bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and Anthropometric Characteristics of the Metabolically Unhealthy Phenotype in Adolescents with Adequate and High BMI
Authors: Magalhães Ana Carla Leocadio , Pierucci Anna Paola T. , Oliveira Maria Núbia G. , Campos Aline B. F. , Jesus Patrícia C. , Ramalho Andrea
Published: March 2020

Background The metabolically healthy (MH) and metabolically unhealthy (MUH) phenotypes have been discussed in the literature but the factors related to the development of these phenotypes, in adolescents with adwuate and high body mass index (BMI), are not yet fully understood. Objective To evaluate the relationship between age during the menarche, serum leptin concentrations, body composition and MH and MUH phenotypes, in adolescents with adequate and high BMI. Methods Observational and cross-sectional study made up of female adolescents attended at Centro de Referência do Adolescente, in Macaé, Rio de Janeiro. The stage of sexual maturation and the age at menarche were analyzed based on the self-declaration of the participants. The menarche was considered early (EM) when the first menstruation occurred up to 11 years of age; normal (NM) between 12 and 14 years old; and late after 15 years of age. Body mass and height were measured to calculate BMI, and the following body variables were analyzed: waist circumference (WC), waist/height ratio (WHR), body fat (BF%), fat body mass index (FBMI) and fat-free mass index (FFMI), visceral adiposity index (VAI). In addition, cardiometabolic components and serum leptin concentrations were measured.Results 82% (n=114) of the adolescents were classified as MH and 18% (n=25) as MU. The mean age at menarche was 11.79 ± 1.39 years. 60% (n=15) of EM and 84% (n=21) of inadequacy of serum leptin were identified in the MUH group. Among eutrophic women, there was 85.7% (n=6) of inadequate WC among MUH adolescents and 2.5% (n=2) among MH ones ( p <0.01), while among adolescents with high BMI, 88.9% (n=16) and 28.6 (n=10) of the MUH and MH groups, respectively, showed inadequacy of this variable ( p <0.01). Among MUH adolescents, there was a strong correlation between the age at menarche and BF% (r= - 0.63 p <0.01); VAI and TG (r=0.87 p <0.01), BF% (r=0.63 p <0.01) and FFM (r=0.61 p <0.01). Conclusion Age at menarche, serum leptin and WC are related to the MUH phenotype in adolescents and should be investigated, during clinical practice, to help prevent cardiometabolic diseases in adulthood.
Clinical characteristics and current treatment of critically ill patients with COVID-19 outside Wuhan, China: a multicenter, retrospective, observational study
Authors: Chen Yuhong , Zhang Kun , Zhu Guijun , Liu Lixia , Yan Xixin , Cai Zhigang , Zhang Zhongheng , Hu Zhengjie
Published: March 2020

Background: A novel coronavirus disease 2019 (COVID-19) occurred in Wuhan and rapidly spread elsewhere. The clinical characteristics and treatment of critical ill patients outside Wuhan remain unknown. We aimed to describe the epidemiology and treatment of critical ill patients with COVID-19 in Hebei province.Methods: All patients were from designated hospitals of Hebei province and fit the criteria. We collected the clinical data, laboratory examinations and treatment of all participants.Results: By 14 February 2020, 37 critical ill patients were included. The mean age of the patients was 58.73 (SD 13.76) years, 21 (56.80%) patients were men, 18 (48.60%) were familial cluster, 26 (70.30%) patients had chronic illness. The patients with critical type had a longer period of confirmation time, more severe inflammation and lung injury, a lower lymphocyte percentage. All patients were treated with antiviral agents, 33 (89.20%) with antibacterial agents, 35 (95.60%) patients with methylprednisolone and traditional Chinese drugs. Nine (60.00%) patients with critical type were treated with invasive mechanical ventilation, 9 (60.00%) of those with complications. The patients with critical type received more fluid and more diuretics.Conclusion: Patients with underlying disease and the confirmation time> 10 days were more likely to develop to critical type. The critical type patients had higher risk of infection, respiratory depression, circulatory collapse, and complications. The strategy of lung-protective mechanical ventilation and restrictive fluid management should be strictly followed.
Cardiac arrest survival post-resuscitation in-hospital (CASPRI)—a tool to predict neurological outcome after ROSC
Authors: Liu Bofu , He Yarong , Jiang Peng , Sun Jiachen , Han Tianyong , Li Qin , Li Ruixin , Cao Yu
Published: March 2020

Objectives: To develop a cardiac arrest survival post-resuscitation in-hospital (CASPRI) scoring system evaluating the prognosis of neurological function in ROSC patients.Methods: This single-center, retrospective study reviewed the eligible patients admitted to the emergency department of West China Hospital of Sichuan University who received cardiopulmonary resuscitation and restored spontaneous circulation from January 1, 2014 00:00 to December 31, 2017 23:59. Clinical histories, blood test, biochemistry proﬁle, coagulation indexes and other laboratory tests during emergency department visit were collected. The MEWS, sOHCA, APACHE II, and the highest SOFA scores were calculated during the period between emergency room admission and ROSC. The clinical data of ROSC patients in the test group were analyzed by univariate and multivariate logistic analysis. The possible risk factors related to the unfavorable prognosis of 90-day neurological function were screened and CASPRI score was constructed. The eﬃcacy of CASPRI score on evaluating the neurological function of ROSC patients was analyzed by ROC curve and proved in the validation group.Main results: 503 patients were included in the test group. After correcting potential confounding factors, multivariate logistic regression analysis showed that TBIL, ALB at admission of emergency department, Lac at ROSC, resuscitation time, non-shockable rhythms were independent risk factors for poor neurological prognosis of ROSC patients (p<0.05). ROC curve showed that the CASPRI score was superior to the APACHE II score, SOFA score, MEWS score and sOHCA score, and the diﬀerence was statistically signiﬁcant (p<0.05). In the validation group with 256 patients included, the incidence of poor neurological prognosis in high-risk, intermediate-risk, and low-risk groups based on CASPRI score were 97.89%, 85.59%, and 58.33%, respectively, and the diﬀerence was statistically signiﬁcant (p<0.001). CASPRI score was superior to the SOFA score and MEWS score, the diﬀerence was statistically signiﬁcant (p<0.05).Conclusions: CASPRI score is an eﬀective tool for the early evaluation of the neurological prognosis of ROSC patients. Its eﬃcacy exceeds the MEWS and SOFA scoring systems currently used in clinical practice.
Formula-fed and Clostridium difficile infected neonatal piglets carry a highly diverse and abundant set of antimicrobial resistance genes
Authors: Pieper Robert , Dadi Temesgen , Grzeskowiak Lukasz , Pieper Laura , Siegmund Britta , Vahjen Wilfried , Schwarz Stefan , Heinsen Femke-Anouska , Franke Andre , Reinert Knut , Zentek Jürgen
Published: March 2020

Background: Clostridium difficile infection (CDI) is an increasing zoonotic health threat and has also been documented as a cause of enteritis outbreaks in neonatal pigs. Furthermore, CDI in neonatal piglets cause changes in microbial gut colonization. We hypothesized that an imbalanced microbial colonization in piglets with CDI could be associated with an altered abundance of antimicrobial resistance genes. Results: We analyzed fecal metagenomic data of lactating sows (S), their piglets during suckling (SP), the same piglets two weeks after weaning (WP), 5-day old artificially reared and formula-fed siblings (FP) and FP infected with C. difficile (FP-CD) for microbiota composition and antimicrobial resistance gene abundance. FP and FP-CD piglets had an immature-type microbiota and increased abundance of antimicrobial resistance genes. A co-occurrence of genes encoding for resistance against aminoglycosides (e.g. aph(3”)-lb, aph(6)-ld, ant(2”)-la), β-lactams (blaCTX-M, blaTEM), fluoroquinolones (pat(A) macrolides (mph(A)), sulfonamides (sul1, sul2), polypeptides (e.g. pmrB, pmrC, arnA, bac(A)) and tetracyclines (e.g. tet(A-D),) was observed. Conclusion: Increased abundance of antimicrobial resistance genes in formula feeding and concomitant CDI may be associated with therapeutic resistance later in life and warrant further studies.
The biological effects of microencapsulated organic acids and botanicals induces tissue-specific and dose-dependent changes to the microbiota
Authors: Feye Kristina , Swaggerty Christina L. , Kogut Michael H. , Ricke Steven C. , Piva Andrea , Grilli Ester
Published: March 2020

Background: Microencapsulated organic acids and botanicals have the potential to develop into important tools for the poultry industry. A blend of vanillin, thymol, sorbic, and citric acids (AviPlus®P) has previously been shown to reduce Salmonella and other foodborne pathogens in chickens; however, changes to the microbiota of the jejunum and ileum have not been evaluated. Microbiota diversity is linked to, but not correlated with, the efficacy of natural products including organic acids and natural compounds; therefore, understanding the effects of these products on the microbiota is a necessary first step into evaluating the potential for wide-spread use within the poultry industry as an alternative to antibiotics. Results: Day-of-hatch by-product breeder chicks (n=30) were placed into either the control (0 g/MT AviPlus®P; n=5) or one of two experimental groups (300 g/MT; n=5; 500 g/MT AviPlus®P; n=5). The experiment was conducted using two replicate pens therefore 10 chicks/treatment were used for all analysis. Chickens were sacrificed 15d post-hatch and total jejunum and ileum contents were individually collected and snap frozen until further processing and analysis. The DNA was extracted and sequenced using the Illumina 16S rDNA MiSeq V3 platform and the samples analyzed in QIIME2.2019.1. Samples were filtered for quality and chimeras using DADA2, with OTU frequencies less than three removed from the study. Alpha and beta diversity analytics indicated compartmentalization within the poultry gastrointestinal tract (GIT). Additionally, LEfSE and ANCOM analysis showed a reduction in Enterobacteriaceae with increased inclusion rate and an increase in Clostridia, both of which are associated with optimal GIT health. Conclusion: The addition of a blend of organic acids and botanicals to the diet of chickens does not adversely impact the microbiota, and in fact, is associated with microbial changes within the ileum and jejunum that are largely thought of as beneficial. Promotion of a healthy GIT has the potential to limit colonization by Salmonella and other foodborne pathogens. The inclusion of the microencapsulated blend of organic acids and botanicals may be a viable antibiotic alternative for use in the poultry industry.
MiR-4792 regulates inflammatory responses in Cryptococcus neoformans infected microglia
Authors: Chen Jianghan , Yao Guotai , Wang Xiaoli , Hou Qing , Gao Rui , Wang Yilin , Teng Liang , Lin Wenting , Wang Yan , Wang Zhongzhi , Jin Yi
Published: March 2020

Background: Investigating the factors that influence inflammatory response of microglial cells is important to understand the pathogenesis of cryptococcal meningitis (CM). MicroRNA (miRNA) have been shown to play an important role in inducing host defenses and activating immune response in the process of microbial infection; however, the regulatory mechanisms of miRNAs in cryptococcal meningitis are poorly defined. In our previous analysis, we assessed the miRNA profiles of BV2 cells following Cryptococcus neoformans (C. neoformans) infection. In this study, we characterized the expression of miR-4792 in CM patients to further our understanding of the host response to pathogen infections.Results: miR-4792 was downregulated in BV2 cells infected with C. neoformans while its target gene EGFR was upregulated. Infected cells with up-regulated miR-4792 exhibited decreased EGFR expression, reduced MAPK signaling and a decreased secretion of inflammatory cytokines. Following antifungal treatment in cryptococcal meningitis patients, the levels of miR-4792 in the CSF significantly increased, while the expression of EGFR significantly decreased.Conclusion: This study identified that miR-4792 and its target EGFR regulate the secretion of inflammatory cytokines in C. neoformans infected BV2 cells. This furthers our knowledge of the host immune responses to fungal infections in the CNS.
Genome-wide scan for runs of homozygosity identifies potential candidate regions associated with growth traits in beef cattle
Authors: Zhao Guoyao , Zhang Tianliu , Liu Yuqiang , Wang Zezhao , Xu Lei , Zhu Bo , Gao Xue , Zhang Lupei , Gao Huijiang , Li Junya , Xu Lingyang
Published: March 2020

Background: Runs of homozygosity (ROH) are continuous homozygous regions that generally exist in the DNA sequence of diploid organisms. Identifications of regions of the genome lead to reduction in performance can provide valuable insight into the genetic architecture of complex traits. Here, we evaluated genome-wide patterns of homozygosity and their association with growth traits in a commercial beef cattle population.Results: We identified a total of 29,271 ROH segments with an average number of 63.36 and an average length of 0.98 Mb in this commercial beef cattle population, representing ~2.53% (~63.36Mb) of the genome. To evaluate the enrichment of ROH across genomes, we initially identified 280 ROH regions by merging ROH events identified across all individuals. Of these, nine regions were significantly associated with six growth phenotype traits (body height, chest circumference, fat coverage, backfat thickness, ribeye area, carcass length; P<0.01), which contain 187 candidate genes. Furthermore, we found 26 consensus ROH regions with frequencies exceeding 10%, and several of these consensus overlapped with QTLs which are associated with weight gain, calving difficulty and stillbirth. To precisely locate locus within each ROH for every studied trait, we further utilized loci-based methods for association analysis among these identified regions. Totally, we obtained 9,360 loci within ROH, and 1,631 loci displaying significant association (P<0.01) for eight traits. In addition, we found that 67 genes embedded with homozygous loci. Several identified candidate genes, including EBF2, SLC20A2, SH3BGRL2, HMGA1 and ACSL1, were related to growth traits.Conclusions: This study assessed genome-wide autozygosity pattern and inbreeding level in a commercial beef cattle population. Our study identified many candidate regions and genes with ROH for growth traits in beef cattle, which can provide important insights into investigating homozygosity across genome in other farm animals. Our findings may further be unitized to assist the design of selection mating strategy.
WITHDRAWN: Deep expression scrutiny provides genetic basis of aluminium tolerance in wild (Lens nigrican) and cultivated lentil (Lens culinaris Medik.)
Authors: Singh Dharmendra , Singh Chandan Kumar , Taunk Jyoti , Sharma Shristi , Tomar RamSewak Singh , Pal Madan , Konjengbam Noren Singh , Singh M. Premjit , Sharma Ph Ranjit , Sengar Rakesh Singh
Published: March 2020

Background: Aluminium (Al) stress hinders crop productivity in acidic soils. Lentil contains rich source of protein and micronutrients and cultivated in different parts of world. To enhance knowledge about Al toxicity tolerance, present study emphasizes on mechanistic analysis of genes associated with Al stress through de novo transcriptomic analysis of tolerant (L-4602), wild (ILWL-15) and sensitive (BM-4) genotypes. Result: Illumina HiSeq 2500 platform evaluated contigs ranging from 15,305 to 18,861 for all the samples with N50 values of 1795 bp. Four annotation softwares revealed differential regulation of several genes where 30,158 genes were specifically up-regulated for combinations under Al stress conditions alone. Top up-regulated Differentially Expressed Genes (DEGs) in tolerant cultivar when compared to the sensitive one were found to be involved in protein transport as well as degradation, defences, cell growth and development. Wild v/s cultivar comparison revealed upregulation of wild DEGs that are involved in regulation of transcription in differentiating cells, pre-mRNA splicing, catalysis and protein ubiquitination. Based on assembled Unigenes, 89,722 high-quality SNPs and 39,874 SSRs were detected. Twelve selected genes were validated using qRT-PCR. KEGG pathway analysis extracted 8,757 GO annotation terms within molecular, cellular and biological processes. Pathway analysis indicated that organic acid synthesis and their transportation along with detoxification of ROS, an alternate pathway involving metacaspase-1,4,9 for programmed cell death were also significantly induced due to Al stress.Conclusion: Present study unveils the characterization of differential transcripts generated under Al stress indicating Al tolerance as a multiplex phenomenon which will directly widen crop improvement programmes for Al toxicity utilizing molecular approaches.
Analysis of Regulation Networks in the Formation of Green Pigment in Garlic
Authors: Li Ningyang , Lu Xiaoming , Sun Xiudong , Qiao Xuguang
Published: March 2020

Background: Garlic (Allium sativum L.) has high medical and edible value, but is prone to producing green pigment during storage, which seriously affects product quality. Herein, we found multiple metabolic pathways involved in green pigment formation by analyzing the transcriptome and proteome changes of garlic stored at 4 °C for 0 day (DS0), 10 days (DS1), 15 days (DS2) and 40 days (DS3). Results: In this work, we found that porphobilinogen is a precursor of garlic green pigment and the citrate cycle (TCA cycle) can promote the formation of garlic green pigment by increasing the content of porphobilinogen. The salicylic acid (SA) inhibits garlic greening, whereas the lignin synthesis pathway positively correlates with greening. In addition to the above metabolic pathways, other pathways may be associated with the formation of garlic’s green pigment, such as glycolysis/gluconeogenesis, pyruvate metabolism and fatty acid metabolism. It has been reported that pyruvate and amino acids play a role in garlic greening, which were also demonstrated in this study. Conclusion: our results have important implications for understanding the mechanism of green pigment formation in garlic.
Structural variants in Mongolian originated ruminant: role in adaptation of extreme-environment
Authors: Xing Yanping , Qi Yu , Purev Chimgee , Wang Shengyuan , Wang Hongbing , Wu Kaifeng , Cao Junwei , Liu Chunxia , Liu Yiyi , Li Lu , Zhang Yanru , Zhou Huanmin
Published: March 2020

Background: Mongolian cattle (MC) is one of an ancient livestock breeds with good economic traits such as adaptation to Mongolian Plateau extreme low temperature in winter, resistant to pathogenic organisms infection and high quality meat. To reveal the molecular mechanism underlying these, the whole genome sequencing and comparative transcriptome sequencing of MC were performed.Results：By genome sequencing and structure variation analysis, 8 genes related to pathogenic organisms infection, including 4 members of bata-defensins gene family (LAP, DEFB1, DEFB2, and DEFB5), 2 members of interferon (IFN) gene family (IFNW1 and IFNT2) and 2 genes coding for BoLA proteins(Mongolian_cattle_21532 and Mongolian_cattle_19448) were found in MC genome inversion region. By transcriptome-sequencing, it was elucidated that 8 genes (FATP, FABP, PEPCK, SCP-X, ADIPO, FABP1, SCD-1, APO) related to PPARα pathway, 23 genes involved in oxidative phosphorylation and 10 P450 genes (CYP7B1, CYP4V2, CYP3A5, CYP11A1, CYP2C18, CYP2B6, CYP7A1, CYP2R1, CYP2E1, CYP27B1) were significantly up-regulated in winter MC transcriptomes, comparative to summer MC transcriptomes.Conclusions: Here, we characterized 41 genes implicated in fatty acid metabolism were up-regulated in winter MC transcriptomes. These genes probably account for the MC adaptation to extreme low temperature. At the same time, 8 genes in MC genome inversion region were discovered. And these genes gave clue to the MC resistant to pathogenic organisms infection. In sum, our revealed genes are of important for us to understand the molecular mechanisms of MC to adapt to their environments and valuable for cattle breeding.
Immunoregulation of PD-1/PD-L1 Inhibitory Pathway on Fetomaternal Tolerance in abortion Triggered by thyroid autoimmunity
Authors: Liu Haixia , Chen Mengya , Shan Zhongyan , Teng Weiping
Published: March 2020

Background: TAI in euthyroid pregnant women is associated with miscarriage. Studies have shown that the PD-1/PD-L1 signaling pathway plays an important role in maternal-fetal tolerance by promoting Treg cells development and inhibition of Th17 cells responses, whereby it is essential for normal pregnancy maintenance. However, whether the PD-1/PD-L1 pathway leads to a Treg/Th17 imbalance has not been fully investigated in TAI.Methods: TAI fetal loss model was established by thyroglobulin (mTg) immunized CBA/J female mice. The frequencies of splenic Th17, Treg, PD-1 and PD-L1 were tested by flow cytometry. IL-17, Foxp3, RORγt, PD-1 and PD-L1 mRNA levels were tested by real-time PCR.Results: Compared with the control group, the number of CD4 + CD25 + Foxp3 + T lymphocyte in the placenta and spleen were significantly reduced (P<0.05) in the experimental group (mTg group), CD4 + IL-17 + T-cell subsets and expression of RORγt and IL-17 mRNA in the placenta were increased (P<0.05), the ratio of Treg/IL-17 in the placenta and spleen was decreased (P<0.05). The expression of PD-1 and PD-L1 in mice immunized with mTg in CD4 + T group decreased the subsetof cells in the placenta and spleen including Tregs.Conclusions: The role of PD-1/PD-L1 pathway in an isolated thyroglobulin antibodies (TgAb) positive mouse abortion model is that it may lead to a peripheral Treg/Th17 imbalance and the maternal-fetal tolerance balance breakdown, which may ultimately result in fetal loss.
An analysis of the negative asymmetry in the coronal body shape of the old people in South Korea
Authors: Chen Lin , Lee Soo-Min , Nam Yunja , Park Jinhee
Published: March 2020

Background Existing positive shape models are based on values for the right side of the body. To the best of our knowledge, this is the first comparative study to analyze both left- and right-side data to explore asymmetrical body characteristics, considering that most older people are not able to maintain a healthy spinal vertical tilt presentation. In this study, 3D scanning and 3D measurement were used to analyze and study the asymmetry of the elderly in South Korea to provide more complete basic size data for the development of clothing patterns for the elderly.Methods The calculated values were analyzed by ANOVA and correlation analysis, and the paired sample t-test was performed to find asymmetrical characteristics of the older adult body. Finally, we used the independent t-test to analyze sex differences. Geomagic Design X software was used to record the coordinates of the measured points to reconstruct 3D models of the older adult body. We present a new method based on analysis of the vertex-anterior neck plane, the anterior neck-omphalion plane, and the omphalion-crotch point plane as benchmarks for the center of the head, the upper torso and the lower torso, respectively, to determine lateral asymmetry.Results The Kolmogorov-Smirnov normality test indicated the tendency of the torso to tilt to the right in older men and women. Compared with the inclination of the head, the inclination of the lower torso is more obvious. The correlation analysis results show that the tilt of the head does not affect the asymmetrical characteristics of the trunk.Conclusions This study did not use the traditional median sagittal plane as a central datum plane, instead separating the model according to the structure of the human body into the head, upper body, and lower body, with three independent central datum planes. Therefore, this study contributes an analysis of human asymmetry, thus providing more complete basic size data for the development of clothing patterns for the elderly in South Korea.
Serum Iron for Prognosis of Acute Ischemic Stroke by Endovascular Treatment
Authors: Liu Mingli , Hao Zhongfei , Li Ruiyan , Cai Jinquan , Li Yongli , Jiang Chuanlu
Published: March 2020

Background Iron, as an import micronutrient, is related to many diseases in a human body. Although the function of iron in acute ischemic stroke is yet debatable, there are few reports from clinical data on serum iron for the prognosis of acute ischemic stroke by endovascular treatment. The current retrospective study aimed to investigate the correlation between serum iron and acute ischemic stroke prognosis by endovascular treatment.Methods This study was carried out retrospectively and 84 patients participated from March 2016 to April 2019 who suffered acute ischemic stroke and were treated by endovascular treatment at this stroke center. The laboratory test and clinical data were assessed for the prognosis of acute ischemic stroke by endovascular treatment. An independent relationship was analyzed through binary logistic analysis and receiver operating characteristic curves for the accuracy of the test.Results This retrospective study was carried out at Harbin Medical University’s Second Affiliated Hospital, and enrolled 84 patients from March 2018 to September 2019, including 32 patients in whom the outcomes were clinically favorable and 52 patients with unfavorable clinical outcomes. The groin puncture to recanalization time significantly varied between patients with favorable as well as unfavorable clinical outcomes (45.0 min vs 72.5 min, p = 0.001), serum iron (10.87 μmol/L vs 4.07 μmol/L, p < 0.001) and thrombin time (13.40 s vs 14.25 s, p = 0.034) from univariable analysis. Serum iron (p < 0.001; adjusted OR [95% CI]:70.765 [9.904 - 505.636]) was associated independently with acute ischemic stroke prognosis by endovascular treatment, and receiver operating characteristic showed area under the curve of 0.926 (p < 0.001, 95% CI: 0.872 - 0.979).Conclusions The outcomes of this study reveal that serum iron level was associated independently with acute ischemic stroke prognosis, and high serum iron level could predict favorable clinical outcomes with a significantly accurate ability. Thus, serum iron could be a marker for acute ischemic stroke prognosis through endovascular treatment.
Midterm follow-up with modular fluted tapered stem in the management of Vancouver B3 femoral periprosthetic fracture
Authors: Cheng Qi , Zheng Li , Ding Yunzhi , Zhao Fengchao
Published: March 2020

BackgroundTo evaluate the technique and clinical results of the uncemented fluted, tapered, modular stems in treating Vancouver B3 periprosthetic femoral fractures. MethodsA retrospective study was carried out on 56 patients (56 hips) with the use of the modular femoral stem in revision of total hip arthroplasty between August 2007 and January 2009. The mean patient age was 73.4±6.6 years(rang, 62-82years). Bone defect was categorised as Paprosky types：32 Type IIIA , 20 Type IIIB, 4 Type Ⅳ. 28 hips had allograft struts placed around the fracture. 44 patients had concomitant revision of the acetabular component. The mean duration of follow-up was 102.1±12.2 months (rang, 84-120 months). Hip function and treatment outcome were assessed using Harris Hip Score System and Beals and Tower 's standard. Radiography were used to evaluate the implant stability, bone stock restoration, fracture healing, stem subsidence and complications. ResultsThe mean HHS improved from 45.6 ±5.4 points (range, 32-53 points) preoperatively to 86.3±8.4 points (range, 81-92 points) at the most recent follow-up. Radiographic review showed all fractures of patients united, with maintenance or improvement of bone stock in 96% of patients. The average value of the stem subsidence 4.9±1.5mm (rang, 0-9mm), happening mainly within the first six months after the operation. No implant had been revised because of aseptic loosening or dislocation. 8 of all the 28 allografts united to the host bone. In the last follow-up, 20 cases of treatment results were excellent, 36 cases were good. There were four patients occuring complications such as deep vein thrombosis of lower limbs or subcutaneous haematomas after surgery, all cured during hospitalization. There were no patients occurring the dislocation of hips after revision. Conclusion﻿The uncemented fluted, tapered, modular prosthesis is a good choice with a high rate of fracture union and implant osteointegration when the treatment of the Vancouver B3 femoral periprosthetic fracture.
Analysis of 5 Rare Cases of Esophageal Fistula after Anterior Cervical Decompression, Bone Graft Fusion and Internal Fixation Surgeries
Authors: Huang Yu , Lin Jin , Zhou Lihan , Lin Jianhua , Chen Xuanwei
Published: March 2020

Objective: To retrospectively analyze and discuss the characteristics of the pathogenesis, diagnosis and treatment of esophageal fistula after anterior cervical surgery. Methods: A retrospective analysis of the clinical data of 5 patients complicated with esophageal fistula after anterior cervical surgery in our hospital from January 2003 to December 2018 was performed. Results: Of the 5 patients, 3 died of severe pulmonary infection and sepsis after conservative treatment, and 2 patients healed after surgery performed for debridement and internal fixator removal. Conclusion: Esophageal fistula after anterior cervical spine surgery is a rare and serious complication with a high mortality rate. Surgical debridement and removal of the internal fixator accompanied by other active treatment measures can achieve good curative effects and significantly improve the outcomes of patients.
Analysis on the MRI Results of Neonatal Brain with Different Levels of Bilirubin
Authors: ZHONGXING LU , DING SHOULING , WANG FEN , Lv Haitao
Published: March 2020

Numerous studies have focused on abnormal changes in craniocerebral MRI in neonates at severe bilirubin levels, and no abnormal changes have been reported at moderate and low levels, and the abnormal changes are related to gestational age, birth weight and bilirubin levels And other factors. Here, by analyzing the neonatal craniocerebral MRI manifestations at different levels of bilirubin, it is found that at moderate and low levels of bilirubin, the neonatal cranial MRI has abnormal changes, and the craniocerebras at severe bilirubin levels MRI abnormal changes were not statistically significant, and were not significantly related to gestational age, birth weight, and bilirubin levels. This suggests that neurotoxicity may occur at low and medium levels of bilirubin.
Identifying core competencies for public health professionals in Uttar Pradesh, India: results from a Delphi exercise
Authors: Bhandari Sudip , Wahl Brian , Bennett Sara , Engineer Cyrus Y , Pandey Pooja , Peters David H
Published: March 2020

BackgroundEnsuring the public health workforce has appropriate competencies to fulfill essential public health functions is a challenge in many low- and middle-income countries. The absence of an agreed set of core competencies to provide a basis for developing and assessing knowledge, skills, abilities, and attitudes contributes to this challenge. In Uttar Pradesh, India, where most staff are trained as clinicians, this study is aimed at identifying the requisite core competencies for health professionals in mid-level supervisory and program management roles to effectively perform their public health responsibilities.MethodsWe used a multi-step, interactive Delphi technique to develop an agreed set of public health competencies. A narrative review of core competency frameworks and key informant interviews with human resources for health experts in India were conducted to prepare an initial list of 40 competency statements in eight domains. We then organized a day-long workshop bringing together 22 public health experts and government officials from India, who added to and modified the initial list. After this, a revised list of 54 competency statements was rated on a 5-point Likert scale, with 1 as “not at all important” to 5 as “absolutely essential”. Aggregate statement scores were shared with the participants, who discussed the findings. Finally, the same list was returned to participants for an additional round of ratings. Stability between scores at different steps was identified using the Wilcoxon matched-pairs signed-rank test. Consensus was defined using the percent agreement criterion.ResultsStability between the first and second Delphi scoring steps was reached in 46 of the 54 statements presented to participants. By the end of the second Delphi scoring step, consensus was reached on 48 competency statements across eight domains: public health sciences, assessment and analysis, policy and program management, financial management and budgeting, partnerships and collaboration, social and cultural determinants, communication, and leadership.ConclusionsThis study produced a consensus set of core competencies and domains in public health that can be used to review current training practices, assess competencies of public health professionals, and revise or develop new training programs to address desired competencies in Uttar Pradesh. Findings from this study can also be used to support workforce development by informing competency-based job descriptions for recruitment and performance management and adapted for use elsewhere.
Resveratrol Suppresses the Growth and Metastatic Potential of Cervical Cancer through Inhibiting STAT3Tyr705 Phosphorylation
Authors: Sun Xiaodong , Xu Qianqian , Zeng Lian , Xie Lixia , Zhao Qiang , Xu Hongxia , Wang Xuanbin , Jiang Nan , Fu Pan , Sang Ming
Published: March 2020

Background : The aberrant STAT3 signaling promotes initiation and progression of human cancers by either inhibiting apoptosis or inducing cell proliferation, angiogenesis, invasion, and metastasis. This study aims to investigate the role of STAT3 and its phosphorylation status in resveratrol-mediated suppression of cervical cancer. Methods : The effects of resveratrol on cervical tumor growth were also determined by examining the tumor tissues and their histological changes and the volume and weight of tumor tissues grown from Hela cells injected in female athymic BALB/C nude mice following the pretreatment regimen and the treatment regimen. Resveratrol structure and targets interaction virtual screening was performed using molecular docking program Autodock Vina. The phosphorylated STAT3, EMT molecular markers and ECM degradation enzymes protein levels were determined using Western blotting. Results : Proliferation and the colony formation of Hela cells were inhibited after resveratrol treatment in both dose- and time- dependent manner. Resveratrol inhibited migration and invasion of Hela cells. Molecular docking analysis showed that resveratrol interacted with STAT3 at a pocket composed of 11 amino acidic residues. Treatment with resveratrol resulted in decreases in the level of phosphorylation of STAT3 at Tyr705 but not Ser727, and no obvious changes in the protein level of STAT3 in Hela cells and SiHa cells. Pretreatment or treatment with resveratrol resulted in decreases in the IL-6-induced phosphorylation level of STAT3Tyr705 in Hela cells and SiHa cells, compared with those of treatment with IL-6. Reduced STAT3Tyr705 phosphorylation after STAT3 inhibitors S3I201 enhanced inhibition of invasion potential of Hela cells and SiHa cells treated with Resveratrol. Resveratrol decreases the N-Cadherin, Vimentin, MMP-3, MMP-13 protein level and increases the E-Cadherin protein level in a dose-dependent manner. The tumor size, volume, and weight, and the N-Cadherin, Vimentin, MMP-3, and MMP-13 protein level were significantly decreased, and the E-Cadherin protein level was increased, and the tumors were histologically damaged as revealed by H&E staining in both the resveratrol pretreatment group and the resveratrol treatment group and the magnitude of changes was higher in the former than that of the latter. Conclusion : Resveratrol inhibits growth and metastatic potential of cervical cancer through blocking STAT3Tyr705 phosphorylation.
Evaluation of Intensified Provider Initiated Testing and Counselling Program in Harare City, 2017-2018
Authors: Mandere Edias , Mungati More , Gonese Gloria , Gombe Notion , Juru Tsitsi , Chiwanda Simbarashe , Govha Emmanuel , Tshimanga Mufuta
Published: March 2020

Introduction Knowledge of HIV status remains a challenge despite implementation of various testing strategies including provider-initiated HIV testing (PITC). Harare City intensified provider-initiated HIV testing by targeting testing all eligible clients visiting facilities to achieve the UNAIDS first 95. This study aimed at evaluating the intervention to improve its effectiveness and inform programming decisions for universal access to HIV testing. Methods The study was conducted in Harare City from April to June 2019. Assessment of the intervention was conducted using the logic model approach. Health workers were interviewed using an interviewer administered questionnaire. Exit interviews were conducted for eligible clients >18 years who refused to be tested. HIV screening and testing registers were reviewed using a check list. Ethical approval was obtained from City of Harare and the University of Zimbabwe. Results The median age for clients was 31 and median years in service for health workers was 2. Of the 133 899 clients who were eligible for testing after screening, 74% accepted the test leaving a gap of 26%. However, 47%(n=45) health workers indicated high workload in the morning as the major reason for the leakage. In addition, 36%(n=70) clients indicated long waiting time as the reason for opting out of HIV testing. Conclusion and Recommendation HIV testing coverage for eligible clients was not optimal, 26% opted out. We recommend scaling of community education on the importance of HIV testing. Re-allocation of staff during busy testing time in the morning to easy workload.
Evidence on access to health care information by women of reproductive age in Low-and-Middle-Income Countries: Scoping Review
Authors: Shatilwe Joyce Twahafifwa , Kuupiel Desmond , Mashamba-Thompson Tivani P.
Published: March 2020

Background Majority of women of reproductive age in Low and Middle Income Countries (LMICs) are not able to access health services due to different factors. The main objective of this scoping review is to map the literature on access to healthcare information by women of reproductive age in LMICs. Methods The literature search was conducted through the following databases: Scholar, Science Direct, PubMed, EBSCOhost (Academic search complete, CINAHL with full text, MEDLINE with full text, MEDLINE, and PsycINFO), Emerald, Embase, published and peer reviewed journals, organizational projects, reference list, grey literature as well as reports related to this objective were included in the study. Studies reporting evidence on interventions aimed at enabling access to health care information in LMICs published during the period 2004 to until recent, were eligible for inclusion. Identified key words were used to search articles from the databases. Following title screening, two reviewers independently reviewed the abstracts and full articles. Inclusion and exclusion criteria was considered to guide the screening. Results A total of 451 900 articles were identified from all the databases searched. Of these, four articles meet inclusion criteria after full article screening and were included for data extraction. The included articles were conducted in the following countries: Eastern Uganda, Gauteng, South Africa, Myanmar and Nepal. The themes that emerged from our study are as follows: accessibility, financial accessibility/affordability, connectivity and challenges. This study demonstrated that, there are minimal interventions that enable women of reproductive age to access healthcare information in terms of accessibility, financial accessibility and connectivity. The study further revealed that with the minimal strategies tried, such as telemedicine and text messages, a large population of women could be reached and this strategies are less cost. Conclusion The findings of the study revealed poor access and utilization of maternal healthcare information by women of reproductive age. We therefore recommend primary studies in other LMICs to determine the accessibility, financial accessibility, connectivity and challenges faced by women of reproductive age in LMICs to reduce maternal and neonatal mortality rate and to achieve the Sustainable Development Goal 3.
Detection of Gastrointestinal Parasitism at Recreational Canine Sites in the United States (the DOGPARCS study)
Authors: Stafford Kristina , Kollasch Todd M , Duncan Kathryn T , Horr Stephanie , Goddu Troy , Heinz-Loomer Christine , Rumschlag Anthony J , Ryan William G , Sweet Sarah , Little Susan E
Published: March 2020

Background: The rapid growth in off-leash dog parks provides opportunity for canine socialization activities but carries risk of exposure to intestinal parasites. This study assessed the prevalence of these infections in dogs visiting dog parks.Methods: Fresh defecations were collected from dogs visiting parks in 30 metropolitan areas across the United States. Samples were analyzed by coproantigen immunoassay (CAI) (FecalDx® and Giardia Test, IDEXX Laboratories) and zinc sulfate centrifugal flotation (CF). Owners responded to a questionnaire on their dog’s signalment and use of heartworm/intestinal parasite control medications (HWCM). Results: Samples were examined from 3,006 dogs, 87.9% aged at least 12 months, visiting 288 parks. At least one intestinal parasite was detected in 622 (20.7%) samples, nematodes in 263 (8.8%), with hookworm, whipworm, and ascarids in 7.1, 1.9, and 0.6% of samples, respectively. A sample positive for one or more intestinal parasites was found in 245 (85.1%) parks, with nematodes found in 143 (49.7%). Combined, CAI and CF detected 78.4% more intestinal nematode infections than CF alone. Hookworm and whipworm were detected in all age groups, but ascarids were only detected in dogs less than 4 years. Approximately 42% of dogs aged less than 1 year were positive for nematodes or Giardia. Based on owner reports, HWCM was current for 68.8% of dogs, dogs previously diagnosed with intestinal parasitism were more likely to be receiving a HWCM than those without such history, and a significantly lower (P = 0.0003) proportion of dogs receiving a HWCM were positive for intestinal nematodes compared with those not on such medication.Conclusion: Intestinal parasites, the most common of which were Giardia, Ancylostoma caninum and Trichuris vulpis, were found in 20% of dogs and 85% of dog parks across the United States. Optimal detection of canine intestinal parasitism was achieved by combining CF and CAI. Canine intestinal parasites are common across the United States, and dog health can be enhanced by regular testing of fecal samples and routine administration of medications effective against the most common infections.
Pulmonary Vasodilation by Sildenafil in Acute Pulmonary Embolism—A Randomized Explorative Trial
Authors: Andersen Asger , Waziri Farhad , Schultz Jacob Gammelgaard , Holmboe Sarah , Becker Søren Warberg , Jensen Tage , Søndergaard Hanne Maare , Dodt Karen Kaae , May Ole , Mortensen Ulrik Markus , Kim Won Yong , Mellemkjær Søren , Nielsen-Kudsk Jens Erik
Published: March 2020

Background: To investigate if acute pulmonary vasodilation by sildenafil improves right ventricular function in patients with acute intermediate-high risk pulmonary embolism (PE).Methods: Patients with PE were randomized to a single oral dose of sildenafil 50mg (n=10) or placebo (n=10) as add-on to conventional therapy. Right ventricular function was evaluated immediately before and shortly after (0.5-1.5h) randomization by right heart catheterization (RHC), trans-thoracic echocardiography (TTE), and cardiac magnetic resonance (CMR). The primary efficacy endpoint was cardiac index measured by CMR.Results: Patients had acute intermediate-high risk PE verified by computed tomography pulmonary angiography, systolic blood pressure of 135 ± 18 (mean ± SD) mmHg, increased right ventricular/left ventricular ratio 1.1 ± 0.09 and increased troponin T 167 ± 144 ng/L. Sildenafil treatment did not improve cardiac index compared to baseline (0.02 ± 0.36 l/min/m2, p=0.89) and neither did placebo (0.00 ± 0.34 l/min/m2, p=0.97).Conclusion: A single oral dose of 50 mg sildenafil did not improve cardiac index but lowered systemic blood pressure in patients with acute intermediate-high risk PE.Trial Registration: The trial was retrospectively registered at www.clinicaltrials.gov (NCT04283240) February 2nd 2020, https://clinicaltrials.gov/ct2/show/NCT04283240?term=NCT04283240&draw=2&rank=1
Curcumin Inhibits the Proteolytic Process of SREBP-2 by First Inhibiting the Expression of S1P rather than Directly Inhibiting SREBP-2 Expression.
Authors: Li Yongnan , Wu Shuodong
Published: March 2020

Objective: Many studies have demonstrated that curcumin can downregulate mRNA levels of sterol regulatory element-binding proteins (SREBP-2), however, our study did not find similar results. This study was designed to demonstrate that curcumin inhibits the proteolytic process of SREBP-2 by first inhibiting the expression of membrane-bound transcription factor site-1 protease (S1P) rather than directly inhibiting SREBP-2 expression.Methods: After curcumin treatment, Caco-2 cells were collected to observe the dose- and time-dependent dynamics of precursor and mature SREBP-2, transcription factor specific protein 1 (SP-1) and SREBP cleavage-activating protein (SCAP). After curcumin treatment, SREBP-2 distribution was detected in the cells and S1P protein expression were examined.Results: Curcumin could downregulate mRNA levels of SREBP2, SP-1 and SCAP, but it did not simultaneously downregulate the expression of precursor SREBP-2 (pSREBP-2) and SCAP. Curcumin can inhibit the proteolytic process of SREBP-2, reduce the production of mature SREBP-2 (mSREBP-2) and change the cellular distribution of SREBP-2. The inhibitory effect of curcumin on SP-1 protein expression is short-acting. Conclusion: Curcumin can inhibit the SREBP-2 proteolytic process to reduce mSREBP-2 which functions as a transcription factor, affecting the regulation of cholesterol metabolism-related genes. This process may be achieved by regulating the expression of S1P. Curcumin does not directly inhibit the expression of mSREBP-2 protein, and it has no such inhibitory effect for at least a short period of time, although curcumin does reduce the amount of mSREBP-2 protein.