introduce the rubella vaccine for infants and pregnant mothers and continued surveillance to enhance its control.
Diagnosing congenital Cytomegalovirus infection: don’t get rid of dried blood spots
Authors: Pellegrinelli Laura , Alberti Luisella , Pariani Elena , Barbi Maria , Binda Sandro
Published: March 2020

Background

Congenital Cytomegalovirus (cCMV) is a serious global public health issue that can cause irreversible fetal and neonatal congenital defects in symptomatic or asymptomatic newborns at birth. In absence of universal cCMV screening, the retrospective diagnosis of cCMV infection in children is only possible by examining Dried Blood Spot (DBS) samples routinely collected at birth and stored for different time spans depending on the newborn screening regulations in force in different countries. In this article, we summarize the arguments in favor of long-term DBS sample storage for detecting cCMV infection.

Main text

CMV infection is the most common cause of congenital infection resulting in severe defects and anomalies that can be apparent at birth or develop in early childhood. Sensorineural hearing loss is the most frequent consequence of cCMV infection and may have a late onset and progress in the first years of life. The virological diagnosis of cCMV is essential for clinical research and public health practices. In fact, in order to assess the natural history of CMV infection and distinguish between congenital or acquired infection, children should be diagnosed early by analyzing biological samples collected in the first weeks of life (3 weeks by using viral culture and 2 weeks by molecular assays), which, unfortunately, are not always available for asymptomatic or mildly symptomatic children. It now seems possible to overcome this problem since the CMV-DNA present in the blood of congenitally infected newborns can be easily retrieved from the DBS samples on the Guthrie cards routinely collected and stored within 3 days from birth in the neonatal screening program for genetic and congenital diseases. Early collection and long-term storage are inexpensive methods for long-term bio-banking and are the key points of DBS testing for the detection of cCMV.

Conclusion

DBS sampling is a reliable and inexpensive method for long-term bio-banking, which enables to diagnose known infectious diseases - including cCMV - as well as diseases not jet recognized, therefore their storage sites and long-term storage conditions and durations should be the subject of political decision-making.
The clinical value of long - term electroencephalogram (EEG) in seizure - free populations: implications from a cross-sectional study
Authors: Xinghua Tang , Lin Li , Qinyi Fan , Yarong Wei , Zheng Pu , Zhenguo Liu
Published: March 2020

Backgroud

This study aimed to explore the clinical value of long - term electroencephalogram (LTM EEG) in seizure-free individuals taking antiepileptic drugs (AEDs) for more than 2 years. We try to look for clinical factors associated with epileptiform activity on LTM EEG in seizure free patients. We hope that the detection of epileptiform activity by the LTM EEG recording can develop the better treatment strategy.

Methods

The LTM EEG recordings of 770 individuals with a definite diagnosis of epilepsy were assessed. Two hundred sixty-two individuals accorded with the inclusion criteria and exclusion criteria. We collect the demographic and clinical information and LTM EEG data of these 262 individuals. We analysed the data by one-way analysis of variance and Cox proportional hazards models.

Results

We found that more epileptiform activity were found with LTM EEG recording than regular EEG recording in seizure-free individuals. We found several clinical factors could be associated with epileptiform activity on LTM EEG in seizure free patients by a one-way analysis: symptomatic or cryptogenic epilepsy [hazard ratio (HR) = 2.6], history of cerebral trauma (HR = 7.5), and abnormal imaging findings (HR = 3.1). The following factors suggested a correlation between history of cerebral trauma (HR = 2.4) and history of cerebral surgery (HR = 3.4) with epileptiform activity on LTM EEG presentation by multivariate logistic regression analysis.

Conclusions

The study indicated a correlation of a number of factors with abnormal LTM EEG presentation: symptomatic or cryptogenic epilepsy, history of cerebral trauma, history of cerebral surgery, and abnormal imaging findings. The LTM EEG recording may help find epileptiform activity in high risk seizure-free individuals. The individuals need be reevaluated the therapeutic strateagies, and increase the hope to reach real seizure-free.
Predictors of Helping Babies Breathe knowledge and skills among nurses in primary health settings in Dodoma region, Tanzania
Authors: Joho Angelina A. , Kibusi Stephen M. , Mwampagatwa Ipyana
Published: March 2020

Background

Globally, birth asphyxia is one of the leading causes of neonatal death. In Tanzania, neonatal deaths are estimated to be 25 deaths per 1000 live births and birth asphyxia accounts for 31% of those deaths.

Method

A cross-sectional study was conducted in 40 health centers within 7 districts in Dodoma Region among nurses working in maternity units. Simple random sampling was used to select participants. A knowledge questionnaire and performance skills checklist were used to assess nurses’ knowledge and skills respectively. Chi-square and binary logistic regression were employed to test association and identify significant predictors of HBB knowledge and skills.

Results

A total of 172 participants completed the study out of 176 recruited. This represents a respondent rate of 98%. Findings indicate that age, duration of professional training, and experience in maternity were significant predictors for knowledge and skills. However, after control of the confounders, experience in the maternity unit was found to be the only significant predictor of knowledge and skills in resuscitation of the neonates (AOR = 2.94; CI: 0.96–8.98; P = 0.05) and (AOR = 4.14; CI: 1.12–15.31; P = 0.03) respectively. Nurses with longer maternity nursing care experience of 5 years and above were better able to answer questions that demonstrated adequate knowledge (53.9%) and perform skills correctly (53.2%) related to HBB. Those with less than 5 years’ experience had limited knowledge (20%) and skills (10.5%).

Conclusion

In this setting, direct work experience in the maternity unit was the main factor influencing knowledge and skills in neonatal resuscitation with HBB.
Lithuania’s experience in reducing caesarean sections among nulliparas: the impact of the quality improvement course
Authors: Kacerauskiene Justina , Minkauskiene Meile , Mahmood Tahir , Bartuseviciene Egle , Railaite Dalia R. , Bartusevicius Arnoldas , Kliucinskas Mindaugas , Maleckiene Laima , Ulevicius Jonas , Liubiniene Laura , Smigelskas Kastytis , Maciuliene Kornelija , Drasutiene Grazina , Ramasauskaite Diana , Nadisauskiene Ruta J.
Published: March 2020

Background

To evaluate the role of the quality improvement course (QIC) to reduce the caesarean section (CS) rate among nulliparas (Robson groups 1 and 2) and to find out which group of women have reduced the CS rate following attendance at the course.

Methods

The QIC was organized in 2015. For the evaluation of the CS rate after the OIC, deliveries from the selected hospitals in 2014 and 2016 were compared using MS EXCEL and SPSS 23.0.

Results

Nulliparas accounted for 44.6% (3585/8046) and 42.9% (3628/8460) of all the deliveries in 2014 and 2016 years, respectively. The CS rate among nulliparas decreased from 19.0% (665/3502) in 2014 to 16.8% (593/3526) in 2016 (p = 0.018). The greatest decrease in absolute contribution to the overall CS rate was recorded in group 1 (p = 0.08). Perinatal mortality was 3.1 in 2014 and 3.9 in 2016 per 1000 deliveries (p = 0.569).

Conclusion

The QIC has helped to reduce the CS rate among nulliparas without a negative influence on perinatal mortality. The greatest decrease in the overall CS rate was recorded among nulliparous women who were treated with oxytocin and managed to reach a full cervical dilatation.
Factors associated with short birth interval in low- and middle-income countries: a systematic review
Authors: Pimentel Juan , Ansari Umaira , Omer Khalid , Gidado Yagana , Baba Muhd Chadi , Andersson Neil , Cockcroft Anne
Published: March 2020

Background

There is ample evidence of associations between short birth interval and adverse maternal and child health outcomes, including infant and maternal mortality. Short birth interval is more common among women in low- and middle-income countries. Identifying actionable aspects of short birth interval is necessary to address the problem. To our knowledge, this is the first systematic review to systematize evidence on risk factors for short birth interval in low- and middle-income countries.

Methods

A systematic mixed studies review searched PubMed, Embase, LILACS, and Popline databases for empirical studies on the topic. We included documents in English, Spanish, French, Italian, and Portuguese, without date restriction. Two independent reviewers screened the articles and extracted the data. We used the Mixed Methods Appraisal Tool to conduct a quality appraisal of the included studies. To accommodate variable definition of factors and outcomes, we present only a narrative synthesis of the findings.

Results

Forty-three of an initial 2802 documents met inclusion criteria, 30 of them observational studies and 14 published after 2010. Twenty-one studies came from Africa, 18 from Asia, and four from Latin America. Thirty-two reported quantitative studies (16 studies reported odds ratio or relative risk, 16 studies reported hazard ratio), 10 qualitative studies, and one a mixed-methods study. Studies most commonly explored education and age of the mother, previous pregnancy outcome, breastfeeding, contraception, socioeconomic level, parity, and sex of the preceding child. For most factors, studies reported both positive and negative associations with short birth interval. Shorter breastfeeding and female sex of the previous child were the only factors consistently associated with short birth interval. The quantitative and qualitative studies reported largely non-overlapping results.

Conclusions

Promotion of breastfeeding could help to reduce short birth interval and has many other benefits. Addressing the preference for a male child is complex and a longer-term challenge. Future quantitative research could examine associations between birth interval and factors reported in qualitative studies, use longitudinal and experimental designs, ensure consistency in outcome and exposure definitions, and include Latin American countries.

Trial registration

Prospectively registered on PROSPERO (International Prospective Register for Systematic Reviews) under registration number CRD42018117654.
An immune-centric exploration of BRCA1 and BRCA2 germline mutation related breast and ovarian cancers
Authors: Przybytkowski Ewa , Davis Thomas , Hosny Abdelrahman , Eismann Julia , Matulonis Ursula A. , Wulf Gerburg M. , Nabavi Sheida
Published: March 2020

Background

BRCA1/2 germline mutation related cancers are candidates for new immune therapeutic interventions. This study was a hypothesis generating exploration of genomic data collected at diagnosis for 19 patients. The prominent tumor mutation burden (TMB) in hereditary breast and ovarian cancers in this cohort was not correlated with high global immune activity in their microenvironments. More information is needed about the relationship between genomic instability, phenotypes and immune microenvironments of these hereditary tumors in order to find appropriate markers of immune activity and the most effective anticancer immune strategies.

Methods

Mining and statistical analyses of the original DNA and RNA sequencing data and The Cancer Genome Atlas data were performed. To interpret the data, we have used published literature and web available resources such as Gene Ontology, The Cancer immunome Atlas and the Cancer Research Institute iAtlas.

Results

We found that BRCA1/2 germline related breast and ovarian cancers do not represent a unique phenotypic identity, but they express a range of phenotypes similar to sporadic cancers. All breast and ovarian BRCA1/2 related tumors are characterized by high homologous recombination deficiency (HRD) and low aneuploidy. Interestingly, all sporadic high grade serous ovarian cancers (HGSOC) and most of the subtypes of triple negative breast cancers (TNBC) also express a high degree of HRD.

Conclusions

TMB is not associated with the magnitude of the immune response in hereditary BRCA1/2 related breast and ovarian cancers or in sporadic TNBC and sporadic HGSOC. Hereditary tumors express phenotypes as heterogenous as sporadic tumors with various degree of “BRCAness” and various characteristics of the immune microenvironments. The subtyping criteria developed for sporadic tumors can be applied for the classification of hereditary tumors and possibly also characterization of their immune microenvironment. A high HRD score may be a good candidate biomarker for response to platinum, and potentially PARP-inhibition.

Trial registration

Phase I Study of the Oral PI3kinase Inhibitor BKM120 or BYL719 and the Oral PARP Inhibitor Olaparib in Patients With Recurrent TNBC or HGSOC (NCT01623349), first posted on June 20, 2012. The design and the outcome of the clinical trial is not in the scope of this study.
Correction to: A reactive oxygen species scoring system predicts cisplatin sensitivity and prognosis in ovarian cancer patients
Authors: Sun Chaoyang , Guo Ensong , Zhou Bo , Shan Wanying , Huang Jia , Weng Danhui , Wu Peng , Wang Changyu , Wang Shixuan , Zhang Wei , Gao Qinglei , Xu Xiaoyan , Wang Beibei , Hu Junbo , Ma Ding , Chen Gang
Published: March 2020

Following publication of the original article [1], the authors reported an error in Fig. 1f.
A distinct molecular mutational profile and its clinical impact in essential thrombocythemia and primary myelofibrosis patients
Authors: Zaidi Uzma , Sufaida Gul , Rashid Munazza , Kaleem Bushra , Maqsood Sidra , Mukry Samina Naz , Khan Rifat Zubair Ahmed , Munzir Saima , Borhany Munira , Shamsi Tahir Sultan
Published: March 2020

Background

Classical MPNs including ET and PMF have a chronic course and potential for leukaemic transformation. Timely diagnosis is obligatory to ensure appropriate management and positive outcomes. The aim of this study was to determine the mutational profile, clinical characteristics and outcome of ET and PMF patients in Pakistani population.

Methods

This was a prospective observational study conducted between 2012 and 2017 at NIBD. Patients were diagnosed and risk stratified according to international recommendations. Response to treatment was assessed by IWG criteria.

Results

Of the total 137 patients analysed, 75 were ET and 62 were PMF. JAK2 positivity was seen in 51 cases (37.2%), CALR in 41 cases (29.9%), while triple-negative in 17 (12.4%) cases. None of the patients in the present study were MPL positive. Overall survival for patients with ET and PMF was 92.5 and 86.0% respectively and leukaemia free survival was 100 and 91.6% respectively, at a median follow-up of 12 months. Leukaemic transformation occurred in 6.5% of MF patients; among them, JAK2 mutation was frequently found. Molecular mutations did not influence the OS in ET whereas in PMF, OS was shortest in the triple-negative PMF group as compared to the JAK2 and CALR positive patient groups.

Conclusion

This study shows a different spectrum of molecular mutations in ET and PMF patients in Pakistani population as compared to other Asian countries. Similarly, the risk of leukaemic transformation in ET and PMF is relatively lower in our population of patients. The factors responsible for these phenotypic and genotypic differences need to be analysed in large scale studies with longer follow-up of patients.